Beyond reliability: assessing rater competence when using a behavioural marker system.

Background: Behavioural marker systems are used across several healthcare disciplines to assess behavioural (non-technical) skills, but rater training is variable, and inter-rater reliability is generally poor. Inter-rater reliability provides data about the tool, but not the competence of individual raters. This study aimed to test the inter-rater reliability of a new behavioural marker system (PhaBS - pharmacists' behavioural skills) with clinically experienced faculty raters and near-peer raters.

Oral and Maxillofacial Surgery Curriculum (2021) and Oral Surgery Curriculum (2023): A forensic comparison of two documents.

In the UK Oral and Maxillofacial Surgery (OMFS) and Oral Surgery (OS) are distinct specialties governed respectively by the General Medical Council (GMC) and General Dental Council (GDC) respectively. There has always been overlap of training and care between both specialties. The OMFS curriculum was updated in 2021 and the Oral Surgery Curriculum in 2023.

Radiographer chest x-ray reporting in Scotland in 2023: An exploratory study into the attitudes and challenges concerning the development of a standardised, countrywide reporting service.

Background: The increasing backlog of chest x-ray (CXR) reports in Scotland is well documented, as is reporting radiographer's (RR) ability to provide a cost effective solution to this. Despite this, only 8 CXR RRs currently work in Scotland. This qualitative descriptive study will explore the perceived reasons for this lack of role development by investigating the relevant enablers and challenges.

Clinical application of capsule sponge testing in symptomatic reflux disease: a national prospective cohort study.

Background: Capsule sponge testing, using an oesophageal cell collection device with biomarkers, was implemented nationally across Scotland in 2020 for symptomatic reflux patients referred to secondary care for non-urgent endoscopy. The aim was to use capsule sponge testing as a triage tool to reduce pressures on the endoscopy service during COVID-19, focus endoscopy resources on those most likely to have pathology and streamline the patient pathway. This prospective cohort study presents the first real-world results and evaluates the clinical application of capsule sponge testing in symptomatic reflux disease based on endoscopic biopsy results.

Assessing the landscape and charting paths: UK neurology trainees' opinions on neuroinflammation subspecialty.

Therapeutics of neuroinflammatory disorders including multiple sclerosis is one of the fastest growing areas in neurology. However, pressures on higher specialty training in neurology together with an expanding curriculum have led to challenges in adequately preparing trainees for a subspecialist career. In this study we set out to understand current perceptions and barriers to training in neuroinflammatory disorders among neurology trainees in the UK.

Using disease-modifying treatments in multiple sclerosis: Association of British Neurologists (ABN) 2024 guidance.

The Association of British Neurologists last published guidelines on disease-modifying treatment (DMT) in multiple sclerosis (MS) in 2015. Since then, additional DMTs have been licensed and approved for prescribing within the National Health Service for relapsing-remitting MS, early primary progressive MS and active secondary progressive MS. This updated guidance provides a consensus-based approach to using DMTs.

Scotland's internal medicine simulation strategy: A 5-year journey.

In 2019, the internal medicine (IM) stage 1 curriculum was implemented in the UK. This introduced a revised 3-year training programme for physicians in training. The new IM stage 1 curriculum emphasised simulation-based education, triggering the integration of simulation training on a national scale in Scotland.

Living with COPD and its psychological effects on participating in community-based physical activity in Brazil: a qualitative study. Findings from the Breathe Well group.

Physical activity (PA) improves dyspnoea, psychological wellbeing and quality of life (QoL) for people with COPD reducing their risk of exacerbation. However, engagement in PA is low especially amongst those with anxiety and depression, and PA programmes are limited in countries with limited resources such as Brazil. We explored perceptions of 21 people with COPD about the impact of their disease on taking part in community-based PA programmes in Sao Paulo, Brazil through semi-structured telephone interviews from October 2020 to April 2021.

Primary healthcare professionals' perceptions, attitudes and ideas regarding asthma management in Greece: A mixed-method study.

Background: Implementing asthma guideline recommendations is challenging and there is variation between countries, and different healthcare professionals (HCPs). The International Primary Care Respiratory Group (IPCRG) has introduced the Asthma Right Care (ARC) programme implemented in 24 low, middle, and high countries, including Greece. It offers a promising approach drawn from social movements for health to improve asthma care by engaging HCPs in implementing guideline-based asthma care.

Injection treatments for trapeziometacarpal joint arthritis: a network meta-analysis of randomized studies.

This network meta-analysis of 13 randomized trials comparing injection treatments for trapeziometacarpal joint arthritis found no robust evidence for any treatment. There is low-quality evidence that corticosteroid and hyaluronic acid injections are superior to placebo for mid-term pain.

Leadership Lingo: Developing a Shared Language of Leadership Behaviors to Enrich Debriefing Conversations.

Introduction: Leadership in medical emergencies is variable and frequently suboptimal, contributing to poor patient care and outcomes. Simulation training can improve leadership in both simulated practice and real clinical emergencies. Thoughtful debriefing is essential.

Assessment of the diagnostic value of NT-proBNP in heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a common concern in the medical field due to its prevalence in an ageing western population. HFpEF is associated with significant morbidity and mortality not dissimilar to heart failure (HF) with reduced ejection fraction. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and echocardiography are the guideline diagnostic indicators of HF and their use is being examined in this study, with the aim to consider NT-proBNP thresholds performance as a rule-out test.

Constrictive pericarditis requiring pericardiectomy: an unusual first presentation of extra-articular rheumatoid arthritis-a case report.

Background: We report an unusual case of rheumatoid arthritis presenting for the first time with pericardial constriction and bilateral pleural calcification, in the absence of prior articular disease.

Case Summary: A 46-year-old Caucasian male, who initially presented with shortness of breath, intermittent chest tightness and general malaise, underwent extensive diagnostic workup over a period of six months involving multiple hospital admissions. He was found to have pericardial constriction on echocardiogram and ultimately required surgical pericardiectomy due to decompensation.

Comparative efficacy of aspirin versus direct oral anticoagulants for venous thromboembolism prophylaxis following primary total hip arthroplasty or total knee arthroplasty: A systematic review and meta-analysis of randomised controlled trials.

Introduction: Venous thromboembolisms (VTEs), including deep vein thrombosis (DVT) and pulmonary embolisms (PE), are common after total knee (TKA) and hip arthroplasty (THA). Recent studies suggest that aspirin effectively prevents VTE following major orthopaedic surgery. This meta-analysis compares randomised controlled trials (RCTs) evaluating aspirin versus direct oral anticoagulants (DOACs) for VTE prevention after primary THA and TKA.

Anaesthetic management of obstetric patients with Chiari type I malformation: a retrospective case series and literature review.

The peripartum management of obstetric patients with Chiari type I malformation remains a challenge due to the degree of cerebellar tonsillar herniation and a paucity of published evidence. There is concern about neuraxial anaesthetic blocks and uncertainty regarding the optimum mode of delivery. We systematically searched the literature for the obstetric management of patients with Chiari type I malformation, independent of publication date and language.

Flash Glucose Monitoring is Associated with HbA1c Improvement in Type 2 Diabetes Managed with Multiple Daily Injections of Insulin in the UK: A Retrospective Observational Study.

Introduction: There is a growing body of evidence demonstrating the benefit of flash glucose monitoring in people living with type 2 diabetes mellitus (T2DM). This real-world study aimed to evaluate the effect of initiating flash glucose monitoring on change in HbA1c after 3-6 months in adults living with T2DM treated with multiple daily injections of insulin.

Methods: A retrospective observational study using data from ten clinical centres in the UK for adults with T2DM treated with multiple daily injections of insulin for at least 1 year was conducted.