Enhanced supportive care in cancer centres: national cross-sectional survey.

Objectives: Early' specialist palliative care (SPC) has been shown to improve outcomes for patients with advanced cancer, yet patients are often referred late. 'Enhanced supportive care' (ESC) aims to facilitate earlier integrated supportive care for those with incurable cancer. This study aimed to explore clinicians' understanding of ESC/SPC delivery through description of current service provision.

Understanding the needs and preferences for cancer care among First Nations people: An integrative review.

Aim: This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people.

Design: Integrative review.

Data Sources: An integrative review was conducted.

The Impact of COVID-19 Visitor Restrictions on Clinical Cancer Nurses.

Objectives: To explore the impact of visitor restrictions on clinical cancer nurses, their roles and duties, and the coping strategies used to address the impact.

Data Sources: Semistructured qualitative interviews were conducted through purposive sampling with nurses working in a clinical role within cancer services at the study site for at least 1 year. Interviews were recorded and transcribed.

Provoked overt recognition in acquired prosopagnosia using multiple different images of famous faces.

Provoked overt recognition refers to the fact that patients with acquired prosopagnosia can sometimes recognize faces when presented in arrays of individuals from the same category (e.g., actors or politicians).

3D direct-write printing of water soluble micromoulds for high-resolution rapid prototyping.

Direct-write printing has contributed tremendously to additive manufacturing; in particular extrusion based printing where it has extended the range of materials for 3D printing and thus enabled use across many more sectors. The printing inks for direct-write printing however, need careful synthesis and invariably undergo extensive preparation before being able to print. Hence, new ink synthesis efforts are required every time a new material is to be printed; this is particularly challenging for low storage modulus (G') materials like silicones, especially at higher resolutions (under 10 µm).

Impact of the Practice Environment on Oncology and Hematology Nurses: A Scoping Review.

Background: Practice environments have a significant impact on nurses' practice and their retention within the oncology and hematology specialty. Understanding how specific elements of the practice environment impact nurse outcomes is important for creating supportive and safe practice environments.

Objective: To evaluate the impact of the practice environment on oncology and hematology nurses.

Factors preceding occupational distress in emergency nurses: An integrative review.

Aims And Objectives: This integrative review aimed to synthesise current evidence on the factors that precede and contribute to the occupational distress of emergency nurses.

Background: Emergency nurses practice within an environment challenged by demand exceeding capacity, an inability of staffing to meet this demand in addition to limited resources which contribute to form a unique risk to clinician and patient safety. The risk of occupational distress, while demonstrated across specialties, is noted to be highest in emergency nurses with subsequent impacts for clinicians, organisations and patients being explored.

Quality Evaluation of a Checklist for Intubation Preparation in Graduate Medical Education.

Background Rapid sequence intubation (RSI) is a multistep process that emergency physicians commonly perform. Unfortunately, there is little published in the graduate medical education literature regarding the use of checklists for RSI education. Methods We developed a pre-intubation checklist for RSI preparation and evaluated emergency medicine residents' use of it.

ESPRAS Survey on Breast Reconstruction in Europe.

Background:  The European Leadership Forum (ELF) of the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS) previously identified the need for harmonisation of breast reconstruction standards in Europe, in order to strengthen the role of plastic surgeons. This study aims to survey the status, current trends and potential regional differences in the practice of breast reconstruction in Europe, with emphasis on equity and access.

Materials And Methods:  A largescale web-based questionnaire was sent to consultant plastic and reconstructive surgeons, who are experienced in breast reconstruction and with understanding of the national situation in their country.

Peer teaching medical students during a pandemic.

Our personal views about the challenges of continuing to deliver peer teaching during a pandemic. We are a group of 4 year medical students who are part of a student society which has delivered structured, highly formulaic peer-led teaching sessions for the past three years. During the COVID-19 pandemic, the reduced access to our normal clinical teaching highlighted the importance of peer-led teaching sessions.

Perturbed myoepithelial cell differentiation in BRCA mutation carriers and in ductal carcinoma in situ.

Myoepithelial cells play key roles in normal mammary gland development and in limiting pre-invasive to invasive breast tumor progression, yet their differentiation and perturbation in ductal carcinoma in situ (DCIS) are poorly understood. Here, we investigated myoepithelial cells in normal breast tissues of BRCA1 and BRCA2 germline mutation carriers and in non-carrier controls, and in sporadic DCIS. We found that in the normal breast of non-carriers, myoepithelial cells frequently co-express the p63 and TCF7 transcription factors and that p63 and TCF7 show overlapping chromatin peaks associated with differentiated myoepithelium-specific genes.

Micron resolution, high-fidelity three-dimensional vascular optical imaging phantoms.

Microscopic and mesoscale optical imaging techniques allow for three-dimensional (3-D) imaging of biological tissue across millimeter-scale regions, and imaging phantom models are invaluable for system characterization and clinical training. Phantom models that replicate complex 3-D geometries with both structural and molecular contrast, with resolution and lateral dimensions equivalent to those of imaging techniques (<20  μm), have proven elusive. We present a method for fabricating phantom models using a combination of two-photon polymerization (2PP) to print scaffolds, and microinjection of tailored tissue-mimicking materials to simulate healthy and diseased tissue.

Is The Consent Process Appropriate - The Interns’ Perspective?

Aims Consent is an integral component to any medical procedure involving a competent patient, a communicating doctor, and transfer of information about the procedure. The aim of this study was to assess interns’ experience of the consent process. Methods An online questionnaire was distributed to interns in Ireland questioning their role in the consent process within six months of starting as an intern.

Impact of Lowering Irrigation Flow Rate on Atrial Lesion Formation in Thin Atrial Tissue: Preliminary Observations From Experimental and Clinical Studies.

Objectives: The authors sought to investigate the effect of low irrigation flow rate on lesion characteristics and ablation outcomes in a clinicopathological study.

Background: Irrigated ablation produces deeper lesions compared with nonirrigated ablation, which may not be desirable in the thin-walled posterior left atrium (LA), where collateral esophageal injury is possible.

Methods: Lesions were placed on the smooth posterior right atrium in 20 swine and posterior LA in 60 patients at a maximum power of 20 to 25 W with either: 1) power-controlled ablation at an irrigation flow rate of 17 ml/min (high-flow group 10 swine; n = 40) or 2) temperature-controlled ablation at an irrigation flow rate of 2 ml/min (low-flow group 10 swine; n = 20).

Management of inguinal lymphadenopathy: immediate sartorius transposition and reconstruction of recurrence with pedicled ALT flap.

Inguinal lymphadenectomy is associated with considerable morbidity, and several attempts have been made to minimize the morbidity by well-vascularized flaps of adequate bulk to obliterate the dead space and promote wound healing. In the case of recurrence, the overlying skin is usually involved and the reconstructive surgeon is confronted with exposed femoral vessels and complex groin defects. We report a series of 40 patients that underwent inguinal lymphadenectomy and immediate sartorius transposition for skin malignancies, and 4 patients with recurrence that was treated with radical surgical excision and pedicled anterolateral thigh flap (ATL).

Recipient vessel exposure in the axilla during microvascular breast reconstruction.

Over the years, the favored recipient vessels for microvascular breast reconstruction have changed from the thoracodorsal to the internal mammary vessels, mainly due to the deep position and poor exposure of the vessels in the axilla and all the technical difficulties this reflects. We used the simple maneuver of arm adduction during microvascular anastomoses in the axilla and compared it with the conventional method of abducted arm regarding the exposure of the vessels, the position of the operator and the assistant, and the operative time. We found that this innovation considerably improved the exposure of the vessels and the operator's position, facilitating easier and faster anastomoses.

Comparison of zones 1 to 4 flexor tendon repairs using absorbable and unabsorbable four-strand core sutures.

Absorbable sutures behave favourably in vitro and in an animal model. We report the outcome of flexor tendon injuries in a series of 272 consecutive patients treated over 45 months with a mean follow-up of 4 (range 3-12) months. Five hundred and seventy-six tendons were repaired in 416 digits.

Salvage of total loss of DIEP and skin envelope in breast reconstruction with tissue expansion.

We present two cases of breast reconstruction using abdominal tissue expansion as a salvage procedure for those patients who have had multiple sequential complications using the traditional free flap techniques yet still request some form of reliable breast reconstruction.

Salvage of finger length in septicemic necrosis using 3 free flaps from a single anterolateral thigh donor site.

Severe septicemic necrosis can result in extremely debilitating morbidity for patients, often resulting in 4-limb amputation. Further operative procedures to improve both function and cosmesis can be fraught with complexity and complications. The ideal aim in such patients would be to maintain sufficient length and provide soft tissue cover in a single 1-step procedure.