Patient Safety Incidents Describing Patient Falls in Critical Care in North West England Between 2009 and 2017.

Aim: The aim of the study was to review reported falls in critical care units to see whether the causes and results were different from those described in a general hospital population.

Methods: We reviewed and classified patient safety incidents describing falls from critical care units in the North West of England between 2009 and 2017. The classification reviewed patient and staff factors contributing to the fall, the environment of the fall, and the reported consequences.

The high prevalence of pre-existing mental health complaints in clients attending Saint Mary's Sexual Assault Referral Centre: Implications for initial management and engagement with the Independent Sexual Violence Advisor service at the centre.

Background: The Saint Mary's Sexual Assault Referral Centre has a unique service delivery model whereby it provides an integrated physical and psychological support services to clients, women men and children, living in Greater Manchester. The service is available to those who have reported rape or sexual assault, whether this is recent or historic. Clients living in surrounding areas of Cheshire are provided with forensic and medical services at Saint Mary's Centre, with follow-up care provided locally, as appropriate.

Sarcoma in neurofibromatosis 2: case report and review of the literature.

Neurofibromatosis type 2 (NF2) is associated with the development of several types of benign nervous system tumours, while malignancies are rare. We report a 22-year-old man who presented with retroperitoneal and spinal high-grade sarcomas with epithelial features. Samples showed a mixed epithelioid and spindled cell content with little associated matrix and inconclusive immunochemistry.

High burden of Schistosoma mansoni infection in school-aged children in Marolambo District, Madagascar.

Background: A school-based survey was undertaken to assess prevalence and infection intensity of schistosomiasis in school-aged children in the Marolambo District of Madagascar.

Methods: School-aged children from six purposively selected schools were tested for Schistosoma haematobium by urine filtration and Schistosoma mansoni using circulating cathodic antigen (CCA) and Kato-Katz stool analysis. The investigators did not address soil-transmitted helminths (STH) in this study.

The impact of using weight estimated from mammographic images self-reported weight on breast cancer risk calculation.

Personalised breast screening requires assessment of individual risk of breast cancer, of which one contributory factor is weight. Self-reported weight has been used for this purpose, but may be unreliable. We explore the use of volume of fat in the breast, measured from digital mammograms.

Application of the MechPeff model to predict passive effective intestinal permeability in the different regions of the rodent small intestine and colon.

A major component of physiologically based pharmacokinetic (PBPK) models is the prediction of the rate and extent of absorption of orally dosed drugs for which knowledge of effective passive intestinal permeability (P ) is essential. Single-pass intestinal perfusion (SPIP) studies are used to establish effective permeability in vivo but are difficult to perform in rodents, while mechanistic models to predict drug P in rat and mouse have not been published. This work evaluates the predictive performance of the 'MechPeff' model to predict P in the rodent intestine based upon knowledge of regional gut physiology and drug-specific physicochemical parameters.

Do external support devices reduce sternal wound complications after cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether external support devices reduce sternal wound complications after cardiac surgery with sternotomy. Altogether 116 papers were found using the reported search, of which six presented the best evidence to answer the clinical question.

Pelvic radiation therapy: Between delight and disaster.

In the last few decades radiotherapy was established as one of the best and most widely used treatment modalities for certain tumours. Unfortunately that came with a price. As more people with cancer survive longer an ever increasing number of patients are living with the complications of radiotherapy and have become, in certain cases, difficult to manage.

Step-down vs. step-up noxious stimulation: differential effects on pain perception and patterns of brain activation.

Background: We hypothesize that pain and brain responses are affected by changes in the presentation sequence of noxious stimuli that are, overall, identical in intensity and duration.

Methods: During functional magnetic resonance imaging (fMRI) scanning, 21 participants experienced three patterns of noxious stimulation: Up-type (step-up noxious stimulation, 15 s), Down-type (step-down noxious stimulation, 15 s), and Down-up-type (decreasing and increasing pattern of noxious stimulation, 15 s). The total intensity and duration of the three noxious stimulation patterns were identical, but the stimulation sequences were different.

Treatment of Scaphoid Nonunion: A Systematic Review of the Existing Evidence.

Purpose: To determine by systematic review the optimal treatment of scaphoid nonunion.

Methods: We conducted a systematic review of the literature with a meta-analysis of proportions to investigate the comparative effectiveness of different surgical techniques.

Results: A total of 48 publications (1,602 patients) met the eligibility criteria.

Reinterpretation of O'Brien test in posterior labral tears of the shoulder.

Background: Injuries to the posterior labrum are less common and more difficult to diagnose compared to anterior labral pathology. This may be in part due to difficulties in preoperative diagnosis. Posterior labral injuries cause abnormal loading of the rotator cuff with subsequent weakness.

Are health education interventions effective for the control and prevention of urogenital schistosomiasis in sub-Saharan Africa? A systematic review.

An estimated 129 million people are infected with urogenital schistosomiasis in sub-Saharan Africa. Current control recommendations endorse mass administration of praziquantel. Health education is an important component of effective schistosomiasis prevention and control, but there has been limited research on its effectiveness.

Self-report distortions of puffing topography in daily smokers.

Under-reporting tobacco consumption is common, although there is lack of evidence whether under-reporting is associated with health risk perception. In this study, smoking topography from 110 smokers was recorded over 24 hours, aiming to capture a representative average of smoking behaviour. Participants significantly under-reported the duration of secondary exposure, and there was a significant interaction between self-report distortion type and risk perception.

Reversible Cerebral Vasoconstriction Syndrome: an important cause of thunderclap headache.

Reversible cerebral vasoconstriction syndrome (rCVS) is an important cause of acute severe headache that is poorly understood and under-recognised. It typically presents with recurrent thunderclap headaches and is characterised by multifocal, segmental constriction and dilatation of the cerebral arteries, shown by a 'string of beads' appearance, on cerebral angiography. We describe a case of rCVS in a 39-year-old male presenting with post-coital thunderclap headaches following a whiplash-type injury.

An evolutionary perspective on gradual formation of superego in the primal horde.

Freud proposed that the processes which occurred in the primal horde are essential for understanding superego formation and therefore, the successful dissolution of the Oedipus complex. However, Freud theorized superego formation in the primal horde as if it is an instant, all-or-none achievement. The present paper proposes an alternative model aiming to explain gradual development of superego in the primitive man.

Medical students' reactions to an experience-based learning model of clinical education.

An experience-based learning (ExBL) model proposes: Medical students learn in workplaces by 'supported participation'; affects are an important dimension of support; many learning outcomes are affective; supported participation influences students' professional identity development. The purpose of the study was to check how the model, which is the product of a series of earlier research studies, aligned with students' experiences, akin to the 'member checking' stage of a qualitative research project. In three group discussions, a researcher explained ExBL to 19 junior clinical students, who discussed how it corresponded with their experiences of clinical learning and were given a written précis of it to take away.

Is heavy menstrual bleeding investigated and managed appropriately?

Heavy menstrual bleeding (HMB) accounts for approximately 20% of gynaecology referrals. The National Institute of Clinical Excellence (NICE) recommendations provide the framework for evidence-based management of HMB. Despite this, previous studies have highlighted significant variation in the investigation and management of HMB.