Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
Vitamin D screening
The Choosing Wisely movement arose several years ago in North America with the intention of galvanising the medical profession to reduce unnecessary care. One of the recommendations that has emerged from this campaign advises against routine screening for Vitamin D deficiency, on the basis that there is minimal benefit to screening and subsequent treatment in the general population. An American research team recently sought to reduce such screening.1 They tested a low-resource intervention that included an educational memo distributed to primary care physicians and the removal of the Vitamin D test from the quick order screen in the electronic health record, and found it was associated with significant reductions in Vitamin D test ordering. As a bonus, annualised savings were approximately 1 million dollars.
Startups
The lockdown of large parts of society has come as a considerable shock to many companies, not least innovative startups. Economic crises worldwide have combined to create a unique situation that has no documented equivalent in the entrepreneurship literature. A German research team responded to this by conducting a ‘rapid response’ mixed-methods study.2
They found that, although startups are successfully leveraging their available resources as a first response to the crisis, their growth and innovation potential are at risk. The authors conclude that policy measures should not only provide first aid to startups by alleviating the pressure caused by constrained cashflow, but also involve long-term measures to ensure rapid recovery and growth. Given the predictions of a significant global recession, it is hard to see how such support will be achievable for most governments.
Social distancing
Since COVID19 is a novel virus, with no vaccines or specific treatments available at present, public health policy in the early phase of the pandemic has relied on non-pharmaceutical interventions, such as social distancing and isolation. A recent study explored the perceptions and experiences of the UK public about these measures, and involved five focus groups carried out in the first week after lockdown, with participants from a range of sex, ethnic, age, and occupational backgrounds.3
They found that social distancing and isolation associated with COVID-19 policy has had substantial negative impacts on the mental health and wellbeing of the UK public within a short time of policy implementation. It has disproportionately negatively affected those in low-paid or precarious employment. Practical social and economic losses — such as the loss of (in-person) social interaction, loss of income, and loss of structure and routine — led to psychological and emotional ‘losses’, including the loss of motivation, loss of meaning, and loss of self-worth. Uncertainty of duration and ability to cope longer-term were key concerns that emerged at that time.
World leaders on Twitter
Billions of people around the world use social media, which is why it is considered a powerful public health tool for world leaders to rapidly and directly communicate information on COVID-19 to citizens, in addition to more conventional media. A public health research team from the UK analysed viral tweets from G7 world leaders containing keywords ‘COVID-19’ or ‘coronavirus’ between November 2019 and March 2020.4 Eight out of nine G7 world leaders had verified and active Twitter accounts, with a total following of 85.7 million users. That sounds a lot, until you see that the vast majority were from a certain former reality TV star President, and that Justin Bieber has 111 million followers alone. Out of a total 203 viral tweets included in the study, 166 were classified as ‘Informative’, of which 48 had weblinks to government-based sources, whereas 19 were ‘Morale-boosting’ and 14 were ‘Political’.
Podcast of the month
Given the current global focus on #BlackLivesMatter, it’s a good time to check out Serial — season three is particularly eye-opening.
- © British Journal of General Practice 2020
