Socioeconomic deprivation has long been associated with many gastrointestinal diseases, yet its influence on esophagogastroduodenoscopy (EGD) diagnosis has not been evaluated. The aim of this study was to investigate the influence of deprivation on outcomes of EGD irrespective of referral reason. Two thousand consecutive patients presenting to four Health Boards in Wales beginning in June 2019 were studied retrospectively with deprivation scores calculated using the Wales Indices of Multiple Deprivation (WIMD).
View Article and Find Full Text PDFRobotic surgery offers potential advantages over laparoscopic procedures, but the training for configuring robotic systems in the operating room remains underexplored. This study seeks to validate immersive virtual reality (IVR) headset training for setting up the CMR Versius in the operating room. This single-blinded randomized control trial randomised medical students with no prior robotic experience using an online randomiser.
View Article and Find Full Text PDFIntroduction: Core Surgical Training (CST) programs are associated with high burnout. This study aimed to assess the influence of Enhanced Stress Resilience Training (ESRT) over a 2-year period in a single UK Statutory Education Body.
Method: CSTs participated in 5-weeks of formal ESRT to address work stressors.
Purpose Of Study: Factors influencing physician specialty choice is a prominent topic given the recruitment challenges faced by various specialties. We aimed to assess whether specialty exposure in the first foundation year was a positive predictive factor for permanent career choice.
Study Design: A questionnaire-based study was distributed online using a survey tool.
Virtual reality endoscopic simulation training has the potential to expedite competency development in novice trainees. However, simulation platforms must be realistic and confer face validity. This study aimed to determine the face validity of high-fidelity virtual reality simulation (EndoSim, Surgical Science, Gothenburg), and establish benchmark metrics to guide the development of a Simulation Pathway to Improve Competency in Endoscopy (SPICE).
View Article and Find Full Text PDFThis study aimed to assess the quality of endoscopy training in a UK Statutory Educational Body compared with Joint Advisory Group on Gastrointestinal Endoscopy Training standards (JETS). A total of 28,298 training procedures recorded by 211 consecutive cross-specialty trainee endoscopists registered with JETS in 18 hospitals during 2019 were analyzed. Data included trainer and trainee numbers, training list frequency, procedures, direct observation of procedural skills (DOPS) completion, and key performance indicators.
View Article and Find Full Text PDFBackground: Antibiotic and dietary behaviour affect the human microbiome and influence antibiotic resistance development. Adolescents are a key demographic for influencing knowledge and behaviour change.
Objectives: To explore adolescents' knowledge and attitudes towards the microbiome and antibiotic resistance, and the capability, motivation and opportunity for educators to integrate microbiome teaching in schools.
Background: Gastric cancer (GC) treatment levies substantial financial burden on health services. Potentially curative surgery with or without chemotherapy is offered to patients with locoregional disease. This study aimed to examine treatment costs related to life-years gained in patients having potentially curative treatment (gastrectomy) and those receiving best supportive care (BSC).
View Article and Find Full Text PDFBackground: The UK 5-year antimicrobial resistance (AMR) National Action Plan highlights the need to prevent community infections through education of children. Activities around infection prevention (IP) and antibiotics were piloted by UK youth groups in 2016-2018, prompting Public Health England (PHE) to develop a standardised programme. The aim of the study was to develop and pilot an educational programme on IP and antibiotics for use by community youth groups in the UK.
View Article and Find Full Text PDFIntroduction: Core surgical training programmes are associated with a high risk of burnout. This study aimed to assess the influence of a novel enhanced stress-resilience training (ESRT) course delivered at the start of core surgical training in a single UK statutory education body.
Method: All newly appointed core surgical trainees (CSTs) were invited to participate in a 5-week ESRT course teaching mindfulness-based exercises to develop tools to deal with stress at work and burnout.
Aim: Foodborne illnesses have a significant global burden and can be life-threatening, with higher risk in vulnerable groups such as children. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers' food safety behaviour. Developing educational resources on food safety for use in schools has potential to improve teaching of our young consumers.
View Article and Find Full Text PDFAims: Unity of effort is an important component of strategic leadership and management theory associated with Core Surgical Training (CST) outcome. The aim was to determine the impact of team diversity on task completion: a creative design challenge, during CST Boot camp.
Methods: Attendees (n = 44) at a single Statutory Education Body's CST Boot camp were stratified into teams related to specialty theme, and set a design challenge as described by Peter Skillman, to build the tallest free-standing tower out of spaghetti (20 pieces), tape (1 m), and string (1 m), with a marshmallow on top in 18 minutes.
Purpose Of The Study: Established over 2000 years ago, horoscopes remain a regular feature in contemporary society. We aimed to assess whether there could be a link between zodiac sign and medical occupation, asking the question-did your specialty choose you?
Study Design: A questionnaire-based study was distributed using an online survey tool. Questions explored the zodiac sign, specialty preferences and personality features of physicians.
Implementation of the Clinical Data Interchange Standards Consortium (CDISC)'s Standard for Exchange of Nonclinical Data (SEND) by the United States Food and Drug Administration Center for Drug Evaluation and Research (US FDA CDER) has created large quantities of SEND data sets and a tremendous opportunity to apply large-scale data analytic approaches. To fully realize this opportunity, differences in SEND implementation that impair the ability to conduct cross-study analysis must be addressed. In this manuscript, a prototypical question regarding historical control data (see Table of Contents graphic) was used to identify areas for SEND harmonization and to develop algorithmic strategies for nonclinical cross-study analysis within a variety of databases.
View Article and Find Full Text PDFBackground & Aims: This study aimed to determine the prognostic significance of low muscle volume (LMV) Bioelectrical Impedance Analysis (BIA), defined skeletal muscle index (SMI, Kg/m male ≤8.75, female ≤5.75) in patients undergoing potentially curative surgery for Oesophageal Cancer (OC).
View Article and Find Full Text PDFBackgroundC-reactive protein (CRP) testing can be used as a point-of-care test (POCT) to guide antibiotic use for acute cough.AimWe wanted to determine feasibility and effect of introducing CRP POCT in general practices in an area with high antibiotic prescribing for patients with acute cough and to evaluate patients' views of the test.MethodsWe used a McNulty-Zelen cluster pragmatic randomised controlled trial design in general practices in Northern England.
View Article and Find Full Text PDFBackground: The aim of this study was to assess the relative prognostic value of biomarkers to measure the systemic inflammatory response (SIR) and potentially improve prognostic modeling in patients undergoing potentially curative surgery for esophageal adenocarcinoma (EC).
Methods: Consecutive 330 patients undergoing surgery for EC between 2004 and 2018 within a regional UK cancer network were identified. Serum measurements of haemoglobin, C-reactive protein, albumin, modified Glasgow Prognostic Score (mGPS), and differential neutrophil to lymphocyte ratio (NLR) were obtained before surgery, and correlated with histopathological factors and outcomes.
Background: The extent to which physiological factors influence outcome following oesophageal cancer surgery is poorly understood. This study aimed to evaluate the extent to which cardiorespiratory fitness and selected metabolic factors predicted complications after surgery for carcinoma.
Methods: Two hundred and twenty-five consecutive patients underwent preoperative cardiopulmonary exercise testing to determine peak oxygen uptake ( o ), anaerobic threshold and the ventilatory equivalent for carbon dioxide ( e/ co ).
Background: Patient education on treatment choices for common respiratory tract infections (RTIs) is important to encourage appropriate antibiotic use. Evidence shows that use of leaflets about RTIs can help reduce antibiotic prescribing. TARGET leaflets facilitate patient-clinician communication in consultations.
View Article and Find Full Text PDFBackground: This report describes our centers' experience of a new approach using coil embolization for femoral pseudoaneurysms (PSAs) in intravenous drug users (IVDUs). Current treatment options for this challenging patient group include femoral/external iliac artery ligation and excision of the PSA, with or without revascularization. Radiological thrombin injection, endoluminal stent grafting, and coil embolization have not been widely studied in this patient group and are most commonly reserved for sterile PSAs.
View Article and Find Full Text PDFBackground: e-Bug, led by Public Health England, educates young people about important topics: microbes, infection prevention, and antibiotics. Body Busters and Stop the Spread are 2 new e-Bug educational games.
Objective: This study aimed to determine students' baseline knowledge, views on the games, and knowledge improvement.
Background: e-Bug is an international health education resource which support World Health Organization (WHO) public health recommendations by educating young people about microbes, hygiene and antibiotics use. The e-Bug team collaborated with Kingfisher Treasure Seekers to develop a six-session course for community groups called covering: microbes; hygiene; antibiotic use; and self-care. A pilot was used to inform further development and evaluation.
View Article and Find Full Text PDFObjectives: To explore the knowledge, skills, attitudes and beliefs of general practice staff about C reactive protein (CRP) point-of-care tests (POCTs) in routine general practice and associated barriers and facilitators to implementing it to improve the management of acute cough.
Design: A qualitative methodology including interviews and focus groups using the Com-B framework to understand individuals' behaviour to implement CRP POCT in routine general practice. Data were analysed inductively and then aligned to the Com-B framework.