The National education and competence framework for advanced critical care practitioners describes:

• the role of an advanced critical care practitioner
• how the role should function within the critical care team
• the benefits of introducing the role in clinical practice
• a national framework of education and competence

• Antenatal care
• Diabetes in pregnancy
• Prophylaxis for Infective Endocarditis
• Maternal and child nutrition
• Mental wellbeing of children in primary education
• Sleep apnoea hypopnea syndrome (obstructive) - continuous positive airway pressure
• Asthma (in adults) - corticosteroids
• Intraoperative nerve monitoring during thyroid surgery
• Suburethral sling insertion for stress urinary incontinence in men

The Bercow Review of services for Children and Young People (0–19) with Speech, Language and Communication Needs - Interim Report ( Executive Summary) identifies 5 key themes:

• Communication is crucial – communication is at the core of all social interaction.  Communication is a key life skill. Communication is a fundamental human right. For some children and young people, acquiring the ability to communicate is a difficult and ongoing challenge. Just as the nature and severity of their needs will vary, so will the type and extent of the help required to address them.
• Early identification and intervention are essential in order to avoid poor outcomes for children and young people – in addressing delay and disorders, the most important facts we know are the value of early intervention and the danger of its absence. If a child receives the right help early on, he or she has a better chance of tackling problems, communicating adequately and making progress. If a child does not benefit from early intervention, there are multiple risks – of lower educational attainment, of behavioural problems, of emotional and psychological difficulties, of poorer employment prospects and, in some cases, of a descent into criminality.
• A continuum of services, designed around the family, is needed – universal, targeted and specialist services are required to meet the range of needs and, as the Government envisages in its recent Children’s Plan, children, young people and their families must be at their heart.
• Joint working is critical – in planning, commissioning and delivering universal, targeted and specialist provision, it is critical that health services and children’s services, including schools, work together in support of children and young people with SLCN. No single agency can deliver any one of the five Every Child Matters outcomes for children and young people by working in isolation. Separate silos produce misunderstandings, cause divisions and can be bewildering or infuriating to parents for whose children services are delayed or denied as a result.
• The current system is characterised by high variability and a lack of equity – the current system is routinely described by families as a “postcode lottery”, particularly in the context of their access to speech and language therapy (SLT).

Person or place-based policies to tackle disadvantage? Not knowing what works from the Joseph Rowntree Foundation looks at the effectiveness of policies introduced by the Labour government since 1997 to encourage employment, education and reducing income disadvantage, focusing on policies that explicitly take account of people and places.

It finds that person and place-based policies have mostly developed separately and often in isolation from each other. This separation does not reflect the relationships between places and the poverty and disadvantage of people who live in them.

Key findings

• Most policy interventions, whether person or place-targeted, had small, favourable impacts. In the rare cases where information on expenditure was available, costs were generally offset by savings to the Exchequer.
• Both forms of intervention had significant positive impacts on particular aspects of education results and employment. However, it was not possible to determine whether person or place-based policies were better, as they tended to have different objectives that prevented direct comparison.
• Some interventions had negative consequences for the average participant or detrimental effects on some groups of participants.
• It was rarely possible to explain properly how policy interventions worked or why they failed, because the way they were intended to work.
• Evaluators judged policies to have the greatest impact if they delivered individually tailored support to the most disadvantaged people with minimal complexity. The evaluators considered policies successful if they reflected local needs and priorities and were shaped by active engagement with stakeholders, including end users.

Tackling health inequalities: 2007 Status Report on the Programme for Action provides a review of developments against the data since the publication of the Programme for Action in 2003. It considers progress against the Public Service Agreement (PSA) target, the national headline indicators and against government commitments. The report shows:

• Further slight narrowing of the infant mortality gap, little change in the gap in male
  life expectancy and a widening of the gap in female life expectancy since 2003–05.

• An encouraging picture on the cross-government indicators, with long-term progress in reducing child poverty and narrowing inequalities in housing quality, educational
  attainment and uptake of flu vaccinations. Cancer and circulatory (heart) disease
  mortality, child road accident casualties and teenage conceptions show a narrowing of
  inequalities in absolute terms (but not in relative terms); other areas, for example
  smoking, show a general reduction in prevalence but no narrowing of the gap between social groups

• Most departmental commitments set out in the Programme for Action and due for
  delivery by the end of 2006 have been wholly or substantially achieved.

Hit or Miss - women’s rights report from ActionAid shows that promises made by the world’s governments to tackle poverty are failing to deliver because the basic rights of women in the developing world are being ignored.  The report finds that women and girls formed the majority of the poor and hungry, and, in south Asia, women are getting a shrinking share of income as the economy continues to grow. Ten million more girls than boys miss out on primary school, while African women accounted for 75% of all young people living with HIV/Aids.

Safe Births: Everybody’s business: An independent inquiry into the safety of maternity services in England from the Kings’s Fund makes the following recommendations:

• Teams themselves should:
  • agree safety-focused objectives
  • identify clear roles and responsibilities
  • utilise clear communication standards and protocols
• Safety should be placed at the heart of shared objectives for maternity services in quality joint working The Royal College of Midwives (RCM) and Royal College of Obstetricians and
• Regular reviews of demand and staffing should be conducted with an emphasis on deliveringthe right skill mix todeliver safe services
• Trust boards and managers should regularly receive information employment levels, skill mix and deployment achieved across all shift.
• Simple and effective tools to help maternity managers to manage employment and deployment, to map demand, capacity and patient flow and to provide timely feedback on levels achieved across all shifts and locations should be developed using work used in other specialties.
• A designated maternity unit manager should keep information on all training completed and planned.  Managers and Boards should reveive regular reports on training.
• RCOG, the Nursing and Midwifery Council (NMC) and the Postgraduate Medical Education and Training Board (PMETB) should spread expertise on skills training and emergency drills to all maternity units by adapting elements of existing simulation based training models and turning them into high-quality training tools that can be
  used locally at minimal cost and disruption
• Safety awareness training must be mainstream professional education at all levels.
• A single set of evidence-based guidelines that are backed by professional organisations, National Institute for Health and Clinical Excellence (NICE) and other organisations shoulddeveloped.
• Guidelines must be supplemented by short one page summaries and usable, consistent protocols.
• All disciplines should be encouraged to familiarise themselves with using guidelines in a local setting and should be trained to use the relevant protocols.  Their use should be regularly audited.
• Annual evidence digests and a national briefing system, tools like Map of Medicine should reinforce use of guidelines.
• A small set of reliable, safety-critical information measures should be collected.
• Simple systems for capturing local information on safety should be designed, implemented and maintained locally.
• Boards must prioritise safety, communicate that to staff and patients and make data on safety publicly available.
• Board members should be trained to strengthen advocacy for maternity safety.
• Governance structures must be in place to assure safety, this should strengthen safety committees and systems for collecting and reporting safety information.
• Regular executive walk-rounds, analysis of claims data, incident reports and other safety indicators, and by reviewing safety incidents in detail should be undertaken.
• Safety must be recognised as a business imperative.
• Standards for the safety of maternity services should be set and monitored only by the Healthcare Commission (in future the Care Quality Commission), with approarpiate advice received by professional bodies.
• Existing standards hould be distilled into a smaller number that are critical to safety, and can beconnected to data that can be collected by teams.
• Strategic health authorities and others providing regional leadership for maternity services should be primed to offer specific support to trusts undergoing reconfiguration.
• DH shouldensure financial incentives are aligned to promote the safest care and to galvanise boards into prioritising safety commissioning and patient choice should act as drivers for improvement.

Children on bullying report summarises research on children’s views on bullying, defining what bullying is and what to do about it. There are both worrying messages and hopeful signs among the varied responses.

It covers children living away from home in England (in children’s homes, boarding schools, residential special schools, residential further education colleges, foster care, adoption placements or residential family centres), those who are getting help of any sort from the children’s social care services of their local council and care leavers.

Achieving Culture Change: A Policy Framework a discussion paper (from the Cabinet Office Strategy Unit) looks at how government policy can be used to encourage particular courses of action and behaviour in cases where powerful cultural factors are at work. The traditional behaviour change approach has been to use a combination of incentives, legislation and regulation in an attempt to encourage and persuade the public into adopting different forms of behaviour. Headlined today in the as Cut crime with drink tax, Gordon Brown told - The Telegraph 15th February 2008.

The paper relevant to a wide range of government objectives, including educational attainment, social mobility and opportunity, healthy living, environmental sustainability, and maintaining thriving communities and explores where cultural factors – for example our attitudes, values, aspirations and sense of self–efficacy – are pointing in the opposite direction. It sets out the state of knowledge about “culture change” and how this can be practically used to inform policy development.

Realising Britain’s Potential: Future Strategic Challenges for Britain (Executive Summary) from the Cabinet Office identifies four major challenges to be faced by Britian:

• The importance of early years learning and childcare in helping those from poorer homes and in improving later performance.

• Continued investment in physical infrastructure (roads and rail).

• Demands on public services and housing, especially in the South East, from a rising population, including continuing net migration into Britain.

• Increasing life expectancy, with a rise of a half within a decade of those aged over 85, and a two-fifths increase by 2022 in the demand for informal care from family, friends and community members.

The report suggests a mix of the public and private sector providers will be required to meet demand. Taxpayers cannot finance all of the expanded early learning and childcare, increased transport facilities and care for the elderly To reduce the tax burden, individuals will have to accept that individuals will have to save much more and pay more in user charges (via road pricing and elderly care).

Organizational Learning, Knowledge and Capacity: A systematic literature review for policy-makers, managers and academics presents the full findings of a systematic literature review on how learning takes place between organizations and how institutional learning and knowledge transfer can be fostered (Executive Summary). Based on existing academic and policy literature, the report outlines key implications for policy and practice, whilst geared towards local authorities this evaluation will allow all organisations to learn from research findings that have addressed learning, knowledge and capacity in organizations.

The new issue of Journal of Epidemiology and Community Health is now available online. If you want to access the full text of the journal you’ll need your Athens password from the NHS (at the moment you’ll need one from Cheshire and Merseyside but from April this resource will be available nationally. If you don’t have an Athens password and are eligible you can get one here). Full contents of the Journal of Epidemiology and Community Health 2008 62(2) February

In this issue
Carlos Alvarez-Dardet and John R Ashton, Joint Edit
J Epidemiol Community Health 2008; 62: 89. [Extract] [Full text] [PDF]

“If you always do…”
JRA
J Epidemiol Community Health 2008; 62: 90. [Extract] [Full text] [PDF]

The subtle trade-off between personal freedom and social responsibility
Francesco Zambon
J Epidemiol Community Health 2008; 62: 90. doi:10.1136/jech.2007.065847 [Extract] [Full text] [PDF]

Area deprivation and mortality in the provincial capital cities of Andalusia and Catalonia (Spain)
R Ocaña-Riola, C Saurina, A Fernández-Ajuria, A Lertxundi, C Sánchez-Cantalejo, M Saez, M Ruiz-Ramos, M A Barceló, J C March, J M Martínez, A Daponte, and J Benach
J Epidemiol Community Health 2008; 62: 147-152. doi:10.1136/jech.2006.053280 [Abstract] [Full text] [PDF]

Adult education and child nutrition: the role of family and community
H Moestue and S Huttly
J Epidemiol Community Health 2008; 62: 153-159. doi:10.1136/jech.2006.058578 [Abstract] [Full text] [PDF]

Is leg length a biomarker of childhood conditions in older Chinese women? The Guangzhou Biobank Cohort Study
C M Schooling, C Q Jiang, M Heys, W S Zhang, X Q Lao, P Adab, B J Cowling, G N Thomas, K K Cheng, T H Lam, and G M Leung
J Epidemiol Community Health 2008; 62: 160-166. doi:10.1136/jech.2006.058917 [Abstract] [Full text] [PDF]

Fetal and childhood growth and the risk of violent and non-violent suicide attempts: a cohort study of 318 953 men
E Mittendorfer-Rutz, D Wasserman, and F Rasmussen
J Epidemiol Community Health 2008; 62: 168-173. doi:10.1136/jech.2006.057133 [Abstract] [Full text] [PDF]

The epidemiology of fractures in England
L J Donaldson, I P Reckless, S Scholes, J S Mindell, and N J Shelton
J Epidemiol Community Health 2008; 62: 174-180. doi:10.1136/jech.2006.056622 [Abstract] [Full text] [PDF]

Explaining the social gradient in long-term sickness absence: a prospective study of Danish employees
Karl Bang Christensen, Merete Labriola, Thomas Lund, and Mika Kivimäki
J Epidemiol Community Health 2008; 62: 181-183. doi:10.1136/jech.2006.056135 [Abstract] [Full text] [PDF]

Living and health conditions of Palestinian refugees in an unofficial camp in the Lebanon: a cross-sectional survey
J E Zabaneh, G C M Watt, and C A O’Donnell
J Epidemiol Community Health 2008; 62: 91-97. doi:10.1136/jech.2006.054338 [Abstract] [Full text] [PDF]

Reducing ambient levels of fine particulates could substantially improve health: a mortality impact assessment for 26 European cities
Ferran Ballester, Sylvia Medina, Elena Boldo, Pat Goodman, Manfred Neuberger, Carmen Iñiguez, Nino Künzli, and on behalf of the Apheis network
J Epidemiol Community Health 2008; 62: 98-105. doi:10.1136/jech.2007.059857 [Abstract] [Full text] [PDF]

Perceived health change in the aftermath of a petrochemical accident: an examination of pre-accident, within-accident, and post-accident variables
M K Peek, M P Cutchin, D H Freeman, N A Perez, and J S Goodwin
J Epidemiol Community Health 2008; 62: 106-112. doi:10.1136/jech.2006.049858 [Abstract] [Full text] [PDF]

The association between school attendance, HIV infection and sexual behaviour among young people in rural South Africa
J R Hargreaves, L A Morison, J C Kim, C P Bonell, J D H Porter, C Watts, J Busza, G Phetla, and P M Pronyk
J Epidemiol Community Health 2008; 62: 113-119. doi:10.1136/jech.2006.053827 [Abstract] [Full text] [PDF]

Iron but not folic acid supplementation reduces the risk of low birthweight in pregnant women without anaemia: a case–control study
S Palma, R Perez-Iglesias, D Prieto, R Pardo, J Llorca, and M Delgado-Rodriguez
J Epidemiol Community Health 2008; 62: 120-124. doi:10.1136/jech.2006.052985 [Abstract] [Full text] [PDF]

Prevalence of overweight and obesity in East and West German children in the decade after reunification: population-based series of cross-sectional studies
C J Apfelbacher, J Cairns, T Bruckner, M Möhrenschlager, H Behrendt, J Ring, and U Krämer
J Epidemiol Community Health 2008; 62: 125-130. doi:10.1136/jech.2007.062117 [Abstract] [Full text] [PDF]

Preventing disability through understanding international megatrends in Deaf bilingual education
I M Munoz-Baell, C Alvarez-Dardet, M T Ruiz, R Ortiz, M L Esteban, and E Ferreiro
J Epidemiol Community Health 2008; 62: 131-137. doi:10.1136/jech.2006.059378 [Abstract] [Full text] [PDF]

Medical illness, medication use and suicide in seniors: a population-based case–control study
D C Voaklander, B H Rowe, D M Dryden, J Pahal, P Saar, and K D Kelly
J Epidemiol Community Health 2008; 62: 138-146. doi:10.1136/jech.2006.055533 [Abstract] [Full text] [PDF]

Coronary heart disease epidemiology: from aetiology to public health, 2nd ednChildhood cancer in Britain
Alberto Izzotti
J Epidemiol Community Health 2008; 62: 184. doi:10.1136/jech.2006.045831 [Extract] [Full text] [PDF]

Childhood cancer in Britain
Kathrine Carlsen
J Epidemiol Community Health 2008; 62: 184. doi:10.1136/jech.2007.064709 [Extract] [Full text] [PDF]

If you need any training in using this or any other electronic resource and you work for Liverpool PCT use the contact form below to contact the library.

New e-journals available via Ingenta Connect you’ll need an Athens password from Liverpool PCT to access them (You can register here if you work for the PCT and don’t have one)

• Clinician in Management 2001 –
• Diversity in Health and Social Care 2004 -
• Education for Primary Care 2001 -
• Primary Care Mental Health 2003 -

If you need any training in the use of these or any other electronic resources and you work for Liverpool PCT you can contact us using the form below.

The vital role of interagency working in childrens services is recognised and developed in a new document setting out the Government’s goals for 2020. it identifies a new leadership role for Children’s Trusts in every area, a new role for schools as the centre of their communities, and more effective links between schools, the NHS and other children’s services so that together they can engage parents and tackle all the barriers to the learning, health and happiness of every child are detailed in The Children’s Plan: building brighter futures (Executive Summary).

The plan will

• strengthen support for all families during the formative early years of their children’s lives
• take the next steps in achieving world class schools and an excellent education for every child
• involve parents fully in their children’s learning
• help to make sure that young people have interesting and exciting things to do outside of school
• and provide more places for children to play safely.

The Single Equality Scheme Delivery Plan that underpins the plan emphasises equality of opportunity regadless of disabilty, race and gender.

How to change practice: Understand, identify and overcome barriers to change  aims to support the NHS and the wider public health community in understanding, identifying and overcoming barriers to change. Set out in three parts, the guide:

• discusses the types of barriers to change encountered in healthcare, highlighting how awareness and knowledge of what needs to change, and why, are important first steps in enabling change to occur

• offers practical suggestions on how to identify the barriers to change faced by organisations

• provides evidence-based advice on what methods work to overcome these barriers, and highlights potential levers to help do this

Effective hand washing is a pre-requisite for infection prevention. But how do staff and managers know how effectively they are washing their hands or what an effective technique is?

From HealthExec TV comes a discussion on the importance of embedding effective hand washing techniques in the working routine of all staff to reduce the risk of infection transmission.

This video covers effective hand washing techniques and a new system for assessing hand washing.  There is though some product placement in this video.