NHS Confederation| June 2018| When tragedy strikes: Reflections on the NHS response to the Manchester Arena bombing and Grenfell Tower fire
To support NHS organisations with planning for major incidents, the NHS Confederation has conducted a series of interviews to capture the learning from the health service’s response to the harrowing events of 2017.
Interviews were held with:
Lord Bob Kerslake, chair of The Kerslake Arena Review
Dr John Green, clinical director of the Grenfell Tower NHS Mental Health Response
Professor Chris Moran, national clinical director for trauma, at NHS England.
The interviews reflect on key aspects of the responses by emergency, mental health, acute and community services, drawing out key issues for executive and non-executive healthcare leaders to consider.
The overarching message is simple: planning and rehearsal, multi-agency collaboration, and effective mental health support for both patients and staff are vital to providing the best possible care when tragedy strikes (Source: NHS Confederation).
Science Daily | June 2018 | Early birds less prone to depression
A study that tracked 32000 middle-aged to older female nurses in the US has found that those with a preference towards waking up early were less likely to experience depression.
At the outset none of the sample had depression, they were asked about their sleep- wake patterns (chronotype) , over a third of the sample (37 per cent) identified as early types, more than half (53 per cent) were intermediate types, and one-tenth perceived themselves to be evening types.
The study followed the nurses over a four-year period to observe how many developed depression. They discovered that the night owls had an increased likelihood of not being married, were likely to live alone and smoke, they were also more likely to have erratic sleep patterns. After allowance for these factors, the researchers discovered that the early risers had between a 12-27 per cent lower risk of depression than intermediate types. The evening types had a 6 per cent higher risk than intermediate types, but this was not thought to be statistically significant (Source: Science Daily).
The research findings have now been published in the Journal of Psychiatric Research
Prior cross-sectional studies have suggested that being a late chronotype is associated with depression and depressive symptoms, but prospective data are lacking.
We examined the association between chronotype and incident depression (defined as self-reported physician/clinician-diagnosed depression or antidepressant medication use) in 32,470 female participants of the Nurses’ Health Study II cohort who self-reported their chronotype (early, intermediate or late) and were free of depression at baseline in 2009 (average age: 55 yrs). Women updated their depression status on biennial questionnaires in 2011 and 2013. We used multivariable (MV)-adjusted Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals for incident depression across chronotype categories (i.e., early, intermediate, and late chronotypes).
Across a follow-up period of 4 years, we observed 2581 cases of incident depression in this cohort. Compared to intermediate chronotypes, early chronotypes had a modestly lower risk of depression after MV adjustment (MVHR = 0.88, 95%CI = 0.81–0.96), whereas late chronotypes had a similar risk of 1.06 ; the overall trend across chronotype categories was statistically significant (ptrend<0.01). Results were similar when we restricted analyses to women who reported average sleep durations (7–8 h/day) and no history of rotating night shift work at baseline.
Our results suggest that chronotype may influence the risk of depression in middle-to older-aged women. Additional studies are needed to confirm these findings and examine roles of both environmental and genetic factors to further our understanding of the role of chronotype in the etiology of mood disorders.
Vetter, Céline et al. 2018 |Prospective study of chronotype and incident depression among middle- and older-aged women in the nurses’ Health Study II | Journal of Psychiatric Research | Vol. 0 | Issue 0| DOI: https://doi.org/10.1016/j.jpsychires.2018.05.022
Rotherham NHS Library staff can request the article here
Public Health England | June 2018 | Children consume more than a year’s worth of sugar in 6 months
It may only be June, but according to figures released today by Public Health England (PHE), children in England have already consumed the equivalent of a year’s intake of sugar. PHE emphasises how children are on track to consume around 4,800 cubes of sugar by the end of the year, more than double the maximum recommendation (PHE).
Sugary soft drinks remain one of the main contributors of free sugars to children’s diets, more than ice cream and puddings combined.
The other sources of sugar in children’s diets are:
Sugary soft drinks (including squashes, juice drinks, energy drinks, cola and other fizzy drinks) 10%
Buns, cakes, pastries and fruit pies 10%
Sugars, including table sugar, preserves and sweet spreads 9%
Breakfast cereals 8%
Chocolate confectionery 7%
Sugar confectionery 7%
Yoghurt, fromage frais and other dairy desserts 6%
The King’s Fund | June 2018 | The role of cities in improving population health: international insights
A new publication from The King’s Fund argues that Metro mayors and other city leaders should be empowered to take greater responsibility for improving the health of the nation’s cities (The King’s Fund). Overview
Cities are playing a growing role in population health improvement and have enormous potential to be health-generating places. However, they also face considerable challenges and need to be governed in a way that gives all citizens the opportunity to enjoy good health.
Drawing on international case studies, this report explores the role of cities in improving population health and the conditions needed for success. It is based on 50 interviews with leaders from 14 cities and includes an extended case study on London that examines the lessons the city might learn from elsewhere.
The King’s Fund research found that although there is wide variation between cities in terms of governance arrangements, powers and resources, there are also some common themes. One is that improving population health depends on co-ordinated action at multiple levels and ensuring that decisions in areas such as housing, employment and transport planning all have a positive impact on health. This city-wide co-ordination requires effective leadership, robust governance, and adequate investment in central programme management.
The role of political leadership is also critical. Elected mayors and other city leaders have soft powers beyond their formal responsibilities that they can use to drive pro-health policies. Significant improvements in population health are possible when city leaders are willing to invest their own political capital to advocate for change.
In England, debate about the role of cities is closely connected with the devolution agenda, with new ‘metropolitan mayors’ now covering one‑fifth of the country’s population. Policy-makers should explore the case for giving cities further fiscal and regulatory freedoms to enable them to tackle population health challenges more effectively. (Source: The King’s Fund)
An accompanying press release from The King’s Fund is available here
The King’s Fund | June 2018 | Mind the gap: women and leadership in the NHS
The King’s Fund has released its latest podcast. This month the focus is on women and leadership in the NHS. Following the recent gender pay gap debate, and as part of The King’s Fund wider work on diversity, Helen McKenna talks about leadership and gender in the NHS with Jane Dacre, President of the Royal College of Physicians, Anne-Marie Archard, Director of the London Leadership Academy, Sam Jones, former Director of the New Care Models programme at NHS England, and Deborah Ward, Senior Analyst at The King’s Fund.
You can listen to the podcast via The King’s Fund here
NHS Confederation | June 2018| System under strain: Why demand pressures are more than a winter phenomenon
System under strain is a new report from NHS Confederation. It shows that increases in demand are not restricted to particular parts of the service and specific times of the year. It describes ways in which increasing demand in one part of the system can affect the performance of other NHS services elsewhere. It outlines how some NHS and social care providers have adapted their services to enable patients and service users to access care more efficiently.
Finally, it argues in support of a shift away from viewing performance solely as an organisational issue. It calls for regulators to support NHS and social care providers and commissioners in thinking more holistically about how the benefits of local provider and commissioner relationships can be maximised to meet soaring demand (NHS Confederation).
Young people and those with mental health problems experience a poorer than average inpatient experience, new data shows | Adult inpatient survey 2017 | Care Quality Commission | via OnMedica
The majority of people who stayed as an inpatient in hospital were happy with the care they received, had confidence in the doctors and nurses treating them and had a better overall experience, according to a national survey from the Care Quality Commission (CQC).
However, for a second year running, responses were less positive across most areas for patients with a mental health condition. Those with mental health conditions said they had less confidence and trust in hospital staff, thought they were treated with less respect and dignity and felt less informed about their care. These patients gave lower than average scores in relation to whether their needs, values and preferences were fully considered, and for the quality of the coordination and integration of their care.
The survey asked people to give their opinions on the care they received, including quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink and assist with personal hygiene, and on their discharge arrangements.
Science Daily | Mediterranean-style eating with lean, unprocessed red meat improves heart disease risk | June 2018
A new study that measured the impact of following a Mediterranean diet (n= 41) on participants, some of whom reduced their consumption of meat, reports that heart health can be improved irrespective of eating of whether the diet contained meat or not. Participants’ LDL cholesterol, used as a predictor in the development of cardiovascular disease, was noted to improve with typical intake of red meat. (Source: Science Daily).
A Mediterranean-style eating pattern (Mediterranean Pattern) is often described as being low in red meat. Research shows that lean, unprocessed red meat can be incorporated into healthy eating patterns to improve cardiometabolic disease (CMD) risk factors.
We assessed the effects of consuming different amounts of lean, unprocessed red meat in a Mediterranean Pattern on CMD risk factors. We hypothesized that consuming a Mediterranean Pattern would improve CMD risk factors and that red meat intake would not influence these improvements.
In an investigator-blinded, randomized, crossover, controlled feeding trial, 41 subjects [mean ± SD age: 46 ± 2 y; mean ± SD body mass index (kg/m2): 30.5 ± 0.6] were provided with a Mediterranean Pattern for two 5-wk interventions separated by 4 wk of self-selected eating. The Mediterranean Patterns contained ∼500 g [typical US intake (Med-Red)] and ∼200 g [commonly recommended intake in heart-healthy eating patterns (Med-Control)] of lean, unprocessed beef or pork per week. Red meat intake was compensated by poultry and other protein-rich foods. Baseline and postintervention outcomes included fasting blood pressure, serum lipids, lipoproteins, glucose, insulin, and ambulatory blood pressure. The presented results were adjusted for age, sex, and body mass at each time point (P < 0.05).
Total cholesterol decreased, but greater reductions occurred with Med-Red than with Med-Control (−0.4 ± 0.1 and −0.2 ±0.1 mmol/L, respectively, intervention × time = 0.045]. Low-density lipoprotein decreased with Med-Red but was unchanged with Med-Control [−0.3 ± 0.1 and −0.1 ± 0.1 mmol/L, respectively, intervention × time = 0.038], whereas high-density lipoprotein (HDL) concentrations decreased nondifferentially [−0.1 ± 0.0 mmol/L]. Triglycerides, total cholesterol:HDL, glucose, and insulin did not change with either Med-Red or Med-Control. All blood pressure parameters improved, except during sleep, independent of the red meat intake amount.
Adults who are overweight or moderately obese may improve multiple cardiometabolic disease risk factors by adopting a Mediterranean-style eating pattern with or without reductions in red meat intake when red meats are lean and unprocessed. This trial was registered at clinicaltrials.gov as NCT02573129.
O’Connor, L.E., Paddon-Jones, D., Wright, A. J., Campbell, W. A., | Mediterranean-style eating pattern with lean, unprocessed red meat has cardiometabolic benefits for adults who are overweight or obese in a randomized, crossover, controlled feeding trial | The American Journal of Clinical Nutrition| nqy075 | https://doi.org/10.1093/ajcn/nqy075