We live in a divided world with reasoning for depression and anxiety (Figure 1). I say something rude -because it touches me emotionally- while on the other side of the world in the US children are doing suicide because they are obese (BMI> 30), at the same time, a huge number of children are dying - mainly in East Africa in the sub-Saharan region as a result of hunger in combination with war. These scientific facts support my perception that we live in a divided, torn "Hunger-Obesity" world, and although the phenomenon of hunger has been less common since the 1990s, it seems as if people in developed countries have become emotionally insensitive to this phenomenon because this phenomenon is far away from the Industrialized Western World or Developed countries. In 1991, only a select number of developing countries had undernourishment levels <5%. In 2015, many countries achieved this, particularly across Latin America, the Middle East and North Africa .

Introduction: Headache is the commonest reason for neurology referrals, and the commonest neurological reason for patients attending Emergency Departments (EDs). An ethical approach to health care requires that patients be provided with informed choice about management. However researchers have not addressed patients’ concerns and choices in managing headache. This study aims to describe the views of patients, their fears, use of EDs, their perceived need for a scan and its outcome for them. Methods: A qualitative study using semi-structured interviews with 19 adults aged 23-63, referred by Family Practitioners (FPs) to neurologists for primary headaches approximately two years previously. Audio-recorded interviews were transcribed and analysed thematically. Results: Participants described fears about secondary organic causes for headache, like a brain tumor. They described their headaches as stressful, and leading to a vicious cycle of fear. Many believed they needed a brain scan and requested it. Participants reported relief of their fears after a scan, and in some cases relief of headache symptoms. Discussion: UK FPs now have open access to brain scanning, which may relieve physical concerns. Interventions to address health-related anxiety may also help some consulters for headache.

The burnout syndrome is a response to a long term chronic emotional and interpersonal stressors that are related to workplace. It emerges as the consequence of non-harmonized relations between employees on one, and working environment on the other side. It is defined as chronic work stress that includes three dimensions: the sense of the emotional exhaustion, the negative approach to providing services (depersonalization) and the sense of reduced personal accomplishment. It occurs most often in persons who work in direct contact with other people. Medicine is one of the professions at the greatest risk of suffering from burnout syndrome. The results of the studies conducted in the neighbouring countries, in Europe and in the world showed a big prevalence of burnout syndrome among medical workers, especially in physicians. The acquired results indicate that there is a need to undertake measures for prevention of the burnout syndrome.

Nursing education has a long tradition in the use of simulation as a pedagogical method for the professional competences learning. However, technological advances and the increasing health care complexity requires new challenges in the training process. Simulated high-fidelity practice (SHFP) aims to mimic the clinical environment reality. With the extraordinarily realistic computerized mannequins, it is provided a high level of interactivity and realism to the participants (1). It allows for the development of instrumental, interpersonal and systemic skills, in a protected and controlled environment (2, 3) with the advantage of translating skills from the simulated context to the clinical practice reality.

Introduction: Doctors in primary care are responsible for diagnosing and managing patients with headache, but frequently lack confidence in doing so. We aimed to compare Family Practitioners’ (FPs) diagnosis of headaches to classification based on a symptom questionnaire, and to describe how classification links to other important clinical features. Methods: This was an observational study of patients attending primary care doctors for headache. Main outcome measures: Patients completed a questionnaire including the Headache Impact Test, the Migraine Disability Assessment Score, the Hospital Anxiety and Depression Scale, the Illness Perceptions Questionnaire, a satisfaction scale, a service use inventory and a symptom questionnaire rated by two Practitioners with Special Interest (PSIs) in Headache. Results: 255 patients completed questionnaires. There was low agreement between FP diagnosis and classification using the symptom questionnaire. FPs frequently did not use the diagnosis migraine, when patient reported symptoms which justified this. FPs did not classify patients with =15 days of headache separately as chronic daily headache (CDH), and this could be because the classification system used does not have that code. Patients classified as CDH using the symptom questionnaire reported more disability, more symptoms of anxiety and depression (HADS), more service use, and less satisfaction with FP care. Conclusion: Patients, who present with headache in primary care, tend to receive non-specific diagnoses. Having a system that would allow separate classification of people with headache of = 15 days a month might help FPs to explore and address associated features with patients in terms of disability, psychological co-morbidity and cost, and improve satisfaction with care.