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We’re thrilled you want to give your immune system a fighting chance by trying ZAMboost! Due to overwhelming response, we are currently unable to process any additional sample requests. When we resume processing samples, we’ll let you know via Facebook, Twitter, and our blog.  So “like” or follow us then check back often to get the scoop on deals, giveaways, coupons, and immunity-boosting tips!

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New doctors need more support as they begin their careers, survey finds

Almost three quarters (73%) of junior doctors say they do not have enough time to give patients the care they require. Photograph: Martin Argles for the Guardian

Over the coming weeks about 6,000 new junior doctors will start life on the wards. It is a tough and daunting experience, as they put into practice all the training they have received over the past four or five years.

Predictably, there is negative press coverage around this time, based on research from the Dr Foster unit and the department of acute medicine at Imperial College London. The article, published four years ago, did show a small increase in deaths at the start of August – but the findings did not demonstrate a causal link between the rise in mortalities and the influx of new doctors.

Since that research was first published, junior doctors have become better prepared for the transition from medical student to junior doctor: training is far more patient-focused at medical school, and there is a period of pre-job shadowing, dedicated induction programmes and close clinical supervision. But there is no doubt that this is a challenging time for both junior doctors and senior colleagues.

We conducted a survey of about 350 junior doctors who are just completing their first year on the hospital wards, which produced some interesting findings. It was encouraging to see that more than two thirds had chosen a career to help people, but disheartening that a third were re-considering their career choice due to their early experiences. After years of dedicated study, it is a telling sign of the major stresses placed on the shoulders of young doctors so early in their careers.

We must do more to support junior doctors. Though the profession clearly has a role to play, so too do NHS managers. They have the power to provide appropriate resourcing and support on the ward, which can affect morale. As our survey shows, three quarters of respondents said that they had struggled with long hours. A similar number had difficulty with heavy workloads, and more than a third had felt isolated.

When asked what they had found most challenging when dealing with patients during their first year, 73% of junior doctors said they didn't have enough time to give patients the care they required, and nearly half were working beyond the maximum working hours stipulated by European law.

Managers have an important role in providing a safe learning environment. They should be accessible, and receptive to concerns, queries and new ideas. They will have a pivotal role in delivering Sir Bruce Keogh's vision, set out in his recent review into the quality of care and treatment provided by 14 hospital trusts in England.

I share his belief that junior doctors should not just be seen as the clinical leaders of tomorrow, but the clinical leaders of today. We must harness their enthusiasm and support them to become a valuable and respected member of the team.

Junior doctors are at the frontline of patient care, they understand the challenges faced by both patient and management and are, therefore, a valuable source of intelligence. They are capable of providing real insights and seeing things that affect patient safety.

The NHS has come under sustained fire and we need to nurture it back to health. Junior doctors represent the present and our future, and have a core role in restoring pride in our healthcare system, which we often forget is the envy of many countries.

So spare a thought for the thousands of young doctors who have embarked on a lifetime of dedicated hard work and study, and whose actions are a matter of life and death.

Dr Pallavi Bradshaw is medicolegal adviser at the Medical Protection Society.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

A day in the life of ... a healthcare commissioning support unit manager

Leigh Griffin, managing director of the Greater Manchester Commissioning Support Unit, says at 55 he feels 30 years younger. Photograph: Phil Tragen

My day starts at 5.30am. Like any right-thinking person, the first priority is a cup of tea before I tend to the dog, Dylan, a Welsh springer spaniel and reluctant morning companion.

Refreshed, I'm out of the house by 6.30am. I live in rural north Shropshire, so head down country lanes, picking up the pace of the day by the time I reach Salford, where the Greater Manchester Commissioning Support Unit (CSU) is based. I'm helped by a good dose of loud music on the way in. Current favourites include The National and Depeche Mode – although I always try to catch the Radio 4 news bulletin.

The CSU provides a wide range of support services from IT and data management to large-scale service redesign across 12 NHS clinical commissioning groups and 10 local authorities. Arriving in the office by 8am, I review the day's priorities.

I'm a list-maker, and each evening plan the following day in terms of meetings, plans or priorities; I run through these again, fresh and armed with caffeine.

While no two days follow a similar pattern, my work falls into three broad categories: organisational development and operations; working with our clients; and what I like to call "horizon scanning" – working up a strategy that allows us to define the balance between competition and collaboration with our CSU peers, for example.

My morning is typically focused on internal work. I might write the foreword to our weekly newsletter, meet with directors or deliver a fortnightly face-to-face briefing. Briefings are filmed and available for all colleagues to view from their bases across the region.

When I do these briefings I always seek to be honest, open and, above all, human. Connection and resonance with all members of our extended team (almost 500 staff) is essential. With our staff offering 14 services across many bases, it is important that we have common values and a culture of openness.

I believe that we stand or fall by the relationships we have with our clients, so I spend some time each day reviewing the services we deliver and connecting with our clients.

The focus is on how commissioning can add tangible value and make positive changes for our healthcare clients. We must understand their needs, the challenges they are facing and the opportunities that NHS reform will offer them – especially as many are new and still being shaped as organisations.

Each day I make some time for development, individually and as an organisation. As a senior leader, one of the major challenges for me is to avoid micro-management and retain focus on strategy and innovation. It's important I step back and take a rounder view. It's a challenge to strike the right balance, but a nice problem to have.

Before I leave for the day I make sure to deal with the practical business of emails, drawing up a list and taking any reading home for the night. With that done, I head back to Shropshire, with more music and The Archers (my only concession to middle age).

Back at home, there's normally time for an hour of work before tea, and either a drink in the village pub or some TV; I'm a box set viewer. The last thing running in my mind before I go to sleep tends to be a list of things to do the following day. I do struggle to switch off, but a good book and the occasional use of headphones helps.

Apart from my tastes in rural radio drama, I feel closer to 25 than the 55 years my birth certificate indicates. Although I enjoyed being a primary care trust chief executive, I can honestly say I have never felt more energised by my work than today. The challenge of demonstrating the value of commissioning at scale, while understanding and responding to individual client needs, keeps me buzzing.

I've been involved in something special embedding commissioning support in Greater Manchester, and I would like to continue here for a considerable length of time.

• If you would like to feature in our 'day in the life of series', or know someone who would, then let us know by emailing healthcare@theguardian.com

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

New doctors need more support as they begin their careers, survey finds

Almost three quarters (73%) of junior doctors say they do not have enough time to give patients the care they require. Photograph: Martin Argles for the Guardian

Over the coming weeks about 6,000 new junior doctors will start life on the wards. It is a tough and daunting experience, as they put into practice all the training they have received over the past four or five years.

Predictably, there is negative press coverage around this time, based on research from the Dr Foster unit and the department of acute medicine at Imperial College London. The article, published four years ago, did show a small increase in deaths at the start of August – but the findings did not demonstrate a causal link between the rise in mortalities and the influx of new doctors.

Since that research was first published, junior doctors have become better prepared for the transition from medical student to junior doctor: training is far more patient-focused at medical school, and there is a period of pre-job shadowing, dedicated induction programmes and close clinical supervision. But there is no doubt that this is a challenging time for both junior doctors and senior colleagues.

We conducted a survey of about 350 junior doctors who are just completing their first year on the hospital wards, which produced some interesting findings. It was encouraging to see that more than two thirds had chosen a career to help people, but disheartening that a third were re-considering their career choice due to their early experiences. After years of dedicated study, it is a telling sign of the major stresses placed on the shoulders of young doctors so early in their careers.

We must do more to support junior doctors. Though the profession clearly has a role to play, so too do NHS managers. They have the power to provide appropriate resourcing and support on the ward, which can affect morale. As our survey shows, three quarters of respondents said that they had struggled with long hours. A similar number had difficulty with heavy workloads, and more than a third had felt isolated.

When asked what they had found most challenging when dealing with patients during their first year, 73% of junior doctors said they didn't have enough time to give patients the care they required, and nearly half were working beyond the maximum working hours stipulated by European law.

Managers have an important role in providing a safe learning environment. They should be accessible, and receptive to concerns, queries and new ideas. They will have a pivotal role in delivering Sir Bruce Keogh's vision, set out in his recent review into the quality of care and treatment provided by 14 hospital trusts in England.

I share his belief that junior doctors should not just be seen as the clinical leaders of tomorrow, but the clinical leaders of today. We must harness their enthusiasm and support them to become a valuable and respected member of the team.

Junior doctors are at the frontline of patient care, they understand the challenges faced by both patient and management and are, therefore, a valuable source of intelligence. They are capable of providing real insights and seeing things that affect patient safety.

The NHS has come under sustained fire and we need to nurture it back to health. Junior doctors represent the present and our future, and have a core role in restoring pride in our healthcare system, which we often forget is the envy of many countries.

So spare a thought for the thousands of young doctors who have embarked on a lifetime of dedicated hard work and study, and whose actions are a matter of life and death.

Dr Pallavi Bradshaw is medicolegal adviser at the Medical Protection Society.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

A day in the life of ... a healthcare commissioning support unit manager

Leigh Griffin, managing director of the Greater Manchester Commissioning Support Unit, says at 55 he feels 30 years younger. Photograph: Phil Tragen

My day starts at 5.30am. Like any right-thinking person, the first priority is a cup of tea before I tend to the dog, Dylan, a Welsh springer spaniel and reluctant morning companion.

Refreshed, I'm out of the house by 6.30am. I live in rural north Shropshire, so head down country lanes, picking up the pace of the day by the time I reach Salford, where the Greater Manchester Commissioning Support Unit (CSU) is based. I'm helped by a good dose of loud music on the way in. Current favourites include The National and Depeche Mode – although I always try to catch the Radio 4 news bulletin.

The CSU provides a wide range of support services from IT and data management to large-scale service redesign across 12 NHS clinical commissioning groups and 10 local authorities. Arriving in the office by 8am, I review the day's priorities.

I'm a list-maker, and each evening plan the following day in terms of meetings, plans or priorities; I run through these again, fresh and armed with caffeine.

While no two days follow a similar pattern, my work falls into three broad categories: organisational development and operations; working with our clients; and what I like to call "horizon scanning" – working up a strategy that allows us to define the balance between competition and collaboration with our CSU peers, for example.

My morning is typically focused on internal work. I might write the foreword to our weekly newsletter, meet with directors or deliver a fortnightly face-to-face briefing. Briefings are filmed and available for all colleagues to view from their bases across the region.

When I do these briefings I always seek to be honest, open and, above all, human. Connection and resonance with all members of our extended team (almost 500 staff) is essential. With our staff offering 14 services across many bases, it is important that we have common values and a culture of openness.

I believe that we stand or fall by the relationships we have with our clients, so I spend some time each day reviewing the services we deliver and connecting with our clients.

The focus is on how commissioning can add tangible value and make positive changes for our healthcare clients. We must understand their needs, the challenges they are facing and the opportunities that NHS reform will offer them – especially as many are new and still being shaped as organisations.

Each day I make some time for development, individually and as an organisation. As a senior leader, one of the major challenges for me is to avoid micro-management and retain focus on strategy and innovation. It's important I step back and take a rounder view. It's a challenge to strike the right balance, but a nice problem to have.

Before I leave for the day I make sure to deal with the practical business of emails, drawing up a list and taking any reading home for the night. With that done, I head back to Shropshire, with more music and The Archers (my only concession to middle age).

Back at home, there's normally time for an hour of work before tea, and either a drink in the village pub or some TV; I'm a box set viewer. The last thing running in my mind before I go to sleep tends to be a list of things to do the following day. I do struggle to switch off, but a good book and the occasional use of headphones helps.

Apart from my tastes in rural radio drama, I feel closer to 25 than the 55 years my birth certificate indicates. Although I enjoyed being a primary care trust chief executive, I can honestly say I have never felt more energised by my work than today. The challenge of demonstrating the value of commissioning at scale, while understanding and responding to individual client needs, keeps me buzzing.

I've been involved in something special embedding commissioning support in Greater Manchester, and I would like to continue here for a considerable length of time.

• If you would like to feature in our 'day in the life of series', or know someone who would, then let us know by emailing healthcare@theguardian.com

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

New doctors need more support as they begin their careers, survey finds

Almost three quarters (73%) of junior doctors say they do not have enough time to give patients the care they require. Photograph: Martin Argles for the Guardian

Over the coming weeks about 6,000 new junior doctors will start life on the wards. It is a tough and daunting experience, as they put into practice all the training they have received over the past four or five years.

Predictably, there is negative press coverage around this time, based on research from the Dr Foster unit and the department of acute medicine at Imperial College London. The article, published four years ago, did show a small increase in deaths at the start of August – but the findings did not demonstrate a causal link between the rise in mortalities and the influx of new doctors.

Since that research was first published, junior doctors have become better prepared for the transition from medical student to junior doctor: training is far more patient-focused at medical school, and there is a period of pre-job shadowing, dedicated induction programmes and close clinical supervision. But there is no doubt that this is a challenging time for both junior doctors and senior colleagues.

We conducted a survey of about 350 junior doctors who are just completing their first year on the hospital wards, which produced some interesting findings. It was encouraging to see that more than two thirds had chosen a career to help people, but disheartening that a third were re-considering their career choice due to their early experiences. After years of dedicated study, it is a telling sign of the major stresses placed on the shoulders of young doctors so early in their careers.

We must do more to support junior doctors. Though the profession clearly has a role to play, so too do NHS managers. They have the power to provide appropriate resourcing and support on the ward, which can affect morale. As our survey shows, three quarters of respondents said that they had struggled with long hours. A similar number had difficulty with heavy workloads, and more than a third had felt isolated.

When asked what they had found most challenging when dealing with patients during their first year, 73% of junior doctors said they didn't have enough time to give patients the care they required, and nearly half were working beyond the maximum working hours stipulated by European law.

Managers have an important role in providing a safe learning environment. They should be accessible, and receptive to concerns, queries and new ideas. They will have a pivotal role in delivering Sir Bruce Keogh's vision, set out in his recent review into the quality of care and treatment provided by 14 hospital trusts in England.

I share his belief that junior doctors should not just be seen as the clinical leaders of tomorrow, but the clinical leaders of today. We must harness their enthusiasm and support them to become a valuable and respected member of the team.

Junior doctors are at the frontline of patient care, they understand the challenges faced by both patient and management and are, therefore, a valuable source of intelligence. They are capable of providing real insights and seeing things that affect patient safety.

The NHS has come under sustained fire and we need to nurture it back to health. Junior doctors represent the present and our future, and have a core role in restoring pride in our healthcare system, which we often forget is the envy of many countries.

So spare a thought for the thousands of young doctors who have embarked on a lifetime of dedicated hard work and study, and whose actions are a matter of life and death.

Dr Pallavi Bradshaw is medicolegal adviser at the Medical Protection Society.

This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

View the original article here

FREE Sample of ZAMboost Immune Support Supplement

UPDATED AS OF 10:20 a.m. AUGUST 21, 2013 
We’re thrilled you want to give your immune system a fighting chance by trying ZAMboost! Due to overwhelming response, we are currently unable to process any additional sample requests. When we resume processing samples, we’ll let you know via Facebook, Twitter, and our blog.  So “like” or follow us then check back often to get the scoop on deals, giveaways, coupons, and immunity-boosting tips!

View the original article here

FREE Sample of ZAMboost Immune Support Supplement

UPDATED AS OF 10:20 a.m. AUGUST 21, 2013 
We’re thrilled you want to give your immune system a fighting chance by trying ZAMboost! Due to overwhelming response, we are currently unable to process any additional sample requests. When we resume processing samples, we’ll let you know via Facebook, Twitter, and our blog.  So “like” or follow us then check back often to get the scoop on deals, giveaways, coupons, and immunity-boosting tips!

View the original article here

Low-grade prostate cancers may not become aggressive with time - adds support for "watch and wait" approach

Main Category: Prostate / Prostate Cancer
Also Included In: Men's Health
Article Date: 15 Aug 2013 - 0:00 PDT Current ratings for:
Low-grade prostate cancers may not become aggressive with time - adds support for "watch and wait" approach

Prostate cancer aggressiveness may be established when the tumor is formed and not alter with time, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.

Researchers found that after the introduction of widespread prostate-specific antigen (PSA) screening, the proportion of patients diagnosed with advanced-stage cancers dropped by more than six-fold in 22 years, but the proportion diagnosed with high Gleason grade cancers did not change substantially. This suggests that low-grade prostate cancers do not progress to higher grade over time.

Cancer stage refers to the extent or spread of the disease, and cancer grade, called Gleason grade for prostate cancer, refers to the aggressiveness of the disease.

"We were able to look at finely stratified time periods to capture pre-PSA, early-PSA, and late-PSA eras within one study. Over time, because of PSA screening, men have been more likely to be diagnosed with prostate cancer at an earlier stage, before the disease has had an opportunity to grow and spread. If Gleason grade also progressed over time, we would expect a similar decrease in high Gleason grade disease over time," said Kathryn Penney, Sc.D., instructor in medicine at the Harvard Medical School and associate epidemiologist at the Channing Division of Network Medicine at Brigham and Women's Hospital in Boston, Mass. "We were surprised by just how constant the incidence of high-grade disease has been over time."

This study adds more evidence to the argument that patients who are diagnosed with low-grade prostate cancers can opt for an active surveillance, or "watch and wait" approach instead of getting treated right away.

Penney and colleagues used data from 420 participants recruited to the Physicians' Health Study and 787 participants recruited to the ongoing Health Professionals Follow-up Study. All participants were diagnosed with prostate cancer between 1982 and 2004, and treated with surgery. The researchers reanalyzed prostate tissue collected from these patients to assess Gleason grade.

The researchers divided the data into four time periods based on when the participants received a diagnosis and treatment: 1982-1993, 1993-1996, 1996-2000, and 2000-2004, to represent the pre-PSA and PSA eras. They found that the number of participants who had undergone PSA screening increased from 42 percent in 1994 to 81 percent in 2000.

They also found that the number of late-stage cancers decreased from 19.9 percent in the 1982-1993 group to just 3 percent in the 2000-2004 group, reflecting an 85 percent drop in stage at diagnosis. However, there was only a moderate decrease in high Gleason grade cancers, from 25.3 percent in the 1982-1993 group to 17.6 percent in the 2000-2004 group, reflecting a 30 percent drop.

With further analyses, the researchers found that the moderate drop in high Gleason grade cancers was not because progression to more aggressive disease was prevented through screening, but because of an increased diagnosis of low-grade disease that would not have been detected without PSA screening.

"Radical prostatectomy or radiation therapy, the usual treatments for prostate cancer, can have negative side effects such as impotence and incontinence; choosing active surveillance could prevent this decline in quality of life," said Penney. "Men with low-grade disease at diagnosis should seriously consider talking with their doctors about active surveillance."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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View the original article here