Take a deep breath

To accompany last year's outcomes strategy for COPD and asthma, DH has produced a companion document that sets out best practice guidance for commissioners, particulraly in the transition period, ahead of the CCGs and the NHS Commissioning Board taking up the reins.  As Pulse points out, the guidance includes a case-finding approach to identifying undiagnosed patients.  A Swedish study of the use of a mini-spirometer in improving diagnosis of COPD finds it a highly effective device.  The companion document also reveals that DH is trialling the use of microspirometry in case finding in Yorkshire and Humber: the project is due to report in late 2012.

Pack shot

DH has launched its consultation on food labelling, aimed at a creating single system of front of pack nutritional information display.   Currently, around 80% of food products sold in the UK do provide nutritional labelling, but there are many systems.  DH estimates that if the big 7 supermarkets all hamonised their nutritional labelling, this would affect about half of all the food sold in the UK.  Responses are due in by 5 August.  Join the queue!  A recent study of Australian consumers found rather poor understanding of energy labelling at least.  The May issueof Public Health Nutrition carries a few articles on the subject, , looking at strategies to increase food label use int he US, German consumer responses to traffic light labelling systems and an online test from New Zealand of consumer response to low sodium labelling.

Price rise

Minimum pricing for alcohol, a key element in the Government's new alcohol strategy, has been questioned by the Local Government Association, over concerns that this will "cause a surge in counterfeit wine and spirits", the BBC reports.  A study from British Columbia, Canada, where minimum pricing has been in force for many years, suggests that it is effective in reducing alcohol consumption.  Approaching the problem from another perspective, a new Public Health Responsibility Deal pledge aims to make lower strength drinks more widely available.  A paper from the University of Sheffield considers the health economic assessment of public health alcohol harm strategies.  Minimum pricing has found support amongst pub landlords in Wales, who have blamed supermarket sales for a fall in their trade.  A study in Alcohol and Alcoholism examines trends in home drinking in the UK. 

Named and shamed

Several UK supermarkets were on the receiving end of the wrath of the Children's Food Campaign for undermining parents' efforts to encourage their children to eat healthily.  The report, Checkouts Checked Out, was highly critical of how much junk food is displayed at checkouts, both in supermarkets and non-food stores.  One of its recommendations is that removal of this kind of food from checkout areas should be included in the Public Health Responsibility Deal, the latest element of which (a calorie reduction initiative) was announced by DH recently. Public Health features an evaluation of the MEND (Mind, Exercise, Nutirition ... Do it!) healthy living programme as delivered in the West Midlands.  A systematic review of evidence about the association of childhood obesity with primary school built environments finds little to commend in the literature.  Community Practitioner offers an overview of the Food Dudes school-based healthy eating programme. 

Integration ahead

DH's recent evaluation of  the integrated care pilots has been found wanting in several quarters.  GP magazine put in a Freedom of Information Act request for clarity on DH's claim that this telecare route will offer £1.2 bn savings, but was turned down.  A lesss investigative approach from Nick Goodwin of the King's Fund echoes the less than enthusiastic response: "It is fair to say that the collective results of these pilots have been mixed."  He also observes that these pilots suffered from a common problem with integrated care, where the process of integration gets priority over the experience of care.  Another significant finding from the report was that emergency admissions increased over the period studied, while outpatient and elective admissions decreased.  The King's Fund is itself currently looking for case sites in its study of co-ordinated care for people with complex chronic illnesses.

On your bike

Preventive Medicine offers several articles on physical exercise interventions, including a UK study on the contribution of active travel to physical activity levels in schoolchildren, the effect of a school-based active commuting intervention and a population-based RCT of a pedometer combined with an intervention toolkit for people with low levels of fitness or physical activity. A systematic review in the American Journal of Preventive Medicine assesses the state of knowledge on adult sedentary behaviour.

Risky rice?

A study linking consumption of white rice with risk of type 2 diabetes has gained an amount of excitable press coverage. NHS Choices Behind the Headlines assesses the merit of this meta-analysis and systematic review and finds it adequate but not overly well represented in the media. Meanwhile, a study from the US Centers for Disease Control (CDC) finds that the HbA1c test is a cost effective pre-diabetes test where the threshold for diagnosis is set at 5.7%, rather lower than the current US level of 6.5%.