Out-of-hours decision-making in deteriorating patients by foundation year doctors: Relationship to moral distress.

Background: Moral distress (MD) refers to psychological unease when healthcare professionals identify morally correct actions to take but are constrained in their ability to take those actions.

Methods: This study evaluated the relationship between out-of-hours decisions and MD among 40 Foundation Year 2 (FY2) doctors. They were asked to choose the 'expected' and the 'right' management options for five out-of-hours scenarios and complete an adapted Measure of Moral Distress for Health Professionals (MMD-HP) questionnaire.

Medical graduate views on statistical learning needs for clinical practice: a comprehensive survey.

Background: This paper seeks to contribute to a reputable evidence base for required competencies across different topics in statistics and probability (statistical topics) in preparing medical graduates for clinical practice. This is in order to inform the prioritization of statistical topics within future undergraduate medical curricula, while exploring the need for preparing tomorrow's doctors to be producers, and not merely consumers, of statistics.

Methods: We conducted a comprehensive online survey from July 2013 to August 2014 for a target group of 462 medical graduates with current or prior experience of teaching undergraduate medical students of the University of Edinburgh of whom 278 (60.

The acceptability to patients of video-consulting in general practice: semi-structured interviews in three diverse general practices.

Background: To improve patient access to healthcare, the UK government has encouraged technology-based approaches including internet video-consulting. However, little is known about patient acceptance of video-consulting as a consulting method. We aimed to explore primary care patients' views video-consulting.

Capnography for procedural sedation in the ED: a systematic review.

Introduction: Procedural sedation and analgesia (PSA) is commonplace in the ED. Previous studies have identified capnography as a reliable indicator of PSA-induced respiratory depression. This review investigates the potential effect on patient safety of the use of capnography in addition to standard monitoring for adult patients undergoing PSA in the ED.

Variation in assessment and standard setting practices across UK undergraduate medicine and the need for a benchmark.

Objectives: The principal aim of this study is to provide an account of variation in UK undergraduate medical assessment styles and corresponding standard setting approaches with a view to highlighting the importance of a UK national licensing exam in recognizing a common standard.

Methods: Using a secure online survey system, response data were collected during the period 13 - 30 January 2014 from selected specialists in medical education assessment, who served as representatives for their respective medical schools.

Results: Assessment styles and corresponding choices of standard setting methods vary markedly across UK medical schools.

A systematic review of therapeutic hypothermia for adult patients following traumatic brain injury.

Introduction: Research into therapeutic hypothermia following traumatic brain injury has been characterised by small trials of poor methodological quality, producing variable results. The Cochrane review, published in 2009, now requires updating. The aim of this systematic review is to assess the effectiveness of the application of therapeutic hypothermia to reduce death and disability when administered to adult patients who have been admitted to hospital following traumatic brain injury.

Are the public ready for organ donation after out of hospital cardiac arrest?

Objective: To assess Emergency Department (ED) relatives' and patients' opinions on: (1) discussing organ donation (OD) with relatives soon after ED death after cardiac arrest and (2) acceptability of organ preservation procedures both before and after discussion with relatives.

Methods: Questionnaire study; convenience sample.

Results: 200 questionnaires were completed.

What is the best method of proteinuria measurement in clinical trials of endothelin receptor antagonists?

Aims: To determine whether protein-creatinine ratio (PCR) and albumin-creatinine ratio (ACR) are comparable to 24h urine protein in terms of agreement and repeatability, and therefore whether they are suitable for monitoring and comparing reduction in proteinuria in clinical trials of endothelin receptor antagonists.

Main Methods: Using data from a recent study of sitaxentan in 27 patients with proteinuric chronic kidney disease, the assays were compared with reference to their agreement, repeatability, the number of measurements required to obtain accurate results and correlation with reduction in proteinuria at baseline.

Key Findings: The median coefficient of variation was lower for PCR than 24h urine protein (25 vs.

Initiating undergraduate medical students into communities of research practise: what do supervisors recommend?

Background: Much has been written in the educational literature on the value of communities of practise in enhancing student learning. Here, we take the experience of senior undergraduate medical students involved in short-term research as a member of a team as a paradigm for learning in a community of practise. Based on feedback from experienced supervisors, we offer recommendations for initiating students into the research culture of their team.

Dyscalculia, dyslexia, and medical students' needs for learning and using statistics.

Much has been written on the learning needs of dyslexic and dyscalculic students in primary and early secondary education. However, it is not clear that the necessary disability support staff and specialist literature are available to ensure that these needs are being adequately met within the context of learning statistics and general quantitative skills in the self-directed learning environments encountered in higher education. This commentary draws attention to dyslexia and dyscalculia as two potentially unrecognized conditions among undergraduate medical students and in turn, highlights key developments from recent literature in the diagnosis of these conditions.

Change in plasma vascular endothelial growth factor during onset and recovery from acute mountain sickness.

There is an increasing body of evidence suggesting that altered vascular permeability may be an important component of the pathogenesis of acute mountain sickness (AMS). Vascular endothelial growth factor (VEGF) is a potent permeability factor subject to hypoxic regulation but its role in the pathogenesis of AMS is yet to be defined. We examined the relationship between plasma VEGF and AMS on ascent to high altitude and subsequent acclimatisation.

A case study using larval therapy in the community setting.

This article discusses the use of larval therapy by district nurses in wound bed preparation in the community. A case study is presented of a patient with a persistently necrotic and painful anterior tibial wound post-fasciotomy. The case study offers an insight into the practicalities involved in the use of larvae as effective and safe debriders of tissue for wound bed preparation.

Effects of Misoprostol on Contrast-Induced Renal Dysfunction.

Radiographic contrast-induced nephropathy (RCIN), defined by a variable rise in serum creatinine, occurs in up to 40% of contrast radiologic procedures. A prospective, randomized double-blind study was done to determine whether misoprostol prevented or modified RCIN. Patients with a serum creatinine less-than-or-equal2.