Realist evaluation of cancer rehabilitation services in South Wales (REEACaRS): a mixed methods study protocol.

Introduction: Long-term and late effects of cancer treatments can cause functional limitations and reduce quality of life. Cancer rehabilitation services, which can comprise physical exercise, psychological support and educational interventions depending on the individual's needs, have been found to have a positive effect on health-related quality of life worldwide. However, accessibility or the lack of awareness on available help can act as barriers and influence the uptake of services, resulting in people having unmet rehabilitation needs.

Influence of physical rehabilitation on heart rate dynamics in patients with idiopathic pulmonary fibrosis.

This study sought to determine whether a 6-week physical rehabilitation programme has a measurable influence on heart rate responsiveness to changing metabolic demand in patients with pulmonary fibrosis. Fifteen individuals (13 with idiopathic pulmonary fibrosis and two with pulmonary fibrosis associated with rheumatoid disease) underwent assessments of physical function (6-min walk test), ventilatory function (spirometry), and cardio-respiratory function (respiratory gas analysis and electrocardiogram [ECG] recording during a protocol consisting of periods of rest, incremental bicycle exercise to maximal effort, and post-exercise recovery). RR (beat-to-beat cardiac intervals) data were derived from the ECG and used to quantify (a) heart rate variability (HRV) and (b) cardiac acceleration (AC) and deceleration capacities (DC) (via phase rectified signal averaging).

Feasibility and economic assessment of chromocolonoscopy for detection of proximal serrated neoplasia within a population-based colorectal cancer screening programme (CONSCOP): an open-label, randomised controlled non-inferiority trial.

Background: Most post-colonoscopy interval colorectal cancers are proximal; serrated polyps are often precursors to these cancers and are considered difficult to detect. We assessed the safety, feasibility, and economic effect of chromocolonoscopy on detection of proximal serrated neoplasia.

Methods: We did an open-label, multicentre, randomised, controlled non-inferiority trial including patients from Bowel Screening Wales centres.

Actual and perceived speedy diagnoses are associated with mothers' unresolved reactions to a diagnosis of autism spectrum disorder for a child.

Reaction to a child's diagnosis can strongly affect the parent, but little is known about the aspects of the diagnostic process associated with such reactions. The pre-diagnostic levels of anxiety, depression, and parenting stress of 67 volunteer mothers of children subsequently diagnosed with autism spectrum disorder were assessed, along with the children's functioning. The speed and number of professionals involved in the diagnosis were recorded, and mothers completed a post-diagnosis assessment of their perceptions of the process.

Postoperative critical care and high-acuity care provision in the United Kingdom, Australia, and New Zealand.

Background: Decisions to admit high-risk postoperative patients to critical care may be affected by resource availability. We aimed to quantify adult ICU/high-dependency unit (ICU/HDU) capacity in hospitals from the UK, Australia, and New Zealand (NZ), and to identify and describe additional 'high-acuity' beds capable of managing high-risk patients outside the ICU/HDU environment.

Methods: We used a modified Delphi consensus method to design a survey that was disseminated via investigator networks in the UK, Australia, and NZ.

Paramedics' experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups.

Objectives: To explore paramedics' experience of delivering fascia iliaca compartment block FICB) to patients with suspected hip fracture at the scene of injury.

Design: Focus groups within a randomised controlled trial.

Setting: Paramedics based at ambulance stations in the catchment area of one Emergency Department in South Wales, recruited and trained in a feasibility study about an alternative to routine prehospital pain management for patients with suspected hip fracture.

Bilateral snapping biceps femoris tendon: a case report and review of the literature.

Snapping biceps femoris tendon is an uncommon cause of lateral knee pain. We report the case of a 15-year-old athlete with bilateral snapping biceps femoris tendons, painful over his right lateral leg during exercise. He underwent elective exploration of the right knee which revealed an accessory biceps femoris tendon with attachment to the anterolateral tibia.

Systematic review of the role of corticosteroids in cervicofacial infections.

The role of corticosteroids in the management of cervicofacial infections continues to cause controversy. Systemic anti-inflammatory and immunomodulatory effects that reduce swelling and improve symptoms in the head and neck may make these agents an effective addition to the antibiotics used and to surgical management, although this same effect may dull the physiological response to infection, and allow infections to progress. We have systematically reviewed the evidence for the use of corticosteroids in common cervicofacial infections following the PRISMA guidelines.

Evaluation of undergraduate psychiatric teaching in Sudan.

Development of an undergraduate psychiatric teaching programme and curriculum is a challenge in the current atmosphere of increasing knowledge and vast literature. However, the curriculum remains the cornerstone for future doctors' development and career. Doctors need to have the abilities to recognise, assess and manage common psychiatric conditions presenting at different levels of health services.

Predictors of objectively measured physical activity in 12-month-old infants: A study of linked birth cohort data with electronic health records.

Background: Physical activity (PA) levels are associated with long-term health, and levels of PA when young are predictive of adult activity levels.

Objectives: This study examines factors associated with PA levels in 12-month infants.

Method: One hundred forty-one mother-infant pairs were recruited via a longitudinal birth cohort study (April 2010 to March 2013).

What's in a smile? A review of the benefits of the clinician's smile.

For millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the false smile, which is all too easily identified and may do more harm than good.

Paediatric nurses' adoption of aseptic non-touch technique.

Background:: in 2015, NHS Wales introduced a national standardised approach to aseptic non-touch technique (ANTT). This approach aims to standardise practice and promote better clinical outcomes.

Aim:: to provide insight into the challenges faced by clinical staff adopting ANTT during intravenous therapy.

Detection rates of recurrent prostate cancer: Gallium (Ga)-labelled prostate-specific membrane antigen choline PET/CT scans. A systematic review.

Background: The aim of this work was to assess the use of prostate-specific membrane antigen (PSMA)-labelled radiotracers in detecting the recurrence of prostate cancer. PSMA is thought to have higher detection rates when utilized in positron emission tomography (PET)/computed tomography (CT) scans, particularly at lower prostate-specific antigen (PSA) levels, compared with choline-based scans.

Methods: A systematic review was conducted comparing choline and PSMA PET/CT scans in patients with recurrent prostate cancer following an initial curative attempt.

Computational investigation of the Laplace law in compression therapy.

This study aims to use computational methods for elucidating the effect of limb shape on subgarment and subcutaneous pressures, stresses and strains. A framework was built that generates computational models from 3D arm scans using a depth sensing camera. Finite Element Analysis (FEA) was performed on the scans taken from 23 lymphoedema patients.

Chemotherapeutic Response and Survival for Patients With an Anal Squamous Cell Carcinoma and Low Hemoglobin Levels.

Purpose: Anemia is associated with poor treatment results for a variety of cancers. The effect of low hemoglobin levels on long-term outcomes after the treatment of patients with an anal squamous cell carcinoma (SCC) remains unclear. For that reason, this study aimed to investigate the effect of anemia on treatment outcomes following chemoradiation for an anal SCC.

Psychopathy and impulsivity: The relationship of psychopathy to different aspects of UPPS-P impulsivity.

Impulsivity is thought to be a major component of psychopathy. However, impulsivity is a multi-faceted concept, and different facets may have differential relationships to psychopathy. We measured impulsivity via the UPPS-P in a sample of prisoners and in patients in a personality disorder service resident in secure psychiatric care.

Treatment of psychiatric comorbidities in patients with epilepsy and intellectual disabilities: Is there a role for the neurologist?

This paper will explore the nature of psychiatric co-morbidities in people with an intellectual disability (ID) who have epilepsy. The complexity of clinical presentations and associated co-morbidities require thorough assessment utilising both neurological and psychiatric skills. The neurologist plays a central role in the management of epilepsy in people with ID and therefore requires basic competencies in the assessment of neuropsychiatric co-morbidities.

Early onset cerebral amyloid angiopathy following childhood exposure to cadaveric dura.

Amyloid-β transmission has been described in patients both with and without iatrogenic Creutzfeldt-Jakob disease; however, there is little information regarding the clinical impact of this acquired amyloid-β pathology during life. Here, for the first time, we describe in detail the clinical and neuroimaging findings in 3 patients with early onset symptomatic amyloid-β cerebral amyloid angiopathy following childhood exposure to cadaveric dura (by neurosurgical grafting in 2 patients and tumor embolization in a third). Our observations provide further in vivo evidence that cerebral amyloid angiopathy might be caused by transmission of amyloid-β seeds (prions) present in cadaveric dura and have diagnostic relevance for younger patients presenting with suspected cerebral amyloid angiopathy.

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.

Negotiating Closed Doors and Constraining Deadlines: The Potential of Visual Ethnography to Effectually Explore Private and Public Spaces of Motherhood and Parenting.

Pregnancy and motherhood are increasingly subjected to surveillance by medical professionals, the media, and the general public, and discourses of ideal parenting are propagated alongside an admonishment of the perceived "failing" maternal subject. However, despite this scrutiny, the mundane activities of parenting are often impervious to ethnographic forms of inquiry. Challenges for ethnographic researchers include the restrictions of becoming immersed in the private space of the home where parenting occurs and an institutional structure that discourages exploratory and long-term fieldwork.

Factors influencing multiple sclerosis disease-modifying treatment prescribing decisions in the United Kingdom: A qualitative interview study.

Background: The proportion of people with relapsing-remitting multiple sclerosis prescribed disease modifying treatments (DMTs) in the United Kingdom (UK) is considered low compared with other countries. There are differences in DMT prescription rates between UK nations (England, Wales, Scotland, Northern Ireland). Despite this, there has been little research into decision-making processes and prescribing practices.

The Inflammatory Response to Ventricular Assist Devices.

The therapeutic use of ventricular assist devices (VADs) for end-stage heart failure (HF) patients who are ineligible for transplant has increased steadily in the last decade. In parallel, improvements in VAD design have reduced device size, cost, and device-related complications. These complications include infection and thrombosis which share underpinning contribution from the inflammatory response and remain common risks from VAD implantation.