Archive for the 'General Medical' Category

The safety of antidepressants in pregnancy

Maternal antidepressants are implicated in ADHD, but so is maternal depression

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The safety of antidepressants in pregnancy is controversial, partly because of profound methodological difficulties in separating the fetal effects of antidepressants from those related to maternal depression (confounding by indication). One central concern is the potential impact of these drugs on fetal brain development. Such effects may be subtle and possibly only detectable years after exposure, such as an increased susceptibility to (multifactorial) neurodevelopmental conditions.

All emergency departments must have GP led triage by October

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Every hospital in England must have a “comprehensive” GP led triage system in emergency departments by October 2017 in a bid to avoid a repeat of the winter crisis that gripped the service this year, NHS leaders have said.

The requirement is one of several “concrete changes” demanded by NHS England’s chief executive, Simon Stevens, and the chief executive of NHS Improvement, Jim Mackey, in a letter sent after the chancellor Philip Hammond’s budget pledge to give the NHS an extra £100m (€115m; $120m) in 2017‑18 to spend on easing pressures in accident and emergency departments.

NICE recommends ixekizumab for persistent severe plaque psoriasis

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The National Institute for Health and Care Excellence (NICE), in its final draft guidance issued this week, has recommended ixekizumab, an antibody that inhibits interleukin-17A, as an option for treating adults with severe plaque psoriasis that doesn’t respond to standard therapies.

General practice opening hours to be scrutinised

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From October general practices in England will be financially penalised if they close during core working hours during the week, the chief executive of NHS England has said.

Simon Stevens told MPs on the House of Commons Public Accounts Committee that changes to the GP contract, which will be introduced in October, will allow NHS England to scrutinise GP opening hours more closely and take action where necessary.

Anaemia is associated with hearing loss in adults

Iron deficiency anaemia (IDA) has been found to be associated with hearing loss in adults by a study published in JAMA Otolaryngology – Head and Neck Surgery.

Using the electronic medical records of 305 339 adults aged between 21 and 90 years, researchers at Pennsylvania State University College of Medicine examined the association between IDA and sensorineural hearing loss (when there is damage to the cochlea or to the nerve pathways from the inner ear to the brain) and conductive hearing loss (hearing loss because of problems with the bones of the middle ear). IDA was determined by low haemoglobin and ferritin levels for age and sex.

Solanezumab and the amyloid hypothesis for Alzheimer’s disease

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Solanezumab’s failure is a wake-up call to look elsewhere for an answer to dementia

Is the amyloid cascade hypothesis of Alzheimer’s disease too big to fail? It proposes that brain deposition of β amyloid protein is the critical early event in the pathogenesis of Alzheimer’s disease and has been the centrepiece of dementia research for decades. The hypothesis suggests that removing β amyloid will reverse or prevent the clinical expression of dementia. However, in all phase III clinical trials to date, treatments targeting β amyloid have failed to improve cognitive outcomes despite reducing brain β amyloid.

End of life care for infants, children and young people with life limiting conditions: summary of NICE guidance

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Children and young people can have a wide range of life limiting conditions and may sometimes live with such conditions for many years. This guideline recommends that end of life care be managed as a long term process that begins at the time of diagnosis of a life limiting condition and entails planning for the future. Sometimes it may begin before the child’s birth. It is part of the overall care of the child or young person and runs in parallel with other active treatments for the underlying condition itself. Finally, it includes those aspects related to the care of the dying.

Many children receive no discharge plan after admission for severe asthma

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Children admitted to hospital with severe asthma attacks generally receive “very effective and efficient” treatment and care, but more attention must be given to asthma education and review at discharge to help prevent future attacks and readmission, says a national audit by the British Thoracic Society.

The society’s National Paediatric Asthma Audit, published on 29 November, reviewed data on more than 5500 children over the age of 1 admitted with severe asthma attacks to 153 UK hospitals in November 2015 and found that most aspects of discharge from hospital were less than optimal.

Swimming, aerobics, and racquet sports are linked to lowest risk of cardiovascular death

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Swimming, racquet sports, and aerobics seem to be the best forms of exercise for reducing the risk of death from heart disease and stroke, research published in the British Journal of Sports Medicine has found.

The researchers said that the small number of events impaired the statistical power in some analyses. There were relatively few deaths from all causes among runners and football players, which may explain the wide confidence intervals. However, they concluded, “These findings demonstrate that participation in specific sports may have significant benefits for public health.”

The digital patient: transforming primary care?

patientsin_controlA report from the Nuffield Trust, an independent health charity, looks at the evidence available on digital technology and its impact on patients in primary care and the NHS. You can access commentary, background information and the report here

Here’s why we need evidence

evidently-cochrane-logoEveryday nursing requires the appropriate use of evidence and this website  from Evidently Cochrane provides useful insights. The article about pressure ulcers illustrates why evidence is needed for everyday practice.

Evidence can be found from a variety of sources and with busy workloads and winter pressures coming, you may find it is hard to find time to search for reliable evidence.

Don’t worry – we can help you!

Your Library and Knowledge Service has skilled  outreach specialists who can help you, either by running an evidence  search or training you to do it effectively. So get ahead and get in touch with us if you are based at East Cheshire NHS Trust.

Falls prevention – October’s update published

The latest monthly update on Falls prevention has been published.

View the current research at: https://fallspreventionnwpctl.wordpress.com/

 

Women are unaware of pregnancy risks linked with sodium valproate

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Doctors are being asked to make sure that women and girls with epilepsy know about the risks of taking sodium valproate during pregnancy, after a survey found that half of those questioned were unaware that it could harm the fetus.

The charities Epilepsy Action, Epilepsy Society, and Young Epilepsy conducted a survey earlier this year, in conjunction with the Medicines and Healthcare Products Regulatory Agency (MHRA), of 2788 women aged 16 to 50 with epilepsy.

Overwhelmed by information?

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BMJ Infographics

Highlighted resource:

BMJ INFOGRAPHICS

These are great visual summaries of a variety of conditions, their management and treatments, and visual overviews of article recommendations. They are found attached to a variety of articles and editorials, and some of the key infographics are found on the infographics page. For example, the infographic of the NICE sepsis guidance or a visual guide to recognising past congenital heart surgery in adults.

New eBooks

The Library has recently purchased 13 new eBooks from the ‘Crash Course‘ series:

Visit http://ectlks.weebly.com/dawsonera.html to access all the eBooks from the DawsonEra collection or search our complete eBooks collection.

All the eBooks can be accessed with an NHS Athens username and password.

For more information please get in touch!

ecn-tr.stafflibrary@nhs.net

01625 661362

crashcoursetitlessept16

Does health literacy matter?

 

Health Literacy is defined by World Health Organisation (2015) as “The personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health.”

This interesting news article, from NHS England, discusses its merits, the importance of health literacy and better health. Read the article here

Delivering high quality, effective, compassionate care: developing the right people with the right skills and right values

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Outlines  the government’s objectives for Health Education England to provide health care education and training for 2016-2017.

This document here  reflects strategic objectives around workforce planning, health education and training and development. The mandate looks at how the healthcare workforce can be developed to improve care for patients through education and training.

New books

NewBooksThe Library & Knowledge Service purchased a large number of new books last month ~ view a selection of the new titles here.

All members of East Cheshire NHS Trust staff, students on placement and volunteers are able to borrow books from the Library.

Contact the Library for more information: ecn-tr.stafflibrary@nhs.net / 01625 66 1362.

 

Reduction in breast cancer deaths is due to treatment not screening, finds study

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The fall in breast cancer mortality seen after widespread mammography screening was introduced in the US was mainly due to improved systemic therapy and not earlier detection of tumours, a comparison of national cancer data before and after the introduction of screening programmes has shown.

SSRI exposure in pregnancy linked to speech disorders in offspring

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A significant rise in the risk of speech and language disorders was found among children born to mothers prescribed selective serotonin reuptake inhibitors (SSRIs) during pregnancy, a study published in JAMA Psychiatry has found.

Sepsis Toolkit Launched by Royal College of General Practitioners

infectionThe Royal College of General Practitioners (RCGP), in partnership with Health Education England and NHS England, has has launched a new sepsis toolkit to support GPs and healthcare professionals to identify and manage the condition in patients.

 

The toolkit has been designed to help GPs and other healthcare professionals in primary care tackle this challenge with a series of educational materials, up-to-date guidance and training resources.

You can access the toolkit here

Read the news post about it  here

Shaping the future of healthcare from an equality, diversity and human rights perspective

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The role of the EDC is to help shape the future of healthcare from an equality, diversity and human rights perspective, and to improve the quality of care for all. In the first of series of blogs, co-chair of the Equality and Diversity Council (EDC), Joan Saddler provides an update from the most recent quarterly meeting and offers an insight into the latest thinking behind the programme of work.

Eggs or peanuts in early infant diet may cut allergy risk

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Introducing eggs or peanuts early into infants’ diet is associated with a lower risk of developing egg or peanut allergy, says a systematic review of the evidence published in JAMA.

The review found “moderate certainty” evidence that introducing eggs to the infant diet at 4 to 6 months was associated with reduced egg allergy and that introducing peanuts at 4 to 11 months was associated with reduced peanut allergy when compared with later introduction of these foods.

NHS winter pressures are becoming an all year reality, warn experts

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The type of intense extra workload pressure often experienced by the NHS in winter has become a year long experience, say experts responding to the publication of the latest official data on the performance of the NHS in England.

NHS England’s combined performance summary data show an NHS that is missing many of its targets and hitting new record lows for performance in some areas.


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