via BBC News – Breast implants: UK to review risk assessment data.
A government review of data used to assess the risks posed by faulty breast implants is to be carried out, Health Secretary Andrew Lansley has said.
BBC News – Sexual health teams ‘should offer alcohol advice’.
Young people should be given advice on the dangers of alcohol when they access sexual health services, a group of health experts has recommended
via Use of community treatment orders for mental health patients rises 29% in a year | BMJ.
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The number of people with mental health problems subject to community treatment orders in England has risen by almost a third in the past year, according to the Care Quality Commission.
This article is available freely via Open Access. Please click on the above link to view it fully.
There is growing evidence that parenting programmes can improve parenting skills and thereby the behaviour of children exhibiting or at risk of developing antisocial behaviour. Given the high prevalence of childhood behaviour problems the task is to develop large scale application of effective programmes. The aim of this study was to evaluate the UK government funded implementation of the Parenting Early Intervention Pathfinder (PEIP). This involved the large scale rolling out of three programmes to parents of children 8-13 years in 18 local authorities (LAs) over a 2 year period.
The UK government’s Department for Education allocated each programme (Incredible Years, Triple P and Strengthening Families Strengthening Communities) to six LAs which then developed systems to intervene using parenting groups. Implementation fidelity was supported by the training of group facilitators by staff of the appropriate parenting programme supplemented by supervision. Parents completed measures of parenting style, efficacy, satisfaction, and mental well-being, and also child behaviour.
A total of 1121 parents completed pre- and post-course measures. There were significant improvements on all measures for each programme; effect sizes (Cohen’s d) ranged across the programmes from 0.57 to 0.93 for parenting style; 0.33 to 0.77 for parenting satisfaction and self-efficacy; and from 0.49 to 0.88 for parental mental well-being. Effectiveness varied between programmes: Strengthening Families Strengthening Communities was significantly less effective than both the other two programmes in improving parental efficacy, satisfaction and mental well-being. Improvements in child behaviour were found for all programmes: effect sizes for reduction in conduct problems ranged from 0.44 to 0.71 across programmes, with Strengthening Families Strengthening Communities again having significantly lower reductions than Incredible Years.
Evidence-based parenting programmes can be implemented successfully on a large scale in community settings despite the lack of concentrated and sustained support available during a controlled trial.
via Lobby groups call for closure of “revolving door” between drug regulators and industry | BMJ.
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The European Commission has been urged to review procedures at the European Medicines Agency (EMA) and the staff regulations that govern the conduct of EU officials, after claims that a former executive director of EMA arranged to become a consultant to the drug industry while still employed by the agency.
BBC News – Hypothermia warning for young drinkers.
The image of a young drinker suffering the effects of a night out, in high heels and skimpy outfit, is usually accompanied by warnings about not drinking too much, and being careful about getting home safely. But there is another danger, and one that most young people – men and women – are unaware of: hypothermia.
This article is available freely via Open Access. Please click on the above link to view it fully.
Mongolia is undergoing rapid epidemiological transition with increasing urbanisation and economic development. The lifestyle and health of Mongolians are changing as a result, shown by the 2005 and 2009 STEPS surveys (World Health Organization’s STEPwise Approach to Chronic Disease Risk Factor Surveillance) that described a growing burden of Non-Communicable Diseases and injuries (NCDs). This study aimed to assess, describe and explore the knowledge, attitudes and practices of the Mongolian adult population around NCDs in order to better understand the drivers and therefore develop more appropriate solutions to this growing disease burden. In addition, it aimed to provide data for the evaluation of current public health programs and to assist in building effective, evidence-based health policy.
This national survey consisted of both quantitative and qualitative methods. A quantitative household-based questionnaire was conducted using a nationally representative sample of 3854 rural and urban households. Participants were selected using a multi-stage cluster sampling technique in 42 regions across Mongolia, including rural and urban sites. Permanent residents of sampled households were eligible for recruitment, if aged between 15-64 years. This quantitative arm was then complemented and triangulated with a qualitative component: twelve focus group discussions focusing on diet, exercise and alcohol consumption. Discussions took place in six sites across the country, facilitated by local, trained health workers. These six sites were chosen to reflect major Mongolian cultural and social groups.
KAP surveys are well represented in the literature, but studies that aim to explore the knowledge, attitudes and practices of a population around NCDs remain scarce. This is despite the growing number of national epidemiological surveys, such as STEPS, which aim to quantify the burden of these diseases but do not explore the level of population-based awareness, understanding, risk-perception and possible motivation for change. Therefore this paper will contribute to building a knowledge base of NCD KAP survey methodology for future use in epidemiology and research worldwide.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production. |
Patients in areas of England will be able to register with a GP practice of their choice under new plans.
via BBC News – Patients to choose GP practices under NHS plans.
An evidence summary produced by NHS Bolton Library. Please click on the link to view. This is an original piece of work. Please contact the library if you wish to re-use in any format
An evidence summary produced by NHS Bolton Library. Please click on the link to view. This is an original piece of work. Please contact the library if you wish to re-use in any format.
Please find below a selection of the most relevant and interesting news stories of the past week. Including:
via Further pay restrictions are a “bitter blow” to NHS staff, says BMA | BMJ.
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The government has added to its already acrimonious dispute with public sector employees by announcing a cap of 1% on pay rises for the next two years.
via Care Quality Commission cuts inspections to meet deadlines for registration | BMJ.
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The Care Quality Commission halved the number of inspections, or “compliance reviews,” it carried out last winter, while it struggled to meet deadlines for registering providers, says a report from the National Audit Office (NAO).
Source: Joint working in health and social care remains patchy despite years of effort | BMJ.
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Professionals in health and social care are still not working together closely enough to provide care for people despite years of efforts to improve joint working, says the public spending watchdog.
via College urges government to rethink its proposals on commissioning support | BMJ.
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The government needs to rethink support services to clinical commissioning groups to ensure they can deliver the service that patients need, the Royal College of General Practitioners says.
via Managing motion sickness | BMJ.
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Summary points
Hospital admissions for alcoholic liver disease among people in their early-30s in north-east England have increased by more than 400% over eight years
via BBC News – Liver disease epidemic warning in North East.
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Background Early and persistent exposure to socioeconomic disadvantage impairs children’s health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0–1, 2–3, 4–5 and 6–7 years.
Methods 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income.
Results Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages.
Conclusions From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.
Greater Manchester Public Health Network, in conjunction with the GM Public Health Practice Unit, is organising the second workshop in their CPD programme, to be held in central Manchester on 12 December 2011.
The workshop, Leadership development, methods and tips, is aimed at the public health, and related, workforce who are seeking to improve their understanding of the role and responsibilities of a leader and how they may develop their knowledge and skills of leadership.
Further details of the programme are attached. Please feel free to circulate to colleagues.
Booking information
To book a place, please contact Simon Guest at the GM Public Health Practice Unit by Thursday 8 December 2011 giving your name, address and full contact details. Places are strictly limited to 30 attendees and offered on a first come, first served basis. Should the event be over-subscribed we will run a waiting list. Cancellations after this date, or non-attendance for a booked place, will incur a £30 administration charge.
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This article is available freely via Open Access. Please click on the above link to view it fully.
Objectives To compare performance measures across all three rounds of the English bowel cancer screening faecal occult blood test pilot and their relation to social deprivation and ethnicity.
Methods In each round in three primary care trusts, data for a restricted population of over 48 500 aged 60–69 years were analysed. Individual-based data included postcode linked to area-based data on the Index of Multiple Deprivation (IMD) 2004, and ethnicity. Outcomes were the rates of screening and colonoscopy uptake, positivity and detection of neoplasia (adenomas or bowel cancer) and bowel cancer, and the positive predictive values (PPVs) of a positive test for neoplasia and bowel cancer. Sensitivity was calculated by the proportional incidence method using data on interval cancers identified from cancer registrations.
Results The overall uptake rate was 61.8%, 57.0% and 58.7% in the first, second and third rounds, respectively. Although the PPV for cancer decreased over the course of the three rounds (10.9% in the 1st round, 6.5% in 3rd round), the PPV for all neoplasia remained relatively constant (42.6% in 1st round, 36.9% in 3rd round). Deprivation and non-white ethnic background (principally Indian subcontinent in the pilot region) were associated with low screening and colonoscopy uptake rates, and this changed little over the three screening rounds. Uptake was lower in men, although differences in uptake between men and women decreased over time. Non-participation in previous rounds was a strong predictor of low uptake.
Conclusions Performance measures are commensurate with expectations in a screening programme reaching its third round of screening, but a substantial ongoing effort is needed, particularly to address the effects of deprivation and ethnicity in relation to uptake.
via Out of hours GPs’ “culture of avoiding blame” is putting patients at risk | BMJ.
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Out of hours GPs are afraid to admit mistakes and use the systems that have been designed to avoid a repeat of incidents because they fear they will be blamed when things go wrong, according to a new report by the NHS Alliance.
“Garden sheds make men happy and healthy” – Health News – NHS Choices.
NHS Choices examines the science behind the newspaper headlines.
One man and his shed: Why the humble garden retreat could help men live longer. Daily Mail, November 30 2011
Why every man needs time in his shed. The Daily Telegraph, November 30 2011
White A, McKee M, Richardson N et al. Europe’s men need their own health strategy. BMJ. 2011;343:d7397
European Commission: The State of Men’s Health in Europe (PDF, 3.64Mb). 2011
Ormsby J, Stanley M, and Jaworski K. Older men’s participation in community-based men’s sheds programmes. Health and Social Care in the Community. 2010;18: 607–613.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Clinical commissioning groups will not need to have a doctor as their most senior officer, and will be able to commission services from local GPs subject to extra safeguards to minimise the danger of a conflict of interests.
This article is available freely via Open Access. Please click on the above link to view it fully.
Objective To assess the effectiveness of strategies incorporating training and support of traditional birth attendants on the outcomes of perinatal, neonatal, and maternal death in developing countries.
Design Systematic review with meta-analysis.
Data sources Medline, Embase, the Allied and Complementary Medicine database, British Nursing Index, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, BioMed Central, PsycINFO, Latin American and Caribbean Health Sciences Literature database, African Index Medicus, Web of Science, Reproductive Health Library, and Science Citation Index (from inception to April 2011), without language restrictions. Search terms were “birth attend*”, “traditional midwife”, “lay birth attendant”, “dais”, and “comadronas”.
Review methods We selected randomised and non-randomised controlled studies with outcomes of perinatal, neonatal, and maternal mortality. Two independent reviewers undertook data extraction. We pooled relative risks separately for the randomised and non-randomised controlled studies, using a random effects model.
Results We identified six cluster randomised controlled trials (n=138 549) and seven non-randomised controlled studies (n=72 225) that investigated strategies incorporating training and support of traditional birth attendants. All six randomised controlled trials found a reduction in adverse perinatal outcomes; our meta-analysis showed significant reductions in perinatal death (relative risk 0.76, 95% confidence interval 0.64 to 0.88, P<0.001; number needed to treat 35, 24 to 70) and neonatal death (0.79, 0.69 to 0.88, P<0.001; 98, 66 to 170). Meta-analysis of the non-randomised studies also showed a significant reduction in perinatal mortality (0.70, 0.57 to 0.84, p<0.001; 48, 32 to 96) and neonatal mortality (0.61, 0.48 to 0.75, P<0.001; 96, 65 to 168). Six studies reported on maternal mortality and our meta-analysis showed a non-significant reduction (three randomised trials, relative risk 0.79, 0.53 to 1.05, P=0.12; three non-randomised studies, 0.80, 0.44 to 1.15, P=0.26).
Conclusion Perinatal and neonatal deaths are significantly reduced with strategies incorporating training and support of traditional birth attendants.
via Pension talks set to continue on Friday | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
The government and health unions are set to hold their latest round of talks tomorrow over changes to pensions in the wake of yesterday’s strike.
via CCG management could learn from schools – Lansley | News | Health Service Journal.
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The health secretary has said clinical commissioning groups should learn from boards of governors in schools how to meet statutory responsibilities without spending large sums on running costs
via DH to set out CCG behaviour guidance | News | Health Service Journal.
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
The government is to set out how a clinical commissioning group can buy from its own practices, and set out expectations for their governance, in an imminent paper
This article is solely the work of the HSJ. For a full copy of the article please contact the library.
Foundation trust regulator Monitor is withholding information on foundations’ forecast headcounts for coming years on grounds that news of “significant” redundancy plans could harm their competitiveness
Financial reports show health boards are struggling to make ends meet, even after an injection of cash.
via BBC News – Welsh NHS boards may go £50m in red despite extra cash.
