Faraz Mughal

Ramadan: what it means for general practice

Ramadan is the month of fasting, one of five pillars of Islam, and is ordained for Muslims in the Qur’an.1 In the Arabic language the word for fasting ‘sawm’ means abstinence, and this applies to eating, drinking, sexual relations, and all immoral vices from dawn to sunset. Islam exempts the duty of fasting for pregnant or nursing women where there is reason to fear harm to the mother or child, prepubescent children, older people, those with a mental illness, the sick, and those with chronic illness if there is medical concern that harm may occur. Despite this flexibility, many patients still choose to fast.2 This year, Ramadan begins at the end of June, with daily fasts exceeding 18 hours in length. It is therefore helpful for GPs to know how to counsel individuals when making such decisions. Fasting has many …

Shisha: is this addressed within smoking cessation in general practice?

Waterpipe tobacco smoking has become a widespread practice. In the UK, shisha smoking has been taken up by many, reflected in the increased number of shisha lounges and cafes. The evidence of the harmful effects of shisha smoking is growing and an association with lung cancer and respiratory illness has already been identified. …

Will next year's rise in UK tuition fees change the demographic of future medical and dental students?

Dear SirWhen a student is deciding whether to enter higher education, especially onto slightly longer courses such as medicine and dentistry, they must take into account the costs and long-term deb...

The junior doctor contract in the National Health Service

The progression of the junior doctor contract negotiations within the National Health Service (NHS) has been widely reported. We aim to provide a comprehensive summary of the current state of affairs with the contract negotiations and hope to inform those who may not be familiar with the situation affecting junior doctors in the NHS.

Severe depression with Cotard’s phenomenon: treatment of a capacitated patient within the United Kingdom’s Mental Health Act 2007

Treatment of Cotard’s syndrome with electroconvulsive therapy (ECT) has been seen to be an effective treatment option when pharmacological options are not successful. Recent changes in the Mental Health Act 2007 used within the United Kingdom has resulted in clinicians unable to prescribe treatment for patients who have capacity but are not providing consent for treatment. We report a case of a patient in the UK with Cotard’s phenomenon and severe depression, where the only effective treatment of ECT was restricted due to changes in mental health law. The role of maintenance ECT as well as the ethical dilemma faced is discussed.

From traditional to modern: easing students transition to problem-based learning

No abstract available. (Published: 6 August 2014) Citation: Med Educ Online 2014, 19 : 25438 - http://dx.doi.org/10.3402/meo.v19.25438

A pause for thought: reflections on the 2011 SAPC Annual Conference

The 41st Annual Scientific Meeting of the Society for Academic Primary Care (SAPC) was held in Bristol. A packed and varied programme, together with excellent organisation, brought people together to share ‘breaking news’ in primary care teaching and research. However, conferences are about more than dissemination of new work. They offer opportunities for activities not easily achieved by other forms of communication and scholarly activity. Conferences should be a ‘festival for ideas’: stimulating new conversations and new thoughts, as well as critiques of existing ideas. We asked a selection of this year’s Conference goers to send us a few words on ‘something that made me stop and think’. Here we reflect on what they tell us about SAPC’s goal to ‘support, promote, and develop the discipline of academic primary care’.

Peer influence as a driver of technological innovation in the UK National Health Service: a qualitative study of clinicians’ experiences and attitudes

Background Accelerating innovation to improve quality is a key policy target for healthcare systems around the world. Effectively influencing individuals’ behaviour is crucial to the success of innovation initiatives. This study explores UK clinicians’ lived experiences of, and attitudes towards, clinical peers endorsing healthcare innovations. Methods Qualitative interviews with UK-based clinicians in one of two groups: (1) clinicians working in ‘front-line’ service provision and (2) clinicians in strategic leadership roles within health institutions. Participants were identified through purposive sampling, and participated in semistructured telephone interviews. Thematic analysis was used to identify and analyse themes in the data. Results 17 participants were recruited: eight clinicians from front-line UK healthcare settings and nine clinicians in leadership roles. Two major themes were identified from the interviews: power and trust. Participants recognised and valued peers’ powerful influence, exerted in person via social networks and routine work-related activities. Peers were implicitly trusted, although often on condition of their credibility and deservingness of respect, supporting evidence and absence of conflict of interest. While the groups shared similar views, they diverged on the subject of institutions, felt to be powerful by strategic leaders yet scarcely mentioned by front-line clinicians. Conclusions UK clinicians view peers as a powerful and trustworthy source to promote innovative technologies. Policies that aim to support this process should seek to control the wider conditions that nurture peer-to-peer influence. Further research into interpersonal influence in health settings may improve implementation of change initiatives.

Encouraging smoking cessation in Ramadan in primary care

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Smoking reduction during Ramadan

In Ramadan, Muslims choose to abstain from food and drink from dawn till dusk to learn virtues such as gratefulness and to improve in God-consciousness.1 The observer must also refrain from smoking. Ramadan begins …