There is much evidence supporting the efficacy of communication skills training; however, very little of this evidence comes from patient feedback. The primary aim of this pilot study was to evaluate whether the advanced communications skills training improves patients' experience of consultations. Healthcare professionals working in oncology and palliative care services from the North East of England were invited to participate in this study. Interactions between healthcare professionals (n = 21) and patients (n = 1103) were evaluated using the Consultation and Relational Empathy (CARE) Measure, which is a brief questionnaire designed to assess the patients' perceptions of relational empathy in the consultation. Additional demographic variables, such as patient age, length of consultation, familiarity with healthcare professional and overall satisfaction with consultation, were also collected. Healthcare professionals were either part of the intervention group who attended a 3-day communication skills training course or part of the control group who were on the waiting list for training. No differences in the patients' ratings on the CARE measure were found between Time 1 (before training) and Time 2 (after training) for the intervention group. Possible explanations for the findings are explored and implications for communication skills training are discussed.
Prior studies document a high prevalence of respiratory symptoms among brick workers in Nepal, which may be partially caused by non-occupational exposure to fine particulate matter (PM2.5) from cooking. In this study, we compared PM2.5 levels and 24 h trends in brick workers’ homes that used wood or liquefied petroleum gas (LPG) cooking fuel. PM2.5 filter-based and real-time nephelometer data were collected for approximately 24 h in homes and outdoors. PM2.5 was significantly associated with fuel type and location (p < 0.0001). Pairwise comparisons found significant differences between gas, indoor (geometric mean (GM): 79.32 μg/m3), and wood, indoor (GM: 541.14 μg/m3; p = 0.0002), and between wood, indoor, and outdoor (GM: 48.38 μg/m3; p = 0.0006) but not between gas, indoor, and outdoor (p = 0.56). For wood fuel homes, exposure peaks coincided with mealtimes. For LPG fuel homes, indoor levels may be explained by infiltration of ambient air pollution. In both wood and LPG fuel homes, PM2.5 levels exceeded the 24 h limit (25.0 µg/m3) proposed by the World Health Organization. Our findings suggest that increasing the adoption of LPG cookstoves and decreasing ambient air pollution in the Kathmandu valley will significantly lower daily PM2.5 exposures of brick workers and their families.
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