There is limited evidence for effectiveness of mindfulness-based interventions for patients with chronic pain. Better-quality studies are required.

BackgroundThe aims of the study were to determine the prevalence of cardiometabolic risk factors and establish the proportion of people with psychosis meeting criteria for the metabolic syndrome (MetS). The study also aimed to identify the key lifestyle behaviours associated with increased risk of the MetS and to investigate whether the MetS is associated with illness severity and degree of functional impairment.MethodBaseline data were collected as part of a large randomized controlled trial (IMPaCT RCT). The study took place within community mental health teams in five Mental Health NHS Trusts in urban and rural locations across England. A total of 450 randomly selected out-patients, aged 18–65 years, with an established psychotic illness were recruited. We ascertained the prevalence rates of cardiometabolic risk factors, illness severity and functional impairment and calculated rates of the MetS, using International Diabetes Federation (IDF) and National Cholesterol Education Program Third Adult Treatment Panel criteria.ResultsHigh rates of cardiometabolic risk factors were found. Nearly all women and most men had waist circumference exceeding the IDF threshold for central obesity. Half the sample was obese (body mass index ≥ 30 kg/m2) and a fifth met the criteria for type 2 diabetes mellitus. Females were more likely to be obese than males (61% v. 42%, p < 0.001). Of the 308 patients with complete laboratory measures, 57% (n = 175) met the IDF criteria for the MetS.ConclusionsIn the UK, the prevalence of cardiometabolic risk factors in individuals with psychotic illnesses is much higher than that observed in national general population studies as well as in most international studies of patients with psychosis.

Reliable assessment of standard competencies is complex and resource intensive. There would need to be a marked increase in the number of samples of clinical work assessed to be able to make reliable judgements about proficiency.

Good communication skills enhance consultations between health professionals and patients, leading to better patient outcomes and increased satisfaction. Health professionals working in diabetes can find it difficult to understand patients' apparent self‐management ‘failures’, but may lack psychological skills to support efforts at behaviour change. This paper reports on the impact of three‐day workshops using evidenced psychological theory as a basis for promoting communication and behaviour change skills in health professionals working in diabetes.Workshops were delivered in seven urban or rural health service areas in Scotland by a multidisciplinary team. Each included three full‐day sessions two weeks apart, and used a range of theoretically‐underpinned and evidenced teaching and learning methods. Eighty‐one health professionals working in diabetes care participated. Pre‐and post‐evaluations utilised questionnaires with closed and open questions.Participants recorded a significant increase in ‘positive’ communication and behaviour change techniques and a decrease in ‘negative’ techniques over the three workshops. Improved communication and behaviour change skills were perceived as having a positive impact on their understanding of patients' motivations and on their own day‐to‐day practice.In conclusion, communication and behaviour change skills are very important tools for health professionals working in diabetes care. They can be taught effectively in relatively few sessions using theoretically‐based and evidenced approaches, and have a perceived benefit in relation to enhancing patient care and professionals' satisfaction with clinical practice. Copyright © 2011 John Wiley & Sons.

These results indicate that Dose Adjustment for Normal Eating delivered in routine clinical practice is associated with a range of benefits and that certain clinical and psychosocial characteristics are associated with better outcomes.