Worcestershire wellbeing consultant says early intervention is key to mental health

The Worcester News and Worcestershire Health and Care NHS Trust have united for the Now We’re Talking campaign, to raise awareness of the county’s Healthy Minds service. Read newspaper article here

New NIHR Signal Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery

New NIHR Signal Aspirin may be a follow-on option to prevent blood clots, starting five days after hip or knee surgery
Published on 5 June 2018


In a recent trial, switching to low-dose aspirin was just as effective at preventing blood clots after joint replacement surgery as continuing the anti-clotting drug rivaroxaban. Six per 1,000 people taking aspirin experienced a blood clot, compared with seven per 1,000 taking rivaroxaban. Three to five per 1,000 patients experienced major bleeding with either drug.
From the NIHR Dissemination Centrre
https://discover.dc.nihr.ac.uk/content/signal-000599/aspirin-may-be-a-follow-on-option-to-prevent-blood-clots-starting-five-days-after-surgery

New NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics

New NIHR Signal Probiotics can prevent bacterial diarrhoea in hospital patients receiving antibiotics
Published on 1 May 2018

Giving probiotics to people taking antibiotics reduces the chance of them developing diarrhoea caused by Clostridium difficile (C. difficile) bacteria by 60%. One case of Clostridium-associated diarrhoea was prevented for every 42 people receiving probiotics. They appear to work best for patients at more than 5% risk of Clostridium infection.

From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00589/probiotics-to-prevent-diarrhoea-caused-by-c-difficile

New NIHR Signal Atraumatic needles reduce headaches following lumbar puncture

New NIHR Signal Atraumatic needles reduce headaches following lumbar puncture
Published on 17 April 2018


Use of atraumatic needles rather than conventional needles for lumbar puncture more than halves the rate of post-procedure headache. Moreover, this improvement does not come at the expense of procedure success rates.


From the NIHR Dissemination Centre
https://discover.dc.nihr.ac.uk/content/signal-00583/atraumatic-needles-reduce-headaches-following-lumbar-puncture

New Interventional procedures guidance [IPG616] Intranasal phototherapy for allergic rhinitis

New Interventional procedures guidance [IPG616] Intranasal phototherapy for allergic rhinitis
Published date: June 2018  Next review: June 2021


Evidence-based recommendations on intranasal phototherapy for allergic rhinitis in adults. This involves using light to reduce inflammation inside the nose.
 For full guidance https://www.nice.org.uk/guidance/ipg616

Signal Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children

NIHR Signal Lorazepam confirmed as first-line treatment for stopping prolonged seizures in children


Published on 17 April 2018


Intravenous lorazepam is as effective as intravenous diazepam for stopping children’s tonic-clonic seizures in hospital. https://discover.dc.nihr.ac.uk/content/signal-00586/lorazepam-confirmed-as-first-line-treatment-for-stopping-prolonged-seizures-in-children
From the NIHR Dissemination Centre

NIHR Signal Physiotherapy education before major abdominal surgery reduces lung complications

NIHR Signal Physiotherapy education before major abdominal surgery reduces lung complications


Published on 3 April 2018


A physiotherapy session before planned abdominal surgery, explaining the importance of breathing exercises and sitting out of bed as soon after surgery as possible, halves the risk of pneumonia.


https://discover.dc.nihr.ac.uk/content/signal-00579/physiotherapy-before-abdominal-surgery-helps-prevent-pneumonia


From the NIHR Dissemination Centre

NIHR Signal Short-duration dual antiplatelet treatment is possible for older people receiving drug-coated stents

NIHR Signal Short-duration dual antiplatelet treatment is possible for older people receiving drug-coated stents


Drug-eluting stents are more effective than bare-metal stents for preventing repeat procedures to open narrowed heart arteries in older adults with coronary heart disease. In this trial both types of stents were used alongside short courses of dual antiplatelet medication, outcomes for those receiving drug-eluting stents were improved with no difference in bleeding complications or rates of in-stent clots.
Published on 7 March 2018
Read full document at https://discover.dc.nihr.ac.uk/portal/article/4000966/short-duration-dual-antiplatelet-treatment-is-possible-for-older-people-receiving-drug-coated-stents

Hepatitis E: symptoms, transmission, prevention, treatment

Details

This document explains hepatitis E, describing the:

• symptoms
• means of transmission
• best means of prevention and treatment

From Public Health England

Nutrition and hydration

These resources from NHS Improvement on using nutrition and hydration to reduce the incidence of pressure ulcers and promote good wound healing, include evidence and recommendations for assessment and action when assessing an individual’s risk of developing a pressure ulcer; five top tips to prevent pressure ulcers; and three case studies.

Public Health England: Teenage Pregnancy Prevention Framework

Public Health England has published guidance for local teenage pregnancy prevention programmes designed to help young people avoid unplanned pregnancies and develop healthy relationships.
https://www.gov.uk/government/publications/teenage-pregnancy-prevention-framework

Preventing emergency hospital admissions for children and young people

A briefing from Nuffield Trust looks at the relationship between deprivation and the use of emergency hospital care by children and young people in England.

It describes areas of inequality and explores how they have changed over time. As well as looking at the overall patterns of emergency hospital use, it focuses in particular on three common conditions – asthma, diabetes and epilepsy – where more timely and effective primary, community or outpatient care could prevent admissions.

NIHR Signal Low FODMAP diet may improve irritable bowel symptoms more than other diets

Adults with irritable bowel syndrome (IBS) who followed a low FODMAP diet had fewer symptoms than those who followed standard dietary advice. They scored their symptoms about 50 points better on a 500 point scale.

The low FODMAP diet is an emerging approach for IBS. It is based on the theory that certain carbohydrates can expand or ferment in the gut and cause symptoms for some people.

From the NIHR Dissemination Centre

Falls risk screening tools ‘not accurate’ new report warns

The Royal College of Physicians’ National Audit for Inpatient Falls assessed 5,000 falls, and shows that although prevention across England and Wales has improved slightly, many patients are not receiving the right assessments that can help prevent harm.

The audit reveals that since 2015, many trusts and Local Health Boards (LHBs) have stopped using ‘falls risk screening or prediction tools’ (a drop from 74 per cent in 2015 to 34 per cent).

Health matters: preventing infections and reducing AMR

Guidance from Public Health England outlining the importance of infection prevention and control and how it can contribute to reducing antimicrobial resistance (AMR).

Galcanezumab for the prophylaxis of episodic and chronic migraine

Galcanezumab is being developed as one of a class of specific anti-migraine preventative drugs. By stopping a very specific protein in the brain and nervous system, galcanezumab reduces migraine attacks. Additionally as it is given once-a-month as treatment, it avoids the need to take numerous pills per day. If marketed, galcanezumab may be more preferable to current treatment options for episodic migraine and chronic migraine prevention.

From the NIHR Innovation Observatory

Fremanezumab for chronic and episodic migraine

Fremanezumab is a new medicine under development for preventative treatment of chronic and episodic migraine. It acts by targeting a very specific type of protein called the human calcitonin gene-related peptide (CGRP) which is a well-known to be involved in migraine. Therefore, if licensed it will offer a potential new treatment option for patients with migraine.

From the NIHR Innovation Observatory

Eight reasons why we need to think differently about cardiovascular disease in England

Despite significant success in reducing premature mortality from cardiovascular disease (CVD), it remains a major cause of death and disability in England.The British Heart Foundation looks at eight reasons why tackling undiagnosed medical risk factors, improving quality of care and reducing variation can change millions of lives.

NIHR Signal Vaginal cleansing before caesarean delivery reduces risk of infections

Cleaning the vagina with an antiseptic solution before a caesarean delivery halves the risk of subsequent womb infection. This evidence applies mainly to women who are having a caesarean delivery when already in labour or if their waters have broken.

Womb infections can occur up to six weeks after giving birth and are more common after caesarean delivery. Symptoms include fever, pain and increased vaginal discharge.

This review included 4,837 women who had a planned or unplanned caesarean delivery. It provides evidence of the benefits of this simple, low-cost procedure. Though it is not yet recommended in UK guidance, in theory it could prevent serious illness and future fertility problems secondary to infection.

From the NIHR Dissemination Centre

NIHR Signal Aspirin reduces a woman’s chance of developing pre-eclampsia in pregnancy

Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took a placebo.

Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high risk of the condition. Aspirin did not affect other pregnancy outcomes and didn’t increase the risk of adverse effects.

This research adds to current knowledge about the range of doses that is effective and refines the definition and detection of women at high risk. The research did not compare 75mg with 150mg doses.

From the NIHR Dissemination Centre