Use of e-cigarettes among adults in Great Britain

 Findings from its annual Smokefree GB survey into the use of electronic cigarettes and vapourisers in Great Britain | Action on Smoking and Health

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The study, conducted by YouGov on behalf of ASH, shows an estimated 2.9 million adults in Great Britain currently use electronic cigarettes.

For the first time ever, the survey finds more ex-smokers (1.5 million) who use e-cigarettes than current smokers and the main reason people offered for their use of e-cigarettes was to stop smoking. While this is positive, there are still many people who “dual-use” combustible and electronic cigarettes which still exposes them to the toxic, cancer causing substances in tobacco smoke.

The summary of findings is available for download here

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Why do patients seek primary medical care in emergency departments?

MacKichan, F. (2017) BMJ Open. 7:e013816

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Objectives: To describe how processes of primary care access influence decisions to seek help at the emergency department (ED).

Conclusions: This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around ‘inappropriate’ patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups.

Read the full article here

Reward In The NHS: Good Practice And Innovation Taking Place Across The NHS

In this report, we share the key areas being taken forward and look at how organisations are changing their approach to reward | NHS Employers

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Image source: NHS Employers

This report captures the themes, good practice, and innovation that have emerged from NHS Employers’ Total Reward Engagement Network over the last year. It focuses on key elements of reward and how organisations are changing their approach to reward.

Read the full report here

Cheap blood test could boost prostate cancer treatment

A cheap genetic test costing less than £50 has been developed that could help target treatment for men with advanced prostate cancer and help offset side effects from ineffective treatments | OnMedica

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Cancer researchers across Europe, including doctors from the Institute of Cancer Research (ICR) in London, analysed blood from 265 men with the disease and found those with multiple copies of a particular gene did not respond to abiraterone and enzalutamide – drugs commonly used to treat advanced cases.

About 46,000 men are diagnosed with prostate cancer in the UK every year, one in four of them at an advanced stage. For the study,* published in the journal Annals of Oncology, scientists took blood samples from patients taking part in three different clinical trials.

The team says that more trials are needed but they hope the test could prevent thousands of men undergoing unnecessary treatment and allow more personalised care. The drugs abiraterone and enzalutamide are given to men whose cancer is no longer responding to traditional hormone therapy and has started to spread.

Read the full commentary via OnMedica here

Read the full original research article here

 

Arts-based training in observation and mindfulness for fostering the empathic response in medical residents

Zazulak, J. et al. Medical Humanities. Published online: 27 April 2017.

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Empathy is an essential attribute for medical professionals. Yet, evidence indicates that medical learners’ empathy levels decline dramatically during medical school. Training in evidence-based observation and mindfulness has the potential to bolster the acquisition and demonstration of empathic behaviours for medical learners.

In this prospective cohort study, we explore the impact of a course in arts-based visual literacy and mindfulness practice (Art of Seeing) on the empathic response of medical residents engaged in obstetrics and gynaecology and family medicine training.

The results indicated that programme participants improved in the Mindfulness Scale domains related to self-confidence and communication relative to a group of control participants following the arts-based programme. However, the majority of the psychometric measures did not reveal differences between groups over the duration of the programme. Importantly, thematic qualitative analysis of the interview data revealed that the programme had a positive impact on the participants’ perceived empathy towards colleagues and patients and on the perception of personal and professional well-being. The study concludes that a multifaceted arts-based curriculum focusing on evidence-based observation and mindfulness is a useful tool in bolstering the empathic response, improving communication, and fostering professional well-being among medical residents.

Read the full article here

What does patient feedback reveal about the NHS?

Research finds that staff are likely to be evaluated both positively and negatively according to their interpersonal skills.

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Objective: To examine the key themes of positive and negative feedback in patients’ online feedback on NHS (National Health Service) services in England and to understand the specific issues within these themes and how they drive positive and negative evaluation.

Results: Overall, NHS services were evaluated positively approximately three times more often than negatively. The four key areas of focus were: treatment, communication, interpersonal skills and system/organisation. Treatment exhibited the highest proportion of positive evaluative comments (87%), followed by communication (77%), interpersonal skills (44%) and, finally, system/organisation (41%). Qualitative analysis revealed that reference to staff interpersonal skills featured prominently, even in comments relating to treatment and system/organisational issues. Positive feedback was elicited in cases of staff being caring, compassionate and knowing patients’’ names, while rudeness, apathy and not listening were frequent drivers of negative feedback.

Conclusions: Although technical competence constitutes an undoubtedly fundamental aspect of healthcare provision, staff members were much more likely to be evaluated both positively and negatively according to their interpersonal skills. Therefore, the findings reported in this study highlight the salience of such ‘soft’ skills to patients and emphasise the need for these to be focused upon and developed in staff training programmes, as well as ensuring that decisions around NHS funding do not result in demotivated and rushed staff. The findings also reveal a significant overlap between the four key themes in the ways that care is evaluated by patients.

Community weight loss programmes should be more widely available

Community weight loss programmes, such as Weight Watchers, are effective at helping people to lose weight, according to research published in The Lancet.

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A study published in this weeks issue of The Lancet  found that a three-month weight loss programme helps people lose weight, but a one-year programme helps people lose more weight for longer and reduces their risk of developing type 2 diabetes. The paper suggests that wider availability of these programmes could help people avoid metabolic diseases, such as diabetes, and may save the NHS money in the long run.

In the study the authors compared the effectiveness and cost-effectiveness of three treatment options: referral to Weight Watchers for three months, referral to Weight Watchers for one year, and a brief intervention (one-off advice together with a self-help booklet).

1,267 overweight or obese adults from 23 GP clinics across the UK were recruited and randomly allocated to one of the three interventions. Over a two-year follow-up, those who were referred to Weight Watchers lost more weight than those who were in the self-help group. And those in the one-year programme lost more weight than those in the three-month programme.

At two years, all groups had regained some of the weight, but those given a year-long programme were still lighter than the other groups.

Full reference: Ahern, A.L. et al. Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial. The Lancet. Published online 03 May 2017