Variation in costs to complete surgical training: a cross-sectional observation analysis.

Introduction: Surgical training is expensive. The aim of this study was to quantify the costs surgical trainees are expected to pay related to the ten surgical specialties in a single Statutory Education Body (SEB).

Methods: Intercollegiate Surgical Curriculum Programme (ISCP) and Joint Committee on Surgical Training (JCST) certification requirements including mandatory and highly recommended courses, related to specialty, along with professional registration and examination fees were estimated.

Evolving Strategies in Amblyopia Management: From Traditional Therapies to Cutting-Edge Innovations.

Amblyopia, commonly referred to as "lazy eye," is a prevalent visual disorder affecting children and, in some cases, adults. Traditional treatments, including occlusion therapy and pharmacological approaches, have demonstrated efficacy but also face limitations related to adherence, age dependency, and recurrence rates. This narrative review explores evolving strategies in amblyopia management, from conventional therapies to emerging innovations.

Using individualised bowel care plans to improve clinical outcomes in specialist intellectual disability mental health units in England and Wales: quality improvement project.

Background: Constipation is a significant problem for people with intellectual disabilities, with a prevalence of 33-50%, causing at least five deaths annually in England. Individualised bowel care plans (IBCP) are recommended in England and Wales.

Aims: We evaluated the feasibility and impact of IBCPs for people with intellectual disabilities who are in in-patient psychiatric units, and the effect on clinical outcomes.

Implementation of a care bundle improves PBC management.

Background & Aims: In 2021, we conducted a UK-wide audit of the management of primary biliary cholangitis (PBC) in the National Health Service (NHS) of the UK, which identified widespread deficiencies in PBC-related healthcare. In the current study, recognising the need to address these deficiencies, we aimed to (1) develop a PBC care bundle to support clinicians in the provision of high-quality, standardised care; (2) pilot the bundle in selected centres across the UK; and (3) re-evaluate adherence to quality standards.

Methods: We designed a PBC care bundle that incorporated a checklist of quality standards and a summary of guidelines from the British Society of Gastroenterology.

Comparing Ultrasound and Computed Tomography in Regional Anesthesia: Real-Time Precision or Radiologic Clarity?

This systematic review evaluates the comparative effectiveness of ultrasound and computed tomography (CT) in guiding regional anesthesia, with a focus on block accuracy, anesthetic spread, clinical efficacy, and procedural safety. A total of seven high-quality clinical studies were included, encompassing a range of nerve blocks such as celiac plexus, interscalene, intertransverse, and erector spinae plane blocks. Ultrasound guidance consistently demonstrated outcomes that were equivalent or superior to CT guidance in terms of anesthetic distribution, pain control, and patient satisfaction.

Autophagy in Schizophrenia: A Continuum From Developmental Vulnerability to Progressive Neuronal Stress? A Scoping Review.

Background And Hypothesis: Autophagy, the cell's primary degradation and recycling system, is essential for neuronal homeostasis. A structured synthesis of studies directly investigating autophagy in schizophrenia (SCZ) is lacking. This scoping review aimed to map the available evidence directly assessing autophagy processes in SCZ.

Procalcitonin to guide antibiotic use during the first wave of COVID-19 in English and Welsh hospitals: integration and triangulation of findings from quantitative and qualitative sources.

Aim: To integrate the quantitative and qualitative data collected as part of the PEACH (Procalcitonin: Evaluation of Antibiotic use in COVID-19 Hospitalised patients) study, which evaluated whether procalcitonin (PCT) testing should be used to guide antibiotic prescribing and safely reduce antibiotic use among patients admitted to acute UK National Health Service (NHS) hospitals.

Design: Triangulation to integrate quantitative and qualitative data.

Setting And Participants: Four data sources in 148 NHS hospitals in England and Wales including data from 6089 patients.

Exploring the barriers to athlete personal development within UK Olympic and Paralympic sport.

Elite athletes face a range of challenges throughout their careers including injury, selection, funding status, and retirement. To support athletes to plan for and overcome these challenges, Career Assistance Programs (CAPs) have been developed to support personal and professional development, yet engagement with these services remains low. The aim of this study was to explore the perceived barriers to athletes' engagement with personal development within the UK High-Performance sport system.

Association between meeting adult acute asthma best practice tariff standard of care and 30 day and 90 day hospital readmission: nationwide cohort study.

Objective: To assess whether meeting the NHS best practice tariff standard of care and its constituent elements for hospital admission of adults with acute asthma in England is associated with reduced 30 day and 90 day readmission to hospital.

Design: Nationwide cohort study.

Setting: Secondary care in England, based on data collected from the 2022-23 National Respiratory Audit Programme adult asthma audit, linked with data from Hospital Episode Statistics, 1 April 2022 to 30 June 2023.

A Retrospective Audit of the Management of Shoulder Dislocations at a Trauma Unit.

Introduction: Shoulder dislocation is the most common major joint dislocation encountered in our emergency department, with anterior dislocation accounting for the vast majority. This retrospective audit evaluates adherence to the health board guidelines for managing traumatic shoulder instability at Grange University Hospital.

Methods: Data from 100 patients presenting with native shoulder dislocations between January 2021 and February 2024 were analyzed.

A Rare Case of Prostate Abscess With Pyelonephritis in an Adolescent Male.

Prostatic abscess is a rare urological condition in adolescents. We report the case of a 16-year-old male with no significant past medical history who presented with bilateral flank pain, dysuria, and systemic signs of infection. Imaging revealed bilateral pyelonephritis and a prostatic abscess.

Missed Foreign Body Ingestion in a Cognitively Impaired Adult: A Case Report.

The diagnosis of foreign body ingestion is often clear from the history; diagnostic difficulty and delay in management arise when patients and carers are unable to give a clear history of ingestion. We present the case of a cognitively impaired adult who was misdiagnosed with gastritis when they had, in fact, been suffering from vomiting secondary to foreign bodies impacted in the oesophagus. Timely endoscopy in accordance with the European Society of Gastrointestinal Endoscopy (ESGE) guidelines prevented the potentially significant complications associated with foreign body ingestion.

Can BlueDop be used as an alternative for diagnosing peripheral arterial disease? A prospective comparison of traditional ABPI and TBPI with BlueDop.

ObjectivesAnkle and toe brachial pressure index are recommended globally as first line non-invasive screening tests for peripheral arterial disease. However, they can be inaccurate and have limited utility in patients with incompressible arteries, lower limb wounds and/or lack of digits. This study aims to evaluate BlueDop, a novel device that purports to assess peripheral perfusion without the need for a lower limb tourniquet or patients lying flat.

Artificial Intelligence in Obstetrics and Gynaecology: Advancing Precision and Personalised Care.

Artificial intelligence (AI) is rapidly transforming the landscape of obstetrics and gynaecology, offering unprecedented capabilities in diagnostics, monitoring, and personalised treatment. This review highlights the integration of AI in various domains, including obstetric imaging, fetal monitoring, gynaecologic oncology, fertility treatment, and robotic surgery. AI-powered tools are shown to enhance precision by improving diagnostic accuracy, reducing human error, and supporting clinical decision-making.

A Realist Evaluation of the Implementation and Use of Patient-Reported Outcomes in Four Value-Based Healthcare Programmes.

Aim: To investigate what works when using Patient-Reported Outcome Measures (PROMs), for whom, in what contexts, and why in four Value-Based Healthcare (VBHC) programmes.

Design: Realist evaluation.

Methods: Evaluation of Heart Failure, Parkinson's Disease, Epilepsy and Cataract surgery programmes using data from a scoping review, documentary analysis, questionnaires, quantitative routinely collected data and semi-structured interviews with staff, patients and carers (July 2022-August 2023).

Role of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors in Preventing Cardiac Surgery-Associated Acute Kidney Injury: A Scoping Review.

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent and serious complication associated with increased morbidity, mortality, and healthcare costs. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), including dapagliflozin and empagliflozin, have shown renoprotective benefits in chronic settings, but their perioperative role in CSA-AKI prevention is not well defined. This study was to map the current literature on the use of SGLT2 inhibitors such as empagliflozin and dapagliflozin for the prevention of CSA-AKI, identify evidence gaps, and inform future research directions.

Working time distribution and administrative burden in Austrian community health nursing: A cross-sectional survey.

Background: Community health nursing was introduced in Austria in 2022. As the 117 pilot projects now transition into centrally managed services, data on nurses' working time distribution and client contact patterns are essential for workforce and location planning to ensure optimal service delivery.

Objective: To analyse the working time distribution and client contact patterns of Austrian community health nurses during the pilot phase (2022-2024).

Differential triage in the postmenopausal bleed clinic; getting it right the first time, effect on single cancer pathway.

ObjectiveTo reduce waiting time in PMB clinics, and patient journey on Single cancer pathway.DesignDifferential triage based on risk stratification in USC PMB clinics. Patients with true PMB and with unscheduled bleeding on HRT with risk factors triaged to 2WW.

Enhancing Clinical Documentation and Management of Cauda Equina Syndrome: The Development and Impact of a Structured Assessment Proforma.

Background Cauda equina syndrome (CES) is a neurosurgical emergency associated with potentially devastating neurological sequelae and significant medico-legal implications. Timely surgical decompression is critical; however, effective management relies on precise documentation of clinical findings. In many settings, documentation of key neurovascular assessments remains suboptimal.

Medical Professionals and Pharmacological Intervention for the Treatment of Insomnia: A Cross-Sectional Study.

 To explore the preferences of medical practitioners concerning various medications and other remedies to manage insomnia, and to ascertain whether these preferences are associated with their respective medical specialties.  Employing the snowball sampling technique, we administered two versions of a questionnaire to an international group of medical professionals, including trainees and specialists from diverse medical backgrounds.  Zopiclone, zolpidem, and mirtazapine were evaluated as the most effective treatments for insomnia, while physicians would typically avoid using other tricyclic antidepressants, dual orexin receptor antagonists, and tryptophan for insomnia treatment.

Comparison of sperm concentration in fresh and postal post-vasectomy semen samples: a prospective agreement study.

Background: Most guidelines recommend post-vasectomy semen analysis (PVSA) on fresh samples to confirm success. Postal submission increases compliance although reliability remains controversial. We assessed agreement between first PVSA sperm concentrations on the same sample, freshly and following postage, and determined if any sperm concentration levels other than 'no sperm seen' on a postal sample could be used to advise cessation of other contraceptive methods.

From research to reality: A review of three clinical problems in the last days of life.

All of us will one day die. For most of us, death will be anticipated, usually following a period of ill health. The opportunity to anticipate and manage clinical conditions associated with the agonal process is an essential part of advance care planning.

Impact of the COVID-19 Pandemic on Medical Career Aspirations Among Children of Physicians and Other Healthcare Workers: A Scoping Review.

Existing reviews examine medical students' specialty choices and physician‑parent burnout separately; none link parental pandemic experiences to children's career aspirations. To map and synthesise all empirical evidence on how the COVID‑19 pandemic, particularly parental occupational stress/burnout, has influenced the intentions of children (five to 25 years) of physicians and other healthcare workers (HCWs) to pursue medical careers. We followed the JBI scoping review methodology and PRISMA-ScR guidelines.