UNICEF reports over 20 million children worldwide missed out on measles vaccine annually in past 8 years creating a pathway to current global outbreaks
It is estimated 169m children missed out on 1st dose between 2010 and 2017. US tops list of high-income countries with most children not receiving 1st dose, at>2.5m followed by France and UK with over 600,000 and 500,000 unvaccinated infants, respectively, during same period. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

The UK's pandemic influenza research portfolio: a model for future research on emerging infections
In this Personal View, the authors describe the projects that were set up, the challenges of putting these projects into a maintenance-only state, and ongoing activities to maintain readiness for activation, and discuss how to plan research for a range of major incidents. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

Antimicrobial use in UK long-term care facilities: results of a point prevalence survey
Analysis of data on 17,909 residents in UK from point prevalence survey conducted by community pharmacists (CPHs) noted high prophylactic use of antibiotics [ABs; 25.3%). Pharmacists intervened for 9.5% of AB prescription events; 53.4% of interventions were for clinical reasons. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

Duration and life-stage of antibiotic use and risk of cardiovascular events in women
Analysis of 36,429 women initially free of CVD and cancer from Nurses'Health Study found long-term use of antibiotics ( ≥2 months) in late adulthood was linked to significantly increased CVD risk (HR 1.32, 95% CI 1.03–1.70) vs. women who did not use antibiotics in this life-stage. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

Treating asymptomatic MRSA on discharge from hospital reduces risk of later infection
This study suggests that patients who test positive for MRSA in hospital should be treated after discharge, even if they show no symptoms, in order to reduce the risk of later MRSA infection. Decolonisation treatment is most effective when patients follow the regimen exactly. However, the intensive programme of daily products, and the length of the treatment, may make it difficult for patients to stick to when in their own homes, without medical supervision. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

No time to wait: securing the future from drug-resistant infections
This report demands immediate, co-ordinated and ambitious action to avert a potentially disastrous drug-resistance crisis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

4 in 5 parents concerned about children's exposure to pornography
This report explores the use of technology in the home to manage concerns around online safety and interactions around digital technology use. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 7, 2019 Category: Consumer Health News Source Type: news

Exploring emotions and relationships with young people with SEND
Exploring emotions, relationships and identify with 11 - 25 year olds with learning disabilities (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 2, 2019 Category: Consumer Health News Source Type: news

Fixing the care crisis
This report proposes adopting a “state pension model” by introducing a new Universal Care Entitlement, which guarantees everyone a decent standard of care. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - May 1, 2019 Category: Consumer Health News Source Type: news

Children's Future Food Inquiry
This is the final report of the Children's Future Food Inquiry, a 12-month project that has sought to bring together the views of children and young people living in poverty across the UK as well as those of frontline staff, academics and experts. It includes the Children's #Right2Food Charter, which calls for a new, independent Children's Food Watchdog to lead on tackling children's food insecurity in the UK (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 30, 2019 Category: Consumer Health News Source Type: news

Interventions to improve mental wellbeing and resilience in children and young people living in poverty: an Evidence Synthesis
This evidence-synthesis report aims to investigate the effectiveness of family- and community-based interventions in promoting mental wellbeing and resilience in children and young people (CYP) aged 7-18 years living in poverty. This rapid review was produced by the Risk Factors Intelligence's Evidence Synthesis Team. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 30, 2019 Category: Consumer Health News Source Type: news

Effectiveness of community-based interventions to enable people with long-term conditions and/or frailty to participate in activities of daily living: an Evidence Synthesis report
The aim of this evidence synthesis report is to determine whether community-based interventions enable people living with long-term conditions and/or frailty, to participate in activities of daily living (ADLs) or daily self-care. ADLs refer to the essential activities that an individual is required to perform to live independently, such as bathing, feeding, toileting, dressing, grooming /personal hygiene and functional mobility/transferring. ADLs differ from IADLs (Instrumental ADLs) which refer to extended tasks such as meal preparation, using public transportation, doing household chores and managing finances and medica...
Source: Current Awareness Service for Health (CASH) - April 30, 2019 Category: Consumer Health News Source Type: news

Strengthening the frontline: investing in primary care for effective suicide prevention
This report reviews the evidence about what GPs and their colleagues could do to help save lives among people with suicidal feelings. It identifies five areas for improvement including the provision of ongoing training for GPs; investment to enable longer appointments and continuity of care for patients; provision of emotional support for GPs; effective care pathways between services; and easy access to further support. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 29, 2019 Category: Consumer Health News Source Type: news

Did government spending cuts to social care for older people lead to an increase in emergency hospital admissions? An ecological study, England 20052016
This study reports no significant relationship between changes in government spend on social care for older people& emergency hospital admissions (incidence rate ratio 1.009, 95% CI 0.965 to 1.056). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 29, 2019 Category: Consumer Health News Source Type: news

Local authority spending on homelessness: understanding recent trends and their impact
According to this report, nine years of government cuts have left local services for single homeless people with a shocking £ 1bn a year funding gap. It warns that cuts to council budgets are leaving increasing numbers of people at risk on the streets, and calls on the government to act now to make up the funding shortfall – or inevitably face missing its target of ending rough sleeping by 2027 (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

Taking down junk food ads: how local areas are taking action on outdoor advertising
This report aims to illustrate that local authorities have little power to restrict the advertising of food and drink high in fat, sugar and salt – despite the fact that many areas are struggling with high levels of childhood overweight and obesity. The report makes nine recommendations, including local government being given more power to impose restrictions and tightening restrictions on in-store advertising (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

Building better: the role of transport infrastructure and services in improving mental health
According to this report, mental illness is costing the country £ 66.5 billion every year and better transport journeys can help. The report uses NHS Digital data to assess the prevalence and cost of mental health disorders in different English regions and finds that improving the way people travel and their experience at rail stations, airports and on roads, could play a significant role in improving their mental wellbeing (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

Recognition and treatment of depression in older adults admitted to acute hospitals in England
Retrospective analysis of records of 766 older adults admitted to 27 acute hospitals in England show levels of depression (DP) recorded in clinical notes are lower (13%) than expected given high prevalence of this condition, suggesting under-recognition of DP in this population. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

Improving Staff Retention: A Guide For Employers
The guide includes the latest learning around staff retention and includes good practice examples from work undertaken during 2018/19. The guide covers the key topics affecting retention, including: understanding data, supporting new starters, flexible working, building line manager capability and capacity, staff engagement, and development and career planning. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

NIHR Signal: Getting hospital patients up and moving shortens stay and improves fitness
Expert commentary is provided of review (13 trials;n=2703 older adults;medical admission) which found significant improvements in walking speed among those taking part in programmes to encourage mobilisation, compared with patients who did not. Length of stay was ~ 2 days shorter (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

WHO Guideline: recommendations on digital interventions for health system strengthening
The key aim of this guideline is to present recommendations based on a critical evaluation of the evidence on emerging digital health interventions that are contributing to health system improvements, based on an assessment of the benefits, harms, acceptability, feasibility, resource use and equity considerations (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

What does the NHS England review of waiting times mean for accident and emergency departments?
This'long read'weighs up the impact of the four-hour target and outlines seven key issues for the new standards that have been proposed for emergency departments. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 26, 2019 Category: Consumer Health News Source Type: news

DTB Select: Comparison of antibiotics for Clostridium difficile infection
Synopsis and clinical commentary is provided for a meta-analysis of 24 RCTs (n=5,631) that compared 13 drug treatments for Clostridium difficile which found that fidaxomicin was the most effective treatment in providing a long-term cure. Metronidazole was ranked 11th. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Switching to oral antibiotics early for bone and joint infections gave similar results to continuing intravenous therapy
This research provides good evidence that bone and joint infections can be treated with predominantly oral regimens. This could have several benefits, not least the greater freedom afforded to patients and reduced costs.The importance of taking the medication and potential treatment side effects need to be explained so that patients can seek medical support to modify the treatment when necessary. Also, staff perceptions surrounding the effectiveness of oral antibiotics for this indication also need to be addressed to enable a shift in practice. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Implementation, impact and costs of policies for safe staffing in acute NHS trusts
Analysis of national workforce data undertaken by the study team shows whilst the total number of nursing staff in acute care has increased since the 2013 inquiry, concurrent growth in the number of patient admissions has meant that there has been no net improvement on RN staffing levels.Summary and full report are available to download from the bottom of the page. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Workforce Stress and the Supportive Organisation: A framework for improvement through reflection, curiosity and change.
The framework encourages employers to take a closer look at the systems they currently have in place for managing staff wellbeing, challenges them to give greater consideration to the impact workforce stress has on staff and look at the role they can play in providing better support to staff who may need it. It also gives further weight to the 2 External 0 0 0 Mental Health and Wellbeing Commission false https://www.hee.nhs.uk/our-work/mental-wellbeing-report true false%> and its recommendations that employers need to take steps to support staff in building resilience but is a separate initiative to give further guidanc...
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Averting the antimicrobial resistance crisis: what are the avenues for policy action for countries in Europe?
This policy briefing summarises some of the key policy avenues for tackling antimicrobial resistance (AMR). Following the widely accepted'One Health'approach to combating AMR, the brief aims to support the implementation of national action plans on AMR, drawing on numerous examples of effective policies implemented by European Union member states and involving the human, animal and environmental health sectors. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

People performance management toolkit
The people performance management toolkit encourages NHS managers to make time to talk about all aspects of performance with staff. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

A global scientific strategy to cure hepatitis B
This position paper identifies gaps in current knowledge and new strategies and tools that will be required to achieve hepatitis B virus (HBV) cure. The research outlined in the paper aims to contribute markedly to the goal of eliminating HBV infection worldwide. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Fecal Microbiota Transplantation Is Superior to Fidaxomicin for Treatment of Recurrent Clostridium difficile Infection
RCT (n=64) reports superior clinical& microbiological resolution of infection in 17 FMT patients (71%) vs 8 fidaxomicin patients (33%) and 3 vancomycin patients (19%); P = 0.009 for FMTv vs fidaxomicin; P = 0.001 for FMTv vs vancomycin and P = 0.31 for fidaxomicin vs vancomycin. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Researchers warn antibiotic over-the-counter (OTC) treatments for sore throat could be fuelling antimicrobial resistance
Researchers found that some OTC antibiotics used in sore throat preparations are not sufficiently concentrated to prevent growth of common human pathogens but are enabling these pathogens to develop resistance. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Chlorhexidine for meatal cleaning in reducing catheter-associated urinary tract infections: a multicentre stepped-wedge randomised controlled trial
RCT (n=1642) found cleaning external urethral orifice with chlorhexidine before catheter (CT) insertion (vs. normal saline) decreased incidence of CT linked asymptomatic bacteriuria (incident rate ratio 0 · 26; 95% CI 0 · 08 –0 · 86, p=0 · 026), and UTI (0 · 06; 95% CI 0 · 01 –0 · 32, p=0 · 0008 (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

New patient decision aid to encourage use of more environmentally friendly asthma inhalers
A 2 External 0 0 0 new patient decision aid false https://www.nice.org.uk/guidance/ng80/resources true false%>, released today, highlights that some inhalers have a much higher carbon footprint than others. The aid will help people with asthma, alongside health professionals, to identify which inhalers could meet their needs and control their symptoms. Download decision aid from: https://www.nice.org.uk/guidance/ng80/resources (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Hepatitis B virus infection in children and adolescents
This Series paper summarises knowledge on epidemiology, natural history, and treatment, and highlights key differences from infection acquired in adulthood. It discusses treatment options entecavir and tenofovir, recommending conservative approach to treatment initiation. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Hepatitis C virus infection in children and adolescents
This Series paper summarises knowledge on epidemiology, natural history, and treatment, and highlights key differences from infection acquired in adulthood. It discusses treatment with sofosbuvir with ledipasvir and with ribavirin, and glecaprevir with pibrentasvir. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

New tools to help health professionals boost prevention impact
Public Health England (PHE) has launched a series of new e-learning tools to boost health and care professionals'knowledge and skills in dealing with some of the biggest issues in public health. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

AstraZeneca research finds lack of good lung cancer information available for patients
Analysis of 885 websites found 65% of sources provided info on differences between non-small cell and small cell lung cancer, but only 29% explained disease staging. Info on treatment, when available, was found to be often either too complex or too high-level and incomplete. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

WHO provisional data show measles cases rose nearly four-fold in first quarter 2019
Number of measles cases worldwide nearly quadrupled in first quarter of 2019 to 112,163 against same period last year. Higher numbers have been recorded in all regions, with spikes in case numbers also occurring in countries with high overall vaccination coverage, including US. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

E. coli bacteraemia: monthly data by NHS acute trust
Monthly counts of Escherichia coli (E. coli) bacteraemia by NHS acute trust. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Advances in Cancer Treatment
This document provides an overview of recent advances in cancer treatment, the potential benefits and risks, and considers the opportunities and challenges to using new technologies in the NHS. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Paths into Sepsis: Trajectories of Presepsis Healthcare Use
In national cohorts of patients with sepsis, we have shown that several distinct paths into sepsis exist. These paths, identified by trajectories of presepsis healthcare use, are predictive of 90-day mortality. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Diagnosis Sepsis: Is Newer Better?
In hospitalized patients who deteriorated from suspected infection, Sepsis-3 septic shock criteria predicted in-hospital mortality better than systemic inflammatory response syndrome-based criteria. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Are Sepsis Outcomes Predetermined? How the Road toward Sepsis May Predict Outcomes
[...]recent usage patterns may enhance prognostic capabilities in this vulnerable population. [...]the authors'use of latent profile analysis correctly categorized 99.9% of subjects in the data sets with greater than 95% certainty. [...]the findings were robust not only across three separate cohorts but also across a variety of sensitivity analyses. In their work, Prescott and colleagues have identified that sepsis outcomes vary not solely as a result of differences in sociodemographics or pathobiology, but also as a result of a patient's overall health before the development of sepsis (6). [...]a patient's risk for a poor...
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Cortisol and adrenal androgens as independent predictors of mortality in septic patients
We look to determine the prognostic value of cortisol, Dehydroepiandrosterone (DHEA) and Dehydroepiandrosterone-sulfate (DHEAS), together with their ratios (cortisol/DHEA and cortisol/DHEAS), as independent predictors of mortality in septic patients. Basal cortisol measured within the first 24 hours of the septic process was the best prognostic factor for in-hospital and 28-day mortality, even superior to the Sequential Organ Failure Assessment (SOFA) or Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. The cortisol/DHEAS ratio was an independent predictor of long-term mortality. (Source: Current Awaren...
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Targeting Complement Pathways in Polytrauma- and Sepsis-Induced Multiple-Organ
Exposure to traumatic or infectious insults results in a rapid activation of the complement cascade as major fluid defense system of innate immunity. The complement system acts as a master alarm system during the molecular danger response after trauma and significantly contributes to the clearance of DAMPs and PAMPs. However, depending on the origin and extent of the damaged macro- and micro -milieu, the complement system can also be either excessively activated or inhibited. In both cases, this can lead to a maladaptive immune response and subsequent multiple cellular and organ dysfunction. The arsenal of complement-speci...
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Open abdominal management for perforative peritonitis with septic shock: a retrospective analysis on usefulness of a standardized treatment protocol
Damage control surgery (DCS) with open abdominal management (OAM) has been increasingly expanded to include critically ill non-trauma patients. However, there is limited data regarding the usefulness of this protocol for the treatment of severe perforative peritonitis (PP), especially with septic shock (SS). Here, we retrospectively evaluated the usefulness of our OAM protocol for PP with SS. A standardized protocol for OAM may improve the outcomes of patients with SS due to PP. This damage control approach can be applied for the treatment of severe abdominal sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Bolus therapy with 3% hypertonic saline or 0.9% saline in emergency department patients with suspected sepsis: A pilot randomised controlled trial
The objective of this pilot randomised controlled trial was to measure the effect of hypertonic saline, compared to isotonic saline, on biomarkers of EG shedding and inflammation in emergency department patients with suspected sepsis. Although a single bolus of hypertonic saline increased serum osmolality, it did not reduce biomarkers of EG shedding or inflammation, compared to patients that received isotonic saline. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Association of septic shock definitions and standardized mortality ratio in a contemporary cohort of critically ill patients
The newly proposed septic shock definition has provoked a substantial controversy in the emergency and critical care communities. We aim to compare new (SEPSIS-III) versus old (SEPSIS-II) definitions for septic shock in a contemporary cohort of critically ill patients. Compared to SEPSIS-II, SEPSIS-III definition of septic shock identifies patients further along disease trajectory with higher likelihood of poor outcome. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Crystalloids vs. colloids for fluid resuscitation in the Intensive Care Unit: A systematic review and meta-analysis
Guidelines recommend crystalloids for fluid resuscitation in sepsis/shock and switching to albumin in cases where crystalloids are insufficient. We evaluated hemodynamic response to crystalloids/colloids in critically ill adults. Crystalloids were less efficient than colloids at stabilizing resuscitation endpoints; guidance on when to switch is urgently required. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news

Hemodynamic response to β-blockers in severe sepsis and septic shock: A review of current literature
The administration of β-blockers in patients with sepsis is a trending topic in intensive care medicine since the landmark study by Morelli and colleagues, showing a striking decrease in 28-day mortality compared to standard care. While the available evidence suggests that the use of β-blockers in septic shock is safe, the effects on hemodynamics are controversial. In this paper, we review the effect of β-blockade in septic shock on hemodynamics from animal models to critically ill patients. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - April 25, 2019 Category: Consumer Health News Source Type: news