Comparison of knowledge and awareness of infection control practices among nurses in India: A cross-sectional survey.

Background: Healthcare-associated infections (HAIs) are a significant threat in healthcare settings. Since nurses have the most day-to-day contact with patients, their knowledge about infection control (IC) practices is crucial in preventing HAIs. We therefore conducted a study to assess the knowledge and awareness of IC practices amongst nurses across hospitals in India.

Bilateral cochlear implantation in a young patient with xeroderma pigmentosum (XP-D) and progressive sensorineural hearing loss-How to do it?

Xeroderma pigmentosum (XP), a rare genetic skin condition, causes ultraviolet (UV)-induced neoplasms and possible neurological deficits including sensorineural hearingloss. We present the first case in literature of bilateral cochlear implantation (CI) in a patient with XP-D with neurodegeneration. Multi-disciplinary team members (national XP team, dermatologist, anaesthetist, theatre team, biophysicists) were involved.

Inadvertent Arterial Peripherally Inserted Central Catheter Insertion With Corresponding Electrocardiographic Tracings: A Case Report.

Electrocardiographic (ECG) tip confirmation is a validated technique to place the distal tip of a peripherally inserted central catheter (PICC) in the distal superior vena cava at or near the cavoatrial junction during point-of-care insertions. This case report discusses an inadvertent arterial PICC placement despite navigation technology demonstrating similar confirmatory ECG changes seen in standard venous insertions. The findings demonstrate that ECG navigation technology should not be used to rule out arterial PICC placement.

Primary upper extremity deep vein thrombosis (effort thrombosis).

Primary spontaneous upper extremity deep vein thrombosis is characterised by thrombosis within deep veins draining the upper extremity due to anatomical abnormalities of the thoracic outlet causing axillosubclavian compression and subsequent thrombosis. It is an uncommon condition that typically presents with unilateral arm swelling in a young male following vigorous upper extremity activity. The diagnosis of this condition is usually made by Doppler ultrasound, but other investigations are mandatory to exclude the secondary causes of upper extremity DVT.

Clinical placements in General Practice: concepts and considerations of implementing remote virtual placements in the COVID world.

Medical students are considered as 'essential workers' within the National Health Service (NHS) and the delivery of clinical experience is essential to their learning and progression into the workforce. The COVID-19 pandemic impacted the delivery of clinical placements in primary care; GPs are currently delivering the majority of consultations using telephone or video methods and difficulties in attaining placement experience are being encountered by medical students. Virtual remote consultations are an appropriate adjunct to conventional face-to-face patient encounters and could facilitate students to attain core learning outcomes.

Development of a north-west London paracentesis simulation course for core medical trainees.

We designed, implemented and evaluated a near-peer simulation training programme teaching diagnostic and therapeutic abdominal paracentesis to core medical trainees (CMTs). We taught diagnostic and therapeutic abdominal paracentesis to 77 north-west London CMTs over 8 training days over 4 years, 2015 to 2019. The programme was optimised by use of plan, do, study, act (PDSA) cycles and the content was evaluated by anonymous pre- and post-course questionnaires.

Heart transplantation in the UK during the first wave of the SARS-CoV-2 pandemic.

Background: We aim to evaluate practice and understand the impact of the first wave of the SARS-CoV-2 pandemic on heart transplantation in the UK.

Methods: A retrospective review of the UK Transplant Registry (UKTR) and a national survey of UK heart transplant centers have been performed. The early pandemic period is defined here as 1 March to 31 May 2020.

COVID-19: Causes of anxiety and wellbeing support needs of healthcare professionals in the UK: A cross-sectional survey.

Background: COVID-19 has caused acute changes in healthcare delivery; this may impact mental health and wellbeing needs of healthcare professionals (HCPs).

Aims: We aimed to identify the causes of anxiety in HCPs during the COVID-19 pandemic, to assess whether HCPs felt they had adequate mental health and wellbeing support and to identify their unmet support needs.

Method: We used a web-based survey utilising an online tool circulated to UK HCPs over 5 weeks.

A rapid response and treatment service for care homes: a case study.

Rapid response services provide opportunities for older people living with frailty to remain in their own homes during an episode of deteriorating health. The government has announced additional funding to increase capacity and responsiveness for these services through the Ageing Well programme as part of the NHS Long Term Plan. Older people living with frailty are particularly at risk of the adverse effects of a hospital admission and evidence is emerging of the benefits of enhanced healthcare support to allow them to remain in their own home.

The importance of genetic counseling and screening for people with pathogenic SMARCE1 variants: A family study.

Clear cell meningioma (CCM) is a rare variant of meningioma. In recent years, an association between cranial and spinal CCMs and germline loss of function mutations in the SMARCE1 gene (SWI/SNF chromatin remodeling complex subunit gene) has been discovered. We report a family with an incidental large spinal clear cell meningioma in a young adult following reflex screening for a germline loss of function pathogenic variant (PV) in the SMARCE1 gene.

Staff training in positive behaviour support for behaviour that challenges in people with intellectual disability: cost-utility analysis of a cluster randomised controlled trial.

Background: Behaviour that challenges in people with intellectual disability is associated with higher healthcare, social care and societal costs. Although behavioural therapies are widely used, there is limited evidence regarding the cost and quality-adjusted life-years (QALYs).

Aims: We aimed to assess the incremental cost per QALY gained of therapist training in positive behaviour support (PBS) and treatment as usual (TAU) compared with TAU using data from a cluster randomised controlled trial (Clinical Trials.

Successful treatment of ischaemic VSD and acute RV failure: a challenging case in the modern NHS.

A 52-year-old man, previously fit and well, presented with myocardial infarction complicated by ischaemic ventricular septal defect (VSD) and acute right ventricular failure, was successfully treated with early percutaneous coronary reperfusion, surgical VSD repair and temporary right ventricular assist device (VAD) support. This case is an example of how a modern healthcare system can successfully manage complex emergency cases, combining high levels of clinical care and medical technology. Access to temporary mechanical support played a vital role in this case.

Quality improvement and emergency laparotomy care: what have we learnt from recent major QI efforts?

More than 1.53 million adults undergo inpatient surgery in the UK NHS. Patients undergoing emergency abdominal surgery have a much greater risk of death than patients admitted for elective surgery.

Is less-than-full-time training in dentistry swimming against the tide?

With ongoing changes to the demography of the dental workforce coupled with the changing expectations of those participating in early career post-graduate training, dentistry is experiencing a shift in how it might manage trainees. Drawing on experience from medicine and the anticipated behavioural differences, it is worth considering a way in which training might be able to adapt to the requirements of newer graduates, to ensure that the profession does not lose out on preparing the best candidates possible for careers that improve the state of dentistry both as a vocation and for patient benefit.

A unified national cardiovascular disease (CVD) risk generator is required to address equity in the management of CVD risk in clinical practice in New Zealand.

There is a strong body of evidence that supports identifying and managing people according to their risk of a future cardiovascular (CVD) event. Since 2012 the New Zealand public health sector has achieved 90% CVD risk assessment (CVDRA) for each eligible person across New Zealand using a modified version of an overseas risk equation, through incentivising Primary Health Organisation (PHO) performance. In 2018 the New Zealand Ministry of Health endorsed the use of a suite of four new CVDRA equations which were developed using the large NZ Predict cohort (500,000 people).

Early intervention in psychosis: health economic evaluation using the net benefit approach in a real-world setting.

Background: Early intervention in psychosis is a complex intervention, usually delivered in a specialist stand-alone setting, which aims to improve outcomes for people with psychosis. Previous studies have been criticised because the control used did not accurately reflect actual practice.

Aims: To evaluate the cost-effectiveness of early intervention by estimating the incremental net benefit (INB) of an early-intervention programme, delivered in a real-world setting.

Genomics: the power, potential and pitfalls of the new technologies and how they are transforming healthcare.

Powerful new genomic technologies are transforming healthcare. The faster, cheaper generation of genomic data is driving the integration of genomics into all healthcare specialties. Within the next decade, healthcare professionals will be using genomic data to diagnose and manage their patients.

Management of swallowing problems in community settings.

There is an increase in the demand for community services to provide care closer to home, and care teams are placing a growing emphasis on admission avoidance and early discharge. Community and district nurses are key professionals in this care delivery and are required to be alert to the risk factors for clinical deterioration, such as dysphagia (swallowing problems). Especially in older adults and those with frailty, dysphagia can cause a wide range of problems, from dehydration and malnutrition to respiratory tract infections that warrant antibiotic use and even hospitalisation.