The UK population continues to grow, while nursing numbers have remained static for several decades. Compounding matters, The King’s Fund and Nuffield Trust have reported a 25 per cent increase in nurses and midwives leaving the NHS from 2012 to 2018, from 27,300 to 34,100. In short, in the UK, we now have far fewer nurses relative to the general population than we used to.
What does this mean for patients’ care experience? The situation sounds bad, but how bad? Common sense would suggest that patients will experience poorer care when nurses are overstretched, and there’s plenty of anecdotal evidence to support that interpretation. But there are also positive stories, and claims about greater efficiency compensating for fewer staff.
Now a study in BMJ Quality & Safety provides direct observational evidence suggesting that lower nurse-patient ratios really do result in poorer health-care interactions.
There is increasing recognition that while our personality traits are stable enough to shape our lives profoundly, they are also partly malleable, so that our choices and experiences can feedback and influence the kind of people we become. A new study in the Journal of Research in Personality shines a light on a highly consequential behaviour that captures this dynamic – smoking cigarettes.
The results add “… to existing knowledge on the implications of smoking by showing that this behaviour is also likely to alter individuals’ characteristic ways of thinking, feeling, and behaving over time,” the researchers said.
Looking at the latest epidemiological data, it could be argued that we are in the midst of a pandemic of mental illness, of dimensions never before seen in human history. The WHO estimates that over 350 million people around the world are presently suffering from depression, which constitutes almost 5-6 per cent of the population. At its extreme, depression may lead to suicide, by which it is estimated that around 1 million people die every year. And the numbers continue growing. Faced with this rising tide of illness, it is impossible to overestimate the importance of hard facts and data indicating the paths researchers and clinicians may follow in search of ways to help. Sometimes, as suggested by a meta-analysis of 50 years of studies on indicators that help predict suicide attempts, we are entirely helpless. In other cases, like with the recent meta-analysis of the neural correlates of the changes brought about by psychotherapy in depressed brains, study results do bring us hope.
The results of the first systematic review and meta-analysis of biological markers evaluated in randomized trials of psychological treatments for depression in Neuroscience and Biobehavioral Reviews are another attempt at understanding methods of treating this terrifying illness. The authors – Ioana A. Cristea, Eirini Karyotaki, Steven D. Hollon, Pim Cuijpers and Claudio Gentili – quite rightly point out that understanding how psychological interventions impact or are impacted by biological variables has important implications. For many people, their depression co-occurs with a bodily illness, such as cancer, diabetes, heart disease, and immune system and neurological disorders, and at times is a consequence of that illness. Although we still know little about the reciprocal cause-and-effect mechanisms between psychic and somatic symptoms, some studies have suggested that psychological interventions not only change mood, but also normalise the functioning of the autonomic nervous system, with a therapeutic effect on physical conditions, such as heart disease. But is this really true?
Your personality traits play an important part in how long you are likely to live, as much as, or even more than, other personal factors like your intelligence and your family’s economic background. Now a study in the Journal of Research in Personality has identified a key factor that mediates the personality-mortality link – sleep. Simply put, people with certain personality characteristics are more likely to sleep too little, or too much, or to experience greater sleepiness during the day, and in turn this raises their year-on-year risk of dying (too little or excess sleep, and poor quality sleep, have known links with various health risks, such as cardiovascular disease, depression and chronic inflammation).
“Sleep has been associated with both personality and longevity, yet [before now] no study has investigated whether sleep is a pathway linking personality to objective health outcomes,” say the researchers, led by Shantel Spears at West Virginia University.
You can have £10 today or £12 next week. Which do you go for?
Being able to forego a reward now in favour of gaining something better later is known to be important in determining all kinds of desirable outcomes in life, including greater educational attainment, social functioning and health.
However, choosing to delay gratification won’t always be the best option. If you’re in desperate circumstances – you badly need money to buy food, for example – taking the £10 today could be sensible. But this isn’t necessarily an entirely conscious judgment – there may be biological systems that automatically shift your decision-making priorities according to what is most likely to enhance your survival. A new open-access study published in Scientific Reports provides evidence that having raised levels of inflammation in your body, which is generally caused by the immune system’s response to infection or injury, can skew your judgment to focus more on present rewards, and on instant gratification. If further research backs this up, there could be wide-ranging implications not only for understanding why some people are more impulsive than others, but even for treating substance abuse.
Millions of people around the world spend time and money on healthcare remedies that mainstream science considers ineffective (in the sense of being no more effective than a placebo), like homeopathy and acupuncture. A study published recently in Psychology and Health investigated how to address this issue in the context of multivitamins, which evidence suggests provide no benefit for healthy people – and may even cause harm in some contexts.
Despite this research evidence, huge numbers of healthy people take multivitamins because they appear to be helpful. Scientists refer to this as the “illusion of causality”: when someone takes a vitamin and then their cold goes away, for example, they may believe it was the vitamin that cured them, even though they would have recovered just as quickly anyway. Past research has shown that simply giving people the raw outcomes of clinical trials that show remedies to be ineffective doesnot necessarily help combat this problem, perhaps because the data can involve large numbers and complex findings, which are difficult for the public to interpret.
Douglas MacFarlane and colleagues from the University of Western Australia have explored how to better inoculate people against this illusion. The researchers report that people need to be told clearly about the proportion of people who benefit from the remedy versus taking a placebo – and this data has to be accompanied by a scientific explanation for why the remedy is ineffective.
Feeling good in an emotional sense helps to foster better physical health – at least that’s what’s been found in studies in the West. But “feeling good” doesn’t necessarily mean the same thing in all cultures. In the US, people tend to report that being excited and experiencing other so-called “high arousal positive (HAP) states” is what makes them feel good. Many people in Japan, however, place greater value on the opposite extreme, viewing calm, quiet “low arousal positive (LAP) states” as more pleasant and desirable. So, does this mean that engaging more often in stimulating activities – like a fitness work-out or a party – will make for better health in US citizens, while for people in Japan, engaging in more calming activities – like taking frequent baths – will have more of a beneficial effect? A new paper, published in Emotion, which explores this question, reveals some clear cultural variations – though not all of them are as the researchers predicted.
On the way to meet your friend at a cafe you’re confident about sticking to your resolutions for healthier living. It soon goes awry though – no, not because of your weak willpower, but due to your excess empathy.
Your friend orders first and plumps for the super indulgent Winter Warmer Chocca Mocha with added marshmallows. You follow suit, sensing that if you’d stuck with your original plans for a skinny coffee, you’d have made your friend feel awful. There is now a name for this behaviour: You just engaged in “altruistic indulgence”, the most appealing of excuses for a naughty lapse, described for the first time in a paper in Social Influence.
Asking patients to draw the parts of their body affected by illness (and similar drawing challenges) can provide insights into how they think about their illness, the seriousness of their condition, and how well they are likely to cope, among other things. For instance, when people who had experienced a heart attack were asked on repeated occasions to draw their heart, an increase in the size of their drawings over time correlated with more anxiety and a slower return to work.
This example and many others feature in a new paper in Health Psychology Review that’s charted the use of patient drawings in peer-reviewed research, finding that the approach has increased in popularity in recent years. From 1970 to 2002, the average number of papers involving patient drawings published per year was 0.5, whereas that increased to an average of 5.9 per year between 2003 and 2016. In all, Elizabeth Broadbent at the University of Auckland, and her colleagues found 101 relevant studies covering 27 categories of illness (most often cancer) and involving participants from 29 different countries, from Canada to Zimbabwe. “We can utilise patients’ drawings to improve our understanding of the illness experience and inform our clinical interventions,” they said.
If you’re planning to take off weight in the new year and it suddenly seems like food is everywhere – and is especially enticing – that’s probably your mind playing a particularly unhelpful trick on you. Thinking about food, even in terms of trying to avoid it, can actually make it more likely that you’ll notice food in your environment, especially if you’re already overweight or obese.
That’s according to a recent study in the International Journal of Obesity thatcompared how overweight and healthy weight people pay attention to food. Food cues – sights, smells, advertisements and social contexts like parties – are everywhere these days, so understanding why some people find it harder to ignore them could be key to designing weight loss programmes.