KNOWLEDGE ALERT Date: 17th June 2016

This bulletin highlights recently produced documents and items of interest that have appeared on websites (coverage may not be comprehensive). If you have any comments or suggestions regarding this Bulletin, please email the library library@sthk.nhs.uk. All links are correct at time of publishing. If a link is broken please email the library and we will send you the correct link/document. Some documents are large and may take time to open so please be patient when waiting for links to open. If you have received this bulletin from a third party and would like to receive it direct please email the library. Library Contact Details: Library and Knowledge Service, St Helens & Knowsley Health Informatics, Level 1 Nightingale House, Whiston Hospital, Warrington Road, Prescot, Merseyside L35 5DR www.knowledge-nw.nhs.uk

CONTENTS:

ALLIED HEALTH PROFESSIONALS ANAESTHESIA CANCER CHILDREN & YOUNG PEOPLE COMMISSIONING EMERGENCY MEDICINE/CRITICAL CARE GENERAL MEDICINE GENERAL PRACTICE AND PRACTICE MANAGEMENT HEALTH SERVICES MANAGEMENT INFECTION CONTROL AND INFECTIOUS DISEASES INFORMATICS AND INFORMATION GOVERNANCE MATERNITY & GYNAECOLOGY MEDICINES MANAGEMENT/PHARMACY MENTAL HEALTH AND WELLBEING NEUROLOGY NURSING PRACTICE OLDER PEOPLE PALLIATIVE CARE PATHOLOGY PUBLIC HEALTH/HEALTH IMPROVEMENT RESPIRATORY RHEUMATOLOGY STROKE

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ALLIED HEALTH PROFESSIONALS An Early Start is the Best Start: Tackling Childhood Obesity in Brent for only £1.55 per child Tackling childhood obesity is a priority for Brent Council. The ‘Healthy Little Eaters’ programme is a targeted intervention funded by the Council and delivered by dietitians from Brent Community Services, London North West Healthcare NHS Trust. The programme is set in Children’s Centers across Brent and aims to improve health and wellbeing of children under five and their families. Further information: http://www.fabnhsstuff.net/2016/06/15/early-start-best-start-tackling-childhood-obesity-brent-1-55-per-child/

CONSULTATION: Rheumatoid arthritis (update): Draft scope consultation You can now comment on this National Institute for Health and Care Excellence (NICE) draft scope. The scope defines what the guideline will (and will not) cover. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-ng10014/consultation/html-content EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE

ANAESTHESIA EVENT: Updates in Anaesthesia, Critical Care and Pain Management This three day event is intended for doctors engaged in clinical anaesthesia, pain management and intensive care medicine (i.e. Consultants, Staff and Associate Specialist Grades or their overseas equivalent) who feel they may benefit from a refresher meeting in the latest advances in areas of practice they may be exposed to regularly or only occasionally. It consists of lectures, each of which is followed by ample time for discussion. Further information: https://www.rcoa.ac.uk/education-and-events/updates-anaesthesia-critical-care-and-pain-management-0

CANCER UK first: microscope uses tractor beams to peer inside cells The Institute of Cancer Research (ICR), London, will be the first research organisation in the UK to receive a new type of high-tech microscope, allowing scientists to view dynamic cellular processes in real time. Liz Burtally, Science Writer at the ICR, finds out how this powerful machine will help researchers to design a new generation of drugs that target cell division. Further information: http://www.icr.ac.uk/news-features/latest-features/uk-first-microscope-uses-tractor-beams-to-peer-inside-cells Pioneering cancer drug combination approved A pioneering pair of cancer drugs that unleash the immune system on tumours will be paid for by the NHS in England. In trials, the combination therapy shrank the most aggressive and deadly type of skin cancer in 69% of patients. The decision to approve the drugs is one of the fastest in NHS history and is likely to be adopted throughout the UK. News: http://www.bbc.co.uk/news/health-36549674 Less educated women less likely to spot breast cancer symptoms Women with fewer qualifications are less likely to recognise potential breast cancer symptoms, according to a Cancer Research UK-funded study. Not only were women with fewer qualifications - less likely to link the symptoms to breast cancer compared with university educated women, but they were more likely to want to avoid confronting a potential cancer. Press release: http://www.cancerresearchuk.org/about-us/cancer-news/press-release/2016-06-17-less-educated-women-less-likely-to-spot-breast-cancer-symptoms Abstract: http://onlinelibrary.wiley.com/doi/10.1002/pon.4177/abstract Study links tree nut consumption to prostate cancer mortality In a large prospective study researchers looked at the association between nut consumption and prostate cancer risk and mortality among 47,299 men in the Health Professionals Follow-up Study. While nut consumption was not associated with a reduced risk of prostate cancer, men who had prostate cancer and consumed tree nuts five or more times per week after diagnosis, had a significant 34 percent lower risk of overall mortality than those who consumed nuts less than once per month (HR=0.66, 95% CI: 0.52-0.83, P for trend=0.0005). News: http://ecancer.org/news/9607-study-links-tree-nut-consumption-to-prostate-cancer-mortality.php

Abstract: http://www.nature.com/bjc/journal/vaop/ncurrent/abs/bjc2016181a.html

CHILDREN & YOUNG PEOPLE Unruly pupils may have brain abnormalities, study suggests The unruliest teenagers in a classroom may actually be suffering from brain abnormalities, a new study suggests. One in 20 British youngsters between the ages of 5 and 16 are thought to suffer from Conduct Disorder. But a new study has found that the brains of teenagers diagnosed with Conduct Disorder had areas of thickness in the frontal and temporal regions of the brain, in contrast to those without behavioural problems. News: http://www.telegraph.co.uk/science/2016/06/15/unruly-pupils-may-have-brain-abnormalities-study-suggests/ Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/abstract Full text article (PDF): http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/epdf Behind the Headlines: http://www.nhs.uk/news/2016/06June/Pages/Brain-scans-find-differences-in-badly-behaved-teen-boys.aspx

COMMISSIONING Mobilising Communities - developing solutions Blog from: Ruth Kern, Senior Programme Manager, Nesta and Annette Holman, Assistant Programme Manager, Health Lab, Nesta. Blog: http://www.nesta.org.uk/blog/mobilising-communities-developing-solutions NHS European Office Newsletter, 15 June 2016 Latest issue of the newsletter keeping you informed of key EU developments. Newsletter: http://www.nhsconfed.org/?sc_itemid={885DCF84-E7BF-4CDE-A049-D27221858B88}&sc_lang=en&sc_pd_view=1&ec_as=37F8F21B68EB4D2891B96216BA5E4229 Don Berwick: I have growing confidence in NHS's ability to deliver change American healthcare expert speaks highly of ‘vanguard sites’ – but says change could take some time. Further information: http://www.theguardian.com/healthcare-network/2016/jun/15/don-berwick-confidence-nhs-change Into the woods: how walks are improving mental health A trailblazing approach to mental health by Forestry Commission Scotland and local health boards is seeing service users go on activity-filled woodland walks. Further information: http://www.theguardian.com/healthcare-network/2016/jun/14/woodland-walks-mental-health-forestry-commission-scotland-health-boards Lets get (2)…… Lets get… project is as self-care model aimed at helping the community of Morecambe Bay to improve their health and wellbeing run by Lancashire North Clinical Commissioning Group. As part of the project a “Circulation café” recently opened its doors. Further information: http://www.fabnhsstuff.net/2016/06/15/lets-get-2/ Three versions of the NHS Blog from: Chris Ham, Chief Executive, The King’s Fund. Blog: http://www.kingsfund.org.uk/blog/2016/06/three-versions-nhs NHS Continuing Healthcare Activity Statistics for England, Quarter 4 2015-16 Report, Experimental Statistics This quarterly report, produced by the Health & Social Care Information Centre (HSCIC), publishes data relating to the activity of NHS Continuing Healthcare (NHS CHC) in England. The report provides data relating to the fourth quarter of 2015-16 with respect to the number of patients eligible for NHS CHC in England as at the end of each quarter since quarter 1, 2013-14. Statistics: http://www.hscic.gov.uk/catalogue/PUB20890 Statistics on Women’s Smoking Status at Time of Delivery, England - Quarter 4, 2015-16

This report presents the latest results and trends from the women's smoking status at time of delivery (SATOD) data collection in England. It includes new figures for the fourth quarter of 2015-16 as well as annual figures. Statistics: http://www.hscic.gov.uk/catalogue/PUB20899 News: http://www.hscic.gov.uk/article/7140/Proportion-of-women-giving-birth-recorded-as-smokers-falls-to-lowest-level-since-series-began-in-200607 Syndromic surveillance summary: 16th June 2016 week 23 This weekly summary highlights changes in the number of people visiting GPs, going to emergency departments, and calling NHS 111. It will help GPs and other public health professionals identify trends and prepare for public health threats, like high levels of flu or heat-related illnesses. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529705/PHESyndromicSurveillanceSummary2016Week23.pdf Previous bulletins: https://www.gov.uk/government/publications/syndromic-surveillance-summary Emergency department bulletin: 16th June 2016 week 23 The Emergency Department Syndromic Surveillance System (EDSSS) monitors the patient attendances each day, and what symptoms patients have, in a network of emergency departments across England and Northern Ireland. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529725/EDSSSBulletin2016wk23.pdf Previous bulletins: https://www.gov.uk/government/publications/emergency-department-bulletin Remote health advice: 16th June 2016 week 23 Monitoring patterns in phone calls to the NHS 111 service each day across England, to track the spread of infectious diseases like flu and norovirus. These data provide early warning of community-based infectious diseases. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529723/PHE_Remote_Health_Advice_Weekly_Bulletin_2016_Week_23.pdf Previous bulletins: https://www.gov.uk/government/publications/remote-health-advice-bulletin GP in-hours consultations bulletin: 16th June 2016 week 23 Monitoring the number of visits to GPs during regular surgery hours for important clinical indicators. This system reports daily, and covers over 55% of England’s population. Latest bulletin: https://www.gov.uk/government/publications/gp-in-hours-bulletin Previous bulletins: https://www.gov.uk/government/publications/gp-in-hours-bulletin CONSULTATION: Rheumatoid arthritis (update): Draft scope consultation You can now comment on this National Institute for Health and Care Excellence (NICE) draft scope. The scope defines what the guideline will (and will not) cover. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-ng10014/consultation/html-content Wheelchair services: Operational Data Collection, Quarter 4 (January-March 2016) NHS England has published the latest wheelchair services dataset. The Wheelchair Operational Data Collection is designed to enable the gathering and dissemination of data that can be used for benchmarking and improving the commissioning of wheelchair services and outcomes for wheelchair users. Data: https://www.england.nhs.uk/wp-content/uploads/2016/06/wheelchair-op-data-q4-2015.xlsx Further information: https://www.england.nhs.uk/ourwork/pe/wheelchair-services/nhse-role/ EVENT: Conflicts of interest This workshop has been designed to look at both corporate and individual accountability of commissioning organisations. It uses case studies and scenarios to bring these issues to life and to allow you an opportunity to discuss and explore practical solutions to the problems that you face. The workshop is suitable for commissioning directors and senior managers in CCGs, local authorities, NHS England teams, provider organisations and others who work in the primary care sector. Further information: https://www.pccevents.co.uk/pcc/frontend/reg/thome.csp?pageID=776671&eventID=1491

NHS Confederation Annual Conference and Exhibition – Day Two A round up of day two of the conference and videos of the keynote sessions. Further information: http://www.nhsconfed.org/news/2016/06/day-two-roundup Videos: http://www.nhsconfed.org/conference/watch-again Related news: http://www.nhsconfed.org/media-centre/2016/06/response-to-rt-hon-jeremy-hunts-speech-at-annual-conference Listening to Those Living with Chronic Conditions Blog from: Jamie Ryan, Senior Program Associate, Delivery System Reform, The Commonwealth Fund and Meredith Brown, Program Assistant, Delivery System Reform, The Commonwealth Fund. Blog: http://www.commonwealthfund.org/publications/blog/2016/jun/listening-to-those-living-with-chronic-conditions The facts: EU immigration and pressure on the NHS Blog from: Mark Dayan, Policy and Public Affairs Analyst, Nuffield Trust. Blog: http://www.nuffieldtrust.org.uk/blog/facts-eu-immigration-and-pressure-nhs The Precautionary Principle, Evidence-based Medicine and Decision Theory in Public Health Evaluation The precautionary principle (PP) has been used in the evaluation of the effectiveness and/or cost-effectiveness of interventions designed to prevent future harms in a range of activities, particularly in the area of the environment. Here, Alastair J Fischer, Office of Health Economics (OHE) and Gemma Ghelardi, London School of Economics (LSE) provide details of circumstances under which the PP can be applied to the topic of harm reduction in Public Health. NB: The full text is available by clicking on the RED document icon on the right side of the screen. Abstract: http://journal.frontiersin.org/article/10.3389/fpubh.2016.00107/abstract News: https://www.ohe.org/news/precautionary-principle-healthcare EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE In Norway centralised healthcare works. Should the NHS follow suit? Data and evidence proves that concentrating care in fewer hospitals provides the best patient outcomes, Norwegian health experts argue. Article: http://www.theguardian.com/healthcare-network/2016/jun/15/norway-centralised-healthcare-nhs-hospitals Beyond Survival: The Case for Investing in Young Children Globally This discussion paper is a call to action, informed by science from multiple disciplines. The authors hope it will help to close the gap between what is known and what is done to support the development of children globally and, in turn, sustainable progress for communities and nations. Paper: https://nam.edu/wp-content/uploads/2016/06/Beyond-Survival-The-Case-for-Investing-in-Young-Children-Globally.pdf Further information: https://nam.edu/beyond-survival-the-case-for-investing-in-young-children-globally/ Patients need a more active role in healthcare decision-making Sharing decision-making with patients and the wider community can improve care, help internal NHS collaboration and engage vulnerable people says Joan Saddler, Associate director, NHS Confederation. Article: http://www.theguardian.com/healthcare-network/2016/jun/17/patients-active-role-healthcare-decision-making EVENT: Innovative approaches to end-of-life care

This King’s Fund event will give you an overview of some of the national programmes of work in this area and share lessons from good practice case studies in palliative care and local end-of-life care commissioning and delivery. Further information: http://www.kingsfund.org.uk/events/innovative-approaches-end-life-care

EMERGENCY MEDICINE/CRITICAL CARE Syndromic surveillance summary: 16th June 2016 week 23 This weekly summary highlights changes in the number of people visiting GPs, going to emergency departments, and calling NHS 111. It will help GPs and other public health professionals identify trends and prepare for public health threats, like high levels of flu or heat-related illnesses. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529705/PHESyndromicSurveillanceSummary2016Week23.pdf Previous bulletins: https://www.gov.uk/government/publications/syndromic-surveillance-summary Emergency department bulletin: 16th June 2016 week 23 The Emergency Department Syndromic Surveillance System (EDSSS) monitors the patient attendances each day, and what symptoms patients have, in a network of emergency departments across England and Northern Ireland. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529725/EDSSSBulletin2016wk23.pdf Previous bulletins: https://www.gov.uk/government/publications/emergency-department-bulletin EVENT: Updates in Anaesthesia, Critical Care and Pain Management This three day event is intended for doctors engaged in clinical anaesthesia, pain management and intensive care medicine (i.e. Consultants, Staff and Associate Specialist Grades or their overseas equivalent) who feel they may benefit from a refresher meeting in the latest advances in areas of practice they may be exposed to regularly or only occasionally. It consists of lectures, each of which is followed by ample time for discussion. Further information: https://www.rcoa.ac.uk/education-and-events/updates-anaesthesia-critical-care-and-pain-management-0 EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE

GENERAL MEDICINE Listening to Those Living with Chronic Conditions Blog from: Jamie Ryan, Senior Program Associate, Delivery System Reform, The Commonwealth Fund and Meredith Brown, Program Assistant, Delivery System Reform, The Commonwealth Fund. Blog: http://www.commonwealthfund.org/publications/blog/2016/jun/listening-to-those-living-with-chronic-conditions Prescription drugs are the third leading cause of death Blog from: Peter C Gøtzsche, Danish physician, medical researcher, and leader of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen, Denmark. He co-founded, and has written numerous reviews within the Cochrane Collaboration. He is the author of a number of books on evidence-based medicine. Blog: http://blogs.bmj.com/bmj/2016/06/16/peter-c-gotzsche-prescription-drugs-are-the-third-leading-cause-of-death/ Time to pause Scotland’s “Named Person” policy Blog from: David Payne, digital editor, The BMJ.

Blog: http://blogs.bmj.com/bmj/2016/06/16/david-payne-time-to-pause-scotlands-named-person-policy/ EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE Patients need a more active role in healthcare decision-making Sharing decision-making with patients and the wider community can improve care, help internal NHS collaboration and engage vulnerable people says Joan Saddler, Associate director, NHS Confederation. Article: http://www.theguardian.com/healthcare-network/2016/jun/17/patients-active-role-healthcare-decision-making CONSULTATION: Cystic fibrosis (F508del mutation) - lumacaftor (with ivacaftor) [ID786]: Final Appraisal Determination (FAD) The National Institute for Health and Care Excellence (NICE) Appraisal Committee has prepared a FAD on Lumacaftor and ivacaftor combination therapy for treating cystic fibrosis homozygous for the F508del mutation and submitted it to the Institute. Consultation: https://www.nice.org.uk/guidance/GID-TAG530/documents/html-content-2 Press release: https://www.nice.org.uk/news/press-and-media/cost-of-cystic-fibrosis-treatment-too-high-for-benefit-offered-says-nice

GENERAL PRACTICE AND PRACTICE MANAGEMENT Into the woods: how walks are improving mental health A trailblazing approach to mental health by Forestry Commission Scotland and local health boards is seeing service users go on activity-filled woodland walks. Further information: http://www.theguardian.com/healthcare-network/2016/jun/14/woodland-walks-mental-health-forestry-commission-scotland-health-boards Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies The authors conclude that this meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. Systematic review: http://www.bmj.com/content/353/bmj.i2716 Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events A Systematic Review and Meta-analysis The authors found that among overweight or obese adults, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide, compared with placebo, were each associated with achieving at least 5% weight loss at 52 weeks. Phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5% weight loss. Systematic review: http://jama.jamanetwork.com/article.aspx?articleid=2528211 Three versions of the NHS Blog from: Chris Ham, Chief Executive, The King’s Fund. Blog: http://www.kingsfund.org.uk/blog/2016/06/three-versions-nhs Statistics on Women’s Smoking Status at Time of Delivery, England - Quarter 4, 2015-16 This report presents the latest results and trends from the women's smoking status at time of delivery (SATOD) data collection in England. It includes new figures for the fourth quarter of 2015-16 as well as annual figures. Statistics: http://www.hscic.gov.uk/catalogue/PUB20899 News: http://www.hscic.gov.uk/article/7140/Proportion-of-women-giving-birth-recorded-as-smokers-falls-to-lowest-level-since-series-began-in-200607

Syndromic surveillance summary: 16th June 2016 week 23 This weekly summary highlights changes in the number of people visiting GPs, going to emergency departments, and calling NHS 111. It will help GPs and other public health professionals identify trends and prepare for public health threats, like high levels of flu or heat-related illnesses. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529705/PHESyndromicSurveillanceSummary2016Week23.pdf Previous bulletins: https://www.gov.uk/government/publications/syndromic-surveillance-summary Remote health advice: 16th June 2016 week 23 Monitoring patterns in phone calls to the NHS 111 service each day across England, to track the spread of infectious diseases like flu and norovirus. These data provide early warning of community-based infectious diseases. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529723/PHE_Remote_Health_Advice_Weekly_Bulletin_2016_Week_23.pdf Previous bulletins: https://www.gov.uk/government/publications/remote-health-advice-bulletin GP in-hours consultations bulletin: 16th June 2016 week 23 Monitoring the number of visits to GPs during regular surgery hours for important clinical indicators. This system reports daily, and covers over 55% of England’s population. Latest bulletin: https://www.gov.uk/government/publications/gp-in-hours-bulletin Previous bulletins: https://www.gov.uk/government/publications/gp-in-hours-bulletin CONSULTATION: Rheumatoid arthritis (update): Draft scope consultation You can now comment on this National Institute for Health and Care Excellence (NICE) draft scope. The scope defines what the guideline will (and will not) cover. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-ng10014/consultation/html-content Care Quality Commission (CQC) inspectors highlight outstanding and good care as reports are published on 91 more GP practices The CQC has published a further 91 reports on the quality of care provided by GP practices that have been inspected by specialist teams of inspectors. The Chief Inspector of General Practice has found another 73 practices to be Good (including 2 local) and seven to Require Improvement, four to be Outstanding and two to be Inadequate following recent inspections by the Care Quality Commission. Five reports were focused inspections (including 1 local) which are not rated. Press release: http://www.cqc.org.uk/content/cqc-inspectors-highlight-outstanding-and-good-care-reports-are-published-91-more-gp-0 Patterdale Lodge report: http://www.cqc.org.uk/location/1-570797286 Wingate report: http://www.cqc.org.uk/location/1-581884695 Roseheath (focused): http://www.cqc.org.uk/location/1-515104996 EVENT: Conflicts of interest This workshop has been designed to look at both corporate and individual accountability of commissioning organisations. It uses case studies and scenarios to bring these issues to life and to allow you an opportunity to discuss and explore practical solutions to the problems that you face. The workshop is suitable for commissioning directors and senior managers in CCGs, local authorities, NHS England teams, provider organisations and others who work in the primary care sector. Further information: https://www.pccevents.co.uk/pcc/frontend/reg/thome.csp?pageID=776671&eventID=1491 Loneliness among older men with poor health a growing problem A new analysis by Age UK reveals 550,000 men over the age of 65 in England are lonely. The risk of loneliness and isolation appears to increase with age, and among those with long-term health problems and/or disability. The charity is calling for urgent action to tackle what is fast becoming a major public health challenge. News: http://www.ageuk.org.uk/latest-news/loneliness-among-older-men-growing-problem/ Are GPs having to offer 'budget-airline-style' care?

Blog from: Dr Rebecca Rosen, General Practitioner in Greenwich and a Senior Fellow in Health Policy at the Nuffield Trust. Blog: http://www.nuffieldtrust.org.uk/blog/are-gps-having-offer-budget-airline-style-care Less educated women less likely to spot breast cancer symptoms Women with fewer qualifications are less likely to recognise potential breast cancer symptoms, according to a Cancer Research UK-funded study. Not only were women with fewer qualifications - less likely to link the symptoms to breast cancer compared with university educated women, but they were more likely to want to avoid confronting a potential cancer. Press release: http://www.cancerresearchuk.org/about-us/cancer-news/press-release/2016-06-17-less-educated-women-less-likely-to-spot-breast-cancer-symptoms Abstract: http://onlinelibrary.wiley.com/doi/10.1002/pon.4177/abstract Unruly pupils may have brain abnormalities, study suggests The unruliest teenagers in a classroom may actually be suffering from brain abnormalities, a new study suggests. One in 20 British youngsters between the ages of 5 and 16 are thought to suffer from Conduct Disorder. But a new study has found that the brains of teenagers diagnosed with Conduct Disorder had areas of thickness in the frontal and temporal regions of the brain, in contrast to those without behavioural problems. News: http://www.telegraph.co.uk/science/2016/06/15/unruly-pupils-may-have-brain-abnormalities-study-suggests/ Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/abstract Full text article (PDF): http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/epdf Behind the Headlines: http://www.nhs.uk/news/2016/06June/Pages/Brain-scans-find-differences-in-badly-behaved-teen-boys.aspx Listening to Those Living with Chronic Conditions Blog from: Jamie Ryan, Senior Program Associate, Delivery System Reform, The Commonwealth Fund and Meredith Brown, Program Assistant, Delivery System Reform, The Commonwealth Fund. Blog: http://www.commonwealthfund.org/publications/blog/2016/jun/listening-to-those-living-with-chronic-conditions Prescription drugs are the third leading cause of death Blog from: Peter C Gøtzsche, Danish physician, medical researcher, and leader of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen, Denmark. He co-founded, and has written numerous reviews within the Cochrane Collaboration. He is the author of a number of books on evidence-based medicine. Blog: http://blogs.bmj.com/bmj/2016/06/16/peter-c-gotzsche-prescription-drugs-are-the-third-leading-cause-of-death/ A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults The authors of this review concluded that in adults, psychological interventions, clomipramine, selective serotonin reuptake inhibitors (SSRIs) or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Systematic review: http://www.journalslibrary.nihr.ac.uk/hta/volume-20/issue-43 News: http://www.nets.nihr.ac.uk/news/all/2016/managing-obsessive-compulsive-disorder-in-adults Time to pause Scotland’s “Named Person” policy Blog from: David Payne, digital editor, The BMJ. Blog: http://blogs.bmj.com/bmj/2016/06/16/david-payne-time-to-pause-scotlands-named-person-policy/ Drug Safety Update 2016 Volume: 9 Issue: 11, June Monthly newsletter from the Medicines and Healthcare products Regulatory Agency (MHRA) and its independent advisor the Commission on Human Medicines. Newsletter: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529618/DSU_pdf_June_2016.pdf Five tips on keeping good medical records

Accurate medical records have always been important but with patients now able to access a summary of their notes, clarity is key explains Dr Beverley Ward, medico-legal adviser, Medical Defence Union (MDU). Article: http://www.gponline.com/five-tips-keeping-good-medical-records/article/1398927 The facts: EU immigration and pressure on the NHS Blog from: Mark Dayan, Policy and Public Affairs Analyst, Nuffield Trust. Blog: http://www.nuffieldtrust.org.uk/blog/facts-eu-immigration-and-pressure-nhs Pregnancy - red flag symptoms Red flags to look out for in pregnancy, including back pain, bleeding, headaches, hypertension and high fever, contributed by Dr Matthew West, GP, Hertfordshire. Article: http://www.gponline.com/pregnancy-red-flag-symptoms/womens-health/article/1398533 EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE In Norway centralised healthcare works. Should the NHS follow suit? Data and evidence proves that concentrating care in fewer hospitals provides the best patient outcomes, Norwegian health experts argue. Article: http://www.theguardian.com/healthcare-network/2016/jun/15/norway-centralised-healthcare-nhs-hospitals BNF eNewsletter – June 2016 Latest issue. Newsletter: http://pharmaceuticalpress.cmail20.com/t/ViewEmail/y/E0C316B0E7D2E00F/8905408BF752A3BB6707B176AE29F890 Patients need a more active role in healthcare decision-making Sharing decision-making with patients and the wider community can improve care, help internal NHS collaboration and engage vulnerable people says Joan Saddler, Associate director, NHS Confederation. Article: http://www.theguardian.com/healthcare-network/2016/jun/17/patients-active-role-healthcare-decision-making

HEALTH SERVICES MANAGEMENT Mobilising Communities - developing solutions Blog from: Ruth Kern, Senior Programme Manager, Nesta and Annette Holman, Assistant Programme Manager, Health Lab, Nesta. Blog: http://www.nesta.org.uk/blog/mobilising-communities-developing-solutions NHS European Office Newsletter, 15 June 2016 Latest issue of the newsletter keeping you informed of key EU developments. Newsletter: http://www.nhsconfed.org/?sc_itemid={885DCF84-E7BF-4CDE-A049-D27221858B88}&sc_lang=en&sc_pd_view=1&ec_as=37F8F21B68EB4D2891B96216BA5E4229 Don Berwick: I have growing confidence in NHS's ability to deliver change American healthcare expert speaks highly of ‘vanguard sites’ – but says change could take some time. Further information: http://www.theguardian.com/healthcare-network/2016/jun/15/don-berwick-confidence-nhs-change An Early Start is the Best Start: Tackling Childhood Obesity in Brent for only £1.55 per child Tackling childhood obesity is a priority for Brent Council. The ‘Healthy Little Eaters’ programme is a targeted intervention funded by the Council and delivered by dietitians from Brent Community

Services, London North West Healthcare NHS Trust. The programme is set in Children’s Centers across Brent and aims to improve health and wellbeing of children under five and their families. Further information: http://www.fabnhsstuff.net/2016/06/15/early-start-best-start-tackling-childhood-obesity-brent-1-55-per-child/ Three versions of the NHS Blog from: Chris Ham, Chief Executive, The King’s Fund. Blog: http://www.kingsfund.org.uk/blog/2016/06/three-versions-nhs NHS Surplus Land 2015/16 England The Surplus Land collection has existed since 2008 to provide information to the Department of Health, the Homes and Communities Agency and Government Property Unit on sites that can be disposed of, thereby contributing to the Government Public Sector Land Disposal programme. Report: http://www.hscic.gov.uk/catalogue/PUB20907 NHS Continuing Healthcare Activity Statistics for England, Quarter 4 2015-16 Report, Experimental Statistics This quarterly report, produced by the Health & Social Care Information Centre (HSCIC), publishes data relating to the activity of NHS Continuing Healthcare (NHS CHC) in England. The report provides data relating to the fourth quarter of 2015-16 with respect to the number of patients eligible for NHS CHC in England as at the end of each quarter since quarter 1, 2013-14. Statistics: http://www.hscic.gov.uk/catalogue/PUB20890 Statistics on Women’s Smoking Status at Time of Delivery, England - Quarter 4, 2015-16 This report presents the latest results and trends from the women's smoking status at time of delivery (SATOD) data collection in England. It includes new figures for the fourth quarter of 2015-16 as well as annual figures. Statistics: http://www.hscic.gov.uk/catalogue/PUB20899 News: http://www.hscic.gov.uk/article/7140/Proportion-of-women-giving-birth-recorded-as-smokers-falls-to-lowest-level-since-series-began-in-200607 Syndromic surveillance summary: 16th June 2016 week 23 This weekly summary highlights changes in the number of people visiting GPs, going to emergency departments, and calling NHS 111. It will help GPs and other public health professionals identify trends and prepare for public health threats, like high levels of flu or heat-related illnesses. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529705/PHESyndromicSurveillanceSummary2016Week23.pdf Previous bulletins: https://www.gov.uk/government/publications/syndromic-surveillance-summary Emergency department bulletin: 16th June 2016 week 23 The Emergency Department Syndromic Surveillance System (EDSSS) monitors the patient attendances each day, and what symptoms patients have, in a network of emergency departments across England and Northern Ireland. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529725/EDSSSBulletin2016wk23.pdf Previous bulletins: https://www.gov.uk/government/publications/emergency-department-bulletin Remote health advice: 16th June 2016 week 23 Monitoring patterns in phone calls to the NHS 111 service each day across England, to track the spread of infectious diseases like flu and norovirus. These data provide early warning of community-based infectious diseases. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529723/PHE_Remote_Health_Advice_Weekly_Bulletin_2016_Week_23.pdf Previous bulletins: https://www.gov.uk/government/publications/remote-health-advice-bulletin CONSULTATION: Rheumatoid arthritis (update): Draft scope consultation You can now comment on this National Institute for Health and Care Excellence (NICE) draft scope. The scope defines what the guideline will (and will not) cover. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-ng10014/consultation/html-content

EVENT: Conflicts of interest This workshop has been designed to look at both corporate and individual accountability of commissioning organisations. It uses case studies and scenarios to bring these issues to life and to allow you an opportunity to discuss and explore practical solutions to the problems that you face. The workshop is suitable for commissioning directors and senior managers in CCGs, local authorities, NHS England teams, provider organisations and others who work in the primary care sector. Further information: https://www.pccevents.co.uk/pcc/frontend/reg/thome.csp?pageID=776671&eventID=1491 Employer views on the apprenticeship levy This Chartered Institute of Personnel and Development (CIPD) report is the first major study published on the likely implications of the apprenticeship levy and has some important insights and recommendations for policymakers, which are set out in the conclusions. Report: http://www.cipd.co.uk/binaries/employer-views-on-the-apprenticeship-levy_2016.pdf Press release: http://www.cipd.co.uk/pressoffice/press-releases/apprenticeship-levy-170616.aspx NHS Confederation Annual Conference and Exhibition – Day Two A round up of day two of the conference and videos of the keynote sessions. Further information: http://www.nhsconfed.org/news/2016/06/day-two-roundup Videos: http://www.nhsconfed.org/conference/watch-again Related news: http://www.nhsconfed.org/media-centre/2016/06/response-to-rt-hon-jeremy-hunts-speech-at-annual-conference Listening to Those Living with Chronic Conditions Blog from: Jamie Ryan, Senior Program Associate, Delivery System Reform, The Commonwealth Fund and Meredith Brown, Program Assistant, Delivery System Reform, The Commonwealth Fund. Blog: http://www.commonwealthfund.org/publications/blog/2016/jun/listening-to-those-living-with-chronic-conditions EVENT: Freedom to Speak Up The National Guardian’s Office is hosting a roadshow of regional events for senior HR managers in trusts, where Freedom to Speak Up Guardians have not yet been nominated. Further information: https://www.eventbrite.co.uk/e/freedom-to-speak-up-nhs-staff-tickets-26054963096 News: http://www.nhsemployers.org/news/2016/06/regional-freedom-to-speak-up-events-announced-for-hr-managers Bullying in healthcare The Health, Safety and Wellbeing Partnership Group (HSWPG) has launched new resources and an infographic to support NHS organisations to develop cultures where staff are free from the fear of intimidating behaviour. Resources: http://www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/health-work-and-wellbeing/protecting-staff-and-preventing-ill-health/partnership-working-across-your-organisation/partnership-working-on-health-safety-and-wellbeing/hswpg-publications-advice-and-resources/bullying-in-healthcare Infographic: http://www.nhsemployers.org/~/media/Employers/Publications/NHS%20Bullying%20Infographic.pdf News: http://www.nhsemployers.org/news/2016/06/tackling-bullying-and-harassment-in-the-nhs-new-resources-launched The facts: EU immigration and pressure on the NHS Blog from: Mark Dayan, Policy and Public Affairs Analyst, Nuffield Trust. Blog: http://www.nuffieldtrust.org.uk/blog/facts-eu-immigration-and-pressure-nhs The Precautionary Principle, Evidence-based Medicine and Decision Theory in Public Health Evaluation The precautionary principle (PP) has been used in the evaluation of the effectiveness and/or cost-effectiveness of interventions designed to prevent future harms in a range of activities, particularly in the area of the environment. Here, Alastair J Fischer, Office of Health Economics (OHE) and Gemma Ghelardi, London School of Economics (LSE) provide details of circumstances under which the PP can be applied to the topic of harm reduction in Public Health.

NB: The full text is available by clicking on the RED document icon on the right side of the screen. Abstract: http://journal.frontiersin.org/article/10.3389/fpubh.2016.00107/abstract News: https://www.ohe.org/news/precautionary-principle-healthcare In Norway centralised healthcare works. Should the NHS follow suit? Data and evidence proves that concentrating care in fewer hospitals provides the best patient outcomes, Norwegian health experts argue. Article: http://www.theguardian.com/healthcare-network/2016/jun/15/norway-centralised-healthcare-nhs-hospitals Patients need a more active role in healthcare decision-making Sharing decision-making with patients and the wider community can improve care, help internal NHS collaboration and engage vulnerable people says Joan Saddler, Associate director, NHS Confederation. Article: http://www.theguardian.com/healthcare-network/2016/jun/17/patients-active-role-healthcare-decision-making EVENT: Innovative approaches to end-of-life care This King’s Fund event will give you an overview of some of the national programmes of work in this area and share lessons from good practice case studies in palliative care and local end-of-life care commissioning and delivery. Further information: http://www.kingsfund.org.uk/events/innovative-approaches-end-life-care

INFECTION CONTROL AND INFECTIOUS DISEASES Syndromic surveillance summary: 16th June 2016 week 23 This weekly summary highlights changes in the number of people visiting GPs, going to emergency departments, and calling NHS 111. It will help GPs and other public health professionals identify trends and prepare for public health threats, like high levels of flu or heat-related illnesses. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529705/PHESyndromicSurveillanceSummary2016Week23.pdf Previous bulletins: https://www.gov.uk/government/publications/syndromic-surveillance-summary Remote health advice: 16th June 2016 week 23 Monitoring patterns in phone calls to the NHS 111 service each day across England, to track the spread of infectious diseases like flu and norovirus. These data provide early warning of community-based infectious diseases. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529723/PHE_Remote_Health_Advice_Weekly_Bulletin_2016_Week_23.pdf Previous bulletins: https://www.gov.uk/government/publications/remote-health-advice-bulletin Statin drugs reduce infection risk in stroke patients, report suggests Statin drugs can dramatically lower the risk of infections in stroke patients, report researchers. Patients on statins upon admission to hospital, or early in their stay, had significantly lower risk for developing infections than those put on statins later in their hospitalization or not at all. These findings remained strong after being controlled for other possible influences like the severity of strokes, age and the presence of other conditions like diabetes. News: https://www.sciencedaily.com/releases/2016/06/160616151308.htm Abstract: http://www.strokejournal.org/article/S1052-3057(16)30111-2/abstract Trust each other News and Comment from Roy Lilley. Newsletter: http://campaign.r20.constantcontact.com/render?m=1102665899193&ca=6c9daf5b-a129-44e9-9aa2-6db178726397 EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness

and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? A systematic review and network meta-analysis This review of 59 studies highlights a regimen category that may be more efficacious than the World Health Organization (WHO) population level recommendation, and identify knowledge gaps where data are sparse. Systematic review: http://thorax.bmj.com/content/early/2016/06/13/thoraxjnl-2015-208262.full

INFORMATICS AND INFORMATION GOVERNANCE Using technology to unlock the value of the Information Governance Toolkit Phil Bradshaw, Information Governance Officer, Northern Devon Healthcare NHS Trust comments on the cloud-based Information Asset Register that the Trust has recently implemented. Further information: http://www.fabnhsstuff.net/2016/06/14/using-technology-unlock-value-information-governance-toolkit/

MATERNITY & GYNAECOLOGY Statistics on Women’s Smoking Status at Time of Delivery, England - Quarter 4, 2015-16 This report presents the latest results and trends from the women's smoking status at time of delivery (SATOD) data collection in England. It includes new figures for the fourth quarter of 2015-16 as well as annual figures. Statistics: http://www.hscic.gov.uk/catalogue/PUB20899 News: http://www.hscic.gov.uk/article/7140/Proportion-of-women-giving-birth-recorded-as-smokers-falls-to-lowest-level-since-series-began-in-200607

MEDICINES MANAGEMENT/PHARMACY Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events A Systematic Review and Meta-analysis The authors found that among overweight or obese adults, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide, compared with placebo, were each associated with achieving at least 5% weight loss at 52 weeks. Phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5% weight loss. Systematic review: http://jama.jamanetwork.com/article.aspx?articleid=2528211 Polymyalgia Rheumatica and Giant Cell Arteritis: A Systematic Review The authors concluded that consensus-based recommendations suggest glucocorticoids as the most effective therapy for polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). Methotrexate may be added in patients at risk for relapse and in those with glucocorticoid-related adverse effects or need for prolonged glucocorticoid therapy. Systematic review: http://jama.jamanetwork.com/article.aspx?articleid=2528218 Pioneering cancer drug combination approved A pioneering pair of cancer drugs that unleash the immune system on tumours will be paid for by the NHS in England. In trials, the combination therapy shrank the most aggressive and deadly type of skin cancer in 69% of patients. The decision to approve the drugs is one of the fastest in NHS history and is likely to be adopted throughout the UK. News: http://www.bbc.co.uk/news/health-36549674 Statin drugs reduce infection risk in stroke patients, report suggests Statin drugs can dramatically lower the risk of infections in stroke patients, report researchers. Patients on statins upon admission to hospital, or early in their stay, had significantly lower risk for developing infections than those put on statins later in their hospitalization or not at all. These findings remained strong after being controlled for other possible influences like the severity of strokes, age and the presence of other conditions like diabetes. News: https://www.sciencedaily.com/releases/2016/06/160616151308.htm Abstract: http://www.strokejournal.org/article/S1052-3057(16)30111-2/abstract

Prescription drugs are the third leading cause of death Blog from: Peter C Gøtzsche, Danish physician, medical researcher, and leader of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen, Denmark. He co-founded, and has written numerous reviews within the Cochrane Collaboration. He is the author of a number of books on evidence-based medicine. Blog: http://blogs.bmj.com/bmj/2016/06/16/peter-c-gotzsche-prescription-drugs-are-the-third-leading-cause-of-death/ A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults The authors of this review concluded that in adults, psychological interventions, clomipramine, selective serotonin reuptake inhibitors (SSRIs) or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Systematic review: http://www.journalslibrary.nihr.ac.uk/hta/volume-20/issue-43 News: http://www.nets.nihr.ac.uk/news/all/2016/managing-obsessive-compulsive-disorder-in-adults Drug Safety Update 2016 Volume: 9 Issue: 11, June Monthly newsletter from the Medicines and Healthcare products Regulatory Agency (MHRA) and its independent advisor the Commission on Human Medicines. Newsletter: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529618/DSU_pdf_June_2016.pdf BNF eNewsletter – June 2016 Latest issue. Newsletter: http://pharmaceuticalpress.cmail20.com/t/ViewEmail/y/E0C316B0E7D2E00F/8905408BF752A3BB6707B176AE29F890 What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? A systematic review and network meta-analysis This review of 59 studies highlights a regimen category that may be more efficacious than the World Health Organization (WHO) population level recommendation, and identify knowledge gaps where data are sparse. Systematic review: http://thorax.bmj.com/content/early/2016/06/13/thoraxjnl-2015-208262.full CONSULTATION: Cystic fibrosis (F508del mutation) - lumacaftor (with ivacaftor) [ID786]: Final Appraisal Determination (FAD) The National Institute for Health and Care Excellence (NICE) Appraisal Committee has prepared a FAD on Lumacaftor and ivacaftor combination therapy for treating cystic fibrosis homozygous for the F508del mutation and submitted it to the Institute. Consultation: https://www.nice.org.uk/guidance/GID-TAG530/documents/html-content-2 Press release: https://www.nice.org.uk/news/press-and-media/cost-of-cystic-fibrosis-treatment-too-high-for-benefit-offered-says-nice

MENTAL HEALTH AND WELLBEING Into the woods: how walks are improving mental health A trailblazing approach to mental health by Forestry Commission Scotland and local health boards is seeing service users go on activity-filled woodland walks. Further information: http://www.theguardian.com/healthcare-network/2016/jun/14/woodland-walks-mental-health-forestry-commission-scotland-health-boards Loneliness among older men with poor health a growing problem A new analysis by Age UK reveals 550,000 men over the age of 65 in England are lonely. The risk of loneliness and isolation appears to increase with age, and among those with long-term health problems and/or disability. The charity is calling for urgent action to tackle what is fast becoming a major public health challenge. News: http://www.ageuk.org.uk/latest-news/loneliness-among-older-men-growing-problem/

Unruly pupils may have brain abnormalities, study suggests The unruliest teenagers in a classroom may actually be suffering from brain abnormalities, a new study suggests. One in 20 British youngsters between the ages of 5 and 16 are thought to suffer from Conduct Disorder. But a new study has found that the brains of teenagers diagnosed with Conduct Disorder had areas of thickness in the frontal and temporal regions of the brain, in contrast to those without behavioural problems. News: http://www.telegraph.co.uk/science/2016/06/15/unruly-pupils-may-have-brain-abnormalities-study-suggests/ Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/abstract Full text article (PDF): http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/epdf Behind the Headlines: http://www.nhs.uk/news/2016/06June/Pages/Brain-scans-find-differences-in-badly-behaved-teen-boys.aspx A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults The authors of this review concluded that in adults, psychological interventions, clomipramine, selective serotonin reuptake inhibitors (SSRIs) or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Systematic review: http://www.journalslibrary.nihr.ac.uk/hta/volume-20/issue-43 News: http://www.nets.nihr.ac.uk/news/all/2016/managing-obsessive-compulsive-disorder-in-adults

NEUROLOGY Exercise four hours after learning 'boosts memory' Intensive physical exercise four hours after learning is the key to remembering information learnt, say Dutch researchers. The lead researcher, Guillen Fernandez says that the “results suggest that appropriately timed physical exercise can improve long-term memory”. News: http://www.bbc.co.uk/news/health-36549897 Abstract: http://www.cell.com/current-biology/abstract/S0960-9822(16)30465-1 Full text article (PDF): http://www.cell.com/current-biology/pdfExtended/S0960-9822(16)30465-1 Unruly pupils may have brain abnormalities, study suggests The unruliest teenagers in a classroom may actually be suffering from brain abnormalities, a new study suggests. One in 20 British youngsters between the ages of 5 and 16 are thought to suffer from Conduct Disorder. But a new study has found that the brains of teenagers diagnosed with Conduct Disorder had areas of thickness in the frontal and temporal regions of the brain, in contrast to those without behavioural problems. News: http://www.telegraph.co.uk/science/2016/06/15/unruly-pupils-may-have-brain-abnormalities-study-suggests/ Abstract: http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/abstract Full text article (PDF): http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12581/epdf Behind the Headlines: http://www.nhs.uk/news/2016/06June/Pages/Brain-scans-find-differences-in-badly-behaved-teen-boys.aspx

NURSING PRACTICE EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE

OLDER PEOPLE Loneliness among older men with poor health a growing problem

A new analysis by Age UK reveals 550,000 men over the age of 65 in England are lonely. The risk of loneliness and isolation appears to increase with age, and among those with long-term health problems and/or disability. The charity is calling for urgent action to tackle what is fast becoming a major public health challenge. News: http://www.ageuk.org.uk/latest-news/loneliness-among-older-men-growing-problem/

PALLIATIVE CARE EVENT: Innovative approaches to end-of-life care This King’s Fund event will give you an overview of some of the national programmes of work in this area and share lessons from good practice case studies in palliative care and local end-of-life care commissioning and delivery. Further information: http://www.kingsfund.org.uk/events/innovative-approaches-end-life-care

PATHOLOGY UK first: microscope uses tractor beams to peer inside cells The Institute of Cancer Research (ICR), London, will be the first research organisation in the UK to receive a new type of high-tech microscope, allowing scientists to view dynamic cellular processes in real time. Liz Burtally, Science Writer at the ICR, finds out how this powerful machine will help researchers to design a new generation of drugs that target cell division. Further information: http://www.icr.ac.uk/news-features/latest-features/uk-first-microscope-uses-tractor-beams-to-peer-inside-cells EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE

PUBLIC HEALTH/HEALTH IMPROVEMENT Mobilising Communities - developing solutions Blog from: Ruth Kern, Senior Programme Manager, Nesta and Annette Holman, Assistant Programme Manager, Health Lab, Nesta. Blog: http://www.nesta.org.uk/blog/mobilising-communities-developing-solutions Into the woods: how walks are improving mental health A trailblazing approach to mental health by Forestry Commission Scotland and local health boards is seeing service users go on activity-filled woodland walks. Further information: http://www.theguardian.com/healthcare-network/2016/jun/14/woodland-walks-mental-health-forestry-commission-scotland-health-boards Lets get (2)…… Lets get… project is as self-care model aimed at helping the community of Morecambe Bay to improve their health and wellbeing run by Lancashire North Clinical Commissioning Group. As part of the project a “Circulation café” recently opened its doors. Further information: http://www.fabnhsstuff.net/2016/06/15/lets-get-2/ An Early Start is the Best Start: Tackling Childhood Obesity in Brent for only £1.55 per child Tackling childhood obesity is a priority for Brent Council. The ‘Healthy Little Eaters’ programme is a targeted intervention funded by the Council and delivered by dietitians from Brent Community Services, London North West Healthcare NHS Trust. The programme is set in Children’s Centers across Brent and aims to improve health and wellbeing of children under five and their families. Further information: http://www.fabnhsstuff.net/2016/06/15/early-start-best-start-tackling-childhood-obesity-brent-1-55-per-child/ Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies

The authors conclude that this meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes. Systematic review: http://www.bmj.com/content/353/bmj.i2716 Association of Pharmacological Treatments for Obesity With Weight Loss and Adverse Events A Systematic Review and Meta-analysis The authors found that among overweight or obese adults, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide, compared with placebo, were each associated with achieving at least 5% weight loss at 52 weeks. Phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5% weight loss. Systematic review: http://jama.jamanetwork.com/article.aspx?articleid=2528211 Statistics on Women’s Smoking Status at Time of Delivery, England - Quarter 4, 2015-16 This report presents the latest results and trends from the women's smoking status at time of delivery (SATOD) data collection in England. It includes new figures for the fourth quarter of 2015-16 as well as annual figures. Statistics: http://www.hscic.gov.uk/catalogue/PUB20899 News: http://www.hscic.gov.uk/article/7140/Proportion-of-women-giving-birth-recorded-as-smokers-falls-to-lowest-level-since-series-began-in-200607 Syndromic surveillance summary: 16th June 2016 week 23 This weekly summary highlights changes in the number of people visiting GPs, going to emergency departments, and calling NHS 111. It will help GPs and other public health professionals identify trends and prepare for public health threats, like high levels of flu or heat-related illnesses. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529705/PHESyndromicSurveillanceSummary2016Week23.pdf Previous bulletins: https://www.gov.uk/government/publications/syndromic-surveillance-summary Remote health advice: 16th June 2016 week 23 Monitoring patterns in phone calls to the NHS 111 service each day across England, to track the spread of infectious diseases like flu and norovirus. These data provide early warning of community-based infectious diseases. Latest bulletin: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/529723/PHE_Remote_Health_Advice_Weekly_Bulletin_2016_Week_23.pdf Previous bulletins: https://www.gov.uk/government/publications/remote-health-advice-bulletin Loneliness among older men with poor health a growing problem A new analysis by Age UK reveals 550,000 men over the age of 65 in England are lonely. The risk of loneliness and isolation appears to increase with age, and among those with long-term health problems and/or disability. The charity is calling for urgent action to tackle what is fast becoming a major public health challenge. News: http://www.ageuk.org.uk/latest-news/loneliness-among-older-men-growing-problem/ Exercise four hours after learning 'boosts memory' Intensive physical exercise four hours after learning is the key to remembering information learnt, say Dutch researchers. The lead researcher, Guillen Fernandez says that the “results suggest that appropriately timed physical exercise can improve long-term memory”. News: http://www.bbc.co.uk/news/health-36549897 Abstract: http://www.cell.com/current-biology/abstract/S0960-9822(16)30465-1 Full text article (PDF): http://www.cell.com/current-biology/pdfExtended/S0960-9822(16)30465-1 Less educated women less likely to spot breast cancer symptoms Women with fewer qualifications are less likely to recognise potential breast cancer symptoms, according to a Cancer Research UK-funded study. Not only were women with fewer qualifications - less likely to link the symptoms to breast cancer compared with university educated women, but they were more likely to want to avoid confronting a potential cancer. Press release: http://www.cancerresearchuk.org/about-us/cancer-news/press-release/2016-06-17-less-educated-women-less-likely-to-spot-breast-cancer-symptoms Abstract: http://onlinelibrary.wiley.com/doi/10.1002/pon.4177/abstract

Philadelphia to bring in 'soda tax' to fight obesity Philadelphia has introduced a levy on carbonated sugary drinks, despite a multimillion-dollar campaign by the beverage industry to block it. It will become the first major US city to implement a so-called "soda tax", which supporters say will improve the health of 1.5 million residents. But opponents say it will hurt small businesses and poorer people. News: http://www.bbc.co.uk/news/world-us-canada-36553964 A Proposed Mechanism for Enhancing Public Health Capacity What if private companies could obtain some coverage to protect their foreign investments in developing countries against crippling infectious disease outbreaks such as Ebola? The possible path to offering disease outbreak guarantees is an idea being posed by two global health researchers who suggest that a mechanism for establishing such an instrument could be tied to public health investments. News: http://www.infectioncontroltoday.com/news/2016/06/a-proposed-mechanism-for-enhancing-public-health-capacity.aspx Abstract: http://www.healthfinancejournal.com/index.php/johcf/article/view/69 Full text article (PDF): http://www.healthfinancejournal.com/index.php/johcf/article/view/69/71 Study links tree nut consumption to prostate cancer mortality In a large prospective study researchers looked at the association between nut consumption and prostate cancer risk and mortality among 47,299 men in the Health Professionals Follow-up Study. While nut consumption was not associated with a reduced risk of prostate cancer, men who had prostate cancer and consumed tree nuts five or more times per week after diagnosis, had a significant 34 percent lower risk of overall mortality than those who consumed nuts less than once per month (HR=0.66, 95% CI: 0.52-0.83, P for trend=0.0005). News: http://ecancer.org/news/9607-study-links-tree-nut-consumption-to-prostate-cancer-mortality.php Abstract: http://www.nature.com/bjc/journal/vaop/ncurrent/abs/bjc2016181a.html The Precautionary Principle, Evidence-based Medicine and Decision Theory in Public Health Evaluation The precautionary principle (PP) has been used in the evaluation of the effectiveness and/or cost-effectiveness of interventions designed to prevent future harms in a range of activities, particularly in the area of the environment. Here, Alastair J Fischer, Office of Health Economics (OHE) and Gemma Ghelardi, London School of Economics (LSE) provide details of circumstances under which the PP can be applied to the topic of harm reduction in Public Health. NB: The full text is available by clicking on the RED document icon on the right side of the screen. Abstract: http://journal.frontiersin.org/article/10.3389/fpubh.2016.00107/abstract News: https://www.ohe.org/news/precautionary-principle-healthcare EVENT: Pandemics and Infection Control: Meeting Tomorrow’s Threats and Challenges Today This special symposium offers an invaluable opportunity for emergency planners, infection prevention and control teams, influenza pandemic preparedness leads, health services, local authorities, and other key stakeholders to examine the resilience of the current framework for pandemic preparedness and explore what more still needs to be done. The symposium will allow delegates to assess how well their organisation and local area is prepared and the ways in which good hygiene can be promoted. Further information: http://www.publicpolicyexchange.co.uk/events/GI14-PPE Ambitious, SMART commitments to address non-communicable diseases (NCDs), overweight and obesity This World Cancer Research Fund International policy brief illustrates how recommendations in the Second International Conference on Nutrition (ICN2) Framework for Action can be translated into policy commitments which are SMART (Specific, Measurable, Achievable, Relevant and Time-bound). It focuses on SMART commitments which target overweight & obesity and nutrition-related NCDs; where possible, policy actions are identified which reduce undernutrition at the same time (so-called double-duty actions). Brief: http://www.wcrf.org/sites/default/files/SMART-Advocacy-Brief-WCRFI-NCDA-extended.pdf News: http://www.wcrf.org/int/policy/our-policy-work/ambitious-smart-commitments-address-ncds-overweight-and-obesity Breaking the habit: Why is it so difficult to change cocaine users’ behaviour?

Dr Karen Ersche at the University of Cambridge has found that people with cocaine addiction are not more likely to alter their behaviour if they know the consequences of their actions. She explains why her findings could be important for how we treat cocaine addiction. Further information: http://www.insight.mrc.ac.uk/2016/06/16/breaking-the-habit-why-is-it-so-difficult-to-change-cocaine-users-behaviour/ Abstract: http://science.sciencemag.org/content/352/6292/1468.abstract Beyond Survival: The Case for Investing in Young Children Globally This discussion paper is a call to action, informed by science from multiple disciplines. The authors hope it will help to close the gap between what is known and what is done to support the development of children globally and, in turn, sustainable progress for communities and nations. Paper: https://nam.edu/wp-content/uploads/2016/06/Beyond-Survival-The-Case-for-Investing-in-Young-Children-Globally.pdf Further information: https://nam.edu/beyond-survival-the-case-for-investing-in-young-children-globally/

RESPIRATORY What are the most efficacious treatment regimens for isoniazid-resistant tuberculosis? A systematic review and network meta-analysis This review of 59 studies highlights a regimen category that may be more efficacious than the World Health Organization (WHO) population level recommendation, and identify knowledge gaps where data are sparse. Systematic review: http://thorax.bmj.com/content/early/2016/06/13/thoraxjnl-2015-208262.full CONSULTATION: Cystic fibrosis (F508del mutation) - lumacaftor (with ivacaftor) [ID786]: Final Appraisal Determination (FAD) The National Institute for Health and Care Excellence (NICE) Appraisal Committee has prepared a FAD on Lumacaftor and ivacaftor combination therapy for treating cystic fibrosis homozygous for the F508del mutation and submitted it to the Institute. Consultation: https://www.nice.org.uk/guidance/GID-TAG530/documents/html-content-2 Press release: https://www.nice.org.uk/news/press-and-media/cost-of-cystic-fibrosis-treatment-too-high-for-benefit-offered-says-nice

RHEUMATOLOGY Polymyalgia Rheumatica and Giant Cell Arteritis: A Systematic Review The authors concluded that consensus-based recommendations suggest glucocorticoids as the most effective therapy for polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). Methotrexate may be added in patients at risk for relapse and in those with glucocorticoid-related adverse effects or need for prolonged glucocorticoid therapy. Systematic review: http://jama.jamanetwork.com/article.aspx?articleid=2528218 CONSULTATION: Rheumatoid arthritis (update): Draft scope consultation You can now comment on this National Institute for Health and Care Excellence (NICE) draft scope. The scope defines what the guideline will (and will not) cover. Consultation: https://www.nice.org.uk/guidance/indevelopment/gid-ng10014/consultation/html-content

STROKE Statin drugs reduce infection risk in stroke patients, report suggests Statin drugs can dramatically lower the risk of infections in stroke patients, report researchers. Patients on statins upon admission to hospital, or early in their stay, had significantly lower risk for developing infections than those put on statins later in their hospitalization or not at all. These findings remained strong after being controlled for other possible influences like the severity of strokes, age and the presence of other conditions like diabetes. News: https://www.sciencedaily.com/releases/2016/06/160616151308.htm Abstract: http://www.strokejournal.org/article/S1052-3057(16)30111-2/abstract