Predicting long-term risk of reoperations following abdominal and pelvic surgery: a nationwide retrospective cohort study.

Background: The risk of reoperations after abdominal and pelvic surgery is multifactorial and difficult to predict. The risk of reoperation is frequently underestimated by surgeons as most reoperations are not related to the initial procedure and diagnosis. During reoperation, adhesiolysis is often required, and patients have an increased risk of complications.

Adhesion-related readmissions after open and laparoscopic colorectal surgery in 16 524 patients.

Aim: Colorectal surgery is associated with a high risk of adhesion formation and subsequent complications. Laparoscopic colorectal surgery reduces adhesion formation by 50%; however, the effect on adhesion-related complications is still unknown. This study aims to compare differences in incidence rates of adhesion-related readmissions after laparoscopic and open colorectal surgery.

Transepithelial nasal potential difference in patients with, and at risk of acute respiratory distress syndrome.

Background: Impaired alveolar fluid clearance, determined in part by alveolar sodium transport, is associated with acute respiratory distress syndrome (ARDS). Nasal sodium transport may reflect alveolar transport. The primary objective of this prospective, observational study was to determine if reduced nasal sodium transport, as measured by nasal potential difference (NPD), was predictive of the development of and outcome from ARDS.

Pre-hospital pain assessment in paediatric patients.

The aim of this article is to review the literature on pre-hospital assessment of pain in paediatric patients. Many articles highlight the under-treatment of pain in paediatrics by pre-hospital clinicians, showing that this is an area falling short of best practice. This article evaluates the effectiveness of two established pain assessment tools authorised for the pain assessment of children in pre-hospital environments.

A historical perspective on the introduction of laparoscopic basic surgical training in the Caribbean and factors that contribute to sustainability of such training.

Objective: To report the development of minimally invasive training courses and workshops in the Caribbean and specifically the establishment of the Basic Surgical Skills Course of the Royal College of Surgeons of England (RCSEng) in Trinidad with respect to their value toward Surgical laparoscopic or minimally invasive training in the Caribbean.

Design: & Methods: The literature written on laparoscopy in the region was reviewed and in particular that related to the minimally invasive training courses provided over the period 2004 to 2019 and the development of laparoscopic surgical training described from a historic perspective. The factors that contribute to sustainability of courses were identified.

Provider-based barriers to provision of intrauterine contraception in general practice.

Objectives: Intrauterine contraception (IUC) is highly effective, safe and long-lasting, but is not a popular method of contraception among British women. This study examined barriers to the uptake of IUC in general practice in England.

Method: A sequential mixed-method approach to explore the views of practitioners regarding the provision of IUC.

Need to improve awareness and treatment compliance in high-risk patients for diabetic complications in Nepal.

Objective/introduction: It is known that knowledge, awareness, and practice influence diabetic control. We compared factors pertaining to healthy lifestyle (exercising, avoiding smoking), self-help (attending appointments, following treatment regimens), and diabetic awareness in high-risk patients for diabetic complications, specifically, those on insulin versus non-insulin treatment, and also those with a longer diabetic duration (≥5 years) versus a shorter duration.

Methods: 200 consecutive patients with type 2 diabetes (52.

Feasibility randomised multicentre, double-blind, double-dummy controlled trial of anakinra, an interleukin-1 receptor antagonist versus intramuscular methylprednisolone for acute gout attacks in patients with chronic kidney disease (ASGARD): protocol study.

Introduction: Acute gout occurs in people with chronic kidney disease, who are commonly older people with comorbidities such as hypertension, heart disease and diabetes. Potentially harmful treatments are administered to these vulnerable patients due to a lack of clear evidence. Newly available treatment that targets a key inflammatory pathway in acute gout attacks provides an opportunity to undertake the first-ever trial specifically looking treating people with kidney disease.

Should nurses receive formal commendations?

On 22 March news broke that an incident had occurred at the Palace of Westminster in London. The Metropolitan Police, London Ambulance Service and the Helicopter Emergency Medical Service responded and, as details emerged, it became clear there had been a terrorist attack.

Stand up to cutbacks.

This has been a turbulent year for the NHS and the future is not looking bright. Junior doctors have closed ranks and gone on strike over better working and pay conditions while highlighting patient safety is at risk.

Predictors of non-use of intrauterine contraception among women aged 18-49 years in a general practice setting in the UK.

Objectives: Our research examined the barriers to the uptake of intrauterine contraception (IUC) by women in a general practice (GP) setting in the UK. This study reports predictors of non-use of IUC in this context.

Design: We used a mixed method Qual/Quant approach in which the initial qualitative research provides a framework for subsequent larger quantitative surveys.

A Pilot Study Assessing the Impact of 3-D Printed Models of Aortic Aneurysms on Management Decisions in EVAR Planning.

Introduction: Endovascular repair of aortic aneurysms with difficult anatomy is challenging. There is no consensus for planning such procedures.

Methods: Six cases of aortic aneurysms with challenging anatomical features, such as short, angulated, and conical necks and tortuous iliacs were harvested.

Board's eye view - The weekend effect.

AS THE festive season approaches, the government will reassure the public that the NHS is sufficiently prepared to avoid a winter crisis. However, winter preparations coincide with a junior doctors' pay campaign and a perceived need for 'seven-day services' because of the 'weekend effect'.

The false negative rate and the role for virtual review in a nationally evaluated glaucoma referral refinement scheme.

Purpose: To establish the safety of the CHANGES glaucoma referral refinement scheme (GRRS).

Methods: The CHANGES scheme risk stratifies glaucoma referrals, with low risk referrals seen by a community based specialist optometrist (OSI) while high risk referrals are referred directly to the hospital. In this study, those patients discharged by the OSI were reviewed by the consultant ophthalmologist to establish a 'false negative' rate (Study 1).

Diurnal Intraocular Pressure and the Relationship With Swept-Source OCT-Derived Anterior Chamber Dimensions in Angle Closure: The IMPACT Study.

Purpose: To evaluate diurnal intraocular pressure (DIOP) among individuals with primary angle closure (PAC) or primary angle-closure suspect (PACS). Additionally, the hypothesis that greater DIOP fluctuation is related to smaller angle parameters was investigated.

Methods: Forty Caucasian newly referred untreated patients with bilateral PAC or PACS were recruited.

Co-benefits of designing communities for active living: an exploration of literature.

To reverse the global epidemic of physical inactivity that is responsible for more than 5 million deaths per year, many groups recommend creating "activity-friendly environments." Such environments may have other benefits, beyond facilitating physical activity, but these potential co-benefits have not been well described. The purpose of the present paper is to explore a wide range of literature and conduct an initial summary of evidence on co-benefits of activity-friendly environments.

Impact of a patient-specific co-designed COPD care scorecard on COPD care quality: a quasi-experimental study.

Background: The evidence that sharing mass care quality data with health service users improves care is weak.

Aims: We hypothesised that providing patients with individualised care quality data would drive improvements to the care received by those patients.

Methods: Together with patients who had chronic obstructive pulmonary disease (COPD), we co-designed a quality score card mapping indicators derived from National Institute for Clinical Excellence (NICE) quality standards against matched data taken from their general practice clinical records.

The effectiveness of schemes that refine referrals between primary and secondary care--the UK experience with glaucoma referrals: the Health Innovation & Education Cluster (HIEC) Glaucoma Pathways Project.

Objectives: A comparison of glaucoma referral refinement schemes (GRRS) in the UK during a time period of considerable change in national policy and guidance.

Design: Retrospective multisite review.

Setting: The outcomes of clinical examinations by optometrists with a specialist interest in glaucoma (OSIs) were compared with optometrists with no specialist interest in glaucoma (non-OSIs).

The impact of glaucoma referral refinement criteria on referral to, and first-visit discharge rates from, the hospital eye service: the Health Innovation & Education Cluster (HIEC) Glaucoma Pathways project.

Purpose: To assess the impact of referral refinement criteria on the number of patients referred to, and first-visit discharges from, the Hospital Eye Service (HES) in relation to the National Institute for Health & Clinical Excellence (NICE) Glaucoma Guidelines, Joint College Group Guidance (JCG) and the NICE commissioning guidance.

Methods: All low-risk (one risk factor: suspicious optic disc, abnormal visual field (VF), raised intra-ocular pressure (IOP) (22-28 mmHg) or IOP asymmetry (>5 mmHg) and high-risk (more than one risk factor, shallow anterior chamber or IOP >28 mmHg) referrals to the HES from 2006 to 2011 were analysed. Low-risk referrals were seen by Optometrists with a specialist interest in glaucoma and high-risk referrals were referred directly to the HES.

The effect of changes in referral behaviour following NICE guideline publication on agreement of examination findings between professionals in an established glaucoma referral refinement pathway: the Health Innovation & Education Cluster (HIEC) Glaucoma Pathways project.

Aim: To investigate whether the publication of the National Institute for Health and Clinical Excellence (NICE) glaucoma guidelines had an effect on the agreement of examination findings between professionals involved in an established glaucoma referral refinement pathway.

Methods: To report inter-professional agreement for the clinical examination findings of optometrists with a special interest in glaucoma (OSI), optometrists with no specialist interest in glaucoma (non-OSI) and a glaucoma consultant. Part 1 investigated agreement between an OSI and consultant and part 2 investigated agreement of clinical findings between the non-OSI and a specialist clinician (OSI or consultant).

The Baux score is dead. Long live the Baux score: a 27-year retrospective cohort study of mortality at a regional burns service.

Background: To assess trends in mortality after burn injuries treated in a regional specialist burns service between 1982 and 2008.

Methods: Patient and burn-specific information and mortality were collated from written admission ledgers and the hospital coding department for 11,109 patients. The data set was divided into age cohorts (0-14, 15-44, 45-64, and >65 years) and time cohorts (1982-1991, 1992-2000, and 2000-2008).