Abstract
Conversations in the Community
Mind (Welsh and English mental health and wellbeing charity) has produced a free online course called Conversations in the Community. It can be used by anyone, so both patients and healthcare professionals, and has been created so that you can look at part of it, save progress and log back in another time. The course includes videos and interactive scenarios giving ideas about having conversations about mental health and wellbeing.
www.mind.org.uk/information-support/helping-someone-else/conversations-in-the-community
Dementia toolkit
The Living with Dementia toolkit has a variety of resources for patients and carers. There are specific sections organised in five themes – stay safe and well, stay active, stay connected, keep a sense of purpose and stay positive. I thought the sections on culture, language and heritage might be particularly useful.
Sustainability and iron replacement
When I first trained, iron supplements were prescribed three times a day; new evidence suggests much less frequent dosing. I was interested to see a sustainability prescribing article reminding us that using medication in the most effective regimes and ensuring only appropriate prescribing is one of the simple ways that we can all contribute to sustainability. The authors use the WASTED-RX questions to structure the prescribing assessment.
Sergeant M, Do J and Hategan A (2023) Sustainable practice: Sustainable prescribing of iron replacement therapy. BMJ 383(8406): 242–243. DOI: 10.1136/bmj-2023-075741.
Clap back on the patch
Reproductive Justice Initiative has started a campaign to diversify the colour of the combined contraceptive patch. Despite being widely used across the globe, and in use for 20 years, it still only comes in one colour – ‘nude’. Why would a large group of women wish for their contraceptive choices to be highly visible to the world? The Faculty of Sexual and Reproductive Health is backing the campaign and includes a link to the online petition.
www.fsrh.org/news/fsrh-statement-we-support-reproductive-justices-clap-back-on/
Glue ear
National Institute for Health and Care Excellence (NICE) has produced updated guidelines on the treatment of otitis media with effusion (fluid without infection in the middle ear, or glue ear). The guidance highlights the range of common symptoms related to hearing as well as associated features, such as behavioural problems and poor educational progress. Parents can become very anxious, particularly as watchful waiting is one of the options and because there are considerable delays in referral pathways at present. The guidance suggests sharing specific support strategies, such as facing the child when speaking to them and asking for school adjustment.
NICE (2023) Otitis media with effusion in under 12s. Available at: www.nice.org.uk/guidance/ng233 (accessed 19 January 2024).
RCGP SCA preparation courses
The RCGP is offering both half-day and 3-day comprehensive Simulated Consultation Assessment (SCA) preparation courses to equip AiTs (associates-in-training) with the skills, strategies and confidence to help them pass the SCA. Courses run monthly, offer interactive sessions with experienced trainers and examiners, providing realistic scenarios and expert guidance.
More information can be found at: www.rcgp.org.uk/mrcgp-exams/courses
Breathtaking
A few months ago, the TV drama ‘Breathtaking’ aired – did you watch it? Several medic friends have watched the programme; some found it too close to home. An interesting piece by Thom Perry, who worked on the series, describes his experience and the significance of being able to tell one’s story, considering the role that doctors played in the COVID-19 pandemic.
Perry T (2024) The Doctor will tell you a story now. BMJ 384. DOI: 10.1136/bmj.q431.
Parkinson’s disease update
This neurodegenerative condition is on the rise, with the prediction that the incidence and prevalence of this disease will have doubled by 2065. Earlier this year, The Lancet ran a series of three articles reviewing the epidemiology, pathophysiology, clinical presentation and management of this condition – a good place to go for an up-to-date, evidence-based review. The weblink to the three articles is below.
Exercise in depression
I (KS) often reflect that each month I find, almost without fail, something to include in our two pages of News & Views related to lifestyle medicine, which I appreciate is viewed cynically by some. However, every time I see a new research article, I do feel the need to highlight it here, firm in the belief that as a population we need to be more physically active, to promote both physical and mental health. So, unapologetically, do read the recent BMJ piece that highlighted the role of exercise in depression, concluding ‘exercise is an effective treatment for depression’.
Noetel M, Sanders T, Gallardo-Gamez D, et al. (2024) Effect of exercise for depression: Systematic review and network meta-analysis of randomised controlled trials. BMJ 384: e075847. DOI: 10.1136/bmj-2023-075847.
Same You brain charity
Founded by the Game of Thrones actress Emilia Clarke, the Same You brain charity aims to provide information and resources for individuals recovering from brain injuries, and their families. The website contains a really wide range of helpful patient information, covering everything from strength training, to the role of Omega-3, to returning to work after a brain injury. Additionally, there is a page with a UK-based directory of Neurorehabilitation services.
Asymmetric tonsils in children
Sore throats in children are part of the bread and butter of general practice, but how confident would you feel about assessing and managing asymmetrical tonsils in a child? In this recent article in the British Journal of General Practice, Mughal et al. provide an informative and practical approach to this problem – well worth a read.
Mughal Z, Jangan A, Ahmad A, et al. (2024) Assessing asymmetrical tonsils in children: an evidence-based review for primary care. British Journal of General Practice 74(739): 93–94. DOI: 10.3399/bjgp24X736377.
General practice and the hidden curriculum
A colleague and I were recently discussing the need for ongoing work to ensure that medical students’ experiences related to primary care are positive, and that this includes all aspects of their education, including what is known as the ‘hidden curriculum’. All involved in education of medical students, GP speciality trainees and First5® GPs, should be aware of what the hidden curriculum means, and the role we all have in addressing this to promote general practice as a positive career choice. The concept of the hidden curriculum, and examples of how students experience it, are demonstrated well in this BMJ Open article.
Parekh R, Jones M, Singh S, et al. (2021) Medical students’ experience of the hidden curriculum around primary care careers: A qualitative exploration of reflective diaries. BMJ Open 2021; 11: e049825. DOI: 10.1136/bmjopen-2021-049825.
Inclusive language
This obstetrics and gynaecology article gives some interesting patient scenarios that might generate discussion about gender-specific language.
Stroumsa D and Wu J (2018) Welcoming transgender and nonbinary patients: Expanding the language of “women’s health”. American Journal of Obstetrics and Gynecology 219(6): 585.e1–585.e5.
Media coverage of diseases
This year there have been a number of high-profile individuals with serious illnesses being reported in the media, one example being King Charles’s diagnosis of prostate problems, and subsequent to that a cancer diagnosis. Often, media coverage of diseases leads to a flurry of consultations with patients concerned about their own risk, or symptoms they may have been trying to ignore. How do practices deal with this? Does your practice use social media, or a website to provide information to patients in these scenarios? It strikes me that as GP practices, we should be acting proactively, or involving patient participation groups to consider what would be useful to communities.
