Suicide and community care

The University of Manchester has published The national confidential Inquiry into suicide and homicide by people with mental illness. making mental health care safer: annual report and 20-year review. October 2016.

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This annual report assesses the progress on safety in mental health care across the UK. It provides the latest figures on events and highlights the priorities for safer services. This year’s report highlights acute care, economic adversity and recent migrants.

Additional link: BBC news report

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Vitamin A supplementation for the prevention of morbidity and mortality in infants one to six months of age

The Cochrane Database of Systematic Reviews has published ‘Vitamin A supplementation for the prevention of morbidity and mortality in infants one to six months of age’.

Background
Vitamin A deficiency is a significant public health problem in low- and middle-income countries. Vitamin A supplementation given to children between the ages of six months and five years reduces deaths in these settings. This review focused on babies one to six months of age.

Review question
Does vitamin A supplementation in babies one to six months of age have any beneficial or harmful effects?

Study characteristics
The review authors searched the medical literature to identify relevant studies that compared the effect of vitamin A supplementation versus control on death, illnesses, and side effects in randomly selected infants aged one to six months. The literature is current to 5 March 2016. The search identified 12 studies that involved 24,846 infants. Most of the studies were well conducted and included children from Asia, Africa, and Latin America.

Key results
The results of the studies provided no convincing evidence that vitamin A supplementation reduces death or illness in infants one to six months of age (quality of evidence: moderate). Supplementation had no beneficial effects to reduce death or illness due to diarrhoea or pneumonia. Similarly, vitamin A supplementation did not reduce the proportion of children with vitamin A deficiency based on their blood levels of vitamin A (quality of evidence: moderate). Infants who were given vitamin A had an increased risk of development of bulging of soft spot at the top of the head (called bulging fontanelle) and quality of evidence for this side effect was high. However, this adverse effect did not increase subsequent risk of death or fits.

Read more here

iCBT may be an effective treatment for PTSD

Tomlin, A. The Mental Elf Blog. Published online: 29 September 2016

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Image source: Neil Webb – Wellcome Images // CC BY-NC-ND 4.0

NICE recommends a range of psychological and drug treatments for PTSD such as trauma-focused cognitive behavioural therapy, but does not recommend computer-based psychotherapies. A recent systematic review and meta-analysis from the Netherlands may persuade the guideline developers to think again.

The aim of this meta-analysis was to evaluate the effectiveness of Internet-delivered Cognitive Behavioural Therapy (iCBT) compared to inactive (waitlist control or treatment-as-usual) and active other interventions in reducing PTSD symptoms.

Overall, the results show that iCBT is superior to waitlist, with a trend suggesting that iCBT is more effective than active controls (e.g. psychoeducation and supportive counselling).

  • iCBT compared to waitlist or treatment as usual (11 comparisons from 10 studies of 1,139 participants) found a moderate pooled effect size (g = 0.71, 95% CI 0.49 to 0.93, P < .001) with moderate heterogeneity
  • iCBT compared to other interventions (3 comparisons from 3 studies) found a small pooled effect size (g = 0.28, 95% CI -0.00 to 0.56, P = .05) with low heterogeneity

The effects were strongest when iCBT interventions were therapist-assisted and longer than eight sessions. This echoes what we know from other web-based psychotherapy evidence.

When comparing iCBT to waitlist, visual inspection of the funnel plot and Egger’s test (P = .34) did not indicate the presence of publication bias.

Read the full overview here

Read the original research here

Adolescent Awareness and Use of Electronic Cigarettes: A Review of Emerging Trends and Findings

Greenhill, R. et al. Journal of Adolescent Health. Published online: 29 September 2016

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Adult electronic cigarette (e-cigarette) use is increasing globally, and early studies have suggested that similar trends may be observed among the adolescent population, albeit at lower levels.

The current literature review presents data collected since 2014 from 21 cross-sectional studies and one cohort study that were all published in English. In particular, it focuses on awareness, ever use, past 30-day use, and regular use of e-cigarettes.

The article suggests that adolescents are nearing complete awareness of e-cigarettes. Furthermore, in relation to ever use and past 30-day use, higher prevalence rates continue to be reported across time, especially in the United States. Nonetheless, reported regular use of e-cigarettes remains much lower than past 30-day use, although conclusions are limited due to inconsistencies with measurement and consequent lack of cross-cultural applicability. The majority of studies do not report whether adolescents use non-nicotine e-cigarettes.

There is a current absence of longitudinal studies that explore any association between e-cigarettes and tobacco use and little qualitative data that may illuminate how and why adolescents use e-cigarettes. Through addressing these methodological limitations, future research will be able to inform health care and policy more effectively.

Read the abstract here

 

Increase in the number of people dying with dementia

Public Health England has published a range of products which examine the deaths of people recorded with dementia between 2012 and 2014.

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Image source: https://www.gov.uk/

Figures show the number of deaths with a mention of dementia was:

  • 6.6% of all deaths in 2001
  • 15.8% of deaths in 2014

This is most likely due to an increase in awareness and recording of dementia.

New reports have been produced by the Dementia Intelligence Network (DIN) in collaboration with the National End of Life Care Intelligence Network (NEoLCIN) and draw on national data to see if there have been changes in dementia deaths over time, who the people dying with dementia are, where they die and the cause of their death.

The findings suggest that people who live in more deprived areas die with dementia at a younger age than those who live in more affluent areas.

There are also considerable differences between the place of death for people who have dementia and the general population. People with dementia are considerably more likely to die in hospitals and care homes and less likely to die at home or in end of life care settings such as hospices.

Read the Dementia Intelligence Network (DIN) and the National End of Life Care Intelligence Network (NEOLCIN) reports here

Read the PHE press release here 

Cardiovascular disease: getting serious about prevention

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This series of slides highlights the work done by PHE and partners, and makes the case for the steps to be taken around prevention in the future.

This publication brings together Public Health England’s (PHE’s) broad-ranging work in addressing cardiovascular disease, the second leading cause of premature death and ill health. It sets out the main programmes already underway and the next steps in tackling cardiovascular disease going forward.

The publication is intended for those involved in the commissioning and provision of services for cardiovascular disease and its prevention, including:

  • clinicians
  • local authorities
  • service commissioners
  • public health specialists
  • the third sector
  • PHE staff

Access the full document:  Action on Cardiovascular disease: getting serious about prevention

Childhood obesity plan: PHE’s role in implementation

This document outlines Public Health England’s priority for reducing the proportion of overweight children leaving primary school.

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Public Health England (PHE) will work with the Department of Health, other government departments and a wide range of stakeholders to achieve the aim of halving childhood obesity within the next 10 years.

Two of PHE’s main contributions will be through implementing a sugar reduction programme and reviewing the nutrient profile model which categorises food according to its nutrient value.

More information about this policy paper available from Public Health England