STRANGE JOB INTERVIEW BEHAVIOUR

by Admin 1. May 2005 10:10
 
Most managers have had experiences interviewing candidates for job openings. I'm sure each of you has, at one time or another, been baffled by interviewee behaviour, but we're betting you haven't faced some of the behaviours that we list below. Certainly head-scratchers, and amusing (at least to read about). Strange but true.
Based on a survey published via the Internet, here are some of the odd things reported by interviewing managers:
  1. "... said he was so well-qualified that if he didn't get the job, it would prove that the company's management was incompetent."
  2. "... stretched out on the floor to fill out the job application."
  3. "... brought her large dog to the interview."
  4. "... chewed bubble gum and constantly blew bubbles."
  5. "Candidate kept giggling through serious interview."
  6. "She wore a Walkman and said she could listen to me and the music at the same time."
  7. "Balding candidate abruptly excused himself. Returned to office a few minutes later, wearing a hairpiece."
  8. "Applicant challenged interviewer to arm wrestle."
  9. "... asked to see interviewer's resume to see if the personnel executive was qualified to judge the candidate."
  10. "... announced she hadn't had lunch and proceeded to eat a hamburger and french fries in the interviewer's office."
  11. "Without saying a word, candidate stood up and walked out during the middle of the interview."
  12. "Man wore jogging suit to interview for position as financial vice president."
  13. "Stated that, if he were hired, he would demonstrate his loyalty by having the corporate logo tattooed on his forearm."
  14. "Interrupted to phone his therapist for advice on answering specific interview questions."
  15. "... wouldn't get out of the chair until I would hire him. I had to call the police."
  16. "When I asked him about his hobbies, he stood up and started tap dancing around my office."
  17. "... had a little pinball game and challenged me to play with him."
  18. "... bounced up and down on my carpet and told me I must be highly thought of by the company because I was given such a thick carpet."
  19. "At the end of the interview, while I stood there dumbstruck, went through my purse, took out a brush, brushed his hair, and left."
  20. "... pulled out a Polaroid camera and snapped a flash picture of me. Said he collected photos of everyone who interviewed him."
  21. "Candidate asked me if I would put on a suit jacket to insure that the offer I had made was formal."
  22. "Said he wasn't interested because the position paid too much."
  23. "While I was on a long-distance phone call, the applicant took out a copy of Penthouse, and looked through the photos only, stopping longest at the centerfold."
  24. "During the interview, an alarm clock went off from the candidate's brief case. He took it out, shut it off, apologized and said he had to leave for another interview."
  25. "A telephone call came in for the job applicant. It was from his wife. His side of the conversation went like this: "Which company? When do I start? What's the salary?" I said, "I assume you're not interested in conducting the interview any further." He promptly responded, "I am as long as you'll pay me more." "I didn't hire him, but later found out there was no other job offer. It was a scam to get a higher offer."
  26. "An applicant came in wearing only one shoe. She explained that the other shoe was stolen off her foot in the bus."
  27. "His attache [case] opened when he picked it up and the contents spilled, revealing ladies' undergarments and assorted makeup and perfume."
  28. "He came to the interview with a moped and left it in the reception area. He didn't want it to get stolen, and stated that he would require indoor parking for the moped."
  29. "He took off his right shoe and sock, removed a medicated foot powder and dusted it on the foot and in the shoe. While he was putting back the shoe and sock, he mentioned that he had to use the powder four times a day, and this was the time."
  30. "Candidate said he really didn't want to get a job, but the unemployment office needed proof that he was looking for one."
  31. "He whistled when the interviewer was talking."
  32. "... asked who the lovely babe was, pointing to the picture on my desk. When I said it was my wife, he asked if she was home now and wanted my phone number. I called security."
  33. "... she threw-up on my desk, and immediately started asking questions about the job, like nothing had happened.”

 

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Medtech Features

MRSA– super bug or superstar?

by Admin 1. May 2005 10:07
 

 

MRSA, or methicillin resistant Staphylococcus aureusto give it its full name, has never been so popular!
Working in the devices industry we may forget that we also have a part to play in controlling this evasive disease.
A typical day could mean accessing clinical areas in as many as five hospitals. This has to increase the risk.
This article outlines some of the issues you and your company may wish to consider.
This antibiotic resistant bacteria is the superstar, lets say Brad Pitt, of the microbiology world, hitting the tabloid headlines most weeks!
But what really is the problem with MRSA? Do we know? Do we know how it might affect us as patients, staff or visitors to healthcare settings, and do we know what we can do about it?
Well, the actual problem is more complicated than headlines that tell us ‘MRSA, flesh eating virus, ate my father’s leg’! Headlines like this raise awareness of the fact that there is a problem related to infections acquired while receiving healthcare, however, they are often inaccurate, frightening to would-be patients, and often don’t help to address the true problem.

What is the problem with MRSA ?
The problem with hospital acquired, or healthcare associated infection (HAI) as it is more commonly known, has developed over a number of years, thought to be due to a number of factors. MRSA is thought to be one of the most common bacteria associated with HAI. One factor for this includes the fact that since antibiotics were invented, the bacteria that the antibiotics are used to fight against have been clever and have continued to evolve to protect themselves from certain antibiotics, making some infections harder to treat. This is the case with MRSA. In addition, changing healthcare has led many to believe that the standards within hospitals in particular have fallen, and that this may have contributed to the increased spread of microorganisms such as MRSA, that lead to potentially avoidable infections in susceptible patients.
Some of the problems specifically related to MRSA are reported at a national level, namely MRSA bacteraemia rates. Such blood infections are often the most serious of all infections. In addition, local areas will often report further, more detailed information that they have gathered in order to act upon problem areas, for example those patients who have contracted MRSA infection in surgical wounds.
As Staphylococcus aureusis a bacteria then lives on skin, or can live in dust made up of shedded skin scales, or can cause infection in for example wounds, it is easy to recognise that the most common way in which it might spread is through hand contact. This contact may be directly with a patient or with the healthcare environment where MRSA might be living after being shed from contaminated sites.
The risks associated with contact with the healthcare environment can be considered:
  • Those vulnerable patients, who have compromised health and require intense care, often including the insertion of devices to provide essential treatment, are unfortunately at risk of acquiring infection.
  • Those staff providing such care will also be at risk, of picking up, in particular, bacteria, which may never affect them as healthy individuals, but may be a factor in cross infection to vulnerable patients.
  • Other staff and visitors may be at risk, either to picking bacteria or to being a factor in cross infection. However, this risk should be lower if contact with patients and the healthcare environment is lower.
All of these risks of course depend on how we interact with healthcare environments and the measures that we take to protect ourselves and others.

What can we do to control HAI?
Many recent national and local initiatives have focussed on improving standards to try to ensure all HAI are prevented as far as possible. Recently the focus has been upon hand hygiene and ensuring that all within healthcare settings decontaminate their hands appropriately. The use of alcohol hand solution products, such as gels, has been highlighted in addition to hand washing, to ensure that those who have contact with patients and the healthcare environment can decontaminate their hands at all the appropriate times, especially when staff have many other pressures of work.
Therefore, one of the key messages in the control of MRSA, and other bacteria that can cause HAI, is to adopt simple, fundamental measures that will protect patients and others. If such measures are applied, then we can at least be confident that we have played our part in the fight against MRSA and other HAI.
Training on such measures is crucial, to ensure all within healthcare environments are aware of the actions they can take, and training programmes are available and delivered in many different ways. For visitors, posters are often used to alert them to the problems and actions to be taken. For healthcare workers and other associated staff training programmes delivered by specialists are often given on induction to the workplace, with further updates, at least annually, ensuring awareness is maintained.
Can you guarantee that you and your company are taking this subject seriously and what mechanisms and standards of practice have you put in place to stop the finger being pointed at you.
In the meantime, lets hope it’s not you or one of your family that hit the headlines next along side the MRSA superstar!

Claire Kilpatrick
Nurse Consultant Infection Control
Health Protection Scotland

For further information on Hospital Access please contact Carol Allan on:
carol@hospital-access.com
www.hospital-access.com

 

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Medtech Features

WHAT'S WRONG WITH BUT?

by Admin 1. May 2005 10:05
 

 


Language is one of the most important tools you have to influence someone.

The most successful salespeople and persuaders use positive, active sales language that instills confidence in them and their capabilities. Here is one word that you'll want to avoid using as much as possible when you are selling and persuading.
BUT?
Read the following sentences:
"I really like your company, BUT I am not going to buy from you."
"You gave the best presentation, BUT we are going to buy from the Access Company."

When prospects say things like these, what they are really telling you is that they didn't like your company enough or you didn't give a good enough presentation to get the business.
The prospect's usage of the word 'but' acts to negate whatever came before it. And just as hearing 'but' from a prospect is often a negative message to you, using 'but' in your sales language can hurt your rapport with your prospects.
What would happen if this were your response to a customer's stated project budget?

"I see that you only have a budget of £50,000, BUT let me tell you why our equipment costs £100,000."

You have just given the message to the prospect that you don't care about their budget. You think they should find more money to spend with you (and maybe they should, but such an attitude will not help you get the sale). To stay in rapport with your prospect, replace the word 'but' with the word 'and'.
See here how it works:

"I see that you only have a budget of £50,000, and let me tell you why our equipment costs £100,000."

You have now shown respect for your prospect and his budget.
In using the word 'and' you acknowledge that they only have a budget of £50,000. People like to be acknowledged, and hate to be ignored. Prospects hate it when they feel that a salesperson isn't listening. It’s one of the major reasons why salespeople get little respect in the world today.
The next time you catch yourself using 'but' in a way that disrespects what someone just said, practice changing your sales language by saying the same thing again using 'and' instead of 'but'. Do this a few times and you'll find yourself using 'and' instead of 'but' and you'll have more rapport with more prospects.

 

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Medtech Features

A B P I

by Admin 1. May 2005 05:00

The Association of the British Pharmaceutical Industry said recently that the Health Select Committee’s report rightly acknowledges the importance of the UK pharmaceutical industry in the development of new medicines and the fact that its discoveries “have improved many people’s quality of life, reduced the need for surgical intervention and the length of time spent in hospital and saved many lives.” Dr Richard Barker, Director-General of the ABPI, said: “It is critically important to patients, the NHS and the pharmaceutical industry that the public have trust in and benefit from advances in medicines. To this end the committee’s report puts forward a number of constructive proposals to increase public accountability and transparency among all those involved in decisions about health care.” The industry wholeheartedly supports proposals for improved patient information about medicines and better reporting of side-effects by both patients and doctors. The ABPI agrees with moves towards public registers of funding of patient groups and of financial benefits received by doctors. It warmly welcomes the committee’s proposals for mandatory post-graduate training for all prescribers about medicines and how they can best be used. But there were a number of fundamental misconceptions within the Committee’s report that called into question other recommendations that were intended to restrict doctors’ freedom to prescribe and companies’ ability to provide information to the medical profession. In particular, the report claims that:

  • “Our consumption of drugs is vast and increasing.” In fact, the UK remains bottom of the European league in spending per head on medicines, and this remains steady at 12 per cent of the total NHS bill.
  • “. . . prescribing explosion often seen in the months following a product launch.” In fact, the UK has among the lowest usages of new medicines across Europe during their first five years on the market.
  • “Intensive marketing . . . encourages inappropriate prescribing.” In fact, most doctors receive only a handful of representative visits in a month. The majority say they value the clinical and product information provided.

Hence, artificially limiting the ability of doctors to receive information about medicines and restricting further their ability to prescribe medicines already licensed for use – as proposed in the report – would be a step backwards in the National Health Service’s bid to prevent disease and raise access to best quality treatment. The industry’s own Code of Practice covering the promotion of medicines to health professionals is also currently under review and will take into account the conclusions of the Select Committee. On research priorities, the industry is keen to work with Government to ensure the medicines it develops reflect the needs of the NHS and patients. Nearly half of all medicines developed in the past ten years match the NHS priorities of cancer, heart disease, mental health and the needs of the elderly. All medicines carry both a potential benefit and a risk, and it is the role of regulatory authorities to ensure a proper balance. The Committee’s proposals regarding reform of the MHRA need to take account of the fact that such licensing and safety systems operate on an international basis, and any changes would have to be consistent with those around the globe. Such systems are currently being re-examined in the light of recent public debate on risk-benefit issues involving medicines. “The Committee has rightly recognised the pharmaceutical industry in the UK as world-class. Clearly there is more that can be done to ensure future success. That can only be achieved by all those involved in healthcare sharing knowledge and improving communication and partnership for the benefit of patients,” said Vincent Lawton, the ABPI’s President.

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Features

50% rise in cancer predicted by 2020 How will the market respond?

by Admin 1. May 2005 05:00

Shift in development focus Fortunately for those diagnosed with cancer between now and 2020, a rise in prominence for treatment approaches employing moleculartargeted drugs, improved diagnostics, the emergence of more personalised treatment regimes and cancer’s perpetually high profile in shaping government healthcare policy will help ensure continued improvement in cancer treatment, says Datamonitor senior oncology analyst Nish Saini. “Conversely, for pharmaceutical manufacturers, there are various pharmacoeconomic constraints to contend with including increasing R&D costs, restrictive pricing and reimbursement policies and reduced periods of market exclusivity. This means that drug lifecycle management strategies will play an increasingly prominent role in maximising product revenues and ensuring an adequate return for the significant financial risks incurred in developing new drugs.” In 2004, the top 20 drugs in the seven major pharmaceutical markets** generated combined sales approaching $27bn, with the US accounting for a 66% share of this total, Japan 13% and the EU 21%***. Collectively, sales of the top 20 cancer drugs in each of these markets represents 77% of total global oncology revenues, demonstrating the industry’s heavy reliance on these individual products and specific markets for income. While the economic value of these brands is undisputed, the looming threats of therapeutic competition and of even greater significance, patent expiry, provide a considerable commercial and clinical challenge to the industry, Saini says. Supportive care supports sales The supportive care class of drugs are those that are given to patients to prevent or treat the toxicities associated with chemotherapy, Saini says. “Currently supportive care drugs like recombinant growth factors and serotonin antagonists constitute a significant proportion of oncology drug revenues and Datamonitor anticipates sustained sales growth within this class.” Recombinant growth factors are used to accelerate blood cell count recovery following the administration of chemotherapy and also to treat the symptoms of cancer-related anaemia. Serotonin antagonists have a role in preventing chemotherapy-induced nausea and vomiting. “In fact over the course of the next decade, Datamonitor predicts that of the current cancer drugs that maintain a top 20 position in one or more of the seven markets, only those in the innovative and supportive care classes will maintain a positive CAGR (5.1% and 3% respectively).” “Conversely, existing members in the cytotoxic and antihormonal categories will experience declining sales over the period 2004–14, with patent expiries having the greatest influence on reducing market share.” In the US for example, patent expiration will affect six of the seven cytotoxic drugs in the current top 20, the latest genericisation occurring in 2011, Saini says. “Similarly, all three antihormonal drugs currently featuring in the US top 20 will face patent expiry by 2009.” Therefore, Saini says, strategies to mitigate the challenge of patent expiry, generic incursion and therapeutic competition will rely on innovative approaches to lifecycle management and sustained R&D productivity to maintain a commercially productive pipeline. “This is well evidenced in the cytotoxic market where reformulated second-generation ‘super-generic’ versions of Bristol Myers Squibb’s Taxol, such as Cell Therapeutics’ Xyotax and Abraxis Oncology’s Abraxane, are expected to be launched from 2005. The higher returns achievable from these supergenerics should allow companies to make a higher up-front investment in product development, commercialisation and marketing.”

  Reference * Commercial Insight: Cancer Market Top 20 Drugs - Supportive Care Grows the Cancer Market. ** The seven major pharmaceutical markets are: France, Germany, Italy, Japan, Spain, UK and US. *** In this instance the EU refers to France, Germany, Italy, Spain and the UK only.
Datamonitor plc (DTM.L) is a premium business information company specialising in industry analysis. We help our clients, 5000 of the world’s leading companies, to address complex strategic issues. Through our proprietary databases and wealth of expertise, we provide clients with unbiased expert analysis and in-depth forecasts for six industry sectors: Automotive, Consumer Markets, Energy, Financial Services, Healthcare, Technology. Datamonitor maintains its headquarters in London and has regional offices in New York, San Francisco, Sydney, Tokyo, Frankfurt, Shanghai and Hong Kong. See www.datamonitor.com for further details.

 

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Features

Getting through the bad times, By Dr Anna Oldman, consultant at health and well-being consultancy PPC Worldwide

by Admin 1. May 2005 05:00

MILESTONE EVENTS: moving house; your first redundancy; the death of your parents – everyone will have to face some of these during their lives, leading to high levels of stress or anxiety. 91% of the employees questioned in recent research by PPC Worldwide (published as Milestone or Millstone?) admit that such events affect their productivity at work. In fact, six of the top ten reactions that people have at such times relate to work: taking time off, working less productively and making mistakes. The research reveals that performance is reduced by 20% on average, adding up to a day a week in lost productivity. That’s £15 billion a year lost from the UK’s businesses. Some ‘milestones’ are predictable events, such as returning to work after having a baby. By encouraging people to identify and address these events early enough, they will experience a notable reduction in the levels of stress or anxiety they face. Employers are increasingly offering workplace support to help employees through difficult times – for example, through private healthcare programmes or Employee Assistance Programmes (EAPs). An EAP provides a 24/7 telephone and face-to-face information and counselling service. The most leading-edge ones take a proactive approach to health and well-being: they encourage employees, whenever possible, to address personal and work issues before their performance or well-being is affected. Information and advice are available on all kinds of issues, from financial and legal problems to stress management and life skills training. An employee at Eli Lilly (Lilly) found her EAP invaluable when she received some upsetting news: her ex-husband had passed away in his hotel room in Cyprus, and she had to make all the arrangements. She asked for some time at work to make phone calls – and as she didn’t know where to start, she called the company’s EAP. “The people on the helpline helped me to contact the Foreign Office and also my children in New Zealand. The EAP gave me structure and helped me out of panic mode by easing the burden. By advising me on what to do and providing a plan, they stopped me from being too overwhelmed to deal with the practicalities.” The more emotionally balanced and supported people feel in their lives generally, the better they will handle and recover from the challenges that milestones in their lives present. Too much to take? Our research explored life’s most stressful events and how people cope with them. The results are surprising. While it’s widely accepted that bereavement and illness are difficult to cope with, other less talked-about events – such as infertility and miscarriage – also have severe effects. We also found that ‘everyday’ events, such as raising teenagers and coping with debt, are among the most problematic milestones. These routine events are often unnoticed or ignored by employers, though they can be just as stressful as apparently bigger milestones such as divorce. Even positive milestones, such as getting married or the birth of a child, can result in stress or be hard to cope with. By providing permanent support, employers can help staff to manage these events through preventative measures rather than reactive treatment. Lilly launched its EAP in 2003, believing that the independent advice and counselling would benefit all of its 2,500 staff and their families. Gay Buchanan, the HR Project Leader for Work-Life Balance, says: “The EAP can be accessed by everyone at any time of day or night, and irrespective of what life stage the employee is at or their personal circumstances. Whether they are starting their career with Lilly, retiring, getting married, coping with a bereavement or caring for an elderly relative, the staff view the EAP as a huge benefit.” The EAP’s information service, which covers legal, financial and general ‘Citizens’ Advice Bureau’ type information, has proved to be the most popular as employees cope with routine events such as debt and moving house. People’s coping mechanisms are not always constructive, so employers need to be aware of destructive behaviours that can signal when an employee is under abnormal stress. While our research found that talking to friends and family is the most common thing that people do to cope, they may also use comfort eating, drinking to excess and drugs – which, over time or at an excessive level, can lead to physical and mental health problems. People may also lose their appetite and need to take time off work, or may become violent and aggressive towards their friends and colleagues. These behaviours can lead to further problems, so it’s vital that employers support their staff to ensure that they remain healthy and able to manage situations effectively. Taking care of business Andrew Armes, head of talent development and resourcing at AstraZeneca, says, “I’m not surprised by PPC’s findings: these days there are so many things that can knock us for six. That is why we offer our staff a range of support services in case they need help to cope with these types of problems. This includes up to 13 weeks of unpaid personal leave, allowable every five years, which can be a godsend if they need to be there for their family or friends without worrying about work or just need to get away from it all for two or three months.” PPC’s research findings are a wake-up call to employers and make the Government’s proposed initiative, Investors in Health, more relevant than ever. Like the employer award Investors in People, this would create an accreditation for organisations that look after the health and well-being of their employees to create a supportive working atmosphere. It is not simply the business benefits of a more productive workplace that should encourage employers to become more active in helping their staff deal with life events, but also the opportunity to show a duty of care towards their employees.

For a free copy of PPC’s new report, Milestone or Millstone?, visit www.ppcworldwide.com

The healthcare and pharmaceutical sector For those working in healthcare and pharmaceuticals, the outlook is good. Those in healthcare are the least likely to take drugs to cope, compared to other industries. As they are also less likely to drink heavily, PPC’s research suggests those in healthcare can look after their own health as well as that of others. A quarter of respondents say they are happy to seek help outside of work and 13% (double the national average) are willing to seek help through work, showing a comfortable approach towards counselling. This contrasts markedly with those in the banking and finance sector, who are the least likely to seek professional help: just 9% say they would do that, compared to the national average of 19%.

  The 10 biggest milestones This chart shows the most difficult events, as cited by over half our sample. (The % figure is the percentage of people finding these events hard or very hard to cope with.)
  1. Miscarriage/partner who has miscarried (95%). 2. Death of someone close (94%). 3. Serious illness (93%). 4. Infertility problems (88%). 5. Splitting up with a serious partner (86%). 6. Separation (82%). 7. Being made redundant (75%). 8. Divorce (74%). 9. A court case or legal battle (72%). 10. Bringing up teenagers (63%).
  The 10 most popular coping strategies
  1. Talking to family and friends (63%). 2. Comfort eating or binge eating (41%). 3. Drinking more alcohol (38%). 4. Asking for support from family and friends (34%). 5. Spending money on clothes or treats (32%). 6. Going out to forget what he/she is going through (28%). 7. Consulting books or the Internet (28%). 8. Smoking more (27%). 9. Trying to get more sleep (26%). 10. Ignoring the problem and hoping it will go away (21%).
  PPC Worldwide’s top tips 1. What employers can do for staff
  • Provide an Employee Assistance Programme and ensure that managers and staff are familiar with what it is for, the benefits it provides and how to access it. • Promote an active stress management policy: measure and respond to workplace stress factors and educate staff in how to manage and reduce stress from other sources. • Ensure that managers receive training, guidance and support in dealing with a range of sensitive issues. Many are unsure how to approach staff members who they believe have personal difficulties. The right word at the right time is often seen as hugely supportive, and is valued by staff. • Provide ‘breathing spaces’ for staff to communicate informally. • Encourage and support staff to make healthy choices such as quitting smoking, drinking less and eating wisely. This could be linked to stress management. • State clearly and disseminate your policy on compassionate leave and other benefits, such as maternity/paternity leave. • Write updates on ‘milestones’ and publicise them regularly in order to demystify these life events and the ways people respond to them. • Cultivate a healthy working environment with clear policies and wellinformed, confident management.
  PPC Worldwide’s top tips 2. What people can do for themselves
  • Think ahead – some events can be planned for. For example, negotiate expectations with teenagers before they make demands; discuss wills and funeral arrangements with ageing relatives to avoid extra problems during grief. • If you have an EAP, know the benefits it offers and how it works before you need to use it. Remember: it’s there for all life events, not just for a ‘tragedy’. • If you don’t have an EAP, who can you turn to in difficult times? A private counsellor? A religious adviser? You need someone who is trusted, non-judgmental and supportive. • If you sense conflicting demands between personal events and work, speak to your employer. Make space to avoid having to juggle these demands when you may be stretched emotionally. • Cultivate a healthy, balanced lifestyle. Emotional resilience – the ability to ‘bounce back’ – is linked to physical well-being. • Be comfortable with your own attitudes and beliefs. Self-awareness promotes personal growth, which helps to build resilience. • Take up a regular stress-reducing activity. People who already exercise are more likely to use it as a(healthy) coping mechanism when they most need it. • Cultivate healthy relationships at work and outside: they will be beneficial to your psychological and physical health.

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Features

Snoring

by Admin 1. May 2005 05:00

SNORING IS NOISY breathing through the mouth and nose during sleep. It can occur when you are breathing in or out. What causes snoring and who is at risk? Snoring occurs when air does not flow smoothly through the air passages, or when the soft tissues or muscles in your air passages vibrate. As you fall into a deep sleep, the muscles in your tongue, throat and roof of your mouth (soft palate) relax. This muscle relaxation causes your throat tissues to sag. As you breathe, the sagging tissues narrow your airway and vibrate or flutter, creating the sound of snoring. The narrower your airway becomes, the greater the vibration . . . and the louder your snoring. Snoring affects 45 per cent of the population from time to time and an estimated 25 per cent of people are habitual snorers. There are a number of reasons why you may snore. Age can be a factor. The older you get, the weaker your throat muscles become. Weak throat muscles cause the surrounding tissues to sag and vibrate. If you are overweight, your throat tissues are less firm and more inclined to vibrate when you breathe. A low-set, thick soft palate, or enlarged tonsils or adenoids (the spongy tissue between the back of the nose and throat) can narrow your airway. A longer-than-normal uvula (the triangular piece of skin that hangs from your soft palate) can limit airflow and increase vibrations as you breathe. Nasal blockages caused by allergies or a deviated septum (when the partition between your nose is crooked) can limit airflow through your nose. This forces you to breathe through your mouth where more flabby tissue is located. Alcohol and certain drugs (such as tranquillisers) affect your central nervous system, causing extreme relaxation of your muscles, including those in your throat. When you sleep on your back, your tongue falls backwards into your throat which can narrow your airway and partly block airflow. When does snoring indicate a more serious problem? Rarely, snoring can indicate a more serious problem. If you snore loudly with occasional pauses in breathing, and you frequently wake up during the night, you may be suffering from sleep apnoea. Ask your partner, or a member of your family to listen for signs of this disorder. Sleep apnoea is periods when you stop breathing while you’re sleeping. These interruptions in your breathing, which can last 10 seconds or longer, occur when the muscles in your soft palate, uvula, tongue and tonsils relax during sleep. This is the same process involved with normal snoring, but with sleep apnoea, the airway narrows so much that it closes. Your breathing stops, cutting off the flow of oxygen into your body and reducing the elimination of carbon dioxide (CO2) from the blood. Your brain detects this rise in CO2 and briefly wakes you up, re-opening your airways and re-starting your breathing. This process can be repeated several times during the night. Proper sleep may become impossible, resulting in severe fatigue and a decreased quality of life. Sleep apnoea in adults can increase the risk of serious health problems such as heart failure, because it deprives the sufferer of adequate levels of oxygen, making the heart work harder than normal. How do doctors recognise sleep apnoea? Your doctor will ask you for any history of disturbed sleep, excessive daytime sleepiness, and loud snoring and/or long pauses in breathing reported by a bed partner. These signs are strongly suggestive of sleep apnoea but your doctor will need to refer you for further investigations before treatment can be started. Usually, these investigations are performed in a sleep laboratory and include: • Visual observation of sleep, to detect laboured breathing, with long pauses, followed by arousal from sleep. • Pulse oximetry, to measure the amount of oxygen in the blood and the pulse rate. The recording is taken for at least 8 hours overnight, and can be carried out at home. Multiple dips in oxygen level and peaks in pulse rate are found in people with sleep apnoea. • Polysomnography, which involves many measures of sleep, including eye movements and chin tone to define sleep stages, flow of air through the nose and mouth, movement of the chest wall, oxygen levels in the blood, and ECG (electrocardiography) to measure any serious abnormal heart rhythms. How are snoring and sleep apnoea treated? Self-care action plan Some causes of snoring (listed above) are the result of lifestyle habits. By altering these habits, you can stop - or at least minimise - your snoring. Try to maintain a healthy diet and weight. A healthy diet means eating a wide variety of foods from four main food groups: • bread, other cereals and potatoes • fruit and vegetables • milk and dairy foods • meat, fish and alternatives. You should aim to eat five servings of fresh, frozen or canned fruits and vegetables in your daily diet. You can also prepare meals in a more healthy way, for example baking or grilling foods instead of frying. This will not only reduce the fat in your throat tissues, but will also help improve your general health. Regular exercise will improve muscle strength. If you are starting out begin with a 10-minute period of light exercise and gradually build from there. When you are ready, it is recommended that you exercise at least three to four times a week. Try to do 20–30 minutes a session. Those 30 minutes don’t have to be continuous: we know that three 10-minute sessions of exercise each day is just as good. Occasional vigorous activity is unwise and possibly dangerous if you are ‘out of shape’. Factsheets on diet and weight and exercise are available and you can talk to your doctor about your ideal target weight, and regular exercise. Other measures include: • Always try to sleep on your side, instead of your back • Avoid alcohol before bedtime • Keeping the body in alignment, which could include raising the head of the bed, may help reduce snoring. This should be done by raising the head of the bed itself or by making sure that your pillow is at the correct height. Medicines If you have allergies that cause nasal congestion, try an oral or spray decongestant available from your chemist. Be careful not to use these over-the-counter (OTC) products on a long-term basis. If your nasal congestion doesn’t clear up in a few days, see your doctor as you may need stronger medication, or other measures to clear your nasal passages. If your nasal congestion is caused by a structural problem in the nose such as a deviated septum, there are surgical techniques that can correct it. If your doctor diagnoses sleep apnoea and none of the simple remedies are successful, he or she may recommend wearing an oxygen mask over your face while you sleep, to force air through your airway so that it won’t close. This treatment is called continuous positive airway pressure (CPAP). However, this form of treatment may need to continue for months or years and some people find wearing a mask in bed every night difficult to tolerate. Surgery While making lifestyle changes should be the first step in treating your snoring, these measures are not always effective. If that is the case, you might want to consider a form of surgery called laser-assisted uvulopalatoplasty (LAUP). This relatively new procedure has been found to stop or reduce snoring in most people. LAUP involves removal of excess tissue from your soft palate and uvula with a small, hand-held laser. The operation makes your airway larger, so vibrations are decreased. The procedure is performed under a local anaesthetic and takes about 30 minutes. Depending on the severity of your snoring, you may need more than one session – some people may need up to five or six sessions before their snoring is improved. If you need multiple treatments, they will likely be spaced four to six weeks apart. In general, this surgery does not have serious side effects and you can continue your regular activities immediately after the procedure. Some people may have a sore throat for about one week. In a very few cases, laser surgery can raise or lower the pitch of the voice. Before you decide on laser surgery, talk it over with your doctor. There are also several surgical options for sleep apnoea, depending on the cause: • If your sleep apnoea is caused by a jaw deformity, an operation to correct the deformity (which usually involves lengthening of the jaw bone) will be performed. This is successful in most people • If no cause can be found for your sleep apnoea and it is not considered to be life-threatening, a procedure called uvulopalatopharyngoplasty (UPPP) can be performed, where a surgeon trims and tightens throat tissues while you are under a general anaesthetic. However, this procedure has only a 30-50% success rate and can affect your ability to have CPAP therapy at a later date • If your sleep apnoea is caused by large tonsils and/or adenoids, these can be removed in a simple operation called a tonsillectomy or adenoidectomy. What is the outcome of snoring and sleep apnoea? Snoring is a mild annoyance for most people, but for those who snore habitually, it can cause serious social and marital discord. Usually, it can be remedied by lifestyle changes and/or surgery. Sleep apnoea is a more serious condition that can cause chronic illness if left untreated, but several effective treatment options are available.

For consumer-friendly and reliable health information on over 200 conditions, treatments and living healthily, visit BUPA's website at: www.bupa.co.uk

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Career Insights with comments from Lucy Randle, STAR Medical

by Admin 1. May 2005 05:00
Jackie Park, Neuroscience Specialist and Hospital Representative, has worked for Bristol-Myers Squibb Pharmaceuticals Ltd for eight of her 25 years in the pharmaceutical industry. Her other roles include GP/Hospital Rep, Area Sales Manager and Commercial Manager. She really thrives on the opportunity to make a difference.

Pf asked Jackie: What is the best thing about the specialist hospital role? The best part of my job is when I am discussing individual case studies with a consultant or doctor, thereby helping people with schizophrenia regain control of the quality of their lives. This is when you realise how important the job we do really is. What is the biggest challenge you face? The product I promote is the first of a new class of drug. Therefore I am educating doctors and discussing data on a new innovation, equipping them with the scientific information to make a decision to use a new drug of which they may have no experience of the class. As you can imagine, this is a huge challenge. What would you consider the biggest success in your role, Jackie? The biggest success for me was formulary inclusion in Greater Glasgow Health Board (GGHB); this was the first in Scotland. A REAL RESULT! Also the SMC (Scottish Medicines Consortium) gave us a positive review. The two votes of confidence, especially in Scotland, are the best successes we could have predicated to increase awareness and use of the product. This was only achieved by good team working. Historically, only a handful of products have gained product inclusion this early in a campaign, so I was pleased and very proud of this result. Having worked in various other roles . . . what is it about Having worked in various other roles . . . what is it about hospital selling that you like? I have the opportunity to be at ‘the coal face’ and get first-hand feedback from doctors, nurses and key workers, denoting exactly how they feel about the product and its effects. I also have the luxury of hearing all the positive life-changing stories, which really motivates me – especially in the area of mental health. Working in mental health really demonstrates the improved quality of life and the overall impact we have on patients. Hospital selling is a real people-oriented job and you know every day that you are making a difference! What qualities make a successful hospital representative? What qualities make a successful hospital representative? The ability to: • Motivate yourself • Work independently • Demonstrate respect for the importance of the role A hospital selling role is the only job that could have held my attention and interest over the years, and given the options I would choose the same career pathway again . . . even after 25 years! Lucy Randle of STAR Medical offers some top tips to help you maximise the impact of your CV: Having spent 25 years in the industry, Jackie has held several roles, from GP Rep to Commercial Manager. Throughout her time in the industry, she has taken the time to update her CV in order to sell herself both internally and externally. Do it now It takes at least two days to write a superb new application, addressing the relevant issues and organising the information so that you sell yourself. You need to take this task seriously right from the start. The biggest error most people make is throwing away a great chance by rushing a mediocre CV out at the last minute. Regard your CV and application letter as a work in progress and give it a polish every couple of months. You never know when you will be asked for it. Make it interesting If you follow a boring format or copy out your job definition, it will be as dull as ditchwater to recruiters who have to read lots of applications every day. You need to reach these people where they get interested. The story of your career needs to build up an expectation that you are worth meeting. You need to tell them the context in which your achievements have taken place, and let them know what value you offer for the future. Edit and edit again Professional writers throw away more stuff than they publish. Put it all down and then reduce it until you fit no more than two pages. If necessary, group all of your early career details under a separate heading and just give each job a line or two. Place the focus on the last five to ten years and the highest levels of activity and achievement. Cut the minor roles and competencies that are already implied by the big stuff you do. Write your brief and powerful introduction last, when you know what you need to say in order to summarise your offering, and don’t bother giving it a heading – anyone can see what it is. Think headline and a few strap lines, making sure they hang together to lead into the story – your story. Good luck in writing/updating your CV – and if you want any assistance or feedback, please give me a call on 0870 242 2025.

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LETTERS TO THE EDITOR

by Admin 1. May 2005 05:00

24 April 2005 Dear Pharmaceutical Field I was very interested to read your article in April’s edition on ‘Who’s writing the script?’ As someone who has been a medical representative for the last eight years, I have seen vast changes taking place within our industry. It is certainly true to say that today’s influence networks are very different and that the changes that have been made to deliver improved financial control are here to stay. You asked in your article, “And where does this leave the traditional rep sales force?” In a way you answered your own question by saying firstly that GPs still need product information to inform their choice of on-formulary drugs, and secondly that there is a need to meet evolving GP needs in terms of standard product information, and also to support the new increased budgetary focus. In terms of new products, it is also important to remember that most drug and therapeutic committees include a GP, and that a primary care representative can have a key role in gaining formulary inclusion for new products. With regard to your comment on the qualifications and qualities of a medical representative also needing to change, I believe a better phrase would be to say that we need to adapt – and indeed, as these changes are evolving I can see that this is happening now. Through medical representatives increasing their knowledge and understanding of the new PCOs and developing working alliances, we can remain a valued contributor to our primary care customers. These changes are affecting our GPs too by increasing their workloads, leaving them less time for seeing patients. Our challenge is to remain an integral part of the system in order to continue to provide value to them and their practices. Yours sincerely Kim Hollis Primary Care/Hospital Representative Pfizer Ltd

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Nursing a grievance By Gareth Thomas, Managing Director, Cegedim UK

by Admin 1. May 2005 05:00

THE INFLUX of nurse prescribers into the NHS over the next few years is set to have a major impact on prescription decision-making – particularly in areas of specialist care, such as Parkinson’s Disease, and in the management of conditions such as high cholesterol and diabetes. Yet few pharmaceutical companies have made any serious effort to reach this increasingly important influence network. Nor do they appear to understand the needs and information requirements of nurse prescribers, many of whom spend the major part of their time undertaking home visits. Not only are most representatives still bonused on GP and consultant visits, which gives them no incentive to inform or educate nurses as to new drug efficacy or ease of administering, but there are also limited facilities for providing the ondemand information that is necessary to support individual patient interactions. Is it any wonder that this critical influence group is feeling patronised, aggrieved and overlooked? Indeed, is this persistence in ignoring the nurse prescriber community actually undermining a policy designed to give GPs more consulting time with new patients? With a lack of good, targeted information, many nurse prescribers are not opting to use their new powers. It is time for pharmaceutical companies to step up to the plate and deliver the relevant, timely information required to support the growing number of nurse prescribers in day-to-day patient interaction. A Growing Role A few years ago, there were no nurse prescribers in the UK. Today there are an estimated 50,000 – primarily district and practice nurses – with Government targets for a further 50,000 by the end of this year. Their role – releasing the GP to spend longer with patients, and reducing the need to promote patients to secondary care, by providing specialist expertise within the community – is widely expected to grow as the value of the nurse prescriber is increasingly recognised. Indeed, while they are currently working on a limited formulary, there is a strong move towards extending the formulary in order to provide nurses with full prescribing rights based on the agreed patient plan. Now, when the relevant university courses are oversubscribed with would-be nurse prescribers, perhaps it is time for the pharmaceutical companies to accept the fact that the health service has changed. Certainly, to date, the limited formulary available to nurse prescribers has enabled pharmaceutical companies to ignore their importance in the clinical decision-making process. But it is becoming increasingly evident that a new influence network is in place, and these companies need to develop strategies to inform, educate and convince a different type of clinician. The Big Picture For pharmaceutical companies, the arrival of the nurse prescriber changes the necessary timing and content of the sales message. While GPs and pharmaceutical sales representatives have, by and large, co-existed quite happily for many years, nurses are far less willing to spend time enduring a sales pitch. Furthermore, the majority of nurse prescribers fulfil community and cross-practice roles, so they are unlikely to be available for the standard representative visits. Nor will such visits deliver any reward if the company’s products are not on a PCT formulary, since nurses must remain within prescribing guidelines. Yet nurses will not continue to be tied by the decisions of others on what drugs should or should not be on the formulary. It is inconceivable that the very healthcare professionals who spend the most time with patients will not play an increasingly important role in PCT decisions about the formulary. For every pharmaceutical company dealing with the new NHS, the primary focus must be on attaining formulary status – a strategy that will require delivering targeted, highly relevant messages to the key opinion leaders within PCTs and strategic health authorities. These key opinion leaders will increasingly include nurse prescribers. Once a drug is on formulary, the pharmaceutical company must create a relevant information source for nurse prescribers. For this clinical group, prescribing is just one stage in the complete treatment decision. Key issues include the efficacy and cost-effectiveness of treatment options, the evidence, the benefits and risks of a treatment and the patient’s own involvement in the treatment plan. Nurses, therefore, require information that is precisely tailored to support a specific patient interaction – from the possible side effects of a drug to the different administration options and the key ways to ensure patient compliance with the drug programme. Preferably, given the frequency of community visits made by nurses, the pharmaceutical company must be able to deliver this information on demand. To date, while there is a growing acceptance of the importance of e-detailing in providing information to doctors, few pharmaceutical companies are geared up to meet the needs of the nursing community. Improving the Focus There is a clear opportunity here for pharmaceutical companies to support and influence a key new clinical group. So why are so few seriously addressing this area? For any pharmaceutical company with a specialist niche product, identifying the key nurses will be essential. In addition, pharmaceutical companies must begin to involve nurses in clinical trials and embark upon joint funding studies with PCTs that address not only drug efficacy, but also the key issues that affect nurses’ prescribing decisions, such as compliance and support of the patient management process. Such programmes are essential if pharmaceutical companies are going to earn the respect of nurse prescribers and create the strong, close relationship that will be required in the future. And a key component of that respect will be the use of industry experts, often former nurses, to create and deliver a message that is 100% relevant to the audience. A New Opportunity With the health service and GPs increasingly looking to use nurse prescribers as a means to boost the throughput of key patient types, such as those suffering from diabetes or high cholesterol, the influence of this group can only grow. Pharmaceutical companies need to gear up their resources to support this new network, and they need to do it soon. Those companies that recognise the influence of nurse prescribers and tailor the product message and delivery mechanism to their specific requirements will gain a significant market advantage.

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