Why the NHS needs adult generalists: A call for single certification in general internal medicine.

As the UK NHS faces growing challenges of the ageing population and escalating healthcare costs, we examine the role of the general internal medicine (GIM) consultant in inpatient medicine. We argue that the reintroduction of GIM could provide a sustainable and valuable contribution to high-quality, cost-effective inpatient care drawing on parallels from the GIM hospitalist model in the USA. Additionally, GIM expansion could contribute to improved outcomes for complex medical patients and surgical patients, as well as safety and quality initiatives.

Redefining adjustment after acquired brain injury.

Background: Adjusting to life changes posed by an acquired brain injury (ABI) can be challenging for both individuals with ABI and their families. The current study explores the experience of adjustment, incorporating similarities and differences in this process as reported by the family members and individuals with ABI.

Method: Thirty-nine participants, recruited from a regional brain injury charity group, took part in semi-structured interviews (20/39 individuals with ABI, 19/39 relatives).

The prediction limits of the National Adult Reading Test and its abbreviated and international variants.

Objective: Premorbid tests estimate cognitive ability prior to neurological condition onset or brain injury. Tests requiring oral pronunciation of visually presented irregular words, such as the National Adult Reading Test (NART), are commonly used due to robust evidence that word familiarity is well-preserved across a range of neurological conditions and correlates highly with intelligence. Our aim is to examine the prediction limits of NART variants to assess their ability to accurately estimate premorbid IQ.

Process evaluation of a New psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family).

Introduction: We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year.

Methods: In 2021-2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions.

Transparency, reproducibility, and replicability of pharmacoepidemiology studies in a distributed network environment.

Purpose: Our objective is to describe how the U.S. Food and Drug Administration (FDA)'s Sentinel System implements best practices to ensure trust in drug safety studies using real-world data from disparate sources.

Validity of inpatient electronic health record-based measures of oxygen-related therapy in the United States: Lessons applicable for studying COVID-19 endpoints.

Introduction: During the COVID-19 pandemic, inpatient electronic health records (EHRs) have been used to conduct public health surveillance and assess treatments and outcomes. Invasive mechanical ventilation (MV) and supplemental oxygen (O) use are markers of severe illness in hospitalized COVID-19 patients. In a large US system (n = 142 hospitals), we assessed documentation of MV and O use during COVID-19 hospitalization in administrative data versus nursing documentation.

Prevalence and Predictors of Hereditary Hemorrhagic Telangiectasia and Capillary-Malformation Arteriovenous Malformation Syndrome Among Children with Neurovascular Malformations.

Objective: To investigate the prevalence and predictors of hereditary hemorrhagic telangiectasia (HHT) and capillary-malformation arteriovenous malformation (CM-AVM) syndrome among children with no prior personal or family history of these diseases who presented with an arteriovenous shunt lesion.

Study Design: A retrospective chart review was completed on patients aged 0 through 21 years with arteriovenous shunt lesions evaluated at our Cerebrovascular Center. Diagnosis of definite or suspected HHT or CM-AVM was based on clinical features and genetic testing.

Treatment and care received by children hospitalized with COVID-19 in a large hospital network in the United States, February 2020 to September 2021.

We described care received by hospitalized children with COVID-19 or multi-system inflammatory syndrome (MIS-C) prior to the 2021 COVID-19 Omicron variant surge in the US. We identified hospitalized children <18 years of age with a COVID-19 or MIS-C diagnosis (COVID-19 not required), separately, from February 2020-September 2021 (n = 126 hospitals). We described high-risk conditions, inpatient treatments, and complications among these groups.

COVID-19 vaccine allergy advice and guidance: The experience of a UK tertiary referral centre.

Objective: The objective was to review COVID-19 vaccine allergy advice and guidance requests received and assess the impact of advice outcome on vaccination outcome.

Design: A retrospective analysis of requests for advice and guidance regarding COVID-19 vaccine allergy was completed using an electronic referral system from February 2021 to January 2022.

Participants: A total of 1265 independent patient requests for advice were received from primary care.

A systematic review of process evaluations for psychosocial interventions designed to improve the wellbeing and quality of life of community-dwelling people with dementia and their carers.

Background: Psychosocial interventions improve the wellbeing and quality of life of People Living with Dementia (PLWD) and their family carers; but due to their complexity it can be challenging to identify mechanisms of action. We reviewed process evaluations that have sought to elucidate how these interventions work, to inform their implementation.

Method: We systematically reviewed process evaluations of studies evaluating psychosocial interventions for PLWD in their own home and/or their family carers.

Rural health disparities in health care utilization for dementia in Minnesota.

Purpose: We visualized rural-urban differences in inpatient hospitalization and emergency department (ED) health care utilization (HCU) for older adults with dementia to understand the HCU of rural versus urban older adults in Minnesota and to examine in greater detail the variability of HCU in rural areas.

Methods: For 3 older adult age groups, we utilized Healthcare Cost and Utilization Project (H-CUP) datasets from 2016 to 2018 to profile hospital admission rates, and ED visit rates related to dementia stratified by rurality and regions. Rates were visualized by spatial interpolation method.

Process evaluation of the New Interventions for independence in Dementia Study (NIDUS) Family stream randomised controlled trial: protocol.

Introduction: New Interventions for independence in Dementia Study (NIDUS)-Family is an Alzheimer's Society funded new manualised, multimodal psychosocial intervention to support people living with dementia (PLWD) to achieve goals that they and their family carers set, towards living as independently and as well as possible at home for longer. This process evaluation will be embedded within the NIDUS-Family Randomised Controlled Trial intervention-arm (n=199), testing how the intervention influences change, as measured by goal attainment. The evaluation will test, refine and develop the NIDUS-Family theoretical model, associated causal assumptions and logic model to identify key mechanisms of impact, implementation and contextual factors influencing the intervention's effectiveness.

Effect of infant bilingualism on audiovisual integration in a McGurk task.

Infants growing up in an environment where more than one language is spoken tend to follow the early milestones of early language development. This is an impressive achievement given that they are learning two languages while receiving reduced exposure to each of these languages compared with monolingual infants. This increased variability in their linguistic environment may lead to adjustments in the way bilingual infants process visual and auditory speech.

The impact of family physicians in rural maternity care.

Background: Reduced access to maternity care in rural areas of the United States presents a significant burden to pregnant persons and infants. The objective of this study was to estimate the impact of family physicians (FPs) on access to maternity care in rural United States hospitals, especially where other providers may not be available.

Methods: We administered a survey to 216 rural hospitals in 10 US states inquiring about the number of babies delivered from 2013 to 2017, the types of delivering physicians, and the maternity services offered.

The validity of abbreviated forms of the National Adult Reading Test and Spot-the-Word 2 for estimating full-scale IQ.

In this study, we validate an earlier proposal for an abridged 17-item National Adult Reading Test (NART) by comparing its performance in estimating full-scale IQ against both the full test and the Spot-the-Word 2 (STW-2) test in a new cohort. We also compare the performance of the 17-item NART to two previous attempts to shorten this test, the Mini-NART and the Short NART. Findings include that NART 17 is numerically stronger and statistically equivalent to the other short variants, the full 50-word NART, and STW-2.

Trajectories of verbal fluency and executive functions in multilingual and monolingual children and adults: A cross-sectional study.

The development of verbal fluency is associated with the maturation of executive function skills, such as the ability to inhibit irrelevant information, shift between tasks, and hold information in working memory. Some evidence suggests that multilinguistic upbringing may underpin disadvantages in verbal fluency and lexical retrieval, but can also afford executive function advantages beyond the language system including possible beneficial effects in older age. This study examined the relationship between verbal fluency and executive function in 324 individuals across the lifespan by assessing the developmental trajectories of English monolingual and multilingual children aged 7-15 years ( = 154) and adults from 18 to 80 years old ( = 170).

Estimating the COVID-19 epidemic trajectory and hospital capacity requirements in South West England: a mathematical modelling framework.

Objectives: To develop a regional model of COVID-19 dynamics for use in estimating the number of infections, deaths and required acute and intensive care (IC) beds using the South West England (SW) as an example case.

Design: Open-source age-structured variant of a susceptible-exposed-infectious-recovered compartmental mathematical model. Latin hypercube sampling and maximum likelihood estimation were used to calibrate to cumulative cases and cumulative deaths.

How to investigate a suspected immune deficiency in adults.

Patients with immune deficiencies can present with variable clinical phenotypes. This often translates into a significant delay in their diagnosis, and resultant patient morbidity. This review summarises the most common types of immunodeficiency disorders, primary and secondary, along with their key features.