Paramedics providing end-of-life care: an online survey of practice and experiences.

Background: Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics' current practice and experiences providing end-of-life care was undertaken.

Longer-term survival, quality of life, and cost-effectiveness of conservative versus liberal oxygenation targets in critically ill children: a pre-specified analysis from Oxy-PICU, a multicentre, open, parallel-group, randomised controlled trial.

Background: Peripheral oxygen saturation (SpO) above 94% is typical in children in paediatric intensive critical care units (PICUs) who are receiving invasive ventilation and supplemental oxygen. In a previous report from the Oxy-PICU trial, we showed that lower (conservative) oxygenation targets (SpO 88-92%) are beneficial, showing small but statistically significant differences in duration of organ support and large but non-significant cost reductions at 30 days. In this pre-specified analysis of the Oxy-PICU trial, we compare longer-term outcomes and cost-effectiveness of conservative versus liberal (SpO >94%) oxygenation targets in children with emergency PICU admission.

Improving the arthritis component of the SLEDAI-2K.

Objective: To propose a new definition for SLEDAI arthritis informed by imaging.

Methods: We performed a planned secondary analysis of observational data from a multicentre study evaluating SLE patients with inflammatory joint pain (swelling not required) using various clinical instruments, laboratory tests and ultrasound. For SLEDAI arthritis, assessors (blinded to ultrasound) were asked which of the glossary terms for arthritis in any version of the SLEDAI drove their decision to score for arthritis.

Developing a Curriculum for Trauma and Orthopaedic Higher Surgical Trainees: Implementing Small Group Teaching in a Regional Programme.

Introduction Small group teaching strategies have been considered more efficient than didactic lectures in motivating trainees. There is a lack of studies focusing on the use of small group discussions for higher surgical training. The aims of the current study were to report the implementation of small group teaching and to move away from didactic lectures for a regional trauma and orthopaedics higher surgical trainee teaching programme.

The impact of living with multiple long-term conditions (multimorbidity) on everyday life - a qualitative evidence synthesis.

Background: Multiple long-term conditions (MLTCs), living with two or more long-term conditions (LTCs), often termed multimorbidity, has a high and increasing prevalence globally with earlier age of onset in people living in deprived communities. A holistic understanding of the patient's perspective of the work associated with living with MLTCs is needed. This study aimed to synthesise qualitative evidence describing the experiences of people living with MLTCs (multimorbidity) and to develop a greater understanding of the effect on people's lives and ways in which living with MLTCs is 'burdensome' for people.

Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI).

Purpose: Gastrointestinal (GI) dysfunction is common in critically ill patients and associated with poor outcomes. There is a lack of standardised methods for daily monitoring of GI function. COSMOGI aimed to develop a Core Outcome Set (COS) for daily monitoring of GI function to improve consistency and comparability in future studies in critically ill patients.

Perception of Internalized Stigma in Parents of Children With Autism Spectrum Disorder: Investigating the Effects of Depression, Anxiety, and Family Functioning.

Introduction Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder that impacts communication, behavior, and social interaction. It is well-documented that parents of children with ASD often experience psychiatric conditions like anxiety and depression. Nevertheless, research on the perception of internalized stigma, family functioning, and their interconnections is scarce.

Leucocyte telomere length and conduction system ageing.

Background: Deterioration of the cardiac conduction system is an important manifestation of cardiac ageing. Cellular ageing is accompanied by telomere shortening and telomere length (TL) is often regarded as a marker of biological ageing, potentially adding information regarding conduction disease over and above chronological age. We therefore sought to evaluate the association between leucocyte telomere length (LTL) on two related, but distinct aspects of the cardiac conduction system: ECG measures of conduction (PR interval and QRS duration) and incident pacemaker implantation in a large population-based cohort.

Maintenance oral steroids are not required in severe asthma.

https://bit.ly/4cgrJEL.

High-power versus low-power laser settings during endoscopic stone disease management: a systematic review from the EAU endourology section.

Purpose: Optimal laser settings during endoscopic stone disease management still represents a debatable issue. The aim of this systematic review is to summarize all existing evidence regarding the comparison of high-power (HP) versus low-power (LP) laser settings during different endoscopic lithotripsy procedures.

Methods: PubMed, Scopus and Cochrane databases were systematically screened, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines.

Identifying potential predictors of surgical site infection risk following cardiac surgery: a scoping review.

Objectives: This scoping review was undertaken to identify risk predictions models and preoperative predictors of surgical site infection (SSI) in adult cardiac surgery. A particular focus was on the identification of novel predictors that could underpin the future development of a risk prediction model to identify individuals at high-risk of SSI, and therefore guide a national SSI prevention strategy.

Methods: A scoping review to systematically identify and map out existing research evidence on preoperative predictors of SSI was conducted in two stages.

Assessing radiation exposure of fingers of PET/CTtechnologists during 18F-FDG procedures usingactive extremity dosimeters: A single-center study.

Extremity radiation exposure in nuclear medicine is a growing concern because it may surpass the maximum permissible dose of 500 mSv. This study aimed to assess the occupational nger dose received by technologists during the preparation and administration of 18F-FDG radiopharmaceuticals in PET-CT whole-body scan procedures. Fifty scans were selected, with one procedure excluded due to a high administered activity.

Is COVID-19 Still a Threat? An Expert Opinion Review on the Continued Healthcare Burden in Immunocompromised Individuals.

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact. The emergence of several variants during the pandemic has presented numerous challenges in preventing and managing this disease. The development of vaccines has played a pivotal role in controlling the pandemic, with a significant portion of the global population being vaccinated.

Omega-3 LC-PUFA consumption is now recommended for women of childbearing age and during pregnancy to protect against preterm and early preterm birth: implementing this recommendation in a sustainable manner.

Preterm birth (delivery prior to 37 weeks) appears to be rising globally, increasing the risk of a myriad of down-stream disorders which affect families, their offspring and society, including increased morbidity, mortality and economic costs. Strategies for prevention of preterm birth have therefore become a priority among healthcare providers. One proposed strategy is increased consumption of Omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs), particularly docosahexaenoic acid (DHA) (from food or supplements) in women of childbearing age and during pregnancy.

Pupil sparing oculomotor nerve palsy with concomitant Horner syndrome as a presentation of mantle cell lymphoma relapse.

A woman in her 70s, with a background of mantle cell lymphoma (MCL), presented with headache and diplopia. Neuro-ophthalmic examination revealed a combination of Horner syndrome and ipsilateral pupil sparing oculomotor nerve palsy (ONP). Cerebrospinal fluid immunophenotyping demonstrated CD5 positive clonal B lymphocytes, consistent with neurological involvement by MCL.

The genomic and clinical consequences of replacing procarbazine with dacarbazine in escalated BEACOPP for Hodgkin lymphoma: a retrospective, observational study.

Background: Procarbazine-containing chemotherapy regimens are associated with cytopenias and infertility, suggesting stem-cell toxicity. When treating Hodgkin lymphoma, procarbazine in escalated-dose bleomycin-etoposide-doxorubicin-cyclophosphamide-vincristine-procarbazine-prednisolone (eBEACOPP) is increasingly replaced with dacarbazine (eBEACOPDac) to reduce toxicity. We aimed to investigate the impact of this drug substitution on the mutation burden in stem cells, patient survival, and toxicity.

-related disorder in 87 adults: Natural history and self-sustainability.

Purpose: is one of the most frequently mutated genes in intellectual disability cohorts. Thus, far few adult-aged patients with -related disorder have been described, which limits our understanding of the disease's natural history and our ability to counsel patients and their families.

Methods: Data on patients aged 18+ years with -related disorder were collected through an online questionnaire completed by clinicians and parents.

Feasibility Testing of a Health Literacy Intervention With Adolescents and Young Adults in South Africa: The LifeLab Soweto Programme.

Introduction: Low health literacy levels during adolescence and young adulthood (AYA) may impact acute healthcare access and longer-term health outcomes. Previous research in South African AYA suggests that health literacy levels are typically suboptimal but few interventions exist. This study aimed to test the acceptability and feasibility of a co-created, interactive health literacy intervention (LifeLab-Soweto) with AYA in Soweto, South Africa.