Tools for GPs can help reduce unnecessary antibiotic prescribing
This NIHR Signal is provided for a review of 53 qualitative studies which found that GPs were most likely to accept interventions if perceived as supportive aids. Interventions need to be flexible so that they can be adjusted according to circumstances and priorities. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - November 1, 2018 Category: Consumer Health News Source Type: news

Managing common infections: guidance for primary care
This guidance for managing common infections, including upper and lower respiratory, and urinary tract infections was updated in October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - November 1, 2018 Category: Consumer Health News Source Type: news

Urinary tract infection in under 16s diagnosis and management: Clinical guideline [CG54]
This guideline covers diagnosing and managing first or recurrent upper or lower urinary tract infections in infants, children and young people. It aims to achieve more consistent clinical practice, based on accurate diagnosis and effective management. It was updated in October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - November 1, 2018 Category: Consumer Health News Source Type: news

Urinary tract infection (recurrent): antimicrobial prescribing: NICE guideline [NG112]
This guideline sets out an antimicrobial prescribing strategy for preventing recurrent urinary tract infections in children, young people and adults who do not have a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance. It was published in October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Pyelonephritis (acute): antimicrobial prescribing: NICE guideline [NG111
This guideline sets out an antimicrobial prescribing strategy for acute pyelonephritis (upper urinary tract infection) in children, young people and adults who do not have a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance. It was published in October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Prostatitis (acute): antimicrobial prescribing:NICE guideline [NG110]
This guideline sets out an antimicrobial prescribing strategy for acute prostatitis. It aims to optimise antibiotic use and reduce antibiotic resistance. It was published in October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Urinary tract infection (lower): antimicrobial prescribing: NICE Guideline [NG109]
This guideline sets out an antimicrobial prescribing strategy for lower urinary tract infection (also called cystitis) in children, young people and adults who do not have a catheter. It aims to optimise antibiotic use and reduce antibiotic resistance. It was published in October 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Progress in Kidney Cancer Outcomes Through Collaboration, Innovation, and Discovery
In this Special Series, kidney cancer (KC) experts describe how recent advances can be integrated into clinical management strategies and focus on important future priorities, including understanding mechanisms by which KC develops and becomes resistant to standard therapies. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Clostridium difficile associated disease
This review notes clinical manifestations usually occur on days 4 to 9 of antibiotic (AB) treatment, but may occur up to 8 weeks after discontinuation of ABs. Treatment is started with oral vancomycin or fidaxomicin. It is estimated 5-50% of treated patients have recurrence. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Cefiderocol versus imipenem-cilastatin for the treatment of complicated urinary tract infections caused by Gram-negative uropathogens: a phase 2, randomised, double-blind, non-inferiority trial
This study found cefiderocol was non-inferior to imipenem-cilastatin for the primary endpoint (composite of clinical and microbiological outcomes 7 days after treatment cessation; 73% vs 55%, respectively; adjusted treatment difference 18.58%, 95% CI 8.23-28.92; p=0.0004) (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

The 2018 Surviving Sepsis Campaign's Treatment Bundle: When Guidelines Outpace the Evidence Supporting Their Use
This journal article concludes that although well intentioned, the current sepsis bundles and the potential penalties associated with noncompliance lay a heavy weight on ED care absent evidence that a net benefit will follow. The proposed Surviving Sepsis Campaign abbreviated bundle heightens the burden by further restricting the time allotted for the identification and treatment of patients with suspected sepsis, all without any evidence of benefit or knowledge of the logistic consequences or cost. A more thoughtful approach to both the identification and management of patients with sepsis is needed, one that engages all ...
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Diverticulitis
This review notes the mainstay role of oral antibiotics for outpatient management has been challenged; rifaximin and mesalamine have been proposed as possible agents to reduce recurrence but available data do not suggest a substantive benefit. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Overdiagnosis of Penicillin Allergy Leads to Costly, Inappropriate Treatment
This journal article notes ~10% US residents have been labelled as allergic to penicillin, often since childhood, yet, a growing body of evidence suggests that as few as 10% of people who report they're allergic to the antibiotic really are. It discusses risks of being incorrectly labelled. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Flu vaccination programme in England
This report sets out findings relating to the flu vaccination programme in 2017/18; vaccine uptake; vaccine procurement and provision; and future development in flu vaccination. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Boosting confidence after breast cancer in Salisbury
This case study illustrates how cancer survivors in Salisbury feel more confident and less fatigued after enhanced support to live better after cancer. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 31, 2018 Category: Consumer Health News Source Type: news

Changes in health in the countries of the UK and 150 English Local Authority areas 19902016: a systematic analysis for the Global Burden of Disease Study 2016
Leading causes of age-adjusted years of life lost(YLL) in 2016 were ischaemic heart disease, lung cancers, cerebrovascular disease and COPD. Age-standardised rates of YLLs for all causes varied 2-fold between local areas in England according to levels of socioeconomic deprivation (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 30, 2018 Category: Consumer Health News Source Type: news

End of life care: strengthening choice
This is the report of an inquiry into the extent to which the government is meeting its end of life care choice commitment for babies, children and young people. The inquiry identified a number of challenges and makes recommendations which need to be met if the government is to meet its end of life care choice commitment by 2020. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 30, 2018 Category: Consumer Health News Source Type: news

Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial
This research article found the use of chlorhexidine mouthwash, selective oropharyngeal decontamination or selective digestive tract decontamination was not linked to reductions in ICU-acquired bloodstream infections caused by multidrug-resistant gram-negative bacteria vs. standard care. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 24, 2018 Category: Consumer Health News Source Type: news

Antimicrobial resistance: Eleventh Report of Session 201719
This report highlights that given the severity of the threat, antimicrobial resistance needs to be firmly established as a'top five policy priority'for the Government as a whole, and a dedicated budget should be made available to enable work in this area to make more rapid progress. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 24, 2018 Category: Consumer Health News Source Type: news

Keep Antibiotics Working campaign returns
This press release outlines the campaign, which educates the public about the risks of antibiotic (AB) resistance, urging people to always take healthcare professionals'advice as to when they need ABs. The campaign also provides effective self-care advice to help individuals/their families feel better if they are not prescribed ABs. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 24, 2018 Category: Consumer Health News Source Type: news

English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) Report 2018
This report includes national data on antibiotic prescribing and resistance, antimicrobial stewardship implementation, education and engagement activities. It notes total numbers of antibiotic resistant bloodstream infections has increased by 35% since 2013. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 24, 2018 Category: Consumer Health News Source Type: news

Doomed to repeat? Lessons from the history of NHS reform
Since 2000 the NHS has seen at least 6 major national plans, accompanied by at least 10 reorganisations at various levels. This essay collection brings together research and analysis of the key questions that should inform the new long-term plan for the health service. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 23, 2018 Category: Consumer Health News Source Type: news

Talking about dying: How to begin honest conversations about what lies ahead
This report explores the reasons healthcare professionals find it hard to talk to patients about dying, and offers solutions and resources to help. It includes good practice case studies from four English hospitals leading the way in supporting end-of-life care conversations. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 23, 2018 Category: Consumer Health News Source Type: news

Tackling the causes: Promoting public mental health and investing in prevention
This briefing explores the social determinants of mental health and the relationship between physical and mental health, investigates what is being invested in public mental health across the UK, and makes recommendations for improving public mental health (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

Evaluating implementation of the WHO set of recommendations on the marketing of foods and non-alcoholic beverages to children
The report finds that many existing policies and regulations aimed at tackling food marketing to children are markedly insufficient. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

Sustainability and transformation partnerships in London: An independent review
This report was commissioned by the Mayor of London to identify key developments in London's STPs; explore progress made in the priority areas; highlight examples of integrated working and identify challenges and barriers to progress; and make practical suggestions for addressing these challenges and how integration can be taken forward. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

A Crying Shame
This report looks at how many babies may be vulnerable to death and serious injuries and presents the facts about the sort of risks very young children are being exposed to. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

A connected society: a strategy for tackling loneliness laying the foundations for change
This strategy sets out the government's approach to tackling loneliness in England. It builds on years of work brought together by the Jo Cox Commission on Loneliness. It sets out government's long-term ambitions to work with others to build a more cohesive and connected society. Alongside this, it includes a number of initial commitments that benefit both wider society and people at specific trigger points when they are at greater risk of loneliness (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

An overview of reviews: the effectiveness of interventions to address loneliness at all stages of the life-course
This review is the first of its kind to establish what we know about loneliness and effective ways to tackle it. It reviews the findings of 14 studies, revealing big gaps in the current evidence base, and makes suggestions for policy making in this area. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

" Just one thing after another " : living with multiple conditions
This report shares learnings from ten in-depth interviews with people living with multiple long-term conditions from a wide range of demographics and locations across England. It showcases their everyday experiences and their own perceptions of their quality of life as well as the changes they'd like to see. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

Housing and ageing: linking strategy to future delivery for Scotland, Wales and England 2030
This report calls for a Commissioner for Ageing in England and Scotland to encourage service integration that enables people to age in the right place. It also finds that the UK housing sector is still not ready for ageing, but that there is evidence of real support and political buy-in for ongoing and future solutions. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 22, 2018 Category: Consumer Health News Source Type: news

Assessment of clinical outcome of children with sepsis outside the intensive care unit
In this study, the authors sought to assess the qSOFA score for children with sepsis, who are being treated outside the pediatric intensive care units. The qSOFA score showed a low accuracy to identify children in the pediatric ward at risk for severe sepsis. Clinical tools are needed to facilitate the diagnosis of impending organ dysfunction in pediatric infection outside of the ICU. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Sepsis Core Measures Are They Worth the Cost?
In 2015, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission launched the sepsis core measures in an attempt to decrease sepsis morbidity and mortality. Recent studies call into question the multiple treatment measures in early goal-directed therapy on which these CMS measures are based. There was no difference in the mortality rate of patients with a final diagnosis of sepsis. However, there was a significant increase in the utilization of resources to care for these patients. As a result of the overutilization of these resources, the cost for both patients and hospitals has increased without imp...
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Symmetrical (SDMA) and asymmetrical dimethylarginine (ADMA) in sepsis: high plasma levels as combined risk markers for sepsis survival
The aim of this study was to determine whether plasma concentrations of SDMA and ADMA are markers for sepsis survival. Increased plasma concentrations of SDMA and ADMA are associated with sepsis severity. The findings suggest reduced NO bioavailability in non-survivors of sepsis. The authors state that one may use individual SDMA and ADMA levels to identify patients at risk. In view of the pathophysiological role of NO they conclude that the vascular system and immune response are most severely affected when SDMA and ADMA levels are high. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

P(v-a)CO2/C(a-v)O2-directed resuscitation does not improve prognosis compared with SvO2 in severe sepsis and septic shock: A prospective multicenter randomized controlled clinical study
This study examined the value of P(v-a)CO2/C(a-v)O2 compared with ScvO2 as a target for clinical resuscitation of severe sepsis/septic shock. P(v-a)CO2/C(a-v)O2-directed resuscitation did not improve prognosis compared with ScvO2 in severe sepsis and septic shock. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Association of Neighborhood Socioeconomic Status With Risk of Infection and Sepsis
This study sought to examine the association between neighborhood socioeconomic status (nSES) and hospitalization for infection and sepsis. It showed that differential infection risk may explain nSES disparities in sepsis incidence, as higher nSES is associated with lower infection hospitalization rates, but there is no association was found with sepsis among those hospitalized. Mediation analysis showed that nSES may influence infection hospitalization risk at least partially through physical weakness, individual income, and comorbid diabetes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Evaluation of Repeated Quick Sepsis-Related Organ Failure Assessment Measurements Among Patients With Suspected Infection.
Among patients with suspected infection, a single measurement of the quick Sepsis-related Organ Failure Assessment has good predictive validity for sepsis, yet the increase in validity from repeated measurements is unknown. The authors of this research paper sought to determine the incremental predictive validity for sepsis of repeated quick Sepsis-related Organ Failure Assessment measurements over 48 hours compared with the initial measurement. Repeated measurements of quick Sepsis-related Organ Failure Assessment improve predictive validity for sepsis using in-hospital mortality compared with a single measurement of quic...
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Not all organ dysfunctions are created equal Prevalence and mortality in sepsis
The objective of this study is to quantify the impact of organ dysfunction on in-hospital mortality in infected population. There exist differences in measures of organ dysfunction occurrence and their association with mortality. These findings support increased clinical efforts to identify sepsis patients to inform diagnostic decisions. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Antibiotics has more impact on mortality than other early goal-directed therapy components in patients with sepsis: An instrumental variable analysis
This study estimates the effect of each of the EGDT components, as well as of the antibiotics, on length-of-stay and mortality. Among patients entering ER with infection and shock or hypoperfusion criteria, the use of appropriate antibiotics in the first 3 h is the measure that has the greatest impact on survival. In addition, among patients with hyperlactatemia>4 mmol/L, the clearance of>10% of lactate during resuscitation is associated with better outcomes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Derivation of a screen to identify severe sepsis and septic shock in the Emergency Department-BOMBARD vs. SIRS and qSOFA
This study looks to predict severe sepsis/septic shock in ED patients. The authors conducted a retrospective case-control study of patients ≥18 admitted to two urban hospitals with a combined ED census of 162,000. Study cases included patients with severe sepsis/septic shock admitted via the ED. Controls comprised admissions without severe sepsis/septic shock. Using multivariate logistic regression, a prediction rule was const ructed - BOMBARD. The model's AUROC was internally validated using 1000 bootstrap samples. BOMBARD was more accurate than SIRS and qSOFA at predicting severe sepsis/septic shock and sepsis mortali...
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Smartphone-based pathogen diagnosis in urinary sepsis patients
There is an urgent need for rapid, sensitive, and affordable diagnostics for microbial infections at the point-of-care. Although a number of innovative systems have been reported that transform mobile phones into potential diagnostic tools, the translational challenge to clinical diagnostics remains a significant hurdle to overcome. A smartphone-based real-time loop-mediated isothermal amplification (smaRT-LAMP) system was developed for pathogen ID in urinary sepsis patients. The free, custom-built mobile phone app allows the phone to serve as a stand-alone device for quantitative diagnostics, allowing the determination of...
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Raising Awareness for Sepsis, Sepsis Screening, Early Recognition, and Treatment in the Emergency Department
This journal article outlines how early recognition and initiation of treatment is vital to patient outcomes and survival from sepsis. The authors state that sepsis screening in triage should be completed by nurses on all patients with suspected infection. Initiation of sepsis protocol and/or standing orders for positive sepsis screens should be implemented. Education of staff, patients, and families should be done regarding signs and symptoms of sepsis, severe sepsis, and severe sepsis with shock; raise awareness. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

The global burden of sepsis: barriers and potential solutions
This journal article states that the majority of sepsis cases and deaths are estimated to occur in low and middle-income countries. The authors say barriers to reducing the global burden of sepsis include difficulty quantifying attributable morbidity and mortality, low awareness, poverty and health inequity, and under-resourced and low-resilience public health and acute health care delivery systems. Important differences in the populations at risk, infecting pathogens, and clinical capacity to manage sepsis in high and low-resource settings necessitate context-specific approaches to this significant problem. The paper revi...
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Tuberculosis susceptibility and protection in children
This article discusses the risk of exposure and infection with tuberculosis and the protection provided by childhood vaccination. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Lyme disease: NICE guideline [NG95]
This guideline covers diagnosing and managing Lyme disease. It aims to raise awareness of when Lyme disease should be suspected and ensure that people have prompt and consistent diagnosis and treatment. It does not cover preventing Lyme disease. The guideline was updated in October 2018. Treatment for Lyme carditis in haemodynamically unstable children aged 9-12 was changed to IV ceftriaxone. First alternative was changed to oral doxycycline (DX). Footnote was added on using clinical judgement to determine doses of DX in children (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 19, 2018 Category: Consumer Health News Source Type: news

Quick Guide: the role of allied health professionals in supporting people to live well with and beyond cancer
This online resource is one of a series providing practical advice and case studies to support Allied Health Professionals (AHPs) into Action. This quick guide will support health and care staff who share an interest in making faster progress in improving outcomes for people living with or beyond cancer. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 18, 2018 Category: Consumer Health News Source Type: news

Analysis of the clinical antibacterial and antituberculosis pipeline
The Current clinical pipeline contains 30 new antibacterials with activity against priority pathogens and is dominated by derivatives of established classes. New antibacterials to address problem of extensively or even pan-drug resistant Gram-negative bacteria are under-represented. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 18, 2018 Category: Consumer Health News Source Type: news

Sustainability and transformation partnerships in London
Key messages from this report include the fact that STPs need to build on previous work and demonstrate how they can make a positive impact on issues that require action on a larger scale. They also need to communicate more effectively the contributions they are making (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 18, 2018 Category: Consumer Health News Source Type: news

NHS Funding: Clinical Commissioning Groups
This paper and accompanying Excel file gives details of funding allocations for each CCG in England from 2013/14 to 2020/21. Paper also gives details of the process used to allocate the funds. In 2018/19 NHS England distributed a total of £ 74.2 billion across 195 CCGs in England. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 18, 2018 Category: Consumer Health News Source Type: news

Child health in England in 2030: comparisons with other wealthy countries
Report warns that health of children in England will continue to fall behind other European countries if current trends continue. Key infant mortality risk factors included higher proportion of young mothers, higher rates of smoking during pregnancy, and lower breastfeeding rates (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - October 18, 2018 Category: Consumer Health News Source Type: news