OT – The use of the Wii Fit in forensic mental health: exercise for people at risk of obesity

The use of the Wii Fit in forensic mental health: exercise for people at risk of obesity, British Journal of Occupational Therapy , 2012 Feb; 75(2): 61-8

Abstract:

Introduction: Side effects of psychotropic medication often lead to rapid weight gain, having detrimental effects on forensic mental health patients’ health, wellbeing, occupational performance and quality of life. Virtual reality technology could provide novel environments and motivating forums for exercise, which are otherwise unavailable to patients in such secure settings. This exploratory study aimed to evaluate the use of the Nintendo Wii Fit in changing engagement in physical activity for patients at risk of obesity at a secure hospital. Method: Two participants used a Wii Fit for 8 weeks in individual or group sessions. A mixed methods approach was taken, because participants’ use of the Wii Fit was compared with their attitudes towards it (reported during interviews) and their daily physical activity levels (measured using an accelerometer). Researcher field notes were also used to gather contextual data. Findings: Participants played Wii Fit up to four times a week in sessions ranging from 7 to 127 minutes. When using the Wii Fit, participants increased their overall time spent actively moving their bodies in physical activity, as measured by the accelerometer. Using the Wii Fit also changed participants’ attitudes towards exercise as they realised that it could be ‘fun’ and ‘challenging’, especially if staff members also participated. Conclusion: The Wii Fit encouraged patients to attempt physical activities and to learn about their bodily response to exercise. It provided a meaningful occupational intervention in a secure setting and demonstrated a potential use of the technology in mental health settings.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

A systematic review of the impact of physical activity programmes on social and emotional well-being in at-risk youth

A systematic review of the impact of physical activity programmes on social and emotional well-being in at-risk youth, Child and Adolescent Mental Health, 2012, 17 (1) pp 2–13

Lubans, D. R., Plotnikoff, R. C. and Lubans, N. J.

Abstract:

Background:  Physical activity programmes have been identified as a potential strategy for improving social and emotional well-being in at-risk youth, who have a prevalence of depression and low self-esteem exceeding the general population.

Methods:  A systematic search of six electronic databases (EMBASE, OVID MEDLINE, PsychINFO, PubMed, Scopus and SPORTDiscus) was conducted to identify physical activity programmes designed to improve social and emotional well-being in at-risk youth.

Results:  The search identified 15 studies, which reported the effects of three types of physical activity programmes (i.e. outdoor adventure, sport and skill-based and physical fitness programmes) on social and emotional well-being. While many of the interventions resulted in significant positive effects, the risk of bias was high in all of the included studies.

Conclusion:  Due to the mixed findings and the high risk of bias, it is difficult to determine the efficacy of physical activity programmes for improving social and emotional well being in at-risk youth.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Alcohol – Alcohol & Calories

Acohol and Calories, 2011, BDA

Click on the title above to access the full-text of this document

Abstract:

A joint BDA (British Dietetic Association) and Alcohol Concern Cymru briefing paper on Alcohol and Calories has been released. Alcohol Concern say many of us are taking in more calories in the form of food and drink than our bodies can use – and a major part of this is increasing levels of alcohol consumption.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

A weight reduction club for people with learning disabilities helped participants to each lose 5.9kg on average over a 12-month period. In this article Jeff Bartley describes how the club was set up and the important factors that led to its success

Promoting healthy eating and weight loss, Learning Disability Practice, 2011 Apr; 14 (3): 12-6

Jeff Bartley is a physiotherapist and active living co-ordinator in the North Lancashire community health team

 

Abstract:

A weight reduction club for people with learning disabilities helped participants to each lose 5.9kg on average over a 12-month period. In this article Jeff Bartley describes how the club was set up and the important factors that led to its success. He suggests how other clubs could be created using the learning gained during this pilot project.

 

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

 

Obesity – Counterweight: health improvements from a weight programme

Counterweight: health improvements from a weight programme, Practice Nursing, 2011 Feb; 22(2): 62-4

Iain Broome – Director, Centre for Obesity Research and Epidemiology, Robert Gordon University

Abstract:

The Counterweight programme has been developed by clinicians to tackle the rising incidence of obesity in adults and children. Iain Broom outlines the health benefits and cost-effectivess of this weight management intervention.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

RCT of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change

Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change, Behaviour Research & Therapy,  2010 Dec;48(12):1170-9

Abstract:

Parent-centred interventions for childhood obesity aim to improve parents’ skills and confidence in managing children’s dietary and activity patterns, and in promoting a healthy lifestyle in their family. However, few studies assess changes in parenting over the course of treatment. This study describes the evaluation of a lifestyle-specific parenting program (Group Lifestyle Triple P) on multiple child and parent outcomes. One-hundred-and-one families with overweight and obese 4- to 11-year-old children participated in an intervention or waitlist control condition. The 12-week intervention was associated with significant reductions in child BMI z score and weight-related problem behaviour. At the end of the intervention, parents reported increased confidence in managing children’s weight-related behaviour, and less frequent use of inconsistent or coercive parenting practices. All short-term intervention effects were maintained at one-year follow-up assessment, with additional improvements in child body size. The results support the efficacy of Group Lifestyle Triple P and suggest that parenting influences treatment outcomes. Further research is needed to evaluate the long-term effectiveness of the intervention and to elucidate the mechanisms of change.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

2011 A special briefing produced by the well-being and public mental health programme on the Public Health White Paper Healthy Lives, Healthy People

A special briefing produced by the well-being and public mental health programme on the Public Health White Paper Healthy Lives, Healthy People , 2011, NMHDU

Click on the title to download the special briefing

Abstract:

A special briefing produced by the well-being and public mental health programme on the Public Health White Paper Healthy Lives, Healthy People.

The White Paper presents many opportunities to build on the considerable volume of research and practice evidence for the integration of mental health within an overall public health approach. Furthermore the proposed new public health system at both national and local levels also provides considerable opportunities and scope for mental health to be both complementary and central to future local strategies and improved health and wellbeing outcomes for local communities.

The opportunities lie both in ensuring mental health is complementary and integral to overall approaches to improving public health and well-being and also in ensuring that the promotion of the public’s mental health and wellbeing is an action and commitment in its own right.

Lancashire Care staff can either click on the link, or email: susan.jennings@lancashirecare.nhs.uk

Healthy Eating – Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis

Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis, Diabetes Care. 2010 Nov;33(11):2477-83

Malik, V.S.

Abstract:

OBJECTIVE: Consumption of sugar-sweetened beverages (SSBs), which include soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks has risen across the globe. Regular consumption of SSBs has been associated with weight gain and risk of overweight and obesity, but the role of SSBs in the development of related chronic metabolic diseases, such as metabolic syndrome and type 2 diabetes, has not been quantitatively reviewed.

RESEARCH DESIGN AND METHODS: We searched the MEDLINE database up to May 2010 for prospective cohort studies of SSB intake and risk of metabolic syndrome and type 2 diabetes. We identified 11 studies (three for metabolic syndrome and eight for type 2 diabetes) for inclusion in a random-effects meta-analysis comparing SSB intake in the highest to lowest quantiles in relation to risk of metabolic syndrome and type 2 diabetes.

RESULTS: Based on data from these studies, including 310,819 participants and 15,043 cases of type 2 diabetes, individuals in the highest quantile of SSB intake (most often 1-2 servings/day) had a 26% greater risk of developing type 2 diabetes than those in the lowest quantile (none or <1 serving/month) (relative risk [RR] 1.26 [95% CI 1.12-1.41]). Among studies evaluating metabolic syndrome, including 19,431 participants and 5,803 cases, the pooled RR was 1.20 [1.02-1.42].

CONCLUSIONS: In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes. These data provide empirical evidence that intake of SSBs should be limited to reduce obesity-related risk of chronic metabolic diseases.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Healthy Eating – Obesity interventions for people with a learning disability: an integrative literature review

Obesity interventions for people with a learning disability: an integrative literature review, Journal of Advanced Nursing, 2010

Jinks A, Cotton A, Rylance R

Annette Jinks MA PhD RN
Professor of Nursing
Evidence-based Practice Research Centre, Faculty of Health, Edge Hill University, UK Angela Cotton BSc PhD RMN
Senior Lecturer
Edge Hill University, UK Rebecca Rylance BA RMN PGCert
Lecturer
5 Boroughs Partnership NHS Trust, Prescot, Merseyside, UK

Abstract:

BACKGROUND: With the current obesity epidemic, the search for effective weight loss approaches is required. In the present study, changes in weight, body composition and cardiovascular (CV) risk in response to a low-fat, reduced-energy diet (LFRE), a low-carbohydrate/high-protein diet (LCHP), or a commercially available very low-calorie diet (LighterLife; LL) were assessed.

METHODS: One hundred and twenty obese patients (body mass index ≥35 kg/m² ) underwent a screening period of 3 months on the LFRE. Those who lost >5% of their body weight were maintained on this approach for an additional 3 months, whereas those who lost >10% at this time were maintained for 1 year. Patients failing to achieve these targets were randomly allocated to either the LCHP (n = 38) or LL (n = 34) for a period of 9 months.

RESULTS: Significantly greater weight loss was seen for patients on the LL than the LCHP at 3 (mean (± SD) -11.6 ± 12.9 vs -2.8 ± 4.5 kg, respectively; P < 0.0001) and 9 months (-15.1 ± 21.1 vs -1.9 ± 5.0 kg, respectively; P < 0.0001) after screening. Significantly greater improvement in total cholesterol, low-density lipoprotein-cholesterol, fasting glucose, and diastolic blood pressure was seen at 3 months in patients on the LL compared with the LCHP (P < 0.05). These differences were no longer significant at 9 months, with the exception of fasting glucose. The attrition rate was elevated in the LCHP group, but did not differ significantly from the LL group.

CONCLUSION: Greater weight loss and improved CV risk were achieved with the LL, which mostly reflects the patient support provided for each dietary treatment.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Effects of severe mental illness on survival people with diabetes

Effects of severe mental illness on survival people with diabetes, The British Journal of Psychiatry (2010) 197: 272-277

Vinogradova Y, Coupland C, Hippisley-Cox J, Whyte S, Penny C.

Abstract:

BACKGROUND: People with mental health problems are more likely to die prematurely than the general population but no study has examined this in individuals with diabetes.

AIMS: To compare survival rates in people with diabetes with and without schizophrenia or bipolar disorder.

METHOD: A total of 43,992 people with diabetes were drawn from the QRESEARCH database population of over 9 million patients. Survival rates during the study period, between 1 April 2000 and 1 April 2005, and hazard ratios for deaths associated with schizophrenia and bipolar disorder were adjusted by age and gender and additionally for socioeconomic status, obesity, smoking and use of statins.

RESULTS: Among the participants, we identified 257 people diagnosed with schizophrenia, 159 with bipolar disorder and 14 with both conditions. Although crude survival rates did not show significant differences between the groups during the study period, people with schizophrenia or bipolar disorder and diabetes, compared with those with diabetes alone, had a significantly increased risk of death after adjusting for age and gender, with hazard ratios for schizophrenia of 1.84 (95% CI 1.42-2.40) and for bipolar disorder of 1.51 (95% CI 1.10-2.07). After adjusting for the other factors, hazard ratios were 1.52 (95 CI 1.17-1.97) for schizophrenia and 1.47 (95% CI 1.07-2.02) for bipolar disorder.

CONCLUSIONS: People with schizophrenia or bipolar disorder in addition to diabetes have a relatively higher mortality rate. This suggests that diabetes either progresses more rapidly or is more poorly controlled in these individuals, or that they have higher levels of comorbidity and so are more likely to die of other causes.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

NICE Guidance – Obesity

NICE Guidance CG43 Obesity, January 2010

Click on the link above to access the full-text of this guidance

Abstract:

Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children

Description

The NICE clinical guideline on the prevention, identification, assessment and management of overweight and obesity in adults and children covers: how staff in GP surgeries and hospitals should assess whether people are overweight or obese what staff in GP surgeries and hospitals should do to h …

The NICE clinical guideline on the prevention, identification, assessment and management of overweight and obesity in adults and children covers:

  • how staff in GP surgeries and hospitals should assess whether people are overweight or obese
  • what staff in GP surgeries and hospitals should do to help people lose weight
  • care for people whose weight puts their health at risk.
  • how people can make sure they and their children stay at a healthy weight
  • how health professionals, local authorities and communities, childcare providers, schools and employers should make it easier for people to improve their diet and become more active.

Responsibility for undertaking a review of this guidance at the designated review date has passed to the National Clinical Guidelines Centre for Acute and Chronic Conditions (NCGCACC). The National Collaborating Centre for Primary Care is no longer active.

Lancashire Care staff can click on the link above or email: susan.jennings@lancashirecare.nhs.uk

NICE Guidance – Type 2 Diabetes

Type 2 diabetes (partially updated by CG87) , CG66

Type 2 diabetes: the management of type 2 diabetes (update)

Description

NICE clinical guideline 87 partially updates NICE clinical guideline 66 and replaces it. Most of the recommendations were developed for NICE clinical guideline 66 by the National Collaborating Centre for Chronic Conditions. Details of the methods and evidence used to develop these recommendations

NICE Guidance – Type 1 Diabetes

NICE Guidance – CG15 Type 1 Diabetes ,  July 2004

Diagnosis and management of type 1 diabetes in children, young people and adults

Description

This clinical guideline offers evidence-based advice on the diagnosis of type 1 diabetes in children, young people and adults. It also covers the care and treatment that should be available in the NHS, including transition to adult care. Responsibility for undertaking a review of this guidance has

Diagnosis and management of type 1 diabetes in children, young people and adults

Description

This clinical guideline offers evidence-based advice on the diagnosis of type 1 diabetes in children, young people and adults. It also covers the care and treatment that should be available in the NHS, including transition to adult care. Responsibility for undertaking a review of this guidance has …..

Lancashire Care staff can either click on to the link above or email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Public Health – Booklets on Healthy Eating, Diet, Exercise and more …..

Public Health Agency UK        Physical Activity       Nutrition    Mental Health

Click on the above links to access free downloadable booklets and leaflets

  • Eat well, keep well and reduce your risk of cancer
  • Step this way for better health
  • Enjoy healthy eating
  • Small changes big  benefits
  • Get a live, get active
  • Eat well, keep well and reduce your risk of cancer

Lancashire Care staff can click on the links above to access the booklets or email: susan.jennings@lancashirecare.nhs.uk

Cochrane – Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people

Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people,

Flodgren G, Deane K, Dickinson HO, Kirk S, Alberti H, Beyer FR, Brown JG, Penney TL, Summerbell CD, Eccles MP. Interventions to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people. Cochrane Database of Systematic Reviews 2010, Issue 3. Art. No.: CD000984e

Click on the title above to access the full-text of this Cochrane review

Abstract:

The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for both population health and costs to health services.

OBJECTIVES: To assess the effectiveness of strategies to change the behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese people.

SEARCH STRATEGY: We updated the search for primary studies in the following databases, which were all interrogated from the previous (version 2) search date to May 2009: The Cochrane Central Register of Controlled Trials (which at this time incorporated all EPOC Specialised Register material) (The Cochrane Library 2009, Issue 1), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid). We identified further potentially relevant studies from the reference lists of included studies.

SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared routine provision of care with interventions aimed either at changing the behaviour of healthcare professionals or the organisation of care to promote weight reduction in overweight or obese adults.

DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality.

MAIN RESULTS: We included six RCTs, involving more than 246 health professionals and 1324 overweight or obese patients. Four of the trials targeted professionals and two targeted the organisation of care. Most of the studies had methodological or reporting weaknesses indicating a risk of bias.Meta-analysis of three trials that evaluated educational interventions aimed at GPs suggested that, compared to standard care, such interventions could reduce the average weight of patients after a year (by 1.2 kg, 95% CI -0.4 to 2.8 kg); however, there was moderate unexplained heterogeneity between their results (I(2) = 41%). One trial found that reminders could change doctors’ practice, resulting in a significant reduction in weight among men (by 11.2 kg, 95% CI 1.7 to 20.7 kg) but not among women (who reduced weight by 1.3 kg, 95% CI -4.1 to 6.7 kg). One trial found that patients may lose more weight after a year if the care was provided by a dietitian (by 5.6 kg, 95% CI 4.8 to 6.4 kg) or by a doctor-dietitian team (by 6 kg, 95% CI 5 to 7 kg), as compared with standard care. One trial found no significant difference between standard care and either mail or phone interventions in reducing patients’ weight.

AUTHORS’ CONCLUSIONS: Most of the included trials had methodological or reporting weaknesses and were heterogeneous in terms of participants, interventions, outcomes, and settings, so we cannot draw any firm conclusions about the effectiveness of the interventions. All of the evaluated interventions would need further investigation before it was possible to recommend them as effective strategies.

Lancashire care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Statistics on Obesity, Physical Activity and Diet: England, 2010

Statistics on Obesity, Physical Activity and Diet: England, 2010NHS Information Centre

Click on the title above to access the full-text of this report

Abstract:

This statistical report presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources.

The topics covered include:

  • Overweight and obesity prevalence among adults and children;
  • Physical activity levels among adults and children;
  • Trends in purchases and consumption of food and drink and energy intake; and
  • Health outcomes of being overweight or obese.

This report contains seven chapters which consist of the following:

Chapter 1:

Introduction; this summarises Government plans and targets in this area, as well as providing sources of further information and links to relevant documents.

Chapters 2 to 6:

Covering obesity, physical activity and diet which have been significantly reduced from last year’s report in order to provide an overview of the key findings from these sources, whilst maintaining useful links to each section of the reports.

Chapter 7:

Health Outcomes; presents a range of information about the health outcomes of being obese or overweight which includes information on health risks, hospital admissions and prescription drugs used for treatment of obesity.

Figures presented in Chapter 7 have been obtained from a number of sources and presented in a user-friendly format. Most of the data contained in the chapter have been published previously by the National Audit Office or NHS Information Centre.

Previously unpublished figures on obesity-related Finished Hospital Episodes and Finished Consultant Episodes for 2008/09 are presented using data from The NHS Information Centre’s Hospital Episode Statistics as well as data from the Prescribing Unit at the NHS Information Centre on prescription items dispensed for treatment of obesity.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Cochrane – Exercise therapy for Schizophrenia

Exercise therapy for Schizophrenia  Citation: Gorczynski P, Faulkner G. Exercise therapy for schizophrenia. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No.: CD004412

 Click on the title above to access the full-text of the Cochrane review

Abstract:

BACKGROUND: The health benefits of physical activity and exercise are well documented and these effects could help people with schizophrenia.

OBJECTIVES: To determine the mental health effects of exercise/physical activity programmes for people with schizophrenia or schizophrenia-like illnesses.

SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group Trials Register (December 2008) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. We also inspected references within relevant papers.

SELECTION CRITERIA: We included all randomised controlled trials comparing any intervention where physical activity or exercise was considered to be the main or active ingredient with standard care or other treatments for people with schizophrenia or schizophrenia-like illnesses.

DATA COLLECTION AND ANALYSIS: We independently inspected citations and abstracts, ordered papers, quality assessed and data extracted. For binary outcomes we calculated a fixed-effect risk ratio (RR) and its 95% confidence interval (CI). Where possible, the weighted number needed to treat/harm statistic (NNT/H) and its 95% confidence interval (CI), was also calculated. For continuous outcomes, endpoint data were preferred to change data. We synthesised non-skewed data from valid scales using a weighted mean difference (WMD).

MAIN RESULTS: Three randomised controlled trials met the inclusion criteria. Trials assessed the effects of exercise on physical and mental health. Overall numbers leaving the trials were similar. Two trials (Beebe 2005 and Marzaloni 2008) compared exercise to standard care and both found exercise to significantly improve negative symptoms of mental state (Mental Health Inventory Depression: 1RCT, n=10, MD 17.50 CI 6.70 to 28.30, PANNS negative: 1RCT, n=10, MD -8.50 CI -11.11 to -5.89). No absolute effects were found for positive symptoms of mental state. Physical health improved significantly in the exercise group compared to those in standard care (1RCT, n=13, MD 79.50 CI 33.82 to 125.18), but no effect on peoples’ weight/BMI was apparent. Duraiswamy 2007 compared exercise with yoga and found that yoga had a better outcome for mental state (PANNS total: 1RCT, n=41, MD 14.95 CI 2.60 to 27.30). The same trial also found those in the yoga group had significantly better quality of life scores (WHOQOL Physical: 1RCT, n=41, MD -9.22 CI -18.86 to 0.42). Adverse effects (AIMS total scores) were, however, similar.

AUTHORS’ CONCLUSIONS: Results of this Cochrane review are similar to existing reviews that have examined the health benefits of exercise in this population (Faulkner 2005). Although studies included in this review are small and used various measures of physical and mental health, results indicated that regular exercise programmes are possible in this population, and that they can have healthful effects on both the physical and mental health and well-being of individuals with schizophrenia. Larger randomised studies are required before any definitive conclusions can be drawn.

Lancashire care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Physical Health Check – Rethink – Toolkit

Physical Health Check – Rethink -2009, RETHINK

Abstract:

The Physical Health Check (PHC) project is an innovative programme to improve the physical health of people living with severe mental health problems.  Research has demonstrated that people with mental health problems tend to be at an increased risk of a range of physical illnesses and conditions, including coronary heart disease, diabetes, respiratory disease and greater levels of obesity. Research also shows that people with severe mental illness die on average 10 years younger than the rest of the population. Physical health inequalities play a large role in this discrepancy. The PHC tool will help to identify unmet physical health needs and develop an action plan to address these needs.

The PHC comprises of a booklet divided into four sections. The first three sections contain questions about lifestyle, symptoms and screening respectively.

Each of these sections has a series of tick boxes in the right margin, to enable mental health professionals to identify unmet needs that arise, to return to and address in the Action Plan section that follows at the end.

Lancashire Care staff can request the physical health check tool, email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Lancashire Care Staff – Management of physical health in patients with schizophrenia: international insights

Management of physical health in patients with schizophrenia: international insights, European Psychiatry, Vol. 25 (2) 2010, pgs. S37-S40

Chaudhry IB, Jordan J, Cousin FR, Cavallaro R, Mostaza JM

Lancashire Care NHS Trust Early Intervention Service, The Mount, Whalley Road, Accrington BB5 5DE, United-Kingdom

Abstract:

This international meeting discussed the management of physical health in patients with schizophrenia in several countries including France, Spain, Germany, the UK and Italy. Physical health parameters, including weight, blood pressure, blood glucose, lipids and standard biochemical assessments are measured in many patients at the first hospital consultation. These reveal physical disorders such as obesity, hypertension, dyslipidaemia, the metabolic syndrome, substance abuse, cardiovascular disease, extrapyramidal symptoms, sexual dysfunction and diabetes in substantial proportions of patients. Psychiatrists consider switching antipsychotic therapy if excessive sedation, extrapyramidal symptoms, unacceptable weight gain, hyperglycaemia or dyslipidaemia occur. In general, switching is more likely to be considered for symptomatic adverse events than for laboratory abnormalities. Switching is discouraged by limited knowledge of protocols, the absence of guidelines and fears of relapse or reduced treatment adherence. The physical health of patients with schizophrenia receives much less attention in the community setting than in the hospital setting. Improved guidelines, protocols, resources and support are needed to improve the physical health of patients in the community.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Effect of a motivational group intervention upon exercise self efficacy and outcome expectations for exercise in Schizophrenia Spectrum Disorders

Effect of a motivational group intervention upon exercise self efficacy and outcome expectations for exercise in Schizophrenia Spectrum Disorders, Journal of the American Psychiatric Nurses Association,  2010,16(2) pgs. 105-113

Abstract:

BACKGROUND: Persons with SSDs contend with multiple barriers to exercise. Interventions are needed to enhance attitudes theoretically linked to exercise behavior.

OBJECTIVE: Examine effect of Walk, Address Sensations, Learn About Exercise, Cue Exercise for SSDs (WALC-S) intervention upon exercise self efficacy (SEE) and outcome expectations (OEES) in 97 outpatients with SSDs.

DESIGN: Experimental, pre test posttest. Randomization to experimental (WALC-S) or time-and-attention control (TAC) after baseline SEE and OEES measures. Measures repeated after WALC-S or TAC.

RESULTS: N = 97, 46% female, 43% African American, average age 46.9 years (SD = 2.0). Mean SEE scores were significantly higher in WALC-S participants after intervention (F ((1,95)) = 5.92, p = 0.0168), however, mean OEES scores were significantly higher in control participants after intervention (F ((1,95)) = 5.76, p = 0.0183.

CONCLUSION: This is the first study to examine SEE and OEES in SSDs. Interventions to enhance exercise attitudes are a critical first step toward the ultimate goal of increasing exercise participation.

Lancashire care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Physical Health – NOF – Weight management guidelines Adults & Children

Weight management guidelines Adults & Children, National Obesity Forum

Click on the title to access the full-text of these guidelines

Abstract:

Obesity  and overweight can be  managed  in Primary  Care  by  a motivated well-informed multi-disciplinary  team. The aim of treatment is to achieve and maintain weight loss by promoting sustainable changes in lifestyle.

Lancashire Care staff can request the full-text of these guidelines, email: susan.jennings@lancashirecare.nhs.uk

Physical Health & Wellbeing – Factfile

Public Mental Health & Wellbeing, Factfile 4 , 2010 , National Mental Health & Development Unit 

Click on the title above to access the full-text of this factfile

Click on to the National Mental Health & Development link to access other titles in this series

Abstract:


‘Good mental health and well-being are fundamental to flourishing individuals, families and communities and to national economic productivity and social cohesion’

Lancashire Care staff can either click on the links above or email: susan.jennings@lancashirecare.nhs.uk

Physical Activity – WHO – Global Recommendations on Physical activity for Health

Global Recommendations on Physical activity for Health, 2010, WHO

Click on the title to access the full-text of this report

Abstract:

WHO developed the Global Recommendations on Physical Activity for Health with the overall aim of providing national and regional level policy makers with guidance on the dose-response relationship between the frequency, duration, intensity, type and total amount of physical activity needed for the prevention of NCDs.

The recommendations set out in this document address three age groups: 5–17 years old; 18–64 years old; and 65 years old and above.WHO developed the Global Recommendations on Physical Activity for Health with the overall aim of providing national and regional level policy makers with guidance on the dose-response relationship between the frequency, duration, intensity, type and total amount of physical activity needed for the prevention of NCDs.

The recommendations set out in this document address three age groups: 5–17 years old; 18–64 years old; and 65 years old and above.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Great Outdoors: How Our Natural Health Service Uses Green Space To Improve Wellbeing

Great Outdoors: How Our Natural Health Service Uses Green Space To Improve Wellbeing,   Faculty of Public Health, UK, 2010

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Abstract:

New FPH mental health report calls for more use of walks in parks to treat mental illness

Safe, green spaces may be as effective as prescription drugs for treating mild to moderate forms of depression and anxiety according to a new report published today FPH.

Whilst anti-depressants are generally most effective for the severely depressed, the report suggests that people with milder forms of depression generally improve with access to green space and open air.

The report, Great Outdoors: How Our Natural Health Service Uses Green Space To Improve Wellbeing, also shows that living and working close to green spaces and being able to enjoy them safely can reduce crime and increase productivity in the workplace. Furthermore, easy access to parks and natural areas is shown to decrease health inequalities. The FPH report therefore calls for GPs to use more alternatives to medication for mental illness, including advice to spend time and exercise in green spaces.

Professor Alan Maryon-Davis, FPH President, says: “This report highlights the strong link between safe, green spaces and wellbeing. Everyone should have easy and safe access to parks and other natural areas to help tackle so many mental-health-related issues, from depression and anxiety to high blood pressure and anti-social behaviour. We in the medical community should consider using the natural environment as a great resource for improving people’s mental wellbeing.”

Lancashire Care staff can request the full-text of this report, email susan.jennings@lancashirecare.nhs.uk

Physical Health – Walk more feel the difference

Walk more feel the difference, 2009 , WFH

Click on the title above to access the full-text of this guide, available in easy read and large print too.

Abstract:

 This brand new version of the Walk more… feel the difference booklet includes clear, inspiring text about walking more and the benefits you will gain. There are sections on:

  • Why walk?
  • How much walking do I need to do?
  • Getting started
  • Your walking plan
  • Joining a Walking for Health group
  • How to stick with it!

This booklet is also available in EasyRead for adults with learning difficulties, and also in large print.

 

Lancashire care staff can either click on the links above or email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Walking for Health

Walking for Health - A cost-effective healthcare solution, July, 2010, Walking for Health (WFH)

Click on the title above to access the full-text of this report

Abstract:

The average cost of physical inactivity, per PCT, is over £5,000,000 per year.

Walking for Health is a tried and tested, cost-effective intervention that is proven to get sedentary people active at least 3 times a week for periods of over a year.

It is locally run, flexible and can target:

  • hard-to-reach groups
  • elderly people
  • those at risk of or suffering serious long-term ill health
  • young families

Drawing from 3 case stories from across England, this document explores the direct costs of running a scheme for commissioning organisations.

Lancashire Care staff can either click on the link above or email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Physical health in schizophrenia: a challenge for antipsychotic therapy

Physical health in schizophrenia: a challenge for antipsychotic therapy, European Psychiatry, Volume 25, Supplement 2, June 2010, Pages S6-S11

Heald, A

Ward 7 Office, Leighton Hospital, Middlewich Road, Crewe, Cheshire CW1 4QJ, UK

 

Abstract:

In the management of schizophrenia, mental health outcomes are the principal focus of treatment. The objective is to control the psychotic symptoms while minimising negative features of the illness, to achieve an overall improvement in the societal functioning of patients. Physical health is also important because if it is compromised, many of the benefits of improved mental health will be offset. Compared with the general population, schizophrenia patients are at increased risk of weight gain, abdominal obesity, diabetes, metabolic syndrome, and cardiovascular disease. These physical health problems can contribute to the decreased quality of life, lowered self-esteem and reduced life expectancy commonly reported in schizophrenia. For these reasons there is a pressing need to improve both the monitoring and the management of physical health in patients with schizophrenia as a part of their overall care. A consensus for metabolic monitoring of patients receiving treatment with antipsychotic drugs is available. However, the practicing clinician requires guidance about management of physical health in routine clinical practice. This should include recommendations for measurements that have strong predictive value about physical health risks yet are easy to make, and about the use of medications that have the least effect on physical health parameters. This article will review the gravity of the physical health risks facing schizophrenia patients.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Management of physical health in patients with schizophrenia: practical recommendations

Management of physical health in patients with schizophrenia: practical recommendations, European Psychiatry, Volume 25, Supplement 2, June 2010, Pages S41-S45

Heald, A et al.

Leighton Hospital, Crewe, United-Kingdom

Abstract:

Improved physical health care is a pressing need for patients with schizophrenia. It can be achieved by means of a multidisciplinary team led by the psychiatrist. Key priorities should include: selection of antipsychotic therapy with a low risk of weight gain and metabolic adverse effects; routine assessment, recording and longitudinal tracking of key physical health parameters, ideally by electronic spreadsheets; and intervention to control CVD risk following the same principles as for the general population. A few simple tools to assess and record key physical parameters, combined with lifestyle intervention and pharmacological treatment as indicated, could significantly improve physical outcomes. Effective implementation of strategies to optimise physical health parameters in patients with severe enduring mental illness requires engagement and communication between psychiatrists and primary care in most health settings.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Implementing a physical health strategy in a mental health service

Implementing a physical health strategy in a mental health service, Australasian Psychiatry, October 2010, Vol. 18, No. 5 , Pages 456-459

Bridget Organ Manager Community and Primary Mental Health, Emma Nicholson Psychiatric Registrar and David Castle Chair of Psychiatry

Abstract:

Objective: The aim of this paper is to describe a comprehensive metabolic monitoring strategy within an Australian public mental health service.

Methods: Patient physical health was identified as a high priority within the mental health service. A survey of staff attitudes informed the development of metabolic monitoring guidelines and provision of education for clinicians and patients. An audit was subsequently performed to ascertain rates and results of metabolic monitoring, and focus groups helped to understand patient perspectives.

Results: Despite significant barriers to the implementation of routine metabolic monitoring from both staff and patient perspectives, our programme delivered on around 60% coverage of routine monitoring of blood glucose and lipids and 54% on weight measurement. Compliance with measurement of waist circumference was much less (7%).

Conclusions: To ensure adherence to metabolic monitoring programmes within mental health services, a comprehensive and multifaceted approach is required with ongoing education of both staff and patients.

Lancashire CAre staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Physical Health – Promoting physical health in youth mental health services: ensuring routine monitoring of weight and metabolic indices in a first episode psychosis clinic

Promoting physical health in youth mental health services: ensuring routine monitoring of weight and metabolic indices in a first episode psychosis clinic, Australasian Psychiatry, October 2010, Vol. 18, No. 5 , Pages 451-455

Hetrick, Sarah et al.

Centre of Excellence, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne; headspace (National Youth Mental Health Foundation), Melbourne, VIC, Australia

Abstract:

Objective: Clinicians are increasingly being asked to implement guideline recommendations into their practice, but are given little practical guidance on this complex task. In this paper we outline a promising theory-driven approach we took to implementing guideline recommendations about routine monitoring of weight gain and metabolic disturbance in our first-episode psychosis clinic. While there is significant psychological and physical morbidity associated with weight gain and metabolic disturbance, routine monitoring was not being undertaken according to guideline recommendations. We examined the factors that make it difficult to undertake routine monitoring by interviewing psychiatrists. This barrier analysis allowed us to develop and introduce feasible and acceptable strategies to address these barriers, increasing the likelihood that routine monitoring would take place.

Conclusion: This paper advocates for undertaking an analysis of the barriers clinicians face to undertaking evidence-based practice in order to develop more sophisticated approaches to address areas where clinical practice and evidence are divergent. Such an approach is more likely to ensure that measures to improve practice are successful, are meaningful for the clinicians involved, and become imbedded in the clinical practice of the service.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

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