'Making every contact count' with patients with musculoskeletal conditions: a qualitative exploration of acceptability to physiotherapists.

Aim: To qualitatively explore physiotherapists' experiences and acceptability of implementing 'Making Every Contact Count Healthy Conversation Skills' (MECC HCS) in routine practice with patients with musculoskeletal (MSK) conditions.

Methods: This article reports the second phase of a mixed method, sequential explanatory study. Physiotherapists trained in and delivering MECC HCS in their practice were invited to take part in semi-structured interviews.

Assessing coastline recession for adaptation planning: sea level rise versus storm erosion.

The Sixth Assessment report (AR6) of the Intergovernmental Panel on Climate Change (IPCC) states with high confidence that most sandy coasts around the world will experience an increase in coastal erosion over the twenty-first century. An increase in long term coastal erosion (coastline recession) along sandy coasts can translate into massive socio-economic impacts, unless appropriate adaptation measures are implemented in the next few decades. To adequately inform adaptation measures, it is necessary to have a good understanding of the relative importance of the physical processes driving coastline recession, as well as of linkages between consideration (or not) of certain processes and the level of risk tolerance; understandings that are hitherto lacking.

'I can feel myself coming out of the rut': a brief intervention for supporting behaviour change is acceptable to patients with chronic musculoskeletal conditions.

Aim: To a) understand the perceptions and experiences of patients with musculoskeletal (MSK) conditions in relation to their physiotherapy care and their acceptability of 'Making Every Contact Count Healthy Conversation Skills' (MECC HCS) as a brief intervention within this care and, b) explore the mechanisms through which MECC HCS might facilitate behaviour change and enhance self-management in patients with MSK conditions.

Methods: This study adopted an exploratory qualitative design, in which individual, semi-structured interviews with participants were conducted. Eight participants were interviewed.

Predictors of Infection and Benefit of Antibiotics in Gunshot Wounds to the Face.

Background: Gunshot wounds (GSWs) to the face are at high risk for infection due the extent of tissue injury and often-observed violation of oral and sinus cavities. Given the ambiguous data on antibiotic benefit in GSW to the face, the purpose of this study is to characterize antibiotic usage, infection details, and risk factors associated with higher infection rates in GSW to face.

Methods: We conducted a retrospective review of patients presenting with GSW to the face from 2009 to 2017.

Trainee doctors' perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study.

Background: The demography of the medical profession is changing as more women join the workforce. Traditional assumptions about the personal qualities required to be a successful surgeon may change as more women join the specialty. While exploring the attitudes and beliefs of doctors in their second 'Foundation' year of post-graduate training (FY2) about their choice of specialty, evidence emerged about how the stereotype of the surgeon influences professional identification and beliefs about person-specialty fit.

How useful is the Making Every Contact Count Healthy Conversation Skills approach for supporting people with musculoskeletal conditions?

Aim: To explore the current use and perceptions of the Wessex model of Making Every Contact Count (MECC), incorporating Healthy Conversation Skills (HCS), focussing specifically on physiotherapists supporting people living with musculoskeletal conditions.

Methods: A mixed method, sequential explanatory design was employed. This article reports the first phase of the study, in which an online questionnaire was administered, consisting of items relating to perceived acceptability, appropriateness, feasibility, sustainability, and uptake of MECC HCS.

Impact of Opioid-Minimizing Pain Protocols After Burn Injury.

In 2019, we implemented a pill-based, opioid-minimizing pain protocol and protocolized moderate sedation for dressing changes in order to decrease opioid exposure in burn patients. We hypothesized that these interventions would reduce inpatient opioid exposure without increasing acute pain scores. Two groups of consecutive patients admitted to the burn service were compared: Pre-group (from January 1, 2018 to July 31, 2019) and Post-group (from January 1, 2020 to June 30, 2020) from before and after the implementation of the protocols (from August 1, 2019 to December 31, 2019).

Doctor-patient interactions that exclude patients experiencing homelessness from health services: an ethnographic exploration.

Background: People experiencing homelessness have poor health indices and poor access to health care. Their health service utilisation (HSU) is typified by: late illness presentations; poor attendance rates at appointments; low usage of primary care services and outpatient departments; and high utilisation of emergency departments and inpatient services. Why people experiencing homelessness have these particular HSU patterns is poorly understood.

The Epidemiology and Management of Pediatric Maxillary Fractures.

Background: Most literature regarding traumatic Le Fort or maxillary fractures exists in the adult population, with limited information regarding the epidemiology and management of pediatric fractures. The purpose of this study was to evaluate fracture mechanism, surgical management, and associated injuries in pediatric patients with Le Fort fractures.

Methods: A retrospective chart analysis of all pediatric patients age ≤18 years diagnosed with facial fractures at a single level 1 trauma center over a 10-year period (January 2006-December 2015) was performed.

Low-cost sensors as an alternative for long-term air quality monitoring.

Low-cost air quality sensors are increasingly being used in many applications; however, many of their performance characteristics have not been adequately investigated. This study was conducted over a period of 13 months using low-cost air quality monitors, each comprising two low-cost sensors, which were subjected to a wide range of pollution sources and concentrations, relative humidity and temperature at four locations in Australia and China. The aim of the study was to establish the performance characteristics of the two low-cost sensors (a Plantower PMS1003 for PM and an Alphasense CO-B4 for carbon monoxide, CO) and the KOALA monitor as a whole under various conditions.

What influences young doctors in their decision-making about general practice as a possible career? A qualitative study.

: Recruitment to General Practitioner (GP) training programmes in the United Kingdom is poor. Colleagues' negative comments about general practice could contribute to this.: To investigate what influences Foundation Year 2 (FY2) doctors in their decisions to choose general practice as a career, and how colleagues' comments about GPs might affect those decisions.

Correction to: How does 'banter' influence trainee doctors' choice of career? A qualitative study.

Following publication of the original article [1], the authors reported an error in the first paragraph of the 'Results' section.

Making sense of street chaos: an ethnographic exploration of homeless people's health service utilization.

Background: Homeless people have poor health and mortality indices. Despite this they make poor usage of health services. This study sought to understand why they use health services differently from the domiciled population.

The Trends of Pediatric Facial Fractures Due to Violence in a Level One Trauma Population.

Introduction: Pediatric facial fractures due to intentionally violent mechanisms represent a unique subset of facial fractures. The objective of our research is to identify how violence affects patterns of facial fractures and their management in pediatric patients.

Methods: An IRB approved, retrospective study of our institution's pediatric patients ≤18 years of age who presented with ≥1 facial fracture due to violence from January 2006 to December 2015 was performed.

Factors Associated With Surgical Management for Pediatric Facial Fractures at a Level One Trauma Center.

Pediatric facial fractures present and are managed differently than the adult population. This study describes the pattern and mechanism of facial fractures in children and identifies factors associated with need for surgical management. An IRB-approved retrospective chart analysis of all pediatric patients age ≤ 18 years diagnosed with facial fractures at our level 1 trauma center over a 10-year period (January 2006-December 2015) was performed.

How does 'banter' influence trainee doctors' choice of career? A qualitative study.

Background: Negative comments from senior colleagues about specialties, such as general practice and psychiatry, are known to influence trainees' career choice, but little is known about the extent of this influence or the mechanism by which it works. There have been calls to ban these disparaging comments, also known as 'banter'. This study explored how recently qualified doctors make sense of banter in the context of other experiences and information.

Terrorism and post-traumatic stress disorder: a historical review.

Terror is a psychological state. Historically, most studies of terrorism focused on its societal purpose and structural consequences rather than mental health effects. That emphasis began to change shortly before the Sept 11, 2001, terrorist attacks.

Outcomes research: Mandibular fractures in the diabetic population.

Objective: The study aimed to examine the management and outcomes of mandibular fractures in patients with diabetes mellitus by examining the injury modalities, treatment methods, and complications.

Methods: The study conducted was a retrospective case review of patients admitted to Memorial Hermann Hospital from 2007 to 2011 with diagnoses of diabetes mellitus and mandibular fracture. The electronic medical records were reviewed for patient demographics, injury data, surgery methodology, treatment variables, and complications.

Changes in atmospheric concentrations of polycyclic aromatic hydrocarbons and polychlorinated biphenyls between the 1990s and 2010s in an Australian city and the role of bushfires as a source.

Over recent decades, efforts have been made to reduce human exposure to atmospheric pollutants including polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) through emission control and abatement. Along with the potential changes in their concentrations resulting from these efforts, profiles of emission sources may have also changed over such extended timeframes. However relevant data are quite limited in the Southern Hemisphere.

Competing patient and professional agendas in service development.

Purpose: The purpose of this paper is to engage stakeholders in the development of a community based chronic pain-management service and identify their different agendas for service design and delivery.

Design/methodology/approach: Data were collected using the Nominal Group Technique (NGT), a ten-step process that generates qualitative and quantitative data. Seven NGT groups were conducted in the south-west region of the UK, three with General Practitioners and nurses, three with chronic pain patients, and one with Healthcare Commissioners.

The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain.

The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear.

Resemblance of valgus malalignment of the distal tibia in 15-degree craniocaudal radiographs.

Purpose: To describe and quantify a radiological phenomenon where the distal tibial plafond appears in valgus malalignment in intra-operative fluoroscopy owing to 15 degrees craniocaudal angulation of the X-ray beam.

Methods: The lateral distal tibial angle (LDTA) of 14 male and 9 female skeletally mature patients was measured by a single reviewer using 2 types of anteroposterior radiographs, in which the X-ray beam was projected at 0 (orthogonal to the ankle) and then at 15 (in a craniocaudal direction) degrees. The LDTA was the angle between the long axis of the tibia and a line drawn across the most radiodense part of the tibial plafond.

A feasibility study of brief group-based acceptance and commitment therapy for chronic pain in general practice: recruitment, attendance, and patient views.

Background: Acceptance and commitment therapy (ACT), a form of cognitive-behavioral therapy, may help meet a need for accessible and cost-effective treatments for chronic pain. ACT has a growing evidence base, but has not yet been tested within general practice settings.

Aim: The purpose of the present study was to examine the feasibility of conducting a full-scale randomized controlled trial of ACT in general practice.

Using the nominal group technique to engage people with chronic pain in health service development.

In this methodological paper, we discuss the use of the nominal group technique to facilitate the involvement of people with chronic pain and other stakeholder groups in the design of a community-based pain management programme. On the basis of our experiences of using the technique in a study conducted in the south-west region of the UK, we explore conceptual and logistical issues relating to patient involvement in health service development, discuss political issues relating to the articulation and synthesis of different stakeholder perspectives, and provide a description of how the technique can be applied in the aforementioned context. We conclude that although the nominal group technique is not a panacea for the difficulties encountered in patient involvement, it does offer advantages over other approaches.