Theory-based communication skills training for medicine counter assistants to improve consultations for non-prescription medicines

Context: Medicine counter assistants (MCAs) supply the majority of non-prescription medicines (NPMs) to consumers. Suboptimal communication during consultations between consumers and MCAs has been identified as a major cause of inappropriate supply. Evidence from medical consultations suggests that training in specified communication skills can change professional behaviour. Methods: A feasibility study was conducted to evaluate the effect of theory-based communication skills training for MCAs. Thirty MCAs were recruited from 21 community pharmacies in Grampian, Scotland. The intervention comprised 2 4-hour training sessions, held 1 month apart. The sessions were informed by results from previous studies and the Calgary−Cambridge evidence-based model of communication skills training. Strategies for guiding individuals through change were adopted from cognitive behavioural therapy techniques. The theory of planned behaviour was used to assess potential pathways to behaviour change. Recorded data were collected during covert visits to the pharmacies by simulated patients at baseline and 1 month after each training session. Communication performance was measured as the number and type of questions asked. Results: Compared with baseline measures, the total number of questions asked increased in the intervention group at both timepoints. No change was shown in the control group between baseline and follow-up 1, and a decrease was shown in the total number of questions from follow-up 1 to 2. The intervention appeared to have greater effect on consultations involving advice, compared with those concerning product requests. Discussion: Communication performance improved following training. Increased information exchange is associated with guideline-compliant supply of NPMs. A substantive randomised, controlled trial is now planned to assess the intervention.This study was funded by the Chief Scientist Office, Scottish Executive Health Department

Motivational, volitional and multiple goal predictors of walking in people with type 2 diabetes

Acknowledgment MN’s PhD scholarship was provided by Ministry of Health and Medical Education (Islamic Republic of Iran). This study was funded by the University of Aberdeen reference number: GP007RGC1618. FFS is funded by Fuse, the UK Clinical Research Collaboration Centre of Excellence for Translational Research in Public Health (grant number: MR/K02325X/1). The researchers gratefully acknowledge all the Type 2 diabetic patients and their household members who participated in the study for their contribution to this study; without them there would be no data. The researchers gratefully acknowledge the SDRN for providing the list of Type 2 diabetes and helping for sampling.Peer reviewedPublisher PD

Managing Minor Ailments : The Public’s Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment

Acknowledgements We thank members of the wider study steering group (Dr Karen Gerard, Dr Ben Craig and Mr Ron Marsh) for their input to the study design, and all respondents who completed the survey. Funding: This work was funded by Medical Research Council MR/J004812/1 to VW (www.mrc.ac.uk), and Pharmacy Research UK 1076457 to MW (www.pharmacyresearchuk.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Investigation of Nondestructive Testing Methods for Friction Stir Welding

Friction stir welding is a method of materials processing that enables the joining of similar and dissimilar materials. The process, as originally designed by The Welding Institute (TWI), provides a unique approach to manufacturing—where materials can be joined in many designs and still retain mechanical properties that are similar to, or greater than, other forms of welding. This process is not free of defects that can alter, limit, and occasionally render the resulting weld unusable. Most common amongst these defects are kissing bonds, wormholes and cracks that are often hidden from visual inspection. To identify these defects, various nondestructive testing methods are being used. This paper presents background to the process of friction stir welding and identifies major process parameters that affect the weld properties, the origin, and types of defects that can occur, and potential nondestructive methods for ex-situ detection and in-situ identification of these potential defects, which can then allow for corrective action to be taken

Pharmacist-led management of chronic pain in primary care:results from a randomised controlled exploratory trial

To compare the effectiveness of pharmacist medication review, with or without pharmacist prescribing, with standard care, for patients with chronic pain

Psychosocial Stress and Cervical Neoplasia Risk

OBJECTIVE: We assessed the association between psychosocial stress and preinvasive cervical neoplasia development controlling for HR-HPV infection. METHODS: This case-control study enrolled low-income women receiving family planning services at health department clinics. There were 59 cases with biopsy confirmed HSIL and 163 with low-grade SIL and 160 controls with normal cervical cytology. A modified SLE scale was used to measure stressful events and the perceived impact of the event in the prior 5 years. Unconditional logistic regression was used to assess SIL risk and stressful events scores and by subscales. RESULTS: After adjusting for age, HR-HPV infection, and lifetime number of sex partners, the SLE count score was associated with an increased risk of SIL among white women (aOR = 1.20; 95% CI = 1.04, 1.38) yet not among African American women (aOR = 1.02; 95% CI = 0.87, 1.19). The relationship stress subscale (divorce, infidelity, an increase in the number of arguments, and psychological and physical partner violence) was the only one of four subscales (loss, violence, and financial stress) associated with SIL, again, only among white women (aOR = 1.54; 95% CI = 1.21, 1.96). CONCLUSIONS: These data suggest that psychosocial stress may play a role in SIL development. Future studies are needed to confirm these findings, to explore racial difference in reporting stress, and to explore the mechanism through which psychosocial stress may affect cervical neoplasia risk