Impact of the COVID-19 pandemic on provision of antimicrobial stewardship education and training in UK health service sites.

The impact of the COVID-19 pandemic on antimicrobial stewardship is a cause for serious concern. There is evidence of increased antibiotic usage in many settings and fears of over-use, especially of broad-spectrum antibiotics in patients with COVID-19, raising concerns about potential impact on antimicrobial resistance globally. At the same time, the pandemic has impacted the provision of education and training throughout the health and education sectors, during a period when health services and staff were under unprecedented pressure.

A methodology to facilitate critical care research using multiple linked electronic, clinical and administrative health records at population scale.

Introduction: Critical Care is a specialty in medicine providing a service for severely ill and high-risk patients who, due to the nature of their condition, may require long periods recovering after discharge. Consequently, focus on the routine data collection carried out in Intensive Care Units (ICUs) leads to reporting that is confined to the critical care episode and is typically insensitive to variation in individual patient pathways through critical care to recovery.A resource which facilitates efficient research into interactions with healthcare services surrounding critical admissions, capturing the complete patient's healthcare trajectory from primary care to non-acute hospital care prior to ICU, would provide an important longer-term perspective for critical care research.

Pre- and peri-operative clinical information, physiological observations and outcome measures following flexible ureterorenoscopy (FURS), for the treatment of kidney stones. A single-centre observational clinical pilot-study in 51 patients.

Background: Kidney stone disease contributes to a significant proportion of routine urological practice and remains a common cause of worldwide morbidity. The main aim of this clinical-pilot study was to investigate the effect of flexible ureterorenoscopy (FURS) on pre- and peri-operative clinical information, physiological observations and outcome measures.

Methods: Included were 51 patients (31 males, 20 females), who underwent elective FURS, for the treatment of kidney stones.

SARS-CoV-2 infection risk among 77,587 healthcare workers: a national observational longitudinal cohort study in Wales, United Kingdom, April to November 2020.

Objectives: To better understand the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers, leading to recommendations for the prioritisation of personal protective equipment, testing, training and vaccination.

Design: Observational, longitudinal, national cohort study.

Setting: Our cohort were secondary care (hospital-based) healthcare workers employed by NHS Wales (United Kingdom) organisations from 1 April 2020 to 30 November 2020.

Prevalence of insomnia and poor sleep quality in the prison population: A systematic review.

Insomnia is a public health concern with several associated negative health-related outcomes. Risk factors for insomnia place the prison population at an increased risk of inadequate sleep. This paper systematically reviewed the literature reporting on the prevalence of insomnia and poor sleep quality in the prison population.

Long-term, high-dose opioid prescription for chronic non-cancer pain in primary care: an observational study.

Background: Opioid prescriptions for chronic pain have risen sharply over the last 25 years; harms associated with these drugs are related to dose and length of use.

Aim: The main aim of this study was to identify patients prescribed long-term, high-dose (LTHD) opioids in the community and to assess the prevalence of such use.

Design & Setting: An observational study of opioid prescribing in two demographically dissimilar GP practices in North Wales, UK.

A qualitative systematic review of the role of families in supporting communication in people with dementia.

Background: Cognitive-communication difficulties are often associated with dementia and can impact a person's ability to participate in meaningful conversations. This can create challenges to families, reflecting the reality that people living with dementia rarely have just one regular conversation partner, but interact with multiple family members. To date, there is limited evidence of the impact of changes in communication patterns in families.

The all-Wales forensic adolescent consultation and treatment service (FACTS): A 5-year referral cohort study.

Background: FACTS is a Wales-wide mental health service for 10-17-year-olds with needs beyond the remit of mainstream child and adolescent mental health services (CAMHS). As a purely consultation-liaison service, it differs from other UK services in the field.

Aims: To describe a complete cohort of referrals to FACTS 2013-2017 with service exit by June 2018.

The BILAG-2004 index is associated with development of new damage in SLE.

Objective: To determine whether BILAG-2004 index is associated with the development of damage in a cohort of SLE patients. Mortality and development of damage were examined.

Methods: This was a multicentre longitudinal study.

"You Forget to Apply It to Staff": A Compassion-Focused Group for Mental Health Inpatient Staff. An Exploration of the Barriers to Attendance.

This study explored the feasibility and acceptability of an experiential compassion-focused group intervention for mental health inpatient staff. Findings demonstrated that although participants found sessions enjoyable, and reported a number of benefits, the group attrition was high. Semi-structured interviews were conducted to explore issues related to group dropout.

Role of Therapeutic Plasmapheresis in SARS-CoV-2 Induced Cytokine Release Syndrome: A Retrospective Cohort Study on COVID-19 Patients.

Background: Cytokine release syndrome (CRS) significantly contributes to the pathophysiology and progression of COVID-19. It is speculated that therapeutic plasma exchange (TPE) can dampen CRS via elimination of pathogenic cytokines.

Objectives: The study is intended to compare the outcomes of COVID-19 patients with CRS treated with TPE and standard care (SC) to their counterparts receiving SC alone.

British Association of Dermatologists guidelines for the management of adults with delusional infestation 2022.

The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of delusional infestation (DI) in adults. Linked Comment: I. Coulson.

Acoustic analysis of the effect of personal protective equipment on speech understanding: lessons for clinical environments.

Objective: The use of various types of filtering facepiece class 3 (FFP3) mask have become commonplace since the Covid-19 outbreak. These have been evaluated in terms of efficacy regarding aerosol filtration but less emphasis has been placed on the acoustic effects of such masks and their consequences for clinical communication.

Design: A microphone 65 cm from a sound-producing Head and Torso Simulator (wearing the masks) was used to measure attenuation via a tone sweep.

Safety, immunogenicity, and reactogenicity of BNT162b2 and mRNA-1273 COVID-19 vaccines given as fourth-dose boosters following two doses of ChAdOx1 nCoV-19 or BNT162b2 and a third dose of BNT162b2 (COV-BOOST): a multicentre, blinded, phase 2, randomised trial.

Background: Some high-income countries have deployed fourth doses of COVID-19 vaccines, but the clinical need, effectiveness, timing, and dose of a fourth dose remain uncertain. We aimed to investigate the safety, reactogenicity, and immunogenicity of fourth-dose boosters against COVID-19.

Methods: The COV-BOOST trial is a multicentre, blinded, phase 2, randomised controlled trial of seven COVID-19 vaccines given as third-dose boosters at 18 sites in the UK.

Hajibandeh Index versus NELA score in predicting mortality following emergency laparotomy: A retrospective Cohort Study.

Objectives: To compare performance of the Hajibandeh Index (HI) and National Emergency Laparotomy Audit (NELA) score in predicting postoperative mortality in patients undergoing emergency laparotomy.

Methods: In compliance with STROCSS guidelines for observational studies a cohort study was conducted. All patients aged over 18 who underwent emergency laparotomy between January 2014 and January 2021 in our centre were considered eligible for inclusion.

Evaluating the impact of neurosurgical rotation experience in Africa on the interest and perception of medical students towards a career in neurosurgery: a protocol for a continental, cross-sectional study.

Introduction: Africa has the second highest neurosurgical workforce deficit globally. Despite the many recent advancements in increasing neurosurgical access in Africa, published reports have shown that the vast majority of undergraduate students have little or no exposure to neurosurgery. The lack of exposure may pose a challenge in reducing the neurosurgical workforce deficit, which is one of the long-term strategies of tackling the unmet burden of disease.

The juxtaposition of the natural and the medical perspectives in noisy breathing at the end of life.

Background: Noisy breathing is common at the end of life. Management of noisy breathing aims to reduce the noise via repositioning the person, suctioning the person's airways and using antimuscarinic drugs. Dying people are generally thought not to be distressed by noisy breathing at the end of life, but the noise may distress others.

The SARS-CoV2 envelope differs from host cells, exposes procoagulant lipids, and is disrupted in vivo by oral rinses.

The lipid envelope of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an essential component of the virus; however, its molecular composition is undetermined. Addressing this knowledge gap could support the design of antiviral agents as well as further our understanding of viral-host protein interactions, infectivity, pathogenicity, and innate immune system clearance. Lipidomics revealed that the virus envelope comprised mainly phospholipids (PLs), with some cholesterol and sphingolipids, and with cholesterol/phospholipid ratio similar to lysosomes.

Persistence of immunogenicity after seven COVID-19 vaccines given as third dose boosters following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK: Three month analyses of the COV-BOOST trial.

Objectives: To evaluate the persistence of immunogenicity three months after third dose boosters.

Methods: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose. The analysis was conducted using all randomised participants who were SARS-CoV-2 naïve during the study.