The use of particular coping strategies was systematically associated with symptoms of burnout and work-related posttraumatic stress in this group of intensive care staff, even after controlling for resilience and other factors. More research on how best to promote adaptive coping is needed in these challenging settings.

BackgroundPre-hospital delays in patients experiencing acute coronary syndromes (ACS) remain unacceptably long.AimsTo examine simultaneously a wide range of clinical, sociodemographic and situational factors associated with total pre-hospital delay and its two components.MethodsPre-hospital delay data were collected from 228 patients with ACS using patient's medical notes and semi-structured interviews. Total pre-hospital delay (symptom onset to hospital admission) was divided into 2 components: decision time (symptom onset to call for medical help), and home-to-hospital delay (call for help to hospital admission).ResultsShorter total pre-hospital delays and decision times were associated with ST segment myocardial infarction (STEMI), recognizing symptoms as cardiac in origin, being married, symptom onset outside the home and the presence of a bystander. Shorter home-to-hospital delays were more likely among younger patients, those experiencing an STEMI, and patients reporting a greater number of symptoms. Initial contact with emergency medical services was related to shorter total delays and decision times.ConclusionsDifferent factors were associated with shorter times in the 2 component phases. Greater understanding of the factors impacting on the component phases may help target interventions more effectively and reduce pre-hospital delays.

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Objective To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. Design Parallel group randomised controlled trial. Setting Primary health centre in a deprived, ethnically mixed inner city area. Participants 271 patients aged 18-70 years without serious illness. Intervention Brief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling. Main outcome measures Self reported number of portions of fruit and vegetables eaten per day, plasma carotene, tocopherol, and ascorbic acid concentrations, and 24 hour urinary potassium excretion. Assessment at baseline, eight weeks, and 12 months.

Depressed mood measured soon after admission is a predictor of returning to work following ACS. The management of early depressed mood might promote the resumption of economic activity and enhance the quality of life of cardiac patients.