Pragmatic randomized controlled trial of the Mind Management Skills for Life Programme as an intervention for occupational burnout in mental healthcare professionals.

BACKGROUND: Occupational burnout is highly prevalent in the mental healthcare workforce and associated with poorer job satisfaction, performance and outcomes. AIMS: To evaluate the effects of the Mind Management Skills for Life Programme on burnout and wellbeing. METHODS: N = 173 mental health nurses were recruited from the English National Health Service during the acute phase of the COVID-19 crisis. Participants were allocated to an immediate intervention or a delayed intervention control group, using a stepped wedge randomized controlled trial design. Measures of burnout (OLBI) and wellbeing (WEMWBS) were completed at four time-points: [1] baseline; [2] after the first group finished the intervention; [3] after the second group finished the intervention; and [4] six-months follow-up. RESULTS: Between-group differences were compared at each time-point using ANCOVA adjusting for baseline severity. Statistically significant effects on burnout (d = 0.60) and wellbeing (d = -0.62) were found at time-point 2, favouring the intervention relative to waitlist control. No significant differences were found at subsequent time-points, indicating that both groups improved and maintained their gains after the intervention. CONCLUSIONS: This intervention led to moderate improvements in burnout and wellbeing, despite the adverse circumstances of the COVID-19 pandemic at the time of the study.

Smartphone Mobile Applications to Enhance Diagnosis of Skin Cancer: A Guide for the Rural Practitioner.

Primary care physicians occupy a vital position to impact many devastating conditions, especially those dependent upon early diagnosis, such as skin cancer. Skin cancer is the most common cancer in the United States and despite improvements in skin cancer therapy, patients with a delay in diagnosis and advanced disease continue to have a grave prognosis. Due to a variety of barriers, advanced stages of skin cancer are more prominent in rural populations. In order to improve early diagnosis four things are paramount: increased patient participation in prevention methods, establishment of screening guidelines, increased diagnostic accuracy of malignant lesions, and easier access to dermatologists. Recent expansion in smartphone mobile application technology offers simple ways for rural practitioners to address these problems. More than 100,000 health related applications are currently available, with over 200 covering dermatology. This review will evaluate the newest and most useful of those applications offered to enhance the prevention and early diagnosis of skin cancer, particularly in the rural population.

Dietary intake of people with dementia on acute hospital wards.

The aim of this service evaluation was to understand the factors affecting meal provision on a dementia ward and assess whether meals-based dietary intake met estimated mean energy requirement and reference nutrient intake (RNI). A mixed-methods approach was adopted: 1. Mapping the dietary intake for a cohort ( n =6) of inpatients with advanced dementia over a period of four consecutive days. 2. Semi-structured interviews to explore the experiences of the professionals ( n =5) involved. Two of the participants' four-day mean intakes did not meet their estimated energy requirement based on meal provision. All participants apart from one met the target of 0.75g of protein per kg body weight per day for the general population. Several of the nutrients consumed were at or exceeded the RNI for adults of this age, although participants' mean dietary vitamin D intake was substantially below the RNI for the general population. The themes included communication, time pressure and the continuity of service provision. The meals provided were nutritionally sound. Individuals' nutritional status was improved through staff supporting them with eating. The contribution of drinks and snacks to nutrient intake warrants further exploration. Effective communication between food providers and ward areas is important. Mealtimes should reflect patient need - for example, having the main meal in the evening and a lighter option at lunch. This does not clash with the benefits of a flexible breakfast time.