Campaigners hope UK will follow Australia’s lead on plain packaging for cigarettes

via Campaigners hope UK will follow Australia’s lead on plain packaging for cigarettes | BMJ.

An NHS Athens account may be required to view this in full.

The UK could follow Australia’s historic lead and introduce standardised plain packaging for all cigarettes, a conference heard this week.

 

Analysis: Is it too late to stop the NHS overhaul?

Health staff, it is fair to say, have given the government’s NHS reforms a pretty big thumbs down.

via BBC News – Analysis: Is it too late to stop the NHS overhaul?.

Intelligence changes ‘driven by environment’

Intelligence changes ‘driven by evironment’ – Health News – NHS Choices.

NHS Choices examines the science behind the newspaper headlines.

Conclusion

This study tried to calculate how strongly genetic variations are associated with changes in intelligence over a lifetime. However, none of the study’s results proved statistically significant and therefore it’s not possible to say for certain where the balance of genetic and environmental influences lies.

Despite the lack of statistically significant results, the researchers said that the strengths of this study are that it had an extremely long follow-up and measured intelligence at two points in time, providing an estimate of cognitive change and stability over time, and providing estimates of the relative roles of genetics and the environment in this change.

The researchers also said that further studies are needed to validate their findings, as their cohort was too small to have sufficient “statistical power” to detect a significant association, despite the fact that approximately 2,000 people participated in the research.

Furthermore, the study did not examine individual genetic variations or specific environmental factors that account for the observed changes in intelligence over time. The researchers said that further studies will need to be conducted in order to determine what factors account for change in intelligence.

Overall, this was an interesting combination of a long-running cohort study and new genetic technologies. However, the lack of statistical significance means that we cannot be certain that the results were not due to chance, and the lack of examination of individual environmental factors limits the relevance of this study to our daily lives and decisions.

Links to the headlines

Slowing down a bit? Don’t blame your genes – your lifestyle is key to staying alert into old age. Daily Mail, January 19 2012

Links to the science

Deary IJ, Yang J, Davies G et al. Genetic contributions to stability and change in intelligence from childhood to old age. Nature, [Published online] January 18 2012

 

Articles disputing link between HRT and breast cancer are “ridiculous”

via Articles disputing link between HRT and breast cancer are “ridiculous” | BMJ.

An NHS Athens account may be required to view this in full.

A leading epidemiologist has condemned a group of authors for writing and a journal for publishing a series of articles challenging the well established link between hormone replacement therapy (HRT) and breast cancer, describing their actions as “a disgrace.”

 

Government will not merge health and social care budgets for the present, minister says

via Government will not merge health and social care budgets for the present, minister says | BMJ.

An NHS Athens account may be required to view this in full.

The government is not planning to merge health and social care but has not ruled out the idea of pooled budgets “forever,” health minister Paul Burstow has said.

 

Forty-one commissioning support services are proposed

via Forty-one commissioning support services are proposed | 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 50 primary care trust clusters could set up as many as 41 commissioning support services nationwide, an HSJ investigation has revealed.

 

NHS plans: Unions move to ‘outright opposition’

The unions representing nurses and midwives have joined others in stating their “outright opposition” to the government’s NHS plans in England.

via BBC News – NHS plans: Unions move to ‘outright opposition’.

Delivering sustainable cost improvement programmes

via Delivering sustainable cost improvement programmes | News, events and publications | Monitor.

This guide looks at the evidence from cost improvement plans (CIPs) across the NHS to identify important lessons and provides examples of how NHS trusts and foundation trusts can deliver CIPs whilst improving patient care, patient satisfaction and safety.

 

 

Managers to fly in to run straggling CCGs’ budgets

via Managers to fly in to run straggling CCGs’ budgets | 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 NHS Commissioning Board will not take on the budget responsibilities of clinical commissioning groups which fail to win full authorisation by April next year, HSJ has been told.

 

Houses of Lords backs government plans for new disability payments

via Houses of Lords backs government plans for new disability payments | BMJ.

An NHS Athens account may be required to view this in full.

The government has won a key vote in the House of Lords, defeating attempts to delay the introduction of new disability payments. It is now expected to overturn in the Commons three amendments to the bill passed in the Lords last week, and will seek to have the bill certified as a “money bill” by the Commons speaker, which would prevent the Lords from imposing any further delays.

 

Depression drugs ‘causing falls’

Elderly people with dementia are more likely to suffer falls if they are given anti-depressants by care home staff, a study claims.

via BBC News – Depression drugs ‘causing falls’.

The GLAMA (Girls! Lead! Achieve! Mentor! Activate!) physical activity and peer leadership intervention pilot project: A process evaluation using the RE-AIM framework

BMC Public Health | Abstract | The GLAMA (Girls! Lead! Achieve! Mentor! Activate!) physical activity and peer leadership intervention pilot project: A process evaluation using the RE-AIM framework.

This article is available freely via Open Access. Please click on the above link to view it fully.

 

Abstract (provisional)

Background

Implementing new initiatives and physical activity interventions in schools represents a myriad of ‘challenges’ that if overcome can potentially facilitate a range of behavioural changes. The aim of this paper is to describe the process evaluation of specific design constructs used in the GLAMA (Girls! Lead! Achieve! Mentor! Activate!) peer leadership and physical activity pilot project. Conducted in a state secondary school in Australia, the intervention was designed to provide students with opportunities to develop leadership skills, school and social connectedness in addition to a range of physical activity experiences.

Methods

This process evaluation used the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) health promotion evaluation framework to assess three design constructs of the intervention: the effectiveness of leadership training and leader preparedness, activity suitability and participation, and the barriers to implementation of the intervention and potential solutions to overcome these barriers. As it was not the specific aim of this pilot, no behavioural change data were collected from students. Data were collected using a mixed methods approach including student questionnaires, teachers and researchers reporting on their own observations and feedback from students.

Results

There were three main considerations evident across more than one RE-AIM dimension that need to be addressed to assist with future GLAMA dissemination. Firstly, the development of teacher, school and student participation. This needs to be through a variety of professional development opportunities for teachers, integration of the program within timetabled classes within the school and promoting the program to students as an opportunity to develop a range of skills to apply to future learning and workplace environments. Secondly, the successful translation of leadership training to practice is necessary to ensure that leaders are effectively able to motivate, facilitate and activate their teams. Finally, the need for consistent activity implementation requires sequential, competitive elements, purposeful team selection and clearly defined scoring and time periods for team ‘challenges’.

Conclusions

Factors that have the greatest impact on intervention success are those that come from within the school setting including: the structure of the curriculum, pressure to meet curriculum and assessment content, lack of support for new initiatives, multiple programs already running within the school, time allowances for teachers, appropriate training for teachers, and support for students to participate. These barriers need to be considered when developing all secondary school interventions.

Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults: Study protocol of a cluster randomised controlled trial

BMC Public Health | Abstract | Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults: Study protocol of a cluster randomised controlled trial.

This article is available freely via Open Access. Please click on the above link to view it fully.

 

Abstract (provisional)

Background

Particularly in groups of adolescents with lower educational level the smoking prevalence is still high and constitutes a serious public health problem. There is limited evidence of effective smoking cessation interventions in this group. Individualised text messaging (SMS) based interventions are promising to support smoking cessation and could be provided to adolescents irrespective of their motivation to quit. The aim of the current paper is to outline the study protocol of a trial testing the efficacy of an SMS based intervention for smoking cessation in apprentices.

Methods

A two-arm cluster-randomised controlled trial will be conducted to test the efficacy of an SMS intervention for smoking cessation in adolescents and young adults compared to an assessment only control group. A total of 910 daily or occasional ([greater than or equal to] 4 cigarettes in the preceding month and [greater than or equal to] 1 cigarette in the preceding week) smoking apprentices will be proactively recruited in vocational school classes and, using school class as a randomisation unit, randomly assigned to an intervention group (n = 455) receiving the SMS based intervention or an assessment only control group (n = 455). Individualised text messages taking into account demographic data and the individuals` smoking behaviours will be sent to the participants of the intervention group over a period of 3 months. Participants will receive two text messages promoting smoking cessation per week. Program participants who intend to quit smoking have the opportunity to use a more intensive SMS program to prepare for their quit day and to prevent a subsequent relapse. The primary outcome measure will be the proportion of participants with 7-day point prevalence smoking abstinence assessed at 6-months follow-up. The research assistants conducting the baseline and the follow-up assessments will be blinded regarding group assignment.

Discussion

It is expected that the program offers an effective and inexpensive way to promote smoking cessation among adolescents and young adults including those with lower educational level and independent of their motivation to quit. Trial registration Current Controlled Trials ISRCTN19739792.

Effect of running therapy on depression (EFFORT-D). Design of a randomised controlled trial in adult patients [ ISRCTN 1894]

BMC Public Health | Abstract | Effect of running therapy on depression (EFFORT-D). Design of a randomised controlled trial in adult patients [ ISRCTN 1894].

Abstract (provisional)

Background

The societal and personal burden of depressive illness is considerable. Despite the developments in treatment strategies, the effectiveness of both medication and psychotherapy is not ideal. Physical activity, including exercise, is a relatively cheap and non-harmful lifestyle intervention which lacks the side-effects of medication and does not require the introspective ability necessary for most psychotherapies. Several cohort studies and randomised controlled trials (RCTs) have been performed to establish the effect of physical activity on prevention and remission of depressive illness. However, recent meta-analysis’s of all RCTs in this area showed conflicting results. The objective of the present article is to describe the design of a RCT examining the effect of exercise on depressive patients.

Methods

The EFFect Of Running Therapy on Depression in adults (EFFORT-D) is a RCT, studying the effectiveness of exercise therapy (running therapy (RT) or Nordic walking (NW)) on depression in adults, in addition to usual care. The study population consists of patients with depressive disorder, Hamilton Rating Scale for Depression (HRSD) [greater than or equal to] 14, recruited from specialised mental health care. The experimental group receives the exercise intervention besides treatment as usual, the control group receives treatment as usual. The intervention program is a group-based, 1 h session, two times a week for 6 months and of increasing intensity. The control group only performs low intensive non-aerobic exercises. Measurements are performed at inclusion and at 3,6 and 12 months. Primary outcome measure is reduction in depressive symptoms measured by the HRSD. Cardio-respiratory fitness is measured using a sub maximal cycling test, biometric information is gathered and blood samples are collected for metabolic parameters. Also, co-morbidity with pain, anxiety and personality traits is studied, as well as quality of life and cost-effectiveness.

This article is available freely via Open Access. Please click on the above link to view it fully.

Discussion

Exercise in depression can be used as a standalone or as an add-on intervention. In specialised mental health care, chronic forms of depression, co-morbid anxiety or physical complaints and treatment resistance are common. An add-on strategy therefore seems the best choice. This is the first high quality large trial into the effectiveness of exercise as an add-on treatment for depression in adult patients in specialised mental health care. Dutch Trial Register trial ID:NTR1894, acronym: EFFORT-D

Claim Tamiflu ‘may be ineffective and data is being withheld’

Claim Tamiflu ‘may be ineffective and data is being withheld’ – Health News – NHS Choices.

NHS Choices examines the science behind the newspaper headlines.

Conclusion

This systematic review aimed to assess comprehensively the effect of NIs including Tamiflu and Relenza on the prevention and treatment of flu in healthy adults and children by including results known to have been missed in previous reviews. In this sense, the review failed to meet its aims but for two distinct reasons.

The evidence review of Relenza was suspended because new information about its effects on individual patients became available. The results of this are eagerly awaited.

The review of Tamiflu was incomplete because of difficulties in obtaining sufficiently detailed information from the manufacturer.

The systematic review included 25 studies in its final analysis, but had to exclude 42 relevant studies. By excluding these relevant studies, important information that could influence the conclusions may have been missed. This led the authors to conclude that their results had high levels of publication and reporting bias. Given the high-profile nature of Tamiflu, the conclusions of the review should be treated with great caution. It may be prudent to postpone the judgement on whether Tamiflu is effective until after the outstanding trial information has been obtained and incorporated into the review.

The Daily Telegraph and other news sources have quoted a Roche spokesman as having said that Roche made full clinical study data [on Tamiflu] available to health authorities around the world as part of the licensing process.

The debate on whether Tamiflu is effective continues. The simplest way to resolve it would be to allow independent reviewers to access the full existing results of studies into it. These are currently unavailable to them, but the reasons for this are unclear.

Links to the headlines

Tamiflu maker accused of secrecy over trial data. The Independent, January 18 2012

Prove Tamiflu works, scientists challenge Roche. The Daily Telegraph, January 18 2012

Doctors Raise Doubts Over Pandemic Flu Drug. Sky News, January 18 2012

Side effects and effectiveness of ‘wonder-drug’ Tamiflu under the microscope as Department of Health faces awkward questions over mass prescriptions. Daily Mail, January 18 2012

Tamiflu effects ‘still uncertain’. The Guardian, 18 January 2012

Links to the science

Jefferson T, Jones MA, Doshi P et al. Review: Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children (PDF, 1.6Mb). The Cochrane Collaboration. Published online 2012.

Further reading

<!– heading

end heading –>Pharma company hid vital data on Tamiflu, scientists claim. The Bureau of Investigative Journalism. January 12th 2012

Cohen D. Flu drugs: The search for evidence goes on. BMJ, Published online January 17 2012.

Meningitis jab ‘protection hope’

A vaccine against one of the most common forms of childhood meningitis could reduce the number of deaths in the UK even further

via BBC News – Meningitis jab ‘protection hope’.

 

Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population

BMC Public Health | Abstract | Co-morbid depression is associated with poor work outcomes in persons with cardiovascular disease (CVD): A large, nationally representative survey in the Australian population.

Abstract (provisional)

Background

Co-morbid major depressive disorder (MDD) and cardiovascular disease (CVD) is associated with poor clinical and psychological outcomes. However, the full extent of the burden of, and interaction between, this co-morbidity on important vocational outcomes remains less clear, particularly at the population level. We examine the association of co-morbid MDD with work outcomes in persons with and without CVD.

Methods

This study utilised cross-sectional, population-based data from the 2007 Australian National Survey of Mental Health and Wellbeing (n = 8841) to compare work outcomes of individuals with diagnostically-defined MDD and CVD, MDD but not CVD, CVD but not MDD, with a reference group of “healthy” Australians. Workforce participation was defined as being in full- or part-time employment. Work functioning was measured using a WHO Disability Assessment Schedule item. Absenteeism was assessed using the ‘days out of role’ item.

Results

Of the four groups, those with co-morbid MDD and CVD were least likely to report workforce participation (adj OR:0.4, 95% CI: 0.3-0.6). Those with MDD only (adj OR:0.8, 95% CI:0.7-0.9) and CVD only (adj OR:0.8, 95% CI: 0.6-0.9) also reported significantly reduced odds of participation. Employed individuals with co-morbid MDD and CVD were 8 times as likely to experience impairments in work functioning (adj OR:8.1, 95% CI: 3.8-17.3) compared with the reference group. MDD was associated with a four-fold increase in impaired functioning. Further, individuals with co-morbid MDD and CVD reported greatest likelihood of workplace absenteeism (adj. OR:3.0, 95% CI: 1.4-6.6). Simultaneous exposure to MDD and CVD conferred an even greater likelihood of poorer work functioning.

Conclusions

Co-morbid MDD and CVD is associated with significantly poorer work outcomes. Specifically, the effects of these conditions on work functioning are synergistic. The development of specialised treatment programs for those with co-morbid MDD and CVD is required.

Competitive tendering will be ‘as important’ as any qualified provider

via Competitive tendering will be ‘as important’ as any qualified provider | News | Health Service Journal.

This article is solely the work of the HSJ. For a full copy of the article please contact the library.

Competitive tendering will be as significant as the use of any qualified provider in the reformed NHS, an influential commission is expected to conclude at the end of the month.

 

Exploring the relationships between housing, neighbourhoods and mental wellbeing for residents of deprived areas.

BMC Public Health | Abstract | Exploring the relationships between housing, neighbourhoods and mental wellbeing for residents of deprived areas..

This article is available freely via Open Access. Please click on the above link to view it fully.

Abstract (provisional)

Background

Housing-led regeneration has been shown to have limited effects on mental health. Considering housing and neighbourhoods as a psychosocial environment, regeneration may have greater impact on positive mental wellbeing than mental ill-health. This study examined the relationship between the positive mental wellbeing of residents living in deprived areas and their perceptions of their housing and neighbourhoods.

Methods

A cross-sectional study of 3,911 residents in 15 deprived areas in Glasgow, Scotland. Positive mental wellbeing was measured using the Warwick-Edinburgh Mental Wellbeing Scale.

Results

Using multivariate mulit-nomial logistic rgressions and controlling for socio-demographic characteristics and physical health status, we found that several aspects of people’s residential psychosocial environments were strongly associated with higher mental wellbeing. Mental wellbeing was higher when respondents considered the following: their neighbourhood had very good aesthetic qualities (RRR 3.3, 95% CI 1.9, 5.8); their home and neighbourhood represented personal progress (RRR 3.2 95% CI 2.2, 4.8; RRR 2.6, 95% CI 1.8, 3.7, respectively); their home had a very good external appearance (RRR 2.6, 95% CI 1.3, 5.1) and a very good front door (both an aesthetic and a security/control item) (RRR 2.1, 95% CI 1.2, 3.8); and when satisfaction with their landlord was very high (RRR 2.3, 95% CI 2.2,4.8). Perception of poor neighbourhood aesthetic quality was associated with lower wellbeing (RRR 0.4, 95% CI 0.3, 0.5).

Conclusion

This study has shown that for people living in deprived areas, the quality and aesthetics of housing and neighbourhoods are associated with mental wellbeing, but so too are feelings of respect, status and progress that may be derived from how places are created, serviced and talked about by those who live there. The implication for regeneration activities undertaken to improve housing and neighbourhoods is that it is not just the delivery of improved housing that is important for mental wellbeing, but also the quality and manner of delivery.

Show us the evidence for telehealth

via Show us the evidence for telehealth | BMJ.

An NHS Athens account may be required to view this in full.

A recent Department of Health press release sings the praises of telehealth, saying that it could improve three million lives in England. But where are the data to support this technology, asks Margaret McCartney