Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
Sleep health
Sleep plays a critical role in physical and mental health, although little is known about the intersecting influences on gender and work on sleep health. A recent Canadian study explored motivators, facilitators, and barriers to sleep health in 20 men employed in male-dominated industries.1 Despite an awareness of some of the strategies to enable healthy sleep, the findings indicate that men normalised sleep deprivation. Family responsibilities and workplace norms were implicated and reflected masculine ideals related to perseverance, resilience, and gendered role expectations. In addition to time constraints, intrusive thoughts and worries about burnout kept many men from getting the sleep they wanted and needed. The study concludes that gender-sensitive organisational practices are needed to support sleep health among working men.
Advanced liver disease
Advanced liver disease is a highly morbid condition characterised by frequent complications and limited survival. Patients may not fully understand their prognosis and are often unprepared for the course of illness. A research team from Texas recently explored hepatology clinicians’ and patients’ roles in prognosis discussions.2 Patients favoured initiating discussions early and welcomed a multi-profession approach to conducting discussions. Clinicians favoured a larger role for specialty physicians. Overall, participants conceptualised a multifaceted approach to prognosis conversations that includes discussions of life expectancy, predictions about likely course of liver disease, and expected changes in function and capabilities over time. Prognosis discussions for patients with advanced liver disease, the authors argue, need to be earlier and more structured.
CombiConsultations
Much like in the UK NHS, the primary healthcare system in the Netherlands is facing increasing workforce issues and is responding by exploring innovative solutions that involve the wider healthcare team. A team from Utrecht recently developed a new pharmaceutical care service for patients with a chronic condition: the CombiConsultation.3 This is a medication evaluation service conducted by the community pharmacist and either the practice nurse or GP. It consists of three steps: medication check, implementation, and follow-up. In contrast to a full medication review, it focuses on medication for a specific condition, and pilot testing has been promising. An evaluation of this intervention is currently underway and the findings will, I’m sure, be of interest to policymakers in the Netherlands and elsewhere.
#BetterHealth
The #BetterHealth campaign was launched by the UK Government in July 2020. It encouraged individuals to make healthier lifestyle choices, by losing weight, getting active, and quitting smoking, through a range of tools including mobile applications, virtual fitness videos, a BMI calculator, and offers with organisations who provide weight loss plans. A recent study from Northumbria examined reactions to the campaign on Twitter.4 The findings suggest that the campaign is problematic, given its lack of consideration for mental health and wider societal factors that contribute to obesity. The authors argue that the campaign could exacerbate mental health difficulties for individuals with eating disorders because of its focus on weight and perceived fat-shaming approach. They suggest that voices of vulnerable groups are centred in the development of future campaigns and a ‘whole systems approach’ is taken to promote better health. Hear, hear.
Podcast of the month
For a fascinating exploration of some of the stories, personalities, and events of empires over the course of history, listen to Empire: the Rest is History. There you can delve into the following questions: ‘How do empires rise? Why do they fall? And how have they shaped the world around us today?’ Find it at: https://shows.acast.com/the-rest-is-history-podcast/episodes/introducing-empire-with-william-dalrymple
REFERENCES
- 1.Soprovich AL, Bottorff JL, Wozniak LA, et al. Sleep health in male-dominated workplaces: a qualitative study examining the perspectives of male employees. Behav Sleep Med. 2022;20(2):224–240. doi: 10.1080/15402002.2021.1909594. [DOI] [PubMed] [Google Scholar]
- 2.Arney J, Gray C, Clark JA, et al. Prognosis conversations in advanced liver disease: a qualitative interview study with health professionals and patients. PloS One. 2022;17(2):e0263874. doi: 10.1371/journal.pone.0263874. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Meijvis VA, Heringa M, Kwint HF, et al. The CombiConsultation: a new concept of sequential consultation with the pharmacist and practice nurse/general practitioner for patients with a chronic condition. Int J Clin Pharm. 2022;44(2):580–584. doi: 10.1007/s11096-021-01350-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Talbot CV, Branley-Bell D. #BetterHealth: a qualitative analysis of reactions to the UK government’s better health campaign. J Health Psychol. 2022;27(5):1252–1258. doi: 10.1177/1359105320985576. [DOI] [PMC free article] [PubMed] [Google Scholar]