The impact of adopting low-molecular-weight heparin in place of aspirin as routine thromboprophylaxis for patients with hip fracture.

Purpose Of The Study: In 2010, the National Institute for Health and Care Excellence (NICE) recommended the use of anticoagulants rather than aspirin as pharmacological thromboprophylaxis after hip fracture. We examine the impact of implementing this change in guidance on the clinical incidence of deep vein thrombosis (DVT).

Study Design: Demographic, radiographic and clinical data were retrospectively collected for 5039 patients admitted to a single tertiary centre in the UK for hip fracture between 2007 and 2017.

To bed or not to bed: the sleep question?

Background: Sleep deprivation and fatigue from long-shift work impacts doctors' personal safety, inhibits cognitive performance and risks clinical error. The aim of this study was to assess the sleep quality of surgical trainees participating in European Working Time Directive-compliant training rotations within a UK deanery.

Methods: A trainee cohort numbering 38 (21 core, 17 higher surgical trainees, 29 men and 9 women, median age 31 (25-44 years)) completed a sleep diary over 30 days using the Sleep Time (Azumio) smartphone application and triangulated with on-call rosters to identify shift patterns.

Disciplinary boundaries and integrating care: using Q-methodology to understand trainee views on being a good doctor.

Background: Rising numbers of patients with multiple-conditions and complex care needs mean that it is increasingly important for doctors from different specialty areas to work together, alongside other members of the multi-disciplinary team, to provide patient centred care. However, intra-professional boundaries and silos within the medical profession may challenge holistic approaches to patient care.

Methods: We used Q methodology to examine how postgraduate trainees (n = 38) on a range of different specialty programmes in England and Wales could be grouped based on their rankings of 40 statements about 'being a good doctor'.

In their own words: investigating the preparedness of final year dental students in the UK for independent general dental practice.

Introduction: There is relatively little data on the preparedness of UK dental graduates for independent general dental practice. Two recent studies have indicated that graduates appear well prepared, but although quantifying the level of preparedness, they provide limited understanding of the underlying factors contributing to preparedness. This study aims to more deeply understand the contributing factors leading to assertions of graduate preparedness using focus groups of final year dental students, and semi-structured interviews of senior faculty members.

nhancing the quality and safety of care through training generalist doctors: a longitudinal, mixed-methods study of a UK broad-based training programme.

Objective: Changing patient demographics make it ever more challenging to maintain the quality and safety of care. One approach to addressing this is the development of training for generalist doctors who can take a more holistic approach to care. The purpose of the work we report here is to consider whether a broad-based training programme prepares doctors for a changing health service.

Recurrent hiccups may signal brainstem pathology and should be investigated.

While occasional hiccups are normal, their persistent recurrence is distressing and may have an underlying aetiology. Patients with recurrent hiccups may undergo a long journey and see many physicians before the diagnosis is finally made. The purpose of this report is to increase awareness of central nervous system lesions as a possible cause for recurrent hiccups and provide an illustrative case of an otherwise fit man presenting with ongoing hiccups caused by a medullary haemangioblastoma.

How prepared are foundation dentists in England and Wales for independent general dental practice?

Introduction The Graduate Assessment of Preparedness for Practice (GAPP) questionnaire has been shown to be valid and reliable in assessing the preparedness of foundation dentists (FDs) for independent general dental practice (GDP). In this study it is used to establish preparedness at six weeks of dental foundation training (DFT) across England and Wales.Method GAPP questionnaires were sent to all FDs and ESs in England and Wales in mid-September 2012.

Prospective, longitudinal assessment of quality of life in patients with cancer of the head and neck and their primary carers.

Cancer of the head and neck has profound psychosocial and physical effects on patients, so quality of life (QoL) is an essential consideration-not only is it of importance to the patient but it also provides a subjective measure of the success of treatment. However, we know of little work about its influence on carers. The aim of this study was to assess the impact of the diagnosis and treatment on the QoL of patients and their carers from baseline (preoperatively) to three months postoperatively.

The interpersonal work of dental conscious sedation: A qualitative analysis.

Aims: Whilst there is a considerable body of literature examining the pharmacology of conscious sedation, the social tasks required to successfully provide conscious sedation have not been reported. This paper discusses data regarding the interpersonal work integral to effective conscious sedation provision, from a larger qualitative study exploring how patients and clinicians engage with secondary care conscious sedation provided within the UK.

Method: Semi-structured interviews were conducted with 13 conscious sedation providers and nine patients within UK-based secondary care sedation settings.

The undergraduate preparation of dentists: Confidence levels of final year dental students at the School of Dentistry in Cardiff.

Objective To investigate the self-reported confidence and preparedness of final year undergraduate students in undertaking a range of clinical procedures.Methods A questionnaire was distributed to final year dental students at Cardiff University, six months prior to graduation. Respondents rated their confidence in undertaking 39 clinical procedures using a 5-point scale (1 = can undertake on own with confidence, 5 = unable to undertake).

Can a mobile app improve the quality of patient care provided by trainee doctors? Analysis of trainees' case reports.

Objectives: To explore how a medical textbook app ('iDoc') supports newly qualified doctors in providing high-quality patient care.

Design: The iDoc project, funded by the Wales Deanery, provides new doctors with an app which gives access to key medical textbooks. Participants' submitted case reports describing self-reported accounts of specific instances of app use.

'It's surprising how differently they treat you': a qualitative analysis of trainee reflections on a new programme for generalist doctors.

Objectives: An increase in patients with long-term conditions and complex care needs presents new challenges to healthcare providers around the developed world. In response, more broad-based training programmes have developed to better prepare trainees for the changing landscape of healthcare delivery. This paper focuses on qualitative elements of a longitudinal, mixed-methods evaluation of the postgraduate, post-Foundation Broad-Based Training (BBT) programme in England.

Impact of revalidation on appraisal in primary care: an initial evaluation of the experience of Welsh GPs.

Background: While appraisal is a well-established process and has been a contractual obligation for GPs in Wales since 2004, revalidation is a new requirement for all doctors practising in the UK. Appraisal is an essential component of revalidation. However as appraisal is developmental, and revalidation is summative, there is concern over the potential impact revalidation may have on the appraisal process itself.

Ready, steady, go! What do histopathology trainees think they need from training to enable them to develop autonomy in surgical pathology reporting?

Aims: This is a qualitative study of the perceived learning needs of trainees for graded responsibility in histopathological training in the UK.

Methods: A focus group with trainees and interviews with consultants was carried out. Participants were asked 'What do you perceive are the learning needs of histopathology trainees to develop skills for safe and confident independent reporting in surgical histopathology?' Data was analysed using open coding content analysis for items relating to training content and structure.

Doctors' health: obstacles and enablers to returning to work.

Background: For doctors returning to work after absence due to ill-health or performance concerns, the obstacles can seem insurmountable. Doctors' perspectives of these obstacles have been investigated. To support them more effectively, the perspectives of organizations that interact with such doctors should also be considered.

How a mobile app supports the learning and practice of newly qualified doctors in the UK: an intervention study.

Background: The transition from medical school to the workplace can be demanding, with high expectations placed on newly qualified doctors. The provision of up-to-date and accurate information is essential to support doctors at a time when they are managing increased responsibility for patient care. In August 2012, the Wales Deanery issued the Dr.

The complexity and difficulty of diagnosing lung cancer: findings from a national primary-care study in Wales.

Aim: This paper aims to provide a detailed analysis of the diagnostic process of lung cancer from a primary-care perspective.

Background: Diagnosing lung cancer at a stage where curative treatment is possible remains a challenge. Beginning to understand the complexity and difficulty in the diagnostic journey should enable the development of interventions in order to facilitate timelier diagnosis.

Work-based assessments: making the transition from participation to engagement.

Work-based assessments (WBAs) were only recently introduced into medicine. However, since their introduction, they have rapidly grown in popularity. WBAs are now a routine part of medical training.

How to … be an active appraiser.

Being an active appraiser is very challenging in terms of knowing a doctor's work well enough to appraise them effectively. It also requires a set of skills that need to be developed and applied well in a complex system and in the context of an individual doctor's career development. Being 'active' means bringing these skills and principles together.

Determining the presence of periodontopathic virulence factors in short-term postmortem Alzheimer's disease brain tissue.

The aim of this study was to establish a link between periodontal disease and Alzheimer's disease (AD) with a view to identifying the major periodontal disease bacteria (Treponema denticola, Tannerella forsythia, and Porphyromonas gingivalis) and/or bacterial components in brain tissue from 12 h postmortem delay. Our request matched 10 AD cases for tissue from Brains for Dementia Research alongside 10 non-AD age-related controls with similar or greater postmortem interval. We exposed SVGp12, an astrocyte cell line, to culture supernatant containing lipopolysaccharide (LPS) from the putative periodontal bacteria P.