Failings in diabetes care 'cost thousands of lives'

'Diabetes care depressingly poor, say MPs', is the headline on the BBC News website. This is the damning verdict of a parliamentary report into standards of diabetes care in the NHS. The Public Accounts Committee reported that (in the words of the Daily Mail), "24,000 with diabetes 'are dying needlessly'".

The report was published by the Public Accounts Committee (PAC) – an influential group of MPs who have been given an oversight role to help ensure that taxpayers get value for money.

Based on official figures and spoken and written evidence from independent diabetes experts and officials, the PAC has set out recommendations for improved diabetes care in the NHS.

The report indicates that the NHS spent an estimated £3.9 billion on diabetes services in 2009/10. However, 80% of the costs are estimated to come from the management and treatment of avoidable diabetes-related complications, such as kidney disease and foot ulcers.

The report highlights that the number of people with diagnosed and undiagnosed diabetes is 3.1 million, set to rise to 3.8 million by 2020. This projected increase is likely to have a significant impact on NHS resources, the committee says.

The report accepts that there is consensus about what needs to be done for people with diabetes. However, progress in actually delivering the recommended standards and achieving treatment targets has been 'depressingly poor', it says.

 

Who produced the report?

The report, 'Department of Health: The management of adult diabetes services in the NHS' has been published by the PAC.

The PAC is made up of MPs appointed by the House of Commons, and is responsible for overseeing government expenditures to ensure transparency, value for money, and accountability in government financial operations.

 

What are the main findings?

The main findings of the report are:

• an estimated 80% of the costs of diabetes come from the management and treatment of avoidable diabetes-related complications (such as diabetic eye disease and kidney disease)
• the Department of Health estimates that up to 24,000 people with diabetes are dying each year from causes that could be avoided through better management of their condition
• only half of people with diabetes receive all the basic tests to monitor their condition, and failure to carry out these simple checks heightens the risk of developing complications
• less than one in five people with diabetes have achieved the recommended levels for blood glucose, blood pressure and cholesterol
• despite the Department of Health improving information on diabetes, this information is not being used effectively to assess and improve the quality of care
• many people with diabetes develop avoidable complications because they are not effectively supported to manage their condition and do not always receive care from appropriately trained professionals across primary and secondary care
• the projected increase in the diabetic population could have a significant impact on NHS resources

The report states that the reasons these problems have arisen include:

• the fact there is no strong national leadership – each Primary Care Trust is largely 'left to their own devices' when it comes to how they decide to tackle diabetes
• there are no effective accountability arrangements for commissioners (those in charge of allocating funds to particular services)
• there are no appropriate performance incentives (rewards, usually financial, designed to encourage best practice) for the providers of diabetes care

Source: http://www.nhs.uk/news/2012/11November/Pages/Failings-in-diabetes-care-cost-thousands-of-lives.aspx

£5 million for veterans in need of new prosthetics

The Department of Health has £5 million available to spend on new prosthetics centres for veterans in 2013. The money is part of a £22 million package to support veterans' physical and mental health from 2010 to 2015.

So far this year, 32 veterans applied to get high specification prosthetic equipment, such as computer controlled knee units and specialist feet. The Department of Health has committed to funding clinically appropriate prosthetics for any veteran in England who has lost a limb in the service of their country.

There are currently an estimated 1,335 veteran amputees in the United Kingdom with the majority living in England. The Government wants to raise awareness of this funding so that all veterans who have lost a limb in the service of their country can benefit from the extraordinary, life-changing work the NHS can do with prosthetics. Find out more

NHS Pension Scheme contributions calculator for 2013-14 published

An NHS Pension Scheme contributions calculator for 2013-14 employee contributions has been published today. The employee contributions calculator enables NHS Pension Scheme members to calculate how much their contributions will increase, if at all, on a monthly basis, on both a gross and net of tax relief basis.

View the NHS Pension Scheme contributions calculator for 2013-14

Disabled boy, 4, receives prosthetic blade for Christmas just like his hero Jonnie Peacock

Rio Woolf, from Bushy Heath in Hertfordshire, had to have his lower right leg amputated after being born without a tibia, knee or ankle joint.

Full Story: 
http://www.dailymail.co.uk/health/article-2253006/Disabled-boy-receives-prosthetic-blade-Christmas-just-like-hero-Jonnie-Peacock.html

NHS Mandate published

The first Mandate between the Government and the NHS Commissioning Board, setting out the ambitions for the health service for the next two years, was published on 13 November 2013.

The Mandate reaffirms the Government's commitment to an NHS that remains comprehensive and universal – available to all, based on clinical need and not ability to pay – and that is able to meet patients' needs and expectations now and in the future.

The NHS Mandate is structured around five key areas where the Government expects the NHS Commissioning Board to make improvements:

• preventing people from dying prematurely
• enhancing quality of life for people with long-term conditions
• helping people to recover from episodes of ill health or following injury
• ensuring that people have a positive experience of care
• treating and caring for people in a safe environment and protecting them from avoidable harm.

Through the Mandate, the NHS will be measured, for the first time, by how well it achieves the things that really matter to people.

The key objectives contained within the Mandate include:

• improving standards of care and not just treatment, especially for the elderly
• better diagnosis, treatment and care for people with dementia
• better care for women during pregnancy, including a named midwife responsible for ensuring personalised, one-to-one care throughout pregnancy, childbirth and the postnatal period
• every patient will be able to give feedback on the quality of their care through the Friends and Family Test starting from next April – so patients will be able to tell which wards, A&E departments, maternity units and hospitals are providing the best care
• by 2015 everyone will be able to book their GP appointments online, order a repeat prescription online and talk to their GP online
• putting mental health on an equal footing with physical health – this means everyone who needs mental health services having timely access to the best available treatment
• preventing premature deaths from the biggest killers
• by 2015, everyone should be able to find out how well their local NHS is providing the care they need, with the publication of the results it achieves for all major services.

See NHS Mandate site

Health Secretary, Jeremy Hunt said:

"Never in its long history has the NHS faced such rapid change in our healthcare needs, from caring for an older population, to managing the cost of better treatments, to seizing the opportunities of new technology.

"This Mandate is about giving the NHS the right priorities to deal with those challenges. By focusing on what matters to patients, and giving doctors and other professionals the freedom to deliver, we will make sure the NHS stays relevant to our needs and continues providing the best possible care for us all."

The Mandate has been drawn up following consultation with the public, health professionals and key organisations across the health system between July and September 2012.

Read the following documents:

• The Mandate: A mandate from the Government to the NHS Commissioning Board: April 2013 to March 2015
• The Government's response to the consultation on the draft mandate to the NHS Commissioning Board
• Equality Analysis
• Reference document for policy impact assessments
• Financial Directions to the NHS Commissioning Board

 

National Clinical Director Posts

AHPs are being encouraged to apply for National Clinical Director (NCD) posts.  The post holders will take the clinical lead in driving improvement in quality across all relevant domains of the NHS Outcomes Framework.  As part of that the NCD will be the architect of and responsible for successful design and delivery of a suite of commissioning tools to support system, professional and care pathway changes at a national and local level.  The NCD will work collaboratively with other NCDs to ensure there is coherent commissioning guidance across CCG and specialised commissioned services.   This is a great opportunity for Prosthetists and Orthotists to get involved in key roles that can influence services.   Roles are by secondment and include:

Informatics

Maternity and Children
Mental Health
Urgent Care
Stroke

Rehab and Recovery in the community
Trauma
Spinal
MSK

Integration and Frail elderly
Dementia
CVD
Diagnostics and Imaging
Obesity and Diabetes
Renal
Heart disease
Enhanced recovery and critical care

 

Application is through the NHS Jobs site.

BAPO Conference & Exhibition 2013 - Early Bird Ends 31 December 2012

BAPO CONFERENCE & EXHIBITION 2013 EARLY BIRD OFFER ENDS 31 DECEMBER 2012 Don't miss out on this fantastic Early Bird Discount!!  For further information go to www.bapo.com find us on Facebook http://www.facebook.com/BAPO.com BAPO Secretariat Sir James Clark Building , Abbey Mill Business Centre, Paisley, Renfrewshire, PA1 1TJ T: +44 (0) 0141 561 7217 F: +44 (0) 0141 561 7218 E: Enquiries@bapo.com W: http://www.bapo.com Find us on facebook:http://www.facebook.com/BAPO.com

Review of NHS critical infrastructure risk initiated

A review of critical infrastructure risk (CIR) has been initiated to support the commitments under the NHS Constitution for the NHS 'to provide services from a clean and safe environment that is fit for purpose based on national best practice'.  It may be risking regulatory requirements to ensure service users are protected against risks associated with 'unsafe and unsuitable premises'.

The review will build on existing practices, such as how backlog maintenance is currently determined, and ensure a system is put in place for the future that gets to the heart of the investment required to address risks that are critical.

NHS organisations are invited to participate in the Review of the NHS' recurrent reporting of a need for significant investment in maintenance of its facilities. This is to eliminate 'critical risks' to the safety of patients, visitors and staff; and the resilience of its services.

Creating change: Innovation health and wealth one year on

The report, "Creating change: Innovation health and wealth one year on" provides an update on the implementation of the NHS Chief Executive's report "Innovation health and wealth, accelerating adoption and diffusion in the NHS" published in December 2011.

The first report  set out delivery for spreading innovation quickly and at a scale throughout the NHS. 'Creating change' demonstrates the progress that is being made at a time of great change in the NHS. It highlights what more should be done to deliver the improvements needed to fully embrace and embed innovation in the NHS and improve outcomes and quality for patients and the NHS and drive growth for the UK.

Read Creating change: Innovation health and wealth one year on

New national model to tackle variation in specialist healthcare services

For the first time patients requiring specialised treatment can look forward to the same level and standards of care. The NHS Commissioning Board has published the new Operating Model for commissioning specialised services setting out how a single, national system will ensure patients are offered consistent, high quality services across the country. The number of patients requiring specialised services is small with services located in specialist centres in major towns and cities across England. Concentrating services to provide the same national standards of quality will ensure that specialist staff can be more easily recruited and the necessary levels of training maintained. The new Operating Model and associated Commissioning Intentions mark a clear move away from regional commissioning to a single national approach to both commissioning and contracting. By bringing together the current ten different systems for commissioning specialised services, it provides the opportunity to innovate and introduce new technologies to benefit patients and improve health outcomes in a systematic way. Underpinning the Operating Model are the Commissioning Intentions for 2013/14 ensuring for the first time that the delivery, quality and access for all prescribed specialised services is standard across the country. Ian Dalton, Chief Operating Officer and Deputy Chief Executive at the NHS Commissioning Board said, "This improved system will ensure national consistency in accessing services, reduce variation, and set clear quality standards leading to better health outcomes for patients. It will also allow us to start developing an outcomes framework for rare and specialised conditions, thus starting to move the focus of our discussions with providers from contract inputs to health outcomes. "This is a real opportunity to dramatically improve the way we provide services for people with rare and specialised conditions through having clearly articulated standards for services. "Our next step will be to shortly launch a public consultation on the first ever set of national service specifications and clinical policies for specialised services.  This will be the first time we have had clear national policy and sets our clear intention for the future" The new system will provide a clear focus on a range of rare conditions and low volume treatments ranging from medical genetics, kidney disorders and uncommon cancers to complex cardiac interventions, burn care and some specialised services for children. James Palmer, the new Clinical Director for Specialised Services at the NHS Commissioning Board said, "Strong clinical involvement has been central to the development of this approach. We are working closely in partnership with Clinical Commissioning Groups and colleagues on the frontline to ensure the whole patient pathway is as seamless and locally responsive as possible in meeting patients' needs." Specialised services accounts for approximately 10% of the total NHS budget and accounts for approximately £11.8 billion per annum. More information is available in the specialised commissioning resources area.

Latest NHS Commissioning Board CCG bulletin 27 November 2012

Latest CCG bulletin published by the NHS Commissioning Board.

The NHS Commissioning Board has published its latest bulletin for CCGs from Dame Barbara Hakin, national director for commissioning development. 

Contractual ‘duty of candour’ to drive a more open NHS culture

New rules to toughen transparency in NHS organisations and increase patient confidence have been announced by Health Minister Dr Dan Poulter following a public consultation. The government will create regulations that require the NHS Commissioning Board to include a contractual duty of openness in all commissioning contracts from April 2013.

This means that NHS organisations will be required to tell patients if their safety has been compromised, apologise, and ensure that lessons are learned to prevent them from being repeated. Although all NHS organisations are currently expected to be open about mistakes, there is no contractual duty to hold them to account when this does not happen.

Dr Dan Poulter said:

"The importance of an open culture cannot be underestimated. We expect that Robert Francis will make further recommendations on duty of candour when the Mid Staffordshire Inquiry has been published, and we are committed to taking whatever further action we think is needed as a result. But we cannot simply wait when there are things we can already do – creating this contractual duty of candour now ensures that NHS contracts for the next financial year will champion patients' rights to always have basic honesty from our NHS, as well as safe care."

The responses to the public consultation and the government's analysis of them have now been published, alongside the impact assessment and equalities analysis of the proposed contractual duty of candour.

• Implementing a 'Duty of Candour': A new contractual requirement on providers – Analysis of consultation responses

Source: http://www.dh.gov.uk/health/2012/12/duty-candour/

Relationship Between Tightness of the Posterior Muscles of the Lower Limb and Plantar Fasciitis

Yolanda Aranda Bolívar, Pedro V. Munuera Martínez, and Juan Polo Padillo

Abstract

Background: The aim of this study was to determine whether tightness of the posterior muscles of the lower extremity

was associated with plantar fasciitis.

Methods: A total of 100 lower limbs of 100 subjects, 50 with plantar fasciitis and 50 matching controls were recruited.

Hamstring and calf muscles were evaluated through the straight leg elevation test, popliteal angle test, and ankle dorsiflexion

(knee extended and with the knee flexed). All variables were compared between the 2 groups. In addition, ROC curves,

sensitivity, and specificity of the muscle contraction tests were also calculated to determine their potential predictive

powers.

Results: Differences between the 2 groups for the tests used to assess muscular shortening were significant (P < .001) in

all cases. The straight leg elevation test and ankle dorsiflexion with the knee extended presented respective sensitivities of

94% and 100% and specificities of 82% and 96% as diagnostic tests for the participants in this study.

Conclusion: Tightness of the posterior muscles of the lower limb was present in the plantar fasciitis patients, but not in

the unaffected participants.

Clinical Relevance: The results of this study suggest that therapists who are going to employ a stretching protocol for

treatment of plantar fasciitis should look for both hamstring as well as triceps surae tightness. Stretching exercise programs

could be recommended for treatment of plantar fasciitis, focusing on stretching the triceps surae and hamstrings, apart from

an adequate tissue-specific plantar fascia-stretching protocol.

Level of Evidence: Level III, case control study.

Source: ftp://ftp.sagepub.com/FAI%20Figures/FAI459173.pdf

--

Jonathan 

Rocket-Powered Prosthetics Will Allow Us to Compete With Our Robot Masters

The world of prosthetics is reaching critical turning point. Though the goal in the field has always been to replicate and replace human limbs as accurately as possible, we're now able to see a future where mechanical enhancements may make people stronger and faster than when they were whole. There's no reason why prosthetic-wearers shouldn't be allowed to live as discrete super-human cyborgs, though. Researchers at the University of Alabama are trying to make their new rocket-powered ankle more discrete than those controversial prosthetic blades from a few years back.

Most prosthetic leg-wearers are forced to make a choice when picking an artificial limb: Either choose a light, inanimate object, or an extremely heavy model that features a motor and power supply able to simulate the action of taking a step. The designers behind the rocket-powered ankle are trying to make the best of both worlds, building a lightweight frame that can house something powerful enough to generate a natural-feeling walking motion.

The key to making a lighter self-propelled prothetic, it seems, is actually the fuel. The "rocket-ankle" uses a special liquid fuel called "monorepellant," which can be activated with only a very small amount of catalyst. The minimalistic fuel-type cuts out a lot of the mechanical elements that weigh down most active prosthetics. The ankle also uses a sleeve muscle actuator, an artificial muscle designed to allow for a more natural-feeling stride.

Of course, there are still problems. For starters, the ankle produces a fair amount of hot exhaust. The device also may or may not have a tendency to overheat, which I would assume can get pretty uncomfortable. According to the University, designers hope that the leg will be at least theoretically functional, if not actually in use, by 2016. More importantly, the designers say that, for better or worse, the ankle is being built to simulate human motion, and not turn people into cyborg super-heroes.

Source: http://www.geekosystem.com/rocket-powered-prosthetics/

Influence of malalignment on socket reaction moments during gait in amputees with transtibial prostheses

• David A. Boone
 
• Toshiki Kobayashi
, 
• Teri G. Chou
, 
• Adam K. Arabian
, 
• Kim L. Coleman
, 
• Michael S. Orendurff
, 
• Ming Zhang

Highlights

► Effect of malalignment on socket reaction moments in transtibial prostheses was investigated. ► Socket reaction moments were measured at the base of a socket using an instrumented prosthesis alignment component. ► Both coronal and sagittal malalignment significantly affected the socket reaction moments. ► Socket reaction moments could be biomechanical effects of prosthetic malalignment.

Abstract 

Alignment – the process and measured orientation of the prosthetic socket relative to the foot – is important for proper function of a transtibial prosthesis. Prosthetic alignment is performed by prosthetists using visual gait observation and amputees' feedback. The aim of this study was to investigate the effect of transtibial prosthesis malalignment on the moments measured at the base of the socket: the socket reaction moments. Eleven subjects with transtibial amputation were recruited from the community. An instrumented prosthesis alignment component was used to measure socket reaction moments during ambulation under 17 alignment conditions, including nominally aligned using conventional clinical methods, and angle perturbations of 3° and 6° (flexion, extension, abduction, and adduction) and translation perturbations of 5mm and 10mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. Coronal alignment perturbations caused systematic changes in the coronal socket reaction moments. All angle and translation perturbations revealed statistically significant differences on coronal socket reaction moments compared to the nominal alignment at 30% and 75% of stance phase (P<0.05). The effect of sagittal alignment perturbations on sagittal socket reaction moments was not as responsive as that of the coronal perturbations. The sagittal angle and translation perturbations of the socket led to statistically significant changes in minimum moment, maximum moment, and moments at 45% of stance phase in the sagittal plane. Therefore, malalignment affected the socket reaction moments in amputees with transtibial prostheses.

Source: http://www.gaitposture.com/article/S0966-6362(12)00374-8/abstract

BAPO CONFERENCE & EXHIBITION 2013 SPONSORSHIP INFORMATION Thanks to our sponsors BAPO are once again able to offer a full and varied programme of events at an incredible low price - Early Bird Discount £60 for Full Member (whole weekend) for full programme and prices please go to www.bapo.com http://gallery.mailchimp.com/e99b59101e344f80e38400f12/files/BLANK_DELEGATE_BOOKING_FORM_2013_Final_220812.pdf http://gallery.mailchimp.com/e99b59101e344f80e38400f12/files/Tech_Free_Place_Booking_Form.pdf find us on Facebook http://www.facebook.com/BAPO.com BAPO Secretariat Sir James Clark Building , Abbey Mill Business Centre, Paisley, Renfrewshire, PA1 1TJ T: +44 (0) 0141 561 7217 F: +44 (0) 0141 561 7218 E: Enquiries@bapo.com W: http://www.bapo.com Find us on facebook:http://www.facebook.com/BAPO.com

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The role of foot morphology on foot function in diabetic subjects with or without neuropathy

• Annamaria Guiotto^a, 1, , 
• Zimi Sawacha^a, 2, , 
• Gabriella Guarneri^b, 3, , 
• Giuseppe Cristoferi^b, 4, ,
• Angelo Avogaro^b, 5, , 
• Claudio Cobelli^a,

Abstract

The aim of this study was to investigate the role of foot morphology, related with respect to diabetes and peripheral neuropathy in altering foot kinematics and plantar pressure during gait. Healthy and diabetic subjects with or without neuropathy with different foot types were analyzed. Three dimensional multisegment foot kinematics and plantar pressures were assessed on 120 feet: 40 feet (24 cavus, 20 with valgus heel and 11 with hallux valgus) in the control group, 80 feet in the diabetic (25 cavus 13 with valgus heel and 13 with hallux valgus) and the neuropathic groups (28 cavus, 24 with valgus heel and 18 with hallux valgus). Subjects were classified according to their foot morphology allowing further comparisons among the subgroups with the same foot morphology. When comparing neuropathic subjects with cavus foot, valgus heel with controls with the same foot morphology, important differences were noticed: increased dorsiflexion and peak plantar pressure on the forefoot (P < 0.05), decreased contact surface on the hindfoot (P < 0.03).

While results indicated the important role of foot morphology in altering both kinematics and plantar pressure in diabetic subjects, diabetes appeared to further contribute in altering foot biomechanics. Surprisingly, all the diabetic subjects with normal foot arch or with valgus hallux were no more likely to display significant differences in biomechanics parameters than controls. This data could be considered a valuable support for future research on diabetic foot function, and in planning preventive interventions.

---

Highlights

► Simultaneous three-dimensional kinematics and pressure analysis of three foot's subsegments: hindfoot, midfoot, forefoot. ► Comparison between controls, diabetics non neuropathic and neuropathic subjects' foot biomechanics. ► Foot morphology contribution to altered biomechanics. ► Data were collected during gait on 60 subjects: 20 controls and 40 diabetics. ► Statistically significant alterations on neuropathic and diabetic subjects with different foot morphology and heel/hallux alignment.

Source: http://www.sciencedirect.com/science/article/pii/S0966636212003700

BAPO Conference & Exhibition 2013 Registration now open

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Register for Conference & Exhibition 2013 at www.bapo.com 
 

For for the very latest info on our Clinical Programme, Competitions and Social Programme look no further than latest NewsJigs:
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Fwd: NHS CB welcomes mandate from the Government

PRESS RELEASE

13 November 2012

WE WILL PUT PATIENTS AT THE HEART OF  A LIBERATED AND INNOVATIVE NHS, PLEDGE HEADS OF NEW NHS COMMISSIONING BOARD

The Chief Executive of the NHS Commissioning Board today (Tuesday) welcomed its mandate from the Government.

Sir David Nicholson described the mandate as "a major step on the road to the more liberated and innovative NHS that can be more responsive to its patients." 

The NHS Commissioning Board (NHS CB), which is independent of government, is currently preparing to take on its full responsibilities from 1 April 2013.

Sir David said: "Our aim and our passion is to deliver a better NHS on behalf of patients and the public.  We will do this by working side by side with local clinical leaders; by focussing relentlessly on the outcomes that the NHS delivers for people; and by freeing those on the frontline to transform services in line with the needs of local communities.

"The mandate enables us to do this.  It marks a major step on the road to the more liberated and innovative NHS that can be more responsive to its patients.

"Make no mistake, the NHS will find this a challenging and stretching ask - and it comes against the most challenging financial environment the NHS has ever experienced. But I believe the goals are achievable. 

"The mandate avoids the danger of excessively prescribing the actions of health professionals. We in the NHS Commissioning Board want to ensure power in the NHS sits with those who are closest to the patients. Our role will be to work closely with local clinical leaders and provide the support they need.  Our role is not to tell them what to do."

Sir David concluded: "I am under no illusions about the scale of the task.  There will be bumps in the road and we will have to learn from them. 

"But I have been greatly impressed with the enthusiasm and commitment shown by our new clinical leaders and I look forward to us continuing to work in partnership to do what's best for patients in the coming years.

"We have a once in a lifetime opportunity to do things differently.  We will succeed only by releasing the energy, ideas and commitment of front-line staff and organisations. The NHS Commissioning Board wholeheartedly embraces this challenge."

The Chair of the NHS Commissioning Board, Malcolm Grant, added: "The publication of the Government's mandate to the NHS Commissioning Board marks a vital milestone in the liberation of the NHS.

"It sets clear objectives for the NHS for the coming two years, couched in terms of outcomes for patients, and it recognises that the NHS CB and clinical commissioning groups (CCGs) must operate independently from day-to-day political control.

"The aim of the NHS CB is to secure greatest value to patients from the nation's investment in the NHS. We will oversee delivery against the mandate, and compliance with commissioners' broader legal duties. 

"And we will ensure maximum freedom for CCGs, so that local clinical leaders may respond more effectively to the needs of their local population. They willneed to innovate and transform local health services to meet the needs and wishes of patients, while assuring the delivery of improved outcomes.

"This is an exceptionally challenging yet exciting time for the NHS, and through the mandate the Government has laid the foundation for a locally responsive, clinically-led NHS, focused on improving outcomes for the people of England."

Pressure Ulcers: Prevention and management in primary and secondary care Guideline

Do you work with Children?  Do you have knowledge in treating pressure ulcers?  Why not share this knowledge and join NICE on a consensus panel.  BAPO is a registered stakeholder and you can help out as a BAPO member in offering help to support your professions treatment in this area.

The National Clinical Guideline Centre (NCGC) is now recruiting for members of a Delphi consensus panel to inform the areas regarding children in the guideline 'Pressure Ulcers: Prevention and management in primary and secondary care' guideline.  

The NCGC is currently developing guidance for the prevention and management of pressure ulcers for all who access NHS service. However, it is acknowledged that there are few randomised controlled trials or high quality cohort studies available for children (including neonates, infants, children and young people). It is recognised that, in areas such as this where there is no high quality evidence available, the use of formal consensus methods is appropriate. Therefore, to inform the development of the guideline, the guideline development group will use a modified Delphi consensus technique to agree statements relating to the prevention and management of pressure ulcers in children and young people, which will subsequently be developed into recommendations for inclusion in the guideline.

 

Below is a link to the advertisement, which includes information on the roles required for the panel and all the necessary details on how to apply. The deadline for applications is 5pm, 21^st November 2012.

 

http://www.nice.org.uk/getinvolved/joinnwc/MemberDelphiConsensusPanelPressureUlcers.jsp

Panel members will be expected to take part in two consensus surveys, via email. In addition, panel members will need to be able to deal in a timely manner with any relevant correspondence.

 

If you have any queries regarding these positions, please contact katie.jones@rcplondon.ac.uk.

'Autism gene discovered' by researchers - Health News -

"Genetic mutation discovered in people with autism," The Daily Telegraph reports.

The newspaper goes on to say that this mutation "cuts communication between brain cells to about one-tenth of normal levels" and offers "a likely explanation" for the cognitive and behavioural difficulties experienced by people with autism.
 
This headline is loosely based on recent research into the impact of a previously discovered genetic mutation on the ability of brain cells to transmit signals. The Telegraph speculated that misfiring signals could cause the symptoms of autism.

The study was conducted using rat brain cells, and did not involve people with autism directly.

The researchers described the detailed molecular processes that occur between brain cells when the level of a specific protein is changed. Previous research had discovered that mutations to the gene that controls this protein occurred in people with some types of autism. The authors found that varying the level of this protein affected other proteins responsible for communication between the rats' brain cells.

The research did not, however, examine the impact of this disrupted communication in people with autism, and should not be interpreted as offering "a likely explanation for their cognitive and behavioural difficulties" as reported by the Telegraph.

In addition, many experts think that autism may arise as the result of a combination of factors – not just genetics. Viewing autism as a purely genetic disease may well be an over-simplification.

Source: http://www.nhs.uk/news/2012/11November/Pages/Autism-gene-discovered-by-researchers.aspx