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21/04/2025
Five tips you should know when working from home as a doctorBy Daniel PyeAround half of NHS staff spend at least some of...
10/04/2025

Five tips you should know when working from home as a doctor

By Daniel Pye

Around half of NHS staff spend at least some of their time working from home - here are some tips to work comfortably and safely when you are working away from the clinical environment.

In the 2023 NHS staff survey, 51% of respondents spent at least some of their time working from home and 18% said that they worked remotely often or always.1

Although doctors still predominantly work in a traditional healthcare setting, technology means that some aspects of the job - such as over-the-phone consultations, training modules and paperwork - can be done from another location, depending on employer and legal requirements.

Here is what you need to create a good work-from-home space that helps you work efficiently and effectively.

1. Maintain good posture

The last thing you need in a busy week is a back problem from poor posture when working for long periods on a computer.

The Health and Safety Executive (HSE) gives advice on how to work safely from home when spending extended times looking at a screen.2

Workers should relax their shoulders and have their lower back and feet supported. Their eye level should be at the top of the screen, with wrists straight and equal pressure applied across their thighs. The screen should be about an arm’s length away. If using a laptop, the screen may need to be elevated and the worker may need to use a separate keyboard and mouse to maintain a straight posture.

A remote worker does not necessarily need office furniture to achieve a good posture, the HSE advice states. A cushion might be needed to raise the worker’s seated position or for additional back support to provide extra comfort and support for longer-term use.

The HSE recommends walking away from your screen for 5-10 minutes every hour to reduce static postures.

Stock image. iStock.com/ puhimec

2. Create a professional workspace

It is important for doctors to maintain a professional environment that works as an extension of their clinical workplace. It may be helpful for workers to clear their desk, leaving only essential items.

In response to a Doctors.net.uk forum post about what clinicians think is essential for a good work-from-home space, one said: “Clear desk space on which to spread out all your junk you need. Easy access to plug sockets for any computer. Make sure your tech works before you start so can log on to all systems needed.”

Another doctor said that “privacy and security” were the most basic things to get right in a work-from-home space: “If you are working you should be contactable by all who would be able to contact you if you were at your employer's premises, but you don't want your home landline or personal mobile phone number available to all at your workplace. So you need a work phone.

“And you don't want work stuff on your personal computer, and you don't want work IT to have access to your personal computer. So you need a work laptop.”

Being mindful of your background by testing out the laptop camera before starting calls may help with maintaining professionalism.

3. Choose the best furniture for you

One doctor called a good chair “absolutely essential”. The best chair depends on multiple factors, such as the user’s height, the length of their torso and if they have a disability. What may be ergonomic for one person may be uncomfortable for another, so it is best to try a range before buying.

Standing to work, while trendy, may not provide health benefits to everyone over prolonged sitting. A recent study from Australia, which used accelerometer data from 83,013 adults over several years, concluded that “increasing standing time as a prescription may not lower major CVD risk and may lead to higher orthostatic circulatory disease risk”.3

However, previously another study had found that interrupting sitting time with bouts of light or moderate intensity walking may lower postprandial glucose and insulin levels.4 So adjustable sit-stand desks and incorporating movement into your workday offer promise.

4. Take regular breaks and keep to a routine

The NHS released guidance for the public on how to work effectively from home through its Every Mind Matters platform.5

It recommends sticking to a “steady schedule” to avoid blurring the lines between work and personal time. “Follow your normal sleep and work patterns if you can, and stay consistent,” it states. The guidance adds that the time normally spent commuting could be used for exercising, reading or listening to music before logging in and starting work.

“Most importantly, when your workday ends, stop working,” it states. “Shut down your computer, stop checking emails and focus on your home life.”

The guidance recommends taking 5-to-10-minute breaks every hour, and for lunch and regular screen breaks to aid focus. Regular time outside and in green space is “great” for your mental health, it says.

5. Know your rights

Health and Safety (Display Screen Equipment) Regulations can apply to workers who work at home on a permanent or long-term basis, or routinely split their time between their workplace and home. Any employee who uses display screens daily for continuous periods of an hour or more will be classified as DSE workers. This does not apply to workers who use DSE occasionally or for short periods of time at home.

If you qualify, you can complete a self-assessment form provided by the HSE, which employers can then use to decide if you need additional equipment when working at home. When a DSE workstation assessment indicates that an employee needs equipment, the worker cannot be charged for this.

This article is presented for general interest - doctors should refer to their employer’s guidance when working from home.

References

NHS Staff Survey 2023. NHS staff survey national results. Accessed December 2024
Health and Safety Executive. Working with display screen equipment at home. Accessed December 2024
Ahmadi M N, Coenen P et al. Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence. Int J Epidemiol 2024;53:dyae136 [full text]
Dunstan D W, Kingwell B A et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care 2012;35:976-983 [full text]
NHS. Every Mind Matters. 6 simple tips to tackle working from home. Accessed December 2024

iStock has millions of exclusive stock photos, videos, vectors, and illustrations that are researched and shot by a diverse global community. © 2023 iStockphoto LP.

24/03/2025

What are the risks of prone positioning in infants?

Prone positioning in infants, particularly during sleep, is associated with several risks, the most significant being an increased risk of sudden infant death syndrome (SIDS). Here are the key risks:

1. **Sudden Infant Death Syndrome (SIDS)**: Prone sleeping position is a well-documented risk factor for SIDS. It is associated with reduced arousal responses, impaired autonomic regulation, and decreased cerebral oxygenation.

2. **Respiratory Complications**: Prone positioning can lead to airway obstruction and impaired respiratory mechanics, which may contribute to hypoxia.

3. **Gastroesophageal Reflux**: While prone positioning can sometimes be used to manage GERD under medical supervision, it can also exacerbate reflux symptoms in some infants.

4. **Developmental Concerns**: Prolonged prone positioning may affect motor development and lead to conditions such as plagiocephaly (flattening of the head).

5. **Thermoregulation Issues**: Infants in the prone position may have difficulty regulating their body temperature, potentially leading to overheating.

Due to these risks, the supine position (lying on the back) is recommended for healthy infants during sleep to minimize the risk of SIDS. Prone positioning should only be used under specific medical guidance and supervision.

24/03/2025

Can GERD resolve without medication in infants?

Yes, gastroesophageal reflux disease (GERD) can often resolve without medication in infants. GERD in infants is frequently a self-limiting condition that improves as the infant matures. This is due to the natural development and strengthening of the lower esophageal sphincter, as well as changes in diet and posture as the infant grows.

Non-pharmacological approaches, such as feeding modifications, positioning strategies, and reassurance to parents, are often sufficient to manage symptoms. In many cases, GERD symptoms decrease significantly by the age of 12 months. However, it is important to monitor for any red flag symptoms that may indicate a more serious condition requiring medical intervention.

24/03/2025

Alternative Treatments for GERD in Preterm Infants

- **Positioning Changes**:
- Elevating the head of the bed.
- Prone positioning (only under medical supervision).

- **Dietary Changes**:
- Thickened feeds to reduce reflux episodes.

- **Lifestyle Adjustments**:
- Feeding the baby in an upright position.
- Keeping the baby upright for 30 minutes post-feeding.

- **Non-Pharmacological Interventions**:
- Monitoring and adjusting feeding techniques.
- Ensuring proper burping during and after feeds.

These alternatives focus on minimizing reflux symptoms without the use of medication, which is crucial given the limited data on the safety and efficacy of pharmacological treatments like PPIs in preterm infants.

08/11/2024

Association between omega-6 fatty acid intake and asthma in US children and adolescents.
Xiaolan Zhang, Yinghui Qu, Linjun Du, Lifang Chen

BMC Pediatr. 2024 Oct 30; 24(1): 691

BACKGROUND
Asthma is an inflammatory disease. The potential of omega-6 fatty acids to alleviate asthma symptoms through their anti-inflammatory and immunomodulatory effects has been investigated.
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Olga Kordonouri, MD
Olga Kordonouri, MD
EBAC®.0 CE
Making Plans for Liverpool? Attend This Type 1 Diabetes Event on 18 NovemberJoin the experts as they explore early detection and proactive management in T1D...Register now for live events
article continues here
However, the association of dietary omega-6 fatty acids in childhood and adolescent asthma remains controversial.

OBJECTIVE
The aim of this study was to evaluate the association between dietary intake of omega-6 fatty acids and asthma in children and adolescents in the United States.
METHODS
We conducted a cross-sectional analysis of 5045 children and adolescents from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2020. Covariates were adjusted, and multivariate logistic regression, restricted cubic splines, threshold effects, and subgroup analyses were used.

RESULTS
Of the 5045 participants, 1000 (19.8%) were identified as having asthma. After adjustment for potential confounders, individuals in the second group (T2, 215.3-377.7 mg/kg/day) had an adjusted odds ratio (OR) of 0.70 (95% CI: 0.57-0.86, P = 0.001) for asthma compared with those in the lowest omega-6 fatty acid intake group (T1, < 215.3 mg/kg/day). Similarly, individuals in the third group (T3, > 377.7 mg/kg/day) had an adjusted OR of 0.59 (95% CI: 0.45-0.78, P < 0.001) for asthma. Furthermore, a non-linear (L-shaped) relationship between omega-6 intake and asthma was observed (P = 0.001), with subgroup analyses confirming the stability of the results. In the threshold analysis, a critical turning point was observed at around 384.2 mg/kg/day (OR = 0.996, 95% CI: 0.995-0.998, P < 0.001).

CONCLUSION
The consumption of omega-6 fatty acids in the diet showed an L-shaped association with asthma among children and adolescents in the United States. A critical turning point was noted at approximately 384.2 mg/kg/day.
SOURCE: BMC pediatrics

31/01/2024

High quality diet as a baby ‘could lower risk of bowel disorders in later life’

Encouraging new parents to feed their babies a diet rich in fish and vegetables, and avoid too many sugary drinks, could cut the risk of developing bowel disorders in later life by a quarter, according to a study.

Academics said the link supports the need for further research into diet in early life and the prevention of inflammatory bowel disease (IBD), which comprises Crohn’s disease and ulcerative colitis.

Researchers looked at data from two major cohort studies – All Babies in Southeast Sweden (ABIS) and The Norwegian Mother, Father and Child Cohort Study (MoBa) – which were conducted between 1997 and 1999 and 1999 and 2008 respectively.

Their analysis included dietary information for 81,280 one year olds from ABIS and 70,267 from MoBa.

Using a version of the Healthy Eating Index (HEI) scoring system which was modified for children, the team determined diet quality by measuring the intake of fruit, vegetables, meat, fish, dairy, sweets, snacks and drinks.

In the ABIS study, children’s health was followed up for 21 years, with a follow-up period of 15 years in the MoBa study.

Researchers found 307 children were diagnosed with IBD during the period.

The majority had Crohn’s disease (131), while 97 had ulcerative colitis. Some 79 children were recorded as having unclassified IBD.

Diets with a medium and high HEI score were associated with an overall 25% lower risk of IBD than those with a low quality diet at the age of one.

According to the charity Crohn’s & Colitis UK, IBD effects about one in every 123 people in the UK.

Symptoms of the conditions include tummy pains and diarrhoea, as well as tiredness and weight loss.

Fish intake in particular lowered the risk of ulcerative colitis by 54%, according to the study, while consuming a lot of sugar-sweetened drinks was linked to a 42% higher risk of IBD.

The average age of diagnosis in the ABIS study was 17 and the average on the MoBa study was 12.

Researchers said their “novel findings”, published in medical journal Gut, suggest diet in early life “is important for later IBD development and support further research in this field to understand the role of diet in the prevention of IBD”.

They added: “While non-causal explanations for our results cannot be ruled out, these novel findings are consistent with the hypothesis that early-life diet, possibly mediated through changes in the gut microbiome, may affect the risk of developing IBD.”

By Storm Newton, PA

05/01/2024

Acetaminophen (Paracetamol) Use During Pregnancy Linked to Language Delays in Children

Higher prenatal acetaminophen use during pregnancy may be associated with poorer early language development, according to a study published in Pediatric Research.

Results of the study showed that taking more acetaminophen during pregnancy, particularly during the second and third trimesters, was associated with poorer scores on measures of language development when children were aged 26.5 to 28.5 months and when they were aged 36 to 38 months.

“To our knowledge, this is the first study that has used a standardised measure of language development to assess the potential impact of prenatal exposure to acetaminophen on language development,” reported Megan L. Woodbury, College of Engineering, Northeastern University, Boston, Massachusetts.

The Illinois Kids Development Study is a prospective birth cohort in east-central Illinois. Between December 2013 and March 2020, a total of 532 newborns were enrolled and had exposure data available. Participants reported the number of times they took acetaminophen 6 times across pregnancy. Language data were collected at 26.5 to 28.5 months using the MacArthur-Bates Communicative Development Inventories (CDI; n = 298), and at 36 to 38 months using the Speech and Language Assessment Scale (SLAS; n = 254).

Taking more acetaminophen during the second or third trimester was associated with marginally smaller vocabularies and shorter utterance length (M3L) at 26.5 to 28.5 months. More acetaminophen use during the third trimester was also associated with increased odds of M3L scores ≤25th percentile in male children. More use during the second or third trimester was associated with lower SLAS scores at 36 to 38 months. Third trimester use was specifically related to lower SLAS scores in male children.

“We found that increased use of acetaminophen -- especially during the third trimester -- was associated with smaller vocabulary scores and shorter ‘mean length of utterance’ at 2 years,” Woodbury said.

“At age 3, greater acetaminophen use during the third trimester was related to parents ranking their kids as lower than their peers on their language abilities,” said co-author Susan L. Schantz, University of Illinois at Urbana-Champaign, Urbana, Illinois. “That outcome was seen primarily in male children.”

The researchers noted that their findings need to be tested in larger studies.

Reference:https://www.nature.com/articles/s41390-023-02924-4

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