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Two weeks in primary care...News Roundup

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Mental Health

Recognising eating disorders in young men

Primary care health professionals were slow to recognise the symptoms of eating disorders in men, a study in BMJ Open has suggested. This could have been because of the misconception that they were womens' diseases, the study's subjects suggested. However, health professionals working in primary care are well placed to challenge the misconceptions and beliefs surrounding eating disorders and men, the authors said.

The young men interviewed for the study reported significant delays in diagnosis and referral. However, the authors concluded that clinicians in general practice have fewer opportunistic encounters with young men at which they could identify symptoms, and that raising awareness in society about eating disorders and men is also crucial to alleviating the situation.

The study can be found at www.bmjopen.bmj.com/content/4/4/e004342.full

Midwifery

Report reveals midwives under pressure

Thirty two per cent of midwives surveyed understood the recent NICE quality standard recommending all women be informed within 24 hours of birth about signs and symptoms of life-threatening conditions in them and their babies. A Royal College of Midwives (RCM) report has shown that 50 per cent said they were aware of, but had not had time to read, the NICE quality standard on postnatal care. Thirty six per cent of midwives surveyed said that they would like to do more for mothers and babies immediately after birth.

The report, 24 Hour Signs and Symptoms, conveyed the results of an RCM survey of 3171 midwives, student midwives and maternity support workers. The survey suggested that an increase in staffing levels would enable midwives to spend more time with women after birth, and also allow them to keep up to date with current guidelines. The report recommended that organisations providing maternity care must ensure 'protected time' for midwives to maintain their knowledge and keep it current.

Five recommendations were made in the report, which can be read at: www.rcm.org.uk/college/campaigns-events/pressurepoints/signsandsymptoms

The report is the second in a series of five that will be published this year by the RCM, as part of its campaign 'Pressure Points: the Case for Better Postnatal Care'.

Consultation

CQC seeks input on inspections

The views of primary care nurses are being sought by the Care Quality Commission (CQC) on how it will regulate, inspect and rate a range of services, including general practice, community health and homecare services.

The CQC has launched a consultation on a range of issues, including the questions it needs to ask, the frequency of inspections and the sources of information it uses to assess which services require inspection.

Detailed draft guidance was published on 10 April for the range of services the CQC inspects, including NHS, GP and out-of-hours services. Three overview documents have been introduced by the CQC's chief inspectors, which outline the prospective changes to the organisation's methods.

At an RCN summit in Birmingham, Steve Field, chief inspector of general practice at the CQC, spoke about creating a nursing post within the Commission to advise on inspections.

Speaking on the changes, secretary of state for health Jeremy Hunt said: 'A new, independent and rigorous inspection regime will give the public vital information on health and social care performance, and the chief inspectors will shine a light on areas where improvement is needed.'

The consultation and further details can be found at www.cqc.org.uk/public/consultation

Appointments

Dr Lisa Bayliss-Pratt, director of nursing at Health Education England, has been appointed an honorary visiting professor at the School of Health Sciences at City University London.

Dr Bayliss-Pratt said: 'I am delighted to be appointed honorary visiting professor and I am very much looking forward to working with everyone at City University, particularly the opportunity to work closely with students as they embark on what I hope will be rewarding and lifelong careers with the NHS.'

Professor Angela Tod has become the first Florence Nightingale Chair in clinical nursing practice research in the North West. She will work with the University of Manchester and Central Manchester University Hospitals NHS Foundation Trust.

Professor Tod, who is currently professor in health services research at Sheffield Hallam University, has many years' experience of clinical nursing practice and practice development.

Professor Tod said: 'It is a huge honour to be appointed to the Florence Nightingale Chair in clinical nursing practice research. Throughout my career, I have been committed to conducting research of applied use to patient care, nursing and healthcare organisations.'

Research Analysis

Tamiflu reviewed by the Cochrane Collaboration

The Cochrane Collaboration has reviewed the evidence surrounding the effectiveness of Tamiflu in preventing and treating influenza.

Tamiflu, an antiviral medication, has been stockpiled by the UK since the international bird flu outbreak in 2006. However, a review of the evidence has stated that it was only slightly effective at treating symptoms, and does not prevent spread of the flu or any complications. The analysis concluded that the drug reduced the longevity of flu symptoms from 7 to 6.3 days in adults and 5.8 days in children. However, the authors suggested that a similar result could be achieved by over-the-counter medicines, such as paracetamol. The report also stated that, despite claims that Tamiflu can prevent pneumonia, the medical trials showed 'no visible result'.

The Cochrane Collaboration's review also examined Tamiflu's side effects, said to include nausea and psychiatric events. Roche, the manufacturers of Tamiflu, conjectured that the analysis was statistically flawed.

Mental Health

Community care can save millions

The charity Rethink Mental Illness has released a report, stating that funding cuts to mental health care will cost the NHS millions of pounds over time. The report has asserted that, with fewer people having access to early intervention treatment, more cases are ending up in hospitals. With an average cost of £13 a day for community support, compared with £350 a day when a patient is in hospital, primary care has been shown to be more cost effective.

Health minister Norman Lamb said that early access to community care was 'often the best option' for those affected by mental health issues. The report can be found at www.rethink.org/media/1030280

Cardiovascular Health

Depression increases risk of heart disease

Risk of heart failure was 40 per cent higher in people suffering from moderate to severe depression, according to a new study.

The findings, which were produced from a survey of nearly 63,000 Norwegians, were presented for the first time at the 2014 EuroHeartCare conference earlier this month. The data was collected as part of an epidemiological study titled the Nord-Trondelag Health Study (HUNT), named after the Norwegian county.

Information was collected on body mass index, physical activity, smoking habits and blood pressure. Depression was assessed and ranked for severity using the Hospital Anxiety and Depression Scale. The researchers tracked which patients were hospitalised with heart failure or died from heart failure during the study period.

Lynda Blue, regional service development manager for the British Heart Foundation, said: 'This study is very relevant to nurses in the UK. Most of them are aware that depression is common in many patients but very few have access to psychology services across the UK.'

Lise Tuset Gustad, first author of the study, said: 'We found a dose response relationship between depressive symptoms and the risk of developing heart failure. That means that the more depressed you feel, the more you are at risk.'

Physical Health

Inactivity will lead to pressure on primary care

The All-Party Parliamentary Commission on Physical Health (APPCPH) has published a report suggesting that the UK population is less active than at any other time in history.

The report, titled Tackling Physical Inactivity - A Coordinated Approach, also states that inactivity will cost the UK approximately £20 billion annually. This projected cost will be generated by the expense of healthcare required by people who have developed chronic conditions linked to inactivity, such as heart disease and diabetes.

The report has provoked calls for initiatives to tackle the problem before it becomes unmanageable.

Speaking on the report's findings, prime minister David Cameron said: 'Physical activity is incredibly important to the wellbeing of children and adults, and can play a big part in helping people lead healthier lifestyles. That is why I have… asked Lord Coe to report back to me on raising the level of physical activity across Britain, as part of the Olympic and Paralympic legacy. I want everyone to look at what more can be done and this report will help inform that work.'

Support

QNI initiative targets nurses supporting carers

The Queens Nursing Institute (QNI) has received funding from the Department of Health(DH), to engage 300 community nurses to support carers.

Speaking on the initiative, carers project officer Jennie Whitford said: 'Although the project has been funded for one year only, it is hoped that it will be a conduit for future developments, with respective funding. '

The QNI carers project consists of two phases. The first concentrated solely on district nurses, while phase two will address the specific needs of practice and school nurses, so that QNI can aid nurses in developing skills to support carers across the country.

The project will develop and support a network of 'nurse champions' across the primary care sector. They will be the leads in their areas/regions, so that the workforce is appropriately trained. To support this work, an advisory group, will be set up, to help to steer the implementation of the project.

The project is also intended to expand its programme of skill development for carers and nurses, including setting up training events and seminars. Last year, the DH provided funding to set up online resources for district, as part of phase one. This new funding will allow the expansion of the resources to include content specifically aimed at practice and school nurses.

World News

Ebola

The number of people killed by the Ebola virus in Guinea, West Africa, has passed 100, according to the World Health Organization (WHO).

The virus has now killed 101 people in Guinea and 10 in Liberia. The first outbreak was reported in Southern Guinea in March.

The WHO said that this is the most challenging Ebola outbreak it has ever dealt with and that it could take another four months to contain.

The key to containment is to prevent additional new infections including those in health workers, the WHO stressed. Health workers are often among the victims in the early stage of an outbreak because they come into direct contact with infected people.

Vector-borne disease

This year's World Health Day, which took place on 7 April, focused on preventing vector-borne diseases.

These include malaria, dengue fever, leishmaniasis, Lyme disease(a growing problem in the UK) and yellow fever, carried by mosquitoes, flies, ticks, water snails and other vectors.

These diseases affect the poorest populations. Malnourished people and those with weakened immunity are especially susceptible.

The WHO emphasised that these diseases are entirely preventable and has published a brief that outlines steps which governments, community groups and families can take to protect people from infection.

The brief can be found at www.who.int/mediacentre/news/releases/2014/small-bite-big-threat

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