Obstructive Uropathy: a retained urethral catheter within an ileal conduit.

Following an ileal conduit (IC) urinary diversion for intractable urinary incontinence, a woman in her 50s presented with deteriorating renal function during a routine follow-up. This decline prompted further investigation with an ultrasound scan (USS), which demonstrated bilateral hydroureteronephrosis and an atrophic left kidney. Although the mercaptoacetyltriglycine (MAG-3) renogram was inconclusive in revealing urinary obstruction, a subsequent computed tomography (CT) scan uncovered a calcified tube-like structure within the IC and hydroureteronephrosis extending to this level.

Urinary tract infections: a review of the current diagnostics landscape.

Urinary tract infections are the most common bacterial infections worldwide. Infections can range from mild, recurrent (rUTI) to complicated (cUTIs), and are predominantly caused by uropathogenic (UPEC). Antibiotic therapy is important to tackle infection; however, with the continued emergence of antibiotic resistance there is an urgent need to monitor the use of effective antibiotics through better stewardship measures.

The impact of single-use digital flexible cystoscope for double J removal on hospital costs and work organization: A multicentric evaluation.

Background: Isiris-α® is a single-use digital flexible cystoscope with an integrated grasper designed for double J (DJ) stent removal. Aim of this study was to conduct a multicentric evaluation of the costs and criticalities of stent removals performed with Isiris®-α in different hospitals and health systems, as compared to other DJ removal procedures.

Methods: After gathering 10 institutions worldwide with experience on Isiris-α®, we performed an analysis of the reported costs of DJ removal with Isiris-α®, as compared to the traditional reusable equipment used in each institution.

Evaluating quality improvement at scale: A pilot study on routine reporting for executive board governance in a UK National Health Service organisation.

Background: Quality improvement (QI) in healthcare is a cultural transformation process. We explored how routine reporting could be developed to aid visibility of the process for QI governance.

Method: A retrospective evaluation of QI projects in a large healthcare organisation was conducted.

The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review.

Background: Return on Investment (ROI) is increasingly being used to evaluate financial benefits from healthcare Quality Improvement (QI). ROI is traditionally used to evaluate investment performance in the commercial field. Little is known about ROI in healthcare.

Impact of Meeting Early Hearing Detection and Intervention Benchmarks on Spoken Language.

This study compared preschool spoken language outcomes for children with hearing loss who met Early Hearing Detection and Intervention (EHDI) guidelines to those who did not, as well as to compare outcomes for those who met current EHDI guidelines to those who met earlier benchmarks. Finally, the predictive role of meeting each component of the guidelines was evaluated relative to language outcomes. Children who met the EHDI guidelines had higher language scores than those who did not; however, there was no difference between children who met the current guidelines and those who met the earlier benchmarks.

Identifying and understanding benefits associated with return-on-investment from large-scale healthcare Quality Improvement programmes: an integrative systematic literature review.

Background: We previously developed a Quality Improvement (QI) Return-on-Investment (ROI) conceptual framework for large-scale healthcare QI programmes. We defined ROI as any monetary or non-monetary value or benefit derived from QI. We called the framework the QI-ROI conceptual framework.

Transitioning Speech-Language Assessment to a Virtual Environment: Lessons Learned From the ELLA Study.

Purpose The COVID-19 pandemic has necessitated a quick shift to virtual speech-language services; however, only a small percentage of speech-language pathologists (SLPs) had previously engaged in telepractice. The purpose of this clinical tutorial is (a) to describe how the Early Language and Literacy Acquisition in Children with Hearing Loss study, a longitudinal study involving speech-language assessment with children with and without hearing loss, transitioned from in-person to virtual assessment and (b) to provide tips for optimizing virtual assessment procedures. Method We provide an overview of our decision making during the transition to virtual assessment.

Isiris™ for Ureteric Stent Removal in Renal Transplantation: An Initial Single-Centre Experience of 150 Cases.

. Ureteric stent insertion is performed at the time of renal transplant to minimise the risk of post-operative urological complications, including anastomotic leak and ureteric stenosis or obstruction. Transplant ureteric stent removal (TUSR) has historically been performed via flexible cystoscopy, predominantly in a theatre setting.

Assessment and management of shoulder pain at primary care level.

Most patients with shoulder pain will initially visit their community health centre, private general practitioner or family physician, with various levels of experience in the assessment and management of shoulder conditions. Shoulder conditions will range from early, simple ailments that can be treated in the primary care setting, to post-traumatic injuries and complex pathologies requiring the expertise of an orthopaedic surgeon or a fellowship-trained shoulder surgeon. Correct assessment of the patient's shoulder condition at the index consultation is a prerequisite for appropriate management.

11β-hydroxysteroid dehydrogenase type 1 inhibitor use in human disease-a systematic review and narrative synthesis.

Introduction: 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an intracellular enzyme that catalyses conversion of cortisone into cortisol; correspondingly, 11β-HSD1 inhibitors inhibit this conversion. This systematic review focuses on the use of 11β-HSD1 inhibitors in diseases known to be associated with abnormalities in hypothalamic pituitary adrenal (HPA) axis function.

Methods: The databases screened for suitable papers were: MedLine, EMBASE, Web of Science, ClinicalTrials.

'Walk this way': results from a pilot randomised controlled trial of a health coaching intervention to reduce sedentary behaviour and increase physical activity in people with serious mental illness.

Background: Cardiovascular disease (CVD) is the leading cause of premature death among people with serious mental illness (SMI). Sedentary behaviour (SB) is an independent risk factor for CVD and mortality and people with SMI are highly sedentary. We developed a health coaching intervention called 'Walk this Way' to reduce SB and increase physical activity (PA) in people with SMI and conducted a pilot randomised controlled trial (RCT) to test its feasibility and acceptability.

Self-Reported Childhood Maltreatment and Erotic Target Identity Inversions Among Men with Paraphilic Infantilism.

Adults with paraphilic infantilism may desire to wear diapers or engage in infant-like role play. Erotic target identity inversions (ETII) and childhood maltreatment have been hypothesized to cause regressive interests. To evaluate these two etiological hypotheses, we surveyed the online adult baby/diaper lover community.

Office-based ureteric stent removal is achievable, improves clinical flexibility and quality of care, whilst also keeping surgeons close to their patients.

Introduction: Diagnostic pressure on endoscopy suites can result in stent removal not receiving the required priority and unnecessary morbidity for patients. As well as using stents with extraction strings, the introduction of a portable single-use flexible cystoscope for ureteric stent removal (Isiris™), offered an opportunity to negotiate these issues by relocating stent removal to the office/clinic. This study aimed to determine whether such flexibility reduced stent dwell time with the assumption this would improve patient experience and decrease associated complications.

Humeral Stem Loosening Following Reverse Shoulder Arthroplasty: A Systematic Review and Meta-Analysis.

Background: Aseptic stem loosening following reverse shoulder arthroplasty (RSA) is an uncommon complication. The timing and the factors contributing to aseptic stem loosening remain poorly understood.

Methods: We performed a systematic review that identified 75 articles; 65 of the included articles were case series (Level-IV evidence), 8 were cohort studies (7 Level III, 1 Level II), and 2 were prospective randomized controlled trials (Level I).

Isiris: A Novel Method of Removing Foreign Bodies from the Lower Urinary Tract to Avoid Unnecessary Hospitalization and Anesthesia.

Background: Polyembolokoilamania refers to the practice of inserting foreign bodies (FBs) into natural orifices. A FB within the urethra is a relatively rare phenomenon with 646 cases recorded last year in the United Kingdom. Management of these patients presents technical challenges and complexities because of underlying psychiatric disorders that are often associated.

Tips and tricks of ureteroscopy: consensus statement. Part II. Advanced ureteroscopy.

Our "tips and tricks" focuses on all aspects of upper tract endourology and we hope these will be of use to all trainees and consultants who perform ureteroscopy. We report an "expert consensus view" from experienced endourological surgeons, on all aspects of advanced ureteroscopic techniques, with a particular focus on avoiding and getting out of trouble while performing ureteroscopy. In this paper we provide a summary of placing ureteric access sheath, flexible ureteroscopy, intra renal stone fragmentation and retrieval, maintaining visual clarity and biopsy of ureteric and pelvicalyceal tumours.

The Meaning of the Child Interview: A new procedure for assessing and understanding parent-child relationships of 'at-risk' families.

Reder and Duncan's well-known studies of the 1990s on fatal child abuse drew attention to how parental scripts regarding their children could dangerously distort relationships in ways that were sometimes fatal to children. This article reports on a new system for assessing the 'meaning of the child to the parent', called the Meaning of the Child Interview (MotC). Parents are interviewed using the established Parent Development Interview, or equivalent, and the transcript of the interview is then analysed according to parental sensitivity and likely risk to the child.

Evaluating the clinical and cost effectiveness of a behaviour change intervention for lowering cardiovascular disease risk for people with severe mental illnesses in primary care (PRIMROSE study): study protocol for a cluster randomised controlled trial.

Background: People with severe mental illnesses die up to 20 years earlier than the general population, with cardiovascular disease being the leading cause of death. National guidelines recommend that the physical care of people with severe mental illnesses should be the responsibility of primary care; however, little is known about effective interventions to lower cardiovascular disease risk in this population and setting. Following extensive peer review, funding was secured from the United Kingdom National Institute for Health Research (NIHR) to deliver the proposed study.

Tips and tricks of ureteroscopy: consensus statement Part I. Basic ureteroscopy.

Ureteroscopy is fast becoming the first line treatment option for the majority of urinary tract stones. Ureteroscopy training can be performed in a variety of ways including simulation, hands on ureteroscopy courses and supervised operative experience. We report an "expert consensus view" from experienced endourological surgeons, on all aspects of basic ureteroscopic techniques, with a particular focus on avoiding and getting out of trouble while performing ureteroscopy.

Development of the REFOCUS intervention to increase mental health team support for personal recovery.

Background: There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking.

Aims: To develop a theoretically based and empirically defensible new pro-recovery manualised intervention--called the REFOCUS intervention.

Nephrectomy for benign disease in the UK: results from the British Association of Urological Surgeons nephrectomy database.

Objective: To summarize the practice of UK urologists with regard to nephrectomy for benign disease, documenting the indications, procedural techniques and outcomes.

Methods: All patients undergoing nephrectomy for a benign condition in 2012 were identified from the British Association of Urological Surgeons (BAUS) nephrectomy database. Recorded variables included the technique of surgery, the type of minimally invasive procedure, operating time, blood loss, transfusion rate, conversion rate, intra- and postoperative complications and mortality rate.