The United Nations' General Assembly High-Level Meeting on antimicrobial resistance: a joint statement from the Heads of Government and Chief Medical Officers of the United Kingdom's Overseas Territories.

The UK Overseas Territories (UKOTs) are small, often remote territories with historical and territorial links to the UK. They range from densely populated areas (Cayman, Bermuda, Gibraltar) to land with no permanent inhabitants (British Antarctic Territory, South Georgia). However, they are linked by ecosystem instability (the permacrisis) including antimicrobial resistance (AMR), climate change and biodiversity disruption.

Stroke clinical coding education program in Australia and New Zealand.

Background: Accurate coded diagnostic data are important for epidemiological research of stroke.

Objective: To develop, implement and evaluate an online education program for improving clinical coding of stroke.

Method: The Australia and New Zealand Stroke Coding Working Group co-developed an education program comprising eight modules: rationale for coding of stroke; understanding stroke; management of stroke; national coding standards; coding trees; good clinical documentation; coding practices; and scenarios.

Preliminary development of recommendations for the inclusion of patient-reported outcome measures in clinical quality registries.

Background: Clinical quality registries (CQRs) monitor compliance against optimal practice and provide feedback to the clinical community and wider stakeholder groups. Despite a number of CQRs having incorporated the patient perspective to support the evaluation of healthcare delivery, no recommendations for inclusion of patient-reported outcome measures (PROMs) in CQRs exist. The aim of this study was to develop a core set of recommendations for PROMs inclusion of in CQRs.

New-Onset Nephrotic Syndrome in a Child Associated With COVID-19 Infection.

The COVID-19 outbreak has become a worldwide public health emergency. The renal histopathological features of acute tubular necrosis or thrombotic microangiopathy have been previously reported in adults with severe COVID-19 infections. In children, the renal manifestations associated with COVID-19 disease are not widely reported.

Estimating primary care attendance rates for fever in infants after meningococcal B vaccination in England using national syndromic surveillance data.

Background: In September 2015, the United Kingdom became the first country to introduce the multicomponent group B meningococcal vaccine (4CMenB) into a national infant immunisation programme. In early clinical trials 51-61% of infants developed a fever when 4CMenB was administered with other routine vaccines. Whilst administration of prophylactic paracetamol is advised, up to 3% of parents may seek medical advice for fever following vaccination.

Managing and reviewing evidence-based changes.

Nurses lead many projects to manage change aimed at improving patient safety and care. This two-part series offers practical guidance on how to bring about an evidence-based change in practice, and how to demonstrate the success, or otherwise, of that change. Part 2 is concerned with discovering why the practice is falling short, how to implement improvements and measure the effect of the changes.

Assessing the need for service improvement.

In order to ensure the service they offer is of an appropriate standard, nurses need to know how to assess its quality, identify the need for change, and implement and evaluate that change. This two-part series offers practical guidance on how to bring about an evidence-based change in practice, and how to demonstrate the success, or otherwise, of that change. It uses the example of an initiative undertaken to improve medicines management in a hospice to illustrate the process.

Introduction of a manual vacuum aspiration service: a model of service within a NHS Sexual Health Service.

Background: We assessed the applicability, acceptability and cost implications of introducing the manual vacuum aspiration (MVA) technique with local anaesthesia for fully conscious first-trimester termination of pregnancy within our service and for our population.

Setting: The outpatient setting of a Pregnancy Advisory Service within a NHS Sexual Health Service.

Methods: Self-administered misoprostol and diclofenac, extra-amniotic local anaesthetic gel and paracervical mepivicaine prior to MVA.

Alterations in the predicted regulatory and coding regions of the sterol 14α-demethylase gene (CYP51) confer decreased azole sensitivity in the oilseed rape pathogen Pyrenopeziza brassicae.

The incidence and severity of light leaf spot epidemics caused by the ascomycete fungus Pyrenopeziza brassicae on UK oilseed rape crops are increasing. The disease is currently controlled by a combination of host resistance, cultural practices and fungicide applications. We report decreases in sensitivity of modern UK P.

Understanding clinical review following a death in custody.

This article examines the importance of clinical reviews for people receiving care in custodial settings. A case study is used to illustrate the need for accurate record-keeping, particularly following death. Healthcare professionals have a duty to ensure that prisoners have the same rights as members of the general public in relation to access to health care and opportunities to improve their health.

The critical power concept in all-out isokinetic exercise.

Unlabelled: The critical power concept has been applied to constant-load exhaustive exercise and recently validated for 3-min all-out exercise.

Objectives: To test the application of critical power to a 3-min all-out isokinetic cycling exercise.

Design: Single-group, experimental, comparative design.

Detection and molecular characterisation of Pyrenopeziza brassicae isolates resistant to methyl benzimidazole carbamates.

Background: Methyl benzimidazole carbamate (MBC) fungicides are used to control the oilseed rape pathogen Pyrenopeziza brassicae. Resistance to MBCs has been reported in P. brassicae, but the molecular mechanism(s) associated with reductions in sensitivity have not been verified in this species.

A test to assess aerobic and anaerobic parameters during maximal exercise in young girls.

The Wingate cycle test (WAnT) is a 30-s test commonly used to estimate anaerobic work capacity (AWC). However, the test may be too short to fully deplete anaerobic energy reserves. We hypothesized that a 90-s all-out isokinetic test (ISO_90) would be valid to assess both aerobic and anaerobic capacities in young females.

Time to exhaustion and time spent at a high percentage of VO2max in severe intensity domain in children and adults.

The aim of the study was to compare time spent at a high percentage of VO2max (>90% of VO2max) (ts90%), time to achieve 90% of VO2max (ta90%), and time to exhaustion (TTE) for exercise in the severe intensity domain in children and adults. Fifteen prepubertal boys (10.3 ± 0.

Implementing a health promotion model in a young offender institution.

Young people in young offender institutions experience more physical and mental health problems than the general population. This article explores how the primary nursing service at HM Young Offenders Institution Huntercombe used national policy as a framework for managing change. In outlining the challenges and opportunities that influence practice development, we hope to demystify nursing in a prison setting, which is a hidden and often misunderstood aspect of healthcare.

Limitations to high intensity exercise prescription in chronic heart failure patients.

Background: Interval training is recommended for chronic heart failure patients (CHF), but specific guidelines on setting appropriate workloads have not been fully established. The aim of this study was to compare a traditional method of interval training prescription with a protocol specifically designed for CHF.

Methods: Ten CHF and 7 healthy controls performed 2 maximal incremental cycle tests to determine interval training workload; a standard test (10Wmin(-)(1)) and a steep test (25W.

Cycling efficiency in trained male and female competitive cyclists.

The aim of this study was to examine differences in cycling efficiency between competitive male and female cyclists. Thirteen trained male (mean ± SD: 34 ± 8 yr, 74.1 ± 6.

Stapled transanal rectal resection for obstructed defecation: a cautionary tale.

Purpose: This prospective study was designed to assess the efficacy and safety of a novel technique in treating outlet obstruction syndrome using a transanal double-stapling procedure.

Methods: Two hundred thirty patients (187 female) with obstructed defecation underwent stapled transanal rectal resection over a six-year period with follow-up at 2, 6, and 12 months, then yearly; median follow-up was 24 (range, 12-68) months. All failed conservative measures.

Critical power is not attained at the end of an isokinetic 90-second all-out test in children.

The purpose of this study was to establish whether critical power, as traditionally determined from the performance of three constant-load tests to exhaustion, is attained at the end of a 90-s all-out test in children. Sixteen healthy children (eight males and eight females; mean age 12.3 years, s(x) = 0.

Critical power in adolescent boys and girls--an exploratory study.

The purpose of the study was to identify critical power (CP) in boys and girls and to examine the physiological responses to exercise at and 10% above CP (CP+10%) in a sub-group of boys. Nine boys and 9 girls (mean age 12.3 (0.

Physiological and performance effects of low- versus mixed-intensity rowing training.

Purpose: To examine the impact of low-intensity and a mixture of low- and high-intensity training on physiological and performance responses in rowing.

Methods: Eighteen experienced rowers undertook a 12-wk program of 100% < or = lactate threshold (LT) training (LOW) or 70% training at < or = LT and 30% at halfway (50%Delta) between the V O2 at LT and V O2peak (MIX). Responses were assessed before and after training by a progressive exercise test to exhaustion; multiple "square-wave" rest-to-exercise transitions of 6-min duration at 50%Delta; and a maximal 2000-m ergometer time trial.

A comparison of methods to determine maximal accumulated oxygen deficit in running.

The aim of this study was to compare maximal accumulated oxygen deficit (hereafter O2 deficit) estimated from the methods of Whipp et al. (1986), Medbo et al. (1988), and Hill et al.

Comparison of the oxygen uptake kinetics of club and olympic champion rowers.

Purpose: To test the hypothesis that elite rowers would possess a faster, more economic oxygen uptake response than club standard rowers.

Methods: Eight Olympic champion (ELITE) rowers were compared with a cohort of eight club standard (CLUB) rowers. Participants completed a progressive exercise test to exhaustion, repeated 6-min moderate and heavy square-wave transitions, and a maximal 2000-m ergometer time trial.