Wednesday, 21 March 2012

Let’s Get Moving resources help promote physical activity

Let’s Get Moving resources help promote physical activity:
The Department is publishing updated Let’s Get Moving resources, which have been revised to bring them into line with current practice and the latest guidelines for physical activity 
The revised resources are:
  • a partners booklet that summarises the Let’s Get Moving intervention and explains how to get involved
  • revised commissioning guidance that presents a systematic approach to identifying and supporting adults who are not meeting the exercise recommendations and is intended to equip commisioners with the knowledge they need to commission the intervention
First launched in 2009, as a means of providing advice on physical activity in primary care, Let’s Get Moving is an evidence-based behaviour change intervention to promote physical activity.
The commissioning guidance is intended to create flexibility for the commissioner to establish the best model locally and identify the most appropriate service providers to deliver the intervention and local health outcomes.
Let’s Get Moving can help individuals achieve the recommended levels of physical activity for health as set out in the UK Chief Medical Officers’ guidelines and supports local areas in meeting the health needs priorities in their Joint Strategic Needs Assessment, demonstrating the value of working with local partners to commission an effective and high quality service.
A range of existing materials to support the implementation of Let’s Get Moving, including training resources are also available.
Let’s Get Moving will contribute to the Public Health Outcome Framework physical activity indicator and the National Ambition for physical activity by supporting local areas to increase physical activity levels of their local population. Department of Health
Details of all the Lets Get Moving resources

Here's a really NICE app

Here's a really NICE app: The National Institute for Health and Clinical Excellence has created an app to give healthcare professionals "quick and easy" access to its recommendations and guidance. EHI News

PCT Spend and Outcome Factsheets and Tool (SPOT)

PCT Spend and Outcome Factsheets and Tool (SPOT): The Department of Health commissioned the Association of Public Health Observatories (APHO) to develop a tool which helps commissioners to link health outcomes and expenditure. The development of this tool and a Spend and Outcome Factsheet for every PCT in England has been led by Yorkshire and Humber Public Health Observatory Health Economics work programme. PCTs can use the tool and the factsheets to gain an overview of outcome and expenditure across all programmes.

2011 staff survey statistics

2011 staff survey statistics: The Department of Health has published the 2011 staff survey statistics. The data show that 87% of staff said they feel satisfied with the quality of care they provide to patients, with 90% of staff feeling their role makes a difference to patients. These figures are the same as in 2010. 61% of staff indicated being able to do their job to a standard they are personally pleased with and 30% said there are enough staff in their organisation for them to do their job properly (down from 32% in 2010).

DH press release:

National results:

NHS staff survey: 40% would not recommend health service to family

NHS staff survey: 40% would not recommend health service to family:
NHS poll reveals gulf between foundation hospitals and old-style trusts, with many workers struggling with heavy workloads
Two-fifths of health service staff would not recommend their friends or family being treated at hospitals and clinics where they work, with many workers apparently disillusioned by the government's NHS shakeup, according to a Department of Health survey.
The ninth annual staff poll in the NHS, which drew 134,000 responses, revealed fewer than a third of NHS employees believe there are enough workers at their trust to enable them to do their job properly, while 45% say they do not have time to complete their tasks.
There appeared to be a growing divide between foundation trusts, freed from Whitehall control, and the old-style NHS trusts. Staff in the former scored their hospitals the best – nine out of 10 staff in West Sussex's Queen Victoria foundation trust would be happy for a friend or relative to be treated there. By comparison, only a third of staff at Croydon's NHS trust agreed when asked the same question. The health secretary, Andrew Lansley, plans to give every hospital foundation status.
The survey found staff rated highly feeling part of a team but some were struggling with heavy workloads. More than one in five (22%) say they cannot do their job to a standard they are personally pleased with, 60% think they can and 17% neither agree nor disagree.
Overall, the Department of Health pointed out the measures were the same or better in 25 out of 38 key measures. Lansley said: "This survey shows that NHS staff remain committed to providing the highest quality of care to their patients.
"The number of staff happy with the standard of care remains stable, with some foundation trusts performing to a very high standard. Too many trusts continue to have less favourable levels of recommendation to family and friends. The NHS should use this as a basis for seeing improvement in the services we deliver for patients in the future."
However, the unions said their own surveys revealed a deep disenchantment in the NHS as pressures have been building over the past year. Christina McAnea, Unison's head of health, said: "The staff survey reflects some of the pressures felt by staff, but our own survey painted a much bleaker picture. Unison's survey showed that 85% experienced an increase in workload and 83% suffered an increase in stress over the past year.
"The increase in workload is not a coincidence; it is down to cuts in staffing and to a lack of cover for staff on sick or on leave. And it is not just staff who suffer – the increase in workload and stress is felt by patients and by workers' families."
Dr Peter Carter, the chief executive of the Royal College of Nursing, said; "If ever there was proof of the pressures hitting the NHS frontline then this is it. It is worrying but not surprising that numbers of staff prepared to recommend their trust as a place to work are decreasing. Staff cutbacks are leaving nurses and other NHS workers so stretched that they can feel unable to deliver the level of care for patients that they would wish." Guardian


Aspirin a day cuts cancer risk after just three years

Aspirin a day cuts cancer risk after just three years: Middle-aged people can reduce chances of cancer by taking aspirin, according to research. Telegraph Health News

NHS reforms: Health Bill survives last test

NHS reforms: Health Bill survives last test: Health reforms to become law after last-ditch attempt to halt bill failed. Telegraph Health News

Measure blood pressure in both arms doctors told

Measure blood pressure in both arms doctors told: Doctors and nurses should measure blood pressure in both arms as a difference in the readings can increase the risk of dying within the next ten years, researchers said. Telegraph Health News

Leadership and Governance in Seven Developed Health Systems

Leadership and Governance in Seven Developed Health Systems: Researchers compared the leadership and governance arrangements in seven nations with advanced health systems: Australia, England, Germany, the Netherlands, Norway, Sweden, and Switzerland.Commonwealth Fund

'Electric shock' depression therapy unravelled

'Electric shock' depression therapy unravelled:
Scientists have discovered how electroconvulsive therapy (ECT) works in people with severe depression, The Independent today reported. During ECT patients are anaesthetised and given a controlled electric current through the brain. But although used to treat severe depression for decades, nobody has been able to pinpoint exactly how or why this works.
However, a new study has investigated the question by performing brain scans on nine patients with severe depression before and after their ECT sessions. It found that, after treatment, the patients’ depression improved and there was a reduction in the connections in an area of the brain previously linked to both depression and cognitive function.
The main limitations to this study are its small size and the fact that it didn’t report what happened to patients who weren’t given ECT treatment. This means that it’s not possible to say what changes (if any) would have occurred over time to the patients not given ECT. However, it may be difficult to obtain a control group of similar people with severe depression who would not be offered ECT or an alternative treatment.
ECT is used by the NHS to treat severe cases of depression under specific circumstances and can have benefit for certain patients, although it can also have side effects. This type of research should help scientists to understand how it delivers its effects, and possibly develop other ways to achieve similar results with fewer side effects.

Where did the story come from?

The study was carried out by researchers from the University of Aberdeen and the University of Dundee, and was funded by the Chief Scientist Office of Scotland and the Scottish Funding Council.

The study was published in the peer-reviewed journal, Proceedings of the National Academy of Sciences of the USA (PNAS).
The news sources have provided reasonable coverage of this study, although they do not discuss the lack of a control group receiving no ECT. Including a control group helps to establish a treatment’s effects as it allows researchers to see what patients experience when given a particular treatment and compare this with what happens when they are not.
There might be some difficulty in recruiting a control group who would not receive ECT, as the patients involved have severe depression that had not responded to other treatments such as medication. Therefore not offering ECT might not be ethical.

What kind of research was this?

This was a before-and-after study looking at the effects of ECT on connections between nerve cells in the brain. The researchers say that previous studies have led to the idea that certain aspects of depression might be caused by increases in the connections between certain areas of the brain.
The researchers report that ECT has been used to treat severe depression for more than 70 years and that it is the most potent and rapidly acting antidepressant treatment for the condition. However, it does require administration of a general anaesthetic and is associated with side effects such as memory problems. The researchers also point out that we still do not fully understand how ECT works, They hoped that if they could understand how ECT has an effect, it might be possible to develop other ways to produce the same effect that would have fewer side effects and be less invasive.
As the study only looked at people who had ECT it isn’t possible to say what changes (if any) would have occurred in the brains of people not treated with ECT.

What did the research involve?

The researchers studied nine adults who had been successfully treated for severe depression. They carried out brain scans of these patients before and after they received their treatment and then used special methods to analyse the scans to determine how “connected” each region of the brain was. The researchers were interested in areas where connections displayed changes after the ECT treatment, as these changes could be responsible for the beneficial effects seen after a course of ECT.
The participants in this study had severe depression that had not responded to drug treatment, and they had voluntarily accepted ECT. They received ECT twice a week until their doctors decided that they had recovered from their severe depression. This took an average of 8.3 treatments. Their level of depressive symptoms was assessed before ECT treatment, after the fourth session of treatment and at the end of the ECT treatment. The researchers did not target any specific areas of the brain in their analyses; they looked at the entire brain instead.

What were the basic results?

The researchers found that participants’ depressive symptoms improved significantly after ECT. Brain scans showed that after ECT there was also a decrease in the connections in an area called the “left dorsolateral prefrontal cortex”. This area of the brain has previously been linked to both depression and cognitive functioning, which the researchers thought might explain why efforts to achieve the benefits of ECT without adverse effects might not have been successful.

How did the researchers interpret the results?

The researchers concluded that their findings support the emerging idea that depression might be linked to having too high a level of connectivity in certain areas of the brain. They say that detecting this “hyperconnectivity” might be used as a way of identifing mood disorders, and that these connections could be a target for future treatments.


This small study has found a reduction in the connectivity of one area of the brain in patients who had received successful ECT treatment for severe depression. Previous research has shown that this area, the left dorsolateral prefrontal cortex, is implicated in both depression and cognition.
However, one limitation to the study is that it did not include a control group (patients not treated with ECT), therefore it is not possible to say what changes, if any, would have occurred in their brains. However, due to the severity of their depression, it may be difficult or unethical to obtain a control group of people who would not be offered ECT. Analysis of a larger number of patients receiving ECT would help to confirm these findings, particularly if such studies looked at whether the level of brain changes seen related to how much improvement a patient showed.
ECT has been used in the treatment of depression for a long time, and research such as this should help scientists to understand how it has its effects, and possibly develop other ways to deliver the same results. However, despite its use, developing a fuller understanding of how ECT has its effects, developing new treatments based on this is likely to be a slow process.
The National Institute for Health and Clinical Excellence (NICE) guidance on depression in adults currently recommends that ECT should be considered for severe, life-threatening depression and when a rapid response is required, or when other treatments have failed. They say that ECT should not be routinely used for people with moderate depression but that it can be considered if their depression has not responded to other treatments. They recommend that the decision to use ECT should be made jointly with the patient if possible, and that the patient should be fully informed of the risks and benefits associated with having ECT. The risks they describe include the risks associated with the general anaesthetic needed for ECT and the possibility for side effects such as cognitive impairment (a deterioration in memory). However, this needs to be balanced with the risks associated with not receiving ECT.
Analysis by Bazian

Links To The Headlines

Scientists reveal how electroconvulsive therapy can help depression. The Independent, March 20 2012
Electroconvulsive therapy: Aberdeen team says it 'turns down overactive connection'. BBC News, March 20 2012
Scientists finally solve 75-year-old riddle of how controversial electric shock treatment can treat severe depression. Daily Mail, March 20 2012

Links To Science

Perrina JS, Merzb S, Bennett DM et al. Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder. PNAS, March 19, 2012