The Liver Transplant Anesthesiology Fellowship Training Paradigm Across the United States: Looking for the Next Steps in Quality Education.

Background: Liver transplant anesthesia is a growing nonaccredited subspecialty. Although educational milestones and core competencies for training are published, there is a lack of research into how training is delivered to prepare fellows for independent practice.

Methods: In September 2020, the fellowship directors at all 19 training programs across the United States known to the Society for the Advancement of Transplant Anesthesia (SATA) were surveyed regarding their programs' educational management processes.

External Ventricular Drain Placement Using Active Augmented Reality Guidance: A Proof of Concept of a Clinically Integrable System.

Background And Objectives: Suboptimal placement occurs in 26% of external ventricular drain (EVD) procedures performed using traditional freehand methods. We developed a low-cost augmented reality stereotactic navigation system aimed at improving accuracy and safety of the procedure, which is readily compatible with existing Picture Archiving and Communication Systems and automated image segmentation algorithms.

Methods: The system integrates cloud storage, image segmentation, trajectory planning, point-based image-to-patient registration, and real-time 3-dimensional guidance superimposed over the surgical field.

The economic burden of perinatal mortality due to inaction on preconception health in low and middle-income countries: A population attributable fraction and economic impact analysis.

Background: Poor preconception health has been associated with several pregnancy and childbirth-related complications, including perinatal mortality. Yet, the health and economic burden that inaction on preconception health places on societies remains under-researched, hindering efforts to address these issues effectively. This study aimed to quantify the economic burden of perinatal mortality attributable to five preconception risk factors in fifteen low and middle-income countries (LMICs).

Are tailored primary care services for social inclusion good value for money? A health economics evaluation with Monte-Carlo probabilistic sensitivity analysis comparing tailored social inclusion primary care services to mainstream primary care services for socially excluded people.

Background: Socially excluded groups of people (SEP) live with resources so inadequate that it precludes them from participating fully in the normal acceptable living standards of society. They often have complex health and social care needs yet face structural and attitudinal barriers accessing mainstream healthcare. This can result in ambulatory-care sensitive conditions being left untreated in the community and contributes to the higher use of costly acute services in crisis mode by SEP.

Atrophic Facial Plaque in a 4-Month-Old Male: An Unusual Presentation of Hair Follicle Nevus.

Hair follicle nevus is a rare benign follicular hamartoma that is characterized histologically by the proliferation of vellus hair follicles with peri-follicular fibrous thickening. Clinically, hair follicle nevus is most commonly reported as an asymptomatic papule or nodule on the head and neck. Here, we describe an unusual presentation of hair follicle nevus presenting as an atrophic plaque on the cheek of a male infant.

Implementing a General Practice-Based Link Worker Intervention for People with Multimorbidity During the Covid-19 Pandemic- a Mixed Methods Process Evaluation of the LinkMM RCT.

Background: Social prescribing link workers support patients to connect with community resources to improve their health and well-being. These roles are prominent in policy, but there is limited evidence on what support is provided by link workers and what factors influence implementation of link worker interventions.

Methods: A convergent, mixed methods process evaluation of an exploratory randomised trial of a one-month general practice-based link worker intervention targeting adults with multimorbidity in deprived areas.

An Exploratory Study of Capacity Assessment in Medical Practice in Ireland.

The current legal test for capacity under the common law is a functional test. It determines whether a person can make a particular decision at a particular time; it focuses on retained abilities rather than on presumed deficits - in order to promote patient autonomy in decision-making. International evidence suggests however that the test is not well understood and consequently not being correctly applied in practice by a range of medical professionals.

A case of rapidly progressive unilateral non-nephrogenic hemorrhagic bullous calciphylaxis responding to systemic sodium thiosulfate therapy.

Background: Calciphylaxis is a rare and life-threatening condition characterized by cutaneous necrosis resulting from vessel calcification and thrombosis. Commonly associated with end-stage renal disease and hyperparathyroidism, calciphylaxis presents as retiform purpura evolving into necrotic eschars.

Case Report: This report details an atypical case of non-nephrogenic unilateral bullous calciphylaxis in a 71-year-old female, emphasizing the importance of considering calciphylaxis in the differential diagnosis of bullous disorders.

An exploratory randomised trial investigating feasibility, potential impact and cost effectiveness of link workers for people living with multimorbidity attending general practices in deprived urban communities.

Background: Social prescribing link workers are non-health or social care professionals who connect people with psychosocial needs to non-clinical community supports. They are being implemented widely, but there is limited evidence for appropriate target populations or cost effectiveness. This study aimed to explore the feasibility, potential impact on health outcomes and cost effectiveness of practice-based link workers for people with multimorbidity living in deprived urban communities.

Integrating the social determinants of health into graduate medical education training: a scoping review.

Background: The social determinants of health (SDH) play a key role in the health of individuals, communities, and populations. Academic institutions and clinical licensing bodies increasingly recognize the need for healthcare professionals to understand the importance of considering the SDH to engage with patients and manage their care effectively. However, incorporating relevant skills, knowledge, and attitudes relating to the SDH into curricula must be more consistent.

Perceptions of and preparedness for cross-cultural care: a survey of final-year medical students in Ireland.

Background: Migration is increasing globally, and societies are becoming more diverse and multi-ethnic. Medical school curricula should prepare students to provide high-quality care to all individuals in the communities they serve. Previous research from North America and Asia has assessed the effectiveness of medical cultural competency training, and student preparedness for delivery of cross-cultural care.

Performance characteristics of a polymerase chain reaction-based assay for the detection of EGFR mutations in plasma cell-free DNA from patients with non-small cell lung cancer using cell-free DNA collection tubes.

Survival rates in non-small cell lung cancer (NSCLC) are low. Detection of circulating tumor DNA in liquid biopsy (plasma) is increasingly used to identify targeted therapies for clinically actionable mutations, including EGFR mutations in NSCLC. The cobas® EGFR Mutation Test v2 (cobas EGFR test) is FDA-approved for EGFR mutation detection in tissue or liquid biopsy from NSCLC.

Effectiveness of smoking cessation interventions in pregnant women attending primary care: a scoping review.

Background: Smoking during pregnancy has many adverse effects for infant and mother. Despite this, many pregnant women continue smoking. Primary care is a suitable area to provide smoking cessation interventions.

An evaluation of the social deprivation practice grant in Irish general practice.

Background: The inverse care law states that availability of good medical care varies inversely with the need for it in the population served. In 2019, the main medical union and the Department of Health in the Republic of Ireland (RoI), agreed on funding a social deprivation practice grant for general practices in urban deprived areas.

Aim: To examine the implementation and impact of the social deprivation practice grant in participating general practices.

Enhancing early career professionals' representation and engagement at international conferences: WONCA "Rural Early Career Ambassador Integration" project.

Introduction: International conferences offer an excellent opportunity for career development and are global academic opportunities with the potential to foster educational and professional growth. However, equitable access to participation and meaningful involvement in such events remains an issue. In this article we describe the novel Rural Early Career Ambassador Integration project and its implications for the 2022 World Rural Health Conference, held at the University of Limerick, Ireland.

Integrating the social determinants of health into curriculum: AMEE Guide No. 162.

The World Health Organization (WHO) defines the Social Determinants of Health (SDOH) as the non-medical factors influencing health outcomes. SDOH is associated with conditions in which people are born, grow, work, and live. Medical schools and licensing bodies are increasingly recognizing the need for doctors and healthcare professionals to be aware of their patient's social context and how it impacts their states of health and disease.

Molecular Profiling of Syringocystadenocarcinoma Papilliferum Reveals RAS-Activating Mutations.

Context.—: Syringocystadenocarcinoma papilliferum (SCACP) is a rare adnexal carcinoma and the malignant counterpart of syringocystadenoma papilliferum (SCAP), which is commonly located on the head and neck and may arise in association with a nevus sebaceus. RAS mutations have been identified in both SCAP and nevus sebaceus.

Access to general practice during the COVID-19 pandemic - a cross-sectional view of the opinions of adults who use social media.

Introduction: The COVID-19 pandemic has had a significant impact on the health and wellbeing of people worldwide. General practices were forced to adapt to constantly changing circumstances, leading to predominance of virtual consultations. The aim of this study was to examine the impact the pandemic had on the ability of patients to access general practice.

Decision making capacity assessment in general practice in Ireland.

Introduction: It has been reported internationally that doctors have a limited understanding of the legal standard that applies to decision making capacity (DMC). No research on this has been conducted in Ireland to date. We sought to assess the understanding of legal principles relating to capacity and consent among Irish general practitioners (GPs), alongside how DMC assessments are conducted.

Nasal flu vaccine: attitudes and perceptions of parents who use social media.

Background/aim: In October of 2020, a live attenuated Nasal Flu Vaccine (NFV) was licensed for the first time in Ireland for children aged 2&ndash17 years of age. The uptake of the NFV in Ireland was much lower than expected. The aim of this study was to determine the attitudes of Irish parents towards the NFV, and to examine the relationship between the perceptions of vaccines and the uptake rate.