Less than full-time training, barriers and future needs. A UK-wide online survey of doctors in training.

Background: The the current views of less-than full-time (LTFT) training by both LTFT and full-time (FT) doctors in training, with regards to health and well-being, clinical and non-clinical opportunities, in addition to associated future workforce implications and challenges, are uncertain.

Methods: We performed a cross-sectional study of UK-based doctors in training via an online questionnaire, designed and piloted by the Royal College of Physicians Edinburgh (RCPE) Trainees and Members Committee. Design was informed by prior investigation into LTFT training undertaken amongst similar populations by RCPE in 2019.

Plasma exchange for the management of digoxin toxicity in an individual with an acute kidney injury: A case report.

Digoxin toxicity can be life-threatening. Digoxin-specific antibody (DSA) fragments are used in severe digoxin toxicity, binding to serum-free digoxin and enabling increased renal excretion. In severe renal impairment, clearance of these complexes is prolonged, leading to rebound toxicity.

Capture and inactivation of viral particles from bioaerosols by electrostatic precipitation.

Infectious viral particles in bioaerosols generated during laparoscopic surgery place staff and patients at significant risk of infection and contributed to the postponement of countless surgical procedures during the COVID-19 pandemic causing excess deaths. The implementation of devices that inactivate viral particles from bioaerosols aid in preventing nosocomial viral spread. We evaluated whether electrostatic precipitation (EP) is effective in capturing and inactivating aerosolized enveloped and non-enveloped viruses.

Point-of-care echocardiography and thoracic ultrasound in the management of critically ill patients with COVID-19 infection: Experience in three regional UK intensive care units.

Introduction: Point-of-care ultrasound (POCUS) has an established role in the management of the critically ill. Information and experience of its use in those with COVID-19 disease is still evolving. We undertook a review of cardiac and thoracic ultrasound examinations in patients with COVID-19 on the intensive care unit (ICU).

Anatomic and Biomechanical Study of Thumb Carpometacarpal Dislocations: A Laboratory Study.

Background: No previous study recreating an isolated thumb carpometacarpal (CMC) dislocation with or without suture augmentation has been performed in the laboratory. This investigation aimed to evaluate the mechanism and ligamentous complex of isolated thumb CMC dislocations.

Methods: Biomechanical analysis was performed in 10 cadaveric specimens.

Implementing SAFER Responses to Misconduct and Responding to Biased Patient Requests ASAP.

In response to encounters involving misconduct, discrimination, and harassment toward healthcare workers, the Experience Training, Education, and Coaching (XTEC) team was tasked with empowering staff members to respond to biased requests and misconduct appropriately and consistently. The aim of this article is to discuss communication strategies for how to respond to patient bias and misconduct. XTEC developed a training program with two focused communication strategies: (1) SAFER, a stepped approach to respond to patient and visitor misconduct and (2) ASAP, an approach for responding to patient bias which we describe as requests related to race, religion, ethnicity, gender, and other personal attributes of staff.

Subcutaneous sarcoidosis (Darier-Roussy sarcoidosis) with extensive disease on positron emission tomography: A case report and review of the literature.

Cutaneous manifestations of sarcoidosis are common, but subcutaneous nodules are rare, originally described in 1904 by Darier and Roussy and thought to represent isolated skin disease. We present a 61-year-old male who presented with 3 months of subcutaneous nodules on the forearms and knees. Biopsy confirmed sarcoidosis.

Tocilizumab for the treatment of giant cell arteritis in Scotland: a report on behalf of the Scottish Society for Rheumatology standards subgroup.

Objectives: The aim was to describe a modern National Health Service (NHS) Scotland cohort of patients with GCA over 12 months of care to include clinical presentation, practices relating to assessment and treatment, and specifically, the use of tocilizumab.

Methods: A multicentre audit of patients newly diagnosed with GCA between November 2019 and October 2021 was established on behalf of the Scottish Society for Rheumatology. Clinical data were collected retrospectively by rheumatology teams at participating NHS centres using electronic patient records.

Speaking to the Heart of Our Patients: An Empathic Communication Education Initiative.

Communicating with empathy is a critical skill within the nurse-patient relationship and a driver of a positive patient experience. Staff at a large midwestern medical organization identified an education-based communication improvement strategy to address a gap within its patient experience data. An evidence-based empathic communication education framework was developed and delivered to more than 8,400 nurses and allied health staff.

Improving VTE risk assessment and prophylaxis prescribing rate in medical patients: integrating risk assessment tool into the workflow.

Medical inpatients often have important risk factors for venous thromboembolism (VTE). In our institution, VTE prophylaxis in this group was underused. The main barriers identified were inattention to VTE prophylaxis, competing priorities and lack of confidence in the decision-making.

Is the severity of refractive error dependent on the quantity and extent of retinal laser ablation for retinopathy of prematurity?

Background/aim: To test the hypothesis severity of acquired refractive error in Retinopathy of Prematurity (ROP) is dependent on the quantity of laser treatment delivered.

Methods: Two groups (treated and untreated infants) were age and weight matched. Data on the number of laser burns and Retcam II retinal images were analysed using computer aided design software to determine the proportion of area treated.

Diagnosis and Management Strategies for Distal Biceps Rupture.

Rupture of the distal biceps tendon most commonly is secondary to mechanical overload during eccentric muscle contraction. Due to deficits of strength and endurance, surgical repair usually is recommended. Although both single- and double-incision approaches have been described, double-incision techniques have been shown to better re-create the native anatomic insertion.

Does water birth affect the risk of obstetric anal sphincter injury? Development of a prognostic model.

Introduction And Hypothesis: Obstetric anal sphincter injury (OASI) is a significant complication of vaginal delivery. Water birth has become a popular preference for women giving birth in the UK, however, there is limited data on the risk of OASI following water birth. Our aim was to assess OASI risk in low-risk women giving birth in water without medical intervention compared with on land and to create a prognostic model for OASI prediction.

Red-flag sepsis and SOFA identifies different patient population at risk of sepsis-related deaths on the general ward.

Controversy exists regarding the best diagnostic and screening tool for sepsis outside the intensive care unit (ICU). Sequential organ failure assessment (SOFA) score has been shown to be superior to systemic inflammatory response syndrome (SIRS) criteria, however, the performance of "Red Flag sepsis criteria" has not been tested formally.The aim of the study was to investigate the ability of Red Flag sepsis criteria to identify the patients at high risk of sepsis-related death in comparison to SOFA based sepsis criteria.

Sepsis-related deaths in the at-risk population on the wards: attributable fraction of mortality in a large point-prevalence study.

Objective: Sepsis mortality is reported to be high worldwide, however recently the attributable fraction of mortality due to sepsis (AFsepsis) has been questioned. If improvements in treatment options are to be evaluated, it is important to know what proportion of deaths are potentially preventable or modifiable after a sepsis episode. The aim of the study was to establish the fraction of deaths directly related to the sepsis episode on the general wards and emergency departments.

Retroperitoneal lymphadenopathy secondary to joint replacement wear and debris, a case report.

We present a case of a 63-year-old female who initially presented with complaints of vulvar swelling and was subsequently found to have isolated retroperitoneal lymphadenopathy on imaging. Biopsy was performed and was indicative of weakly polarizable material that raised the consideration of joint prosthesis wear debris. Due to the patient's concern for an underlying malignancy of gynecologic origin, a laparoscopic lymphadenectomy was ultimately performed and final pathology was consistent with reactive changes due to joint wear and debris from the patient's bilateral total knee arthroplasties placed approximately 16 years prior.

Improving Resiliency in Healthcare Employees.

Objectives: The high prevalence of stress at the workplace has been well documented; however, few studies have investigated the efficacy of worksite resiliency programs. Therefore, the objec- tive of this project was to examine the impact of a worksite resilience training program on improving resiliency and health behaviors in healthcare employees.

Methods: Between 2012 and 2016, 137 adult wellness center members of a healthcare institution participating in a single-arm cohort study of a 12-week resiliency training program were assessed at baseline, end of intervention, and at 3-month follow-up.

The information needs of occupational therapy students: a case study.

This article summarises a case study on the information needs of Masters level Occupational Therapy 5 (OT) students at one English university. A mixed methods questionnaire was used to explore motivators for information-seeking, preferred information resources and barriers inhibiting the satisfaction of information needs. Thirteen recommendations for practice were formulated, focusing on how information professionals can best facilitate OT students' learning and evidence-based research skills in preparation for clinical practice.

A review of the importance of immune responses in luminal B breast cancer.

Historically, the immune environment was not considered an important target for breast cancer treatment. However, the association of lymphocytic infiltrates in triple negative and HER-2 over-amplified breast cancer subtypes with better outcomes, has provoked interest in evaluating the role of the immune system in the luminal B subtype that accounts for 39% of breast cancers and has a poor patient prognosis. It is unknown which immunosuppressive cell types or molecules (e.

Empowering international nursing students to become effective library users.

This article summarises the research conducted for a dissertation which addressed the needs of students and academic staff of the Bachelor of Nursing International programme at St. Angela's College, Ireland. Aoife Murray completed an MSc Econ Information and Library Studies in 2015 from Aberystwyth University via distance learning.

Barriers to the use of the library service amongst clinical staff in an acute hospital setting: an evaluation.

This article reports on research into the reasons why clinical staff in an acute hospital may be reluctant to use library services. The research was conducted by Gaynor Thomas at the Prince Philip Hospital in Llanelli in Wales as part of the dissertation she completed for an MSc in Economics. She graduated in July 2014 from Aberystwyth University and has co-written the article with Hugh Preston, her dissertation supervisor.

General practice registrars' views on maternity care in general practice in New Zealand.

Introduction: The number of general practitioners (GPs) providing maternity care in New Zealand has declined dramatically since legislative changes of the 1990s. The Ministry of Health wants GPs to provide maternity care again.

Aim: To investigate New Zealand general practice registrars' perspectives on GPs' role in maternity care; specifically, whether maternity services should be provided by GPs, registrars' preparedness to provide such services, and training opportunities available or required to achieve this.