Surgical and Pathological Results Following Neoadjuvant Nivolumab and Platinum-Based Chemotherapy for Locally Advanced Resectable NSCLC: A Multicentre Real-World Series From England.

Background: To evaluate the real-world surgical and pathological outcomes following neoadjuvant nivolumab in combination with chemotherapy in a multicentre national cohort of patients.

Methods: Retrospective analysis on consecutive patients treated in three tertiary referral hospitals in UK with neoadjuvant chemotherapy and immunotherapy (nivolumab) for stage II-IIIB nonsmall cell lung cancer (March 2023-May 2024). Surgical and pathological outcomes were assessed.

Marburg variant of multiple sclerosis: A young women case report.

Marburg disease (malignant multiple sclerosis, MS) is a rare, acute MS variant, predominantly occurring among young adults. Because it is characterized by rarity, high morbidity and mortality rates, the disease needs to be further characterized, and the experience of the physicians play a role in treatment regimens. We report the case of a 15-years-old female presenting with progressive weakness over the limbs, hyperreflexia and loss of sensation by physical examination, lab tests and radiological investigations (MRI).

The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System.

Future hospitals must be able to adapt in many ways to the changing demands on their roles and functions within evolving healthcare delivery infrastructures. These include changing population structures and needs, new models of healthcare provision, technological advances, and innovations in design, all while enhancing their environmental sustainability. This article sets out the issues that those determining healthcare policy and designing future hospitals must consider if they are to become and remain fit for purpose within the wider health and social care system.

Cross-agency working when conducting a pragmatic RCT for older victims of crime: our experiences and lessons learned.

Background: With the population ageing, more victims of community crime are likely to be older adults. The psychological impact of crime on older victims is significant and sustained, but only feasibility trials have been published regarding potential interventions. The integration of public health and care services and cross-agency working is recommended, but there is little information on how this should be undertaken.

Open lower limb fracture reconstruction in the elderly population: the experience of a major trauma centre.

Purpose: Management of the elderly patients presenting with open lower limb fractures is challenging due to physiological changes and pre-existing co-morbidities. The aim of this study was to assess the compliance with the British Orthopaedic Association's Standards for Trauma Number 4 (BOAST 4) guidelines in this patient group.

Methods: The study included a retrospective analysis of all the patients aged > 65 years old admitted with open lower limb fracture between 2017 and 2019 to a major trauma centre (MTC) in East of England.

A simulation study to quantitatively assess the performance of electronic prescribing systems in English NHS Hospital Trusts.

Prescribing errors are a source of preventable harm in healthcare, which may be mitigated using Electronic Prescribing (EP) systems. Anyone who routinely prescribes medication could benefit from digitally assisted automated checks to identify whether a prescription should potentially not be allowed (e.g.

Longer term follow-up of abdominal symptoms (CFAbd-Score) after initiation of Elexacaftor / Tezacaftor / Ivacaftor in adults with cystic fibrosis.

Background: Whether improvements in gastrointestinal (GI) symptoms observed with Elexacaftor/Tezacaftor/Ivacaftor (ETI) treatment are sustained in the longer-term requires exploration. This study investigated how GI-symptoms change with longer-term ETI use in pancreatic insufficient adults with cystic fibrosis (awCF).

Methods: Participants completed up to three abdominal symptom questionnaires, employing the validated CFAbd-Score.

Exploring knowledge of first aid in epistaxis-25 years on.

Background: Epistaxis is the most common acute disorder managed by ENT services. A 1998 survey (Strachan and England) demonstrated widespread ignorance of correct first aid amongst the public with only 11% of respondents applying correct first aid techniques. Here we repeated and expanded the 1998 study to investigate whether understanding of correct first aid in epistaxis amongst the public and emergency department staff has improved in the last 25 years.

Piloting a minimum data set for older people living in care homes in England: a developmental study.

Background: We developed a prototype minimum data set (MDS) for English care homes, assessing feasibility of extracting data directly from digital care records (DCRs) with linkage to health and social care data.

Methods: Through stakeholder development workshops, literature reviews, surveys and public consultation, we developed an aspirational MDS. We identified ways to extract this from existing sources, including DCRs and routine health and social care datasets.

Higher hospital volume reduces early failure rates in single-stage revision TKR for infection: An analysis of the United Kingdom National Joint Registry and National Administrative Databases.

Purpose: Revision knee replacement (RevKR) for infection is rare but increasing. It is hypothesised that higher hospital volume reduces adverse outcomes. The aim was to estimate the association of surgical unit volume with outcomes following first, single-stage RevKR for infection.

Reimagining psychosis prevention: responding to the accessibility issues of At-Risk Mental State (ARMS) services through a selective public health approach.

At-Risk Mental State (ARMS) services aim to prevent the onset of first-episode psychosis (FEP) in those with specific clinical or genetic risk markers. In England, ARMS services are currently expanding, but the accessibility of this preventative approach remains questionable, especially for a subgroup of FEP patients and those from specific ethnic minority communities. This commentary outlines the key debates about why a complimentary approach to psychosis prevention is necessary, and gives details for an innovative public health strategy, drawing on existing research and health prevention theory.

Effectiveness of Mobile Health Applications for Cardiometabolic Risk Reduction in Urban and Rural India: A Pilot, Randomized Controlled Study.

Introduction: mHealth technology has the potential to deliver personalized health care; however, data on cardiometabolic risk factors are limited. This study aims to assess the effectiveness of mobile health applications (apps) on cardiometabolic risk factor reduction in adults aged 25 to 60 years in urban and rural India.

Methods: The study design was a pilot randomized controlled trial conducted in Tamil Nadu, India.

Joy, sorrow and invisible work and theoretical inconveniences in the labour process of community nurses.

Purpose: This paper uses data from an ethnographic study of a group of NHS community nurses in England, to analyse their work using labour process theory. A theory influenced by Marxist thinking, which is concerned with the examination of the labour process. This study of the nurses' work provides insights into their labour process, as well as proposing theoretical development relating to labour process theory.

Use of virtual reality to remotely train healthcare professionals in paediatric emergency tracheostomy skills: protocol for a multi-centre, non-inferiority educational interventional study with historical controls.

Background: The insertion of a tracheostomy is an established technique used to wean patients off ventilatory support, manage secretions in complex conditions, and as a potentially life-saving procedure to bypass upper airway obstruction. Life-threatening complications during aftercare are not uncommon and may be influenced by a lack of education of carers or healthcare providers of children and young people living with a tracheostomy. Education programmes designed and supported by the National Tracheostomy Safety Project are effective, but resources are not available to educate the workforce at scale.

Exploring the barriers to cervical screening and perspectives on new self-sampling methods amongst under-served groups.

Background: Cervical screening rates have fallen in recent years in the UK, representing a health inequity for some under-served groups. Self-sampling alternatives to cervical screening may be useful where certain barriers prohibit access to routine cervical screening. However, there is limited evidence on whether self-sampling methods address known barriers to cervical screening and subsequently increase uptake amongst under-screened groups.

'Obviously, because it's a tear it won't necessarily mend itself': a qualitative study of patient experiences and expectations of treatment for a meniscal tear.

Objectives: There is a paucity of qualitative research exploring the patient experience of living with a meniscal tear, vital to effective patient management. The aim of this study was to explore the experiences and expectations of treatment of patients aged 18-55 years with a meniscal tear of the knee.

Design: Qualitative study involving semistructured interviews.

Timing of sentinel lymph node biopsy and lymphoscintigraphy before surgery for melanoma: A systematic review and meta-analysis.

Introduction: The management of malignant melanomas often involves performing a sentinel lymph node biopsy (SLNB) aided by imaging with lymphoscintigraphy. Whether lymphoscintigraphy should be performed on the same day as the SLNB operation (SD) or the day before (DB) surgery remains debated. This study aims to summarise existing evidence regarding the impact of the relative timings of lymphoscintigraphy and SLNB on clinical outcomes in melanoma.

Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study.

Introduction: Around 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.

Enabling participation in community-dwelling children and young people with acquired brain injuries and their families: a theory-based, evidence-based and person-based approach to intervention development.

Objective: To codesign and develop an intervention to promote participation and well-being in children and young people (CYP) with acquired brain injury (ABI) and family caregivers.

Design: A complex intervention development study including a scoping review, mixed-methods study, co-design workshop and theoretical modelling.

Setting: Community-dwelling participants in one geographical region of the UK.

'We are not trained to do clinical work': security staff providing physical restraint for NGT feeding in English paediatric wards-a qualitative multi-informant study.

Objective: To gain insights into the experience, and impact, of using security staff to facilitate physical restraints for nasogastric tube feeding.

Design: A cross-sectional design using 39 individual interviews, three online focus groups and three written submissions involving young people with lived experience (PWLE), parents/carers, paediatric staff and security staff involved in nasogastric feeding under restraint in paediatric settings in England. Qualitative semistructured interviews were transcribed and thematically analysed.

Modified Delphi expert elicitation of the clinical and economic burden of obstructive hypertrophic cardiomyopathy in England and Northern Ireland.

Objective: To estimate the resource use of patients with obstructive hypertrophic cardiomyopathy (HCM), stratified by New York Heart Association (NYHA) class, in the English and Northern Irish healthcare systems via expert elicitation.

Design: Modified Delphi framework methodology.

Setting: UK HCM secondary care centres (n=24).

Effectiveness and user experience of nose and throat swabbing techniques for SARS-CoV-2 detection: results from the UK COVID-19 National Testing Programme.

Background: The UK's National Health Service Test and Trace (NHSTT) program aimed to provide the most effective and accessible SARS-CoV-2 testing approach possible. Early user feedback indicated that there were accessibility issues associated with throat swabbing. We report the results of service evaluations performed by NHSTT to assess the effectiveness and user acceptance of swabbing approaches, as well as qualitative findings of user experiences from research reports, surveys, and incident reports.