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Reviewing "Prospective evaluation of efficacy and safety of distal radial and radial artery access using a novel articulating-tip guidewire".
No full texthttps://journals.sagepub.com/doi/full/10.1177/11297298231212227?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.or
Survey of healthcare-associated sink infrastructure, and sink trap antibiotic residues and biochemistry, in twenty-nine UK hospitals
Full text linkBackground Hospital sinks are linked to healthcare-associated infections. Antibiotics and chemicals in sink traps can select for pathogens and antimicrobial resistance (AMR). Optimizing sink design and usage can mitigate sink-to-patient dissemination of pathogens. Aim To perform a large-scale survey of hospital sink infrastructure. Methods Twenty-nine UK hospitals submitted photos and metadata for sinks across three wards (intensive care unit (ICU)/medical/surgical; January–March 2023). Photos were used to classify sink design as ‘optimal’ according to guidelines and published studies. Sink trap aspirates were dipstick-tested for antibiotics and chemistry. Logistic regression was used to characterize associations of ward type and sink location with optimal sink design or detectable trap antibiotics. Findings Of 287 sinks surveyed, 111 were in ICUs, 92 in medical wards, and 84 in surgical wards; 77 were in medicines/drug preparation rooms, 97 on patient bays, 25 in patient side-rooms, and 88 in sluice rooms. Sink-to-bed ratios ranged from 0.23 to 2.83 sinks per patient bed and were higher on ICUs (1.21 versus 0.82 and 0.84 on medical and surgical wards, respectively; P = 0.04). The median sink-to-patient distance was 1.5 m (interquartile range: 1.00–2.21 m). Sink design varied widely; it was deemed ‘optimal’ for 65/122 (53%) sinks in patient bays/side-rooms and ‘optimal’ design was associated with side-room location (P = 0.03). Antibiotics were detected in 95/287 (33%) sink traps and were associated with medicines/drug preparation rooms (P <0.001). Sink trap chemicals detected included metals, chlorine, and fluoride. Conclusion Sinks are common in hospitals, frequently close to patients, and often sub-optimally designed. Commonly used antibiotics were detected in a third of sink traps and may contribute to the selection of pathogens and AMR in these reservoirs, and subsequent transmission to patients.https://www.journalofhospitalinfection.com/article/S0195-6701(25)00033-7/fulltex
The Impact of Baseline Comorbidities and Performance Status on HER2-Targeted Therapy Outcomes.
No full textWe read with great interest the article by Kook et al.,1 comparing adjuvant trastuzumab plus pertuzumab (TP) versus trastuzumab alone (T) in patients with HER2-positive breast cancer who achieved a pathologic complete response (pCR) following neoadjuvant chemotherapy. While the authors concluded that there was no significant difference in recurrence-free survival (RFS) or distant recurrence-free survival (DRFS) between the 2 regimens, we believe the study may have overlooked an important confounding variable: baseline comorbidities and performance status.https://www.clinical-breast-cancer.com/article/S1526-8209(24)00368-9/abstrac
Children and young people with mental health concerns admitted to medical wards
No full textNo abstract availablehttps://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(24)00355-9/abstrac
Metacognition, philosophy in prisons and the demands of rehabilitation
Full text linkThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits
use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or
adaptations are made.
© 2025 The Author(s). The Howard Journal of Crime and Justice published by Howard League and John Wiley & Sons Ltd.Abstract This article sets out the case for providing regular philosophy sessions in prisons by focusing on its role in improving metacognition. We start by drawing attention to an important body of research on metacognition that is relevant to supporting prisoners in transitioning towards more prosocial lifestyles, as well as navigating the complexities of life both during and post-incarceration. We then make the case for offering philosophy programmes in prisons in order to help nurture and develop metacognitive skills in this population.https://onlinelibrary.wiley.com/doi/abs/10.1111/hojo.1259
Stepping into day treatment approach versus inpatient treatment for adults with anorexia nervosa: the DAISIES RCT
Full text linkThis is an Open Access article
distributed in accordance with the terms of the Creative
Commons Attribution (CC BY 4.0) licence, which permits
others to distribute, remix, adapt and build upon this work,
for commercial use, provided the original work is properly
cited. See: https://creativecommons.org/licenses/by/4.0/.
The text below includes minor additions and formatting
changes to the original text.BACKGROUND: A substantial proportion of anorexia nervosa patients require intensive treatments, commonly inpatient or day-patient treatment. The relative merits of these treatments for adults with anorexia nervosa are unknown. Therefore, a trial investigating the clinical effectiveness and cost-effectiveness of inpatient treatment-as-usual versus a stepped-care day-patient approach in adults with anorexia nervosa (DAISIES) was commissioned. This trial terminated prematurely due to poor recruitment, mainly resulting from COVID-19's impact on service provision. OBJECTIVE: We describe the rationale, methods and available outcomes of the DAISIES trial. Reasons behind the trial's failure and implications for future research are investigated. DESIGN: A two-arm multicentre open-label parallel-group non-inferiority randomised controlled trial, evaluating the effectiveness, acceptability and cost-effectiveness of two intensive treatments for adults with severe anorexia nervosa. SETTING: Specialist eating-disorder services in the United Kingdom with inpatient and/or day-patient treatment facilities. PARTICIPANTS: Adults (age 17 +) with severe anorexia nervosa (body mass index ≤ 16 kg/m(2)) requiring intensive treatment and (optionally) their carers. Intended sample size: 386. INTERVENTIONS: Inpatient treatment-as-usual and a stepped-care day-patient treatment approach (with the option of initial inpatient treatment for medical stabilisation). MAIN OUTCOME MEASURES: The primary outcome was body mass index at 12 months post randomisation. Qualitative interviews conducted during the trial included semistructured interviews to investigate patients', families' and clinicians' views on treatments. RESULTS: During the 16-month recruitment period (November 2020 to March 2022), 53 patients were approached. Of these, 15 were enrolled and randomly allocated to the inpatient treatment-as-usual (n = 7) or day-patient treatment (n = 8) treatment arms. All participants were female with a mean (standard deviation) age of 24.8 (9.1) years and a mean (standard deviation) body mass index of 14.4 (1.6) kg/m(2). Patients' body mass indexes had increased similarly in both groups at 12 months. Participants perceived the stepped-care day-patient treatment approach to be more acceptable than inpatient treatment-as-usual. Qualitative interviews with patients, carers and clinicians suggested valued (e.g. multidisciplinary provision of care) and disliked (e.g. perceived over-focus on weight gain) aspects of treatment. Investigation of the reasons behind the trial's failure revealed strong treatment preferences among patients as the most common reason for non-participation, alongside the impact of COVID-19 on service provision. LIMITATIONS: The main trial questions could not be answered due to low participant numbers. CONCLUSIONS: No conclusions can be drawn concerning the clinical and cost-effectiveness of inpatient treatment-as-usual or stepped-care day-patient treatment. The day-patient treatment approach was perceived more positively by patients and carers. Service-related (e.g. reduced clinician time for research), patient-related (e.g. treatment preferences) and wider systemic factors (e.g. reduced service capacity and patient throughput nationally during COVID-19) seem to have contributed to the failure of the DAISIES trial. FUTURE WORK: Despite the trial's failure, the need to investigate the effectiveness and experience of intensive treatments of adult anorexia nervosa remains. Alternative trial designs incorporating patient preferences and investigating community-based intensive treatment options have potential to improve acceptability and recruitment. FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number HTA 17/123/03.https://www.journalslibrary.nihr.ac.uk/hta/published-articles/FTJP674
“You don't have to be a survivor of abuse to be worried about smears”: Cervical screening experience of forensic inpatients
Full text linkThis is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author.Purpose: Childhood trauma, especially sexual abuse is linked to higher health risks including cervical cancer. Forensic inpatients often have complex trauma histories placing them at increased risk of cervical cancer. The uptake of screening in patient forensic inpatient services is sub-optimal, although little is known about their experiences. This study focuses on the cervical screening experiences of people nursed in forensic service inpatients. This group present with unique health challenges and are an under-researched and vulnerable population with a higher risk of cervical cancerMethods: A qualitative study used purposive sampling to recruit eight participants from two NHS secure forensic services. All participants were inpatients detained under the Mental Health Act (1983, revised 2007) in Women’s pathways. Data was collected through semi-structured interviews and was analysed using Interpretive Phenomenological Analysis.Results: Two superordinate themes were developed: (1) Internal Conflict linked past experiences to screening beliefs, and (2) Manufacturing Control showed how individuals employed strategies to feel psychological ready for screening.Conclusions: This study aimed to understand the facilitators and barriers to cervical screening among forensic in-patients and identify ways to improve their experiences to increase engagement in screening. The results identify how participants experiences prior to and within forensic services impact cervical screening uptake. Forensic inpatients require psychological readiness and feelings of control and safety to engage in cervical screening to minimise examinations reminding or re-enacting their trauma history. Systemic factors can enhance safety perceptions and encourage screening in this group.https://www.journalshp.com/article_721175.htm
Aphasia partnership training: What outcomes do people with aphasia, family members and speech and language therapists expect?
Full text linkAbstract Introduction: Life with aphasia affects the whole family with shorter, less frequent conversations, frustration, reduced social networks, isolation and tension in relationships. Evidence suggests communication partner training (CPT) benefits families. However, expected improvements are poorly articulated. The Aphasia Partnership Training (APT) project aimed to identify target outcomes of a new family dyad CPT programme through persons with aphasia (PWA), family member and speech and language therapist (SLT) consensus. Method: Consensus on desired outcomes was achieved through nominal groups with 20 people with mild to severe aphasia across five groups and 10 family members of people with mild to severe aphasia across three groups, each facilitated by —two to three SLTs. Twelve CPT researchers 16 clinical SLTs with experience of CPT participated in a three-round eDelphi to gain consensus on outcomes they perceived most likely to change. Results were triangulated using a convergence coding scheme to demonstrate agreement, partial agreement, dissonance or silence amongst the three stakeholder groups. Results: All stakeholders agreed ‘conversation’ and ‘thoughts and feelings’ were very important outcomes of APT/very likely to change (agreement). Change in ‘relationships’ was very important to family members, important to PWA and considered very likely to change by SLTs (partial agreement). Change in ‘language’ (specifically talking) was very important to PWA, but not important to family members, and SLTs were uncertain about language improvement from APT (dissonance). Each outcome construct is illustrated by specific examples generated and agreed by all stakeholder groups. Conclusions: We should aim to achieve improvements in conversation and thoughts and feelings with CPT, consider the impact on relationships and investigate the potential for language improvement (talking) as an outcome of APT. Outcome measures can be selected based on good coverage of examples generated within these constructs, ensuring they are meaningful to PWA and family members
Vocational rehabilitation for people with multiple sclerosis in the national health service of the United Kingdom: A realist evaluation
Full text linkDe Dios Pérez B, Booth V, das Nair R,
Evangelou N, Hassard J, Ford HL, et al. (2025)
Vocational rehabilitation for people with
multiple sclerosis in the national health service
of the United Kingdom: A realist evaluation.
PLoS ONE 20(2): e0319287. https://doi.
org/10.1371/journal.pone.0319287BACKGROUND: There is limited evidence about how vocational rehabilitation (VR) for people with multiple sclerosis (MS) can be delivered through the United Kingdom's (UK) National Health Service (NHS) and how it works. AIM: To understand the mechanisms and context for implementing a VR intervention for people with MS in the NHS and develop an explanatory programme theory. METHODS: A realist evaluation, including a review of evidence followed by semi-structured interviews. A realist review about VR for people with MS in the NHS was conducted on six electronic databases (PubMed, MEDLINE, PsychINFO, Web of Science, CINAHL, and EMBASE) with secondary purposive searches. Included studies were assessed for relevance and rigour. Semi-structured interviews with people with MS, employers, and healthcare professionals, were conducted remotely. Data were extracted, analysed, and synthesised to refine the programme theory and produce a logic model. RESULTS: Data from 13 studies, and 19 interviews (10 people with MS, five employers, and four healthcare professionals) contributed to producing the programme theory. The resulting programme theory explains the implementation of VR in the NHS for MS populations, uncovering the complex interplay between the healthcare and employment sectors to influence health and employment outcomes. VR programmes that offer timely support, tailored to the needs of the person with MS, and that support and empower the employee beyond the healthcare context are most likely associated with improved employment outcomes, for example, job retention. CONCLUSION: Embedding VR support within the NHS requires substantial cultural and organisational change (e.g., increased staff numbers, training, and awareness about the benefits of work). This study emphasises the need to routinely identify people with MS at risk of job loss and follow a collaborative approach to address employment issues. This realist evaluation provides insight on how to improve the quality of care available to people with MS.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.031928
How Reproducible Are the Ultrasound Features of Adenomyosis Defined by the Revised MUSA Consensus?
Full text linkBackground/Objectives: The aim of this study is to assess the inter- and intra-observer reproducibility of the identification of direct and indirect ultrasonographic features of adenomyosis as defined by the revised Morphological Uterus Sonographic Assessment (MUSA) consensus (2022). Methods: A cohort of 74 women, aged 18 to 45, were recruited from the recurrent miscarriage and general gynaecology clinic at a university-based fertility centre. All the participants underwent 2D and 3D transvaginal Ultrasound scan (TVS) examination in the late follicular and early luteal phase. Conventional grey scale and power Doppler image volumes were acquired and stored. Subsequently, the stored 3D ultrasound images were independently re-evaluated offline by the two observers for the direct and indirect features of adenomyosis as outlined by the revised MUSA group. The intra- and the inter-observer reproducibility was estimated using Cohen's Kappa coefficient. Results: The intra- and interobserver reproducibility (K -0.27, 95% CI 0.06-0.48 and K 0.13, 95% CI -0.10-0.37, respectively) for at least one direct feature of adenomyosis was only modest. Amongst the individual direct features, the interobserver variability of identifying myometrial cysts was fair (K 0.21, 95% CI -0.00-0.42), whereas the intra-observer variability was moderate (K 0.44, 95% CI 0.26-0.63). While hyperechogenic islands identification achieved a fair level of intra- (K 0.31, 95% CI 0.09-0.53) and interobserver (K 0.24, 95% CI 0.01-0.47) agreement, the reproducibility of reporting sub-endometrial lines/buds was fair for the intra-observer (K 0.22, 95% CI -0.02 0.47) and poor for the interobserver (K 0.00, 95% CI -0.20-0.19). The interobserver agreement for indirect features varied from poor to moderate, while the intra-observer agreement ranged between poor to good. Conclusions: The reporting of adenomyosis using direct features suggested by the revised MUSA group consensus showed only modest interobserver and intra-observer agreement. The definitions of ultrasound features for adenomyosis need further refining to enhance the reliability of diagnosis criteria of adenomyosis