Healthcare support worker assistantships should form a mandatory part of medical school curricula: A perspective from UK medical students.

This personal view, regarding the value of healthcare support worker (HCSW) assistantships, is based on our experiences as medical students entering our final year, having both worked as HCSW's during the COVID-19 pandemic, and from SC's experience as a HCSW before and throughout medical school. HCSW's provide a large proportion of the basic care patients receive on the wards, in clinics and primary care. The proximity to patients attracts individuals with excellent communication skills and bedside manner, and means they are well-positioned to assist in the management of both the general wellbeing of patients and equally, to recognise the signs of a deteriorating patient making them a versatile and invaluable member of the multidisciplinary team (MDT). This piece aims to highlight the value of our time spent working as a HCSWs, thus promoting the formation of a mandatory assistantship for medical students, like that seen in Germany. Through this, essential communication skills, empathy, 'ward smarts' and an appreciation for the wider MDT can be gained in a way that typical clinical attachments and classroom teaching do not replicate.

Glyceryl trinitrate in first-episode psychosis unmedicated with antipsychotics: A randomised controlled pilot study.

BACKGROUND: There is a pressing need for new classes of treatment for psychosis. A key therapeutic target for novel compounds is the NMDA receptor, which may be modulated by nitric oxide donors such as sodium nitroprusside (SNP). Recent studies of SNP in patients with psychosis have mixed results, and the drug has to be administered intravenously. Glyceryl trinitrate (GTN) is a well-established cardiovascular medicine that is also a nitric oxide donor, and can be given orally. AIMS: We explored the safety and potential effects of GTN in unmedicated patients with a first episode of psychosis. METHODS: This was a single-centre, randomised, double-blind, placebo-controlled trial from December 2016 to April 2019 (ClinicalTrials.gov identifier: NCT02906553). Patients received 3 × sprays of GTN or placebo for three consecutive days, and were re-assessed on Days 1, 2, 3 and 7. The primary outcome was cognition (Jumping to Conclusions task), secondary outcomes were symptoms (Positive and Negative Syndrome Scale (PANSS)), verbal memory (Hopkins Verbal Learning task), and mood (Bond-Lader Visual Analogue Scales). RESULTS: Nineteen patients were randomised, and 13 participants were included in the analyses. Compared with placebo, GTN was well tolerated, but was not associated with significant effects on cognition, symptoms, or mood. Bayesian statistics indicate that our results were 2× more likely under the null hypothesis than the alternative hypothesis, providing anecdotal evidence that GTN does not improve psychotic symptoms. CONCLUSIONS: We found no indication of an effect of GTN on symptoms of psychosis or cognition.