Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality?

Perreault, K. et al. British Journal of Sports Medicine. Published Online: 31 August 2016

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Objective: To examine whether physical activity (PA) moderates the association between alcohol intake and all-cause mortality, cancer mortality and cardiovascular diseases (CVDs) mortality.

Design: Prospective study using 8 British population-based surveys, each linked to cause-specific mortality: Health Survey for England (1994, 1998, 1999, 2003, 2004 and 2006) and Scottish Health Survey (1998 and 2003).

Participants: 36 370 men and women aged 40 years and over were included with a corresponding 5735 deaths and a mean of 353 049 person-years of follow-up.

Exposures: 6 sex-specific categories of alcohol intake (UK units/week) were defined: (1) never drunk; (2) ex-drinkers; (3) occasional drinkers; (4) within guidelines (<14 (women); <21 (men)); (5) hazardous (14–35 (women); 21–49 (men)) and (6) harmful (>35 (women) >49 (men)). PA was categorised as inactive (≤7 MET-hour/week), active at the lower (>7.5 MET-hour/week) and upper (>15 MET-hour/week) of recommended levels.

Main outcomes and measures: Cox proportional-hazard models were used to examine associations between alcohol consumption and all-cause, cancer and CVD mortality risk after adjusting for several confounders. Stratified analyses were performed to evaluate mortality risks within each PA stratum.

Results: We found a direct association between alcohol consumption and cancer mortality risk starting from drinking within guidelines (HR (95% CI) hazardous drinking: 1.40 (1.11 to 1.78)). Stratified analyses showed that the association between alcohol intake and mortality risk was attenuated (all-cause) or nearly nullified (cancer) among individuals who met the PA recommendations.

Conclusions: Meeting the current PA public health recommendations offsets some of the cancer and all-cause mortality risk associated with alcohol drinking.

Read the abstract here

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Early palliative care improves coping & quality of life for patients with incurable cancers

ScienceDaily | Published online: 7 September 2016.

A randomized clinical trial found that introducing palliative care shortly after a diagnosis of certain metastatic cancers greatly increases a patient’s coping abilities, as well as overall quality of life. Researchers also found that early integration of palliative care results in an increase in discussions about patient end-of-life care preferences.

The findings are part of a growing body of evidence demonstrating the benefits of palliative care on patient quality of life. This study will be presented at the upcoming 2016 Palliative Care in Oncology Symposium in San Francisco.

To explore the effects of early palliative care, researchers randomly assigned 350 patients, who had been recently diagnosed with incurable lung or non-colorectal gastrointestinal cancer, to receive early palliative care integrated with oncology care or oncology care alone.

Read the abstract commentary here

The European Association for Palliative Care White Paper on euthanasia and physician-assisted suicide: Dodging responsibility

Chambaere, K. et al. Palliative Medicine. Published online: September 8, 2016

The White Paper of the European Association for Palliative Care (EAPC) on euthanasia and physician-assisted suicide in a previous issue is the result of a consensus-seeking process among representatives of the national palliative care organisations in Europe as well as the EAPC board members about the position statements that had been formulated in an earlier position paper in 2003.

With the aim of providing ‘a viewpoint from the palliative care perspective’ and an overarching ‘normative ethical framework’, the authors end by reaffirming that ‘euthanasia is not a part of palliative care’ despite noting strong dissent and a lack of consensus on pivotal statements.

Read the extract here

Results of the National Diet and Nutrition Survey

Public Health England & Food Standards Agency | Published online: 9 September 2016

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Image source: gov.uk

This report presents an overview of key findings for food consumption, nutrient intake and nutritional status for the UK in Years 5 and 6 (combined) (2012/13–2013/14) of the NDNS RP.  The sample is drawn from all four UK countries, and is designed to be nationally representative. Recruitment in both Wales10 and Northern Ireland11 was boosted to 200 participants per year in order to achieve country-specific, representative dietary health data. The report also provides background information on the survey, including the sample and methodology (Appendix B). Urinary iodine measurement was introduced in Year 6 of the NDNS RP and is therefore presented for the first time in this report.

Read the full report here

Read expert reaction from Science Media Centre here here 

 

Using information technology to improve the NHS

Report by National Advisory Group on Health Information Technology in England

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This report begins by covering the relevant background, in five areas:

1) General policy/practical issues that relate to health IT

2) A brief history of NPfIT

3) A brief history of health IT in England’s GP sector

4) A brief history of the US experience with digitising its healthcare system, with some possible lessons for the NHS

5) The recent consensus on digitising secondary care in England, reflected in the work of the National Information Board, the Five Year Forward View report, and the allocation of £4.2 billion to support digitisation.

After exploring this background, the report goes on to outline methods, and describe 10 overall findings and principles drawn from  interviews, site visits, and deliberations.

Finally,  10 implementation recommendations are listed along with their rationales.

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Image source: http://www.gov.uk/

Executive summary available here

Full report:

Making IT Work:
Harnessing the Power of Health
Information Technology to
Improve Care in England
Report of the National
Advisory Group on Health
Information Technology
in England

Podcast: Interpretation of the evidence for the efficacy and safety of statin therapy

Podcast:

Related article:

Collins, R. et al. The Lancet. Published online: 8 September 2016

statinsThis Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment.

Read the full article here

See also Statement from Medicines and Healthcare products Regulatory Agency on the risks and benefits of statins.

New recommendations to address deaths from drug misuse

Latest figures show a 8.5% rise in people dying from drug misuse.

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Image source: B.A.DFlickr // CC BY-NC 2.0

Recommendations, from the independent expert group convened by Public Health England (PHE) and the Local Government Association addresses England’s rising number of people dying from drug misuse.

While overall drug use continues to decline, new official statistics show a further rise in deaths for 2015, to the highest number ever recorded (2,300). Registrations of drug misuse deaths in England increased by 8.5% in 2015, following an increase of 17% in 2014 and 21% in 2013.

Heroin related deaths have doubled since 2012 in England and Wales (579 to 1,201, a 107% increase) – to the highest since records began 20 years ago.

The group’s report highlights a number of principles for action by local authorities, drug treatment providers and others, including:

  • coordinate whole-system approaches that can address health inequalities and meet complex needs, with better access to physical and mental healthcare, and to other support which could include housing and employment
  • improve access to good quality drug treatment, especially for those not currently in treatment who are harder to reach, for example, through outreach and needle and syringe programmes
  • maintain a personalised approach to drug treatment and recovery support, tailored to the user’s needs, according to national guidelines
  • ensure that the risk of death is properly assessed and understood, addressing any identified poor practice

Read the national expert group’s report: ‘Understanding and preventing drug-related deaths’

Related: Public Health England press release