scholarly journals The management of suspected scaphoid fractures in the UK: a national cross-sectional study

2021 ◽  
Vol 2 (11) ◽  
pp. 997-1003
Author(s):  
Benjamin J. F. Dean ◽  
Keyword(s):  
Scaphoid Fracture ◽  
Cross Sectional Study ◽  
Mri Imaging ◽  
Sectional Study ◽  
Cross Sectional ◽  
Scaphoid Fractures ◽  
Nice Guidance ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
The Uk

Aims Current National Institute for Health and Clinical Excellence (NICE) guidance advises that MRI direct from the emergency department (ED) should be considered for suspected scaphoid fractures. This study reports the current management of suspected scaphoid fractures in the UK and assesses adherence with NICE guidance. Methods This national cross-sectional study was carried out at 87 NHS centres in the UK involving 122 EDs and 184 minor injuries units (MIUs). The primary outcome was availability of MRI imaging direct from the ED. We also report the specifics of patient management pathways for suspected scaphoid fractures in EDs, MIUs, and orthopaedic services. Overall, 62 of 87 centres (71%) had a guideline for the management of suspected scaphoid fractures. Results A total of 11 of 87 centres (13%) had MRI directly available from the ED. Overall, 14 centres (17%) used cross-sectional imaging direct from the ED: MRI in 11 (13%), CT in three (3%), and a mixture of MRI/CT in one (1%). Four centres (6%) used cross-sectional imaging direct from the MIU: MRI in three (4%) and CT in two (2%). Of 87 centres’ orthopaedic specialist services, 74 (85%) obtained repeat radiographs, while the most common form of definitive imaging used was MRI in 55 (63%), CT in 16 (19%), mixture of MRI/CT in three (3%), and radiographs in 11 (13%). Conclusion Only a small minority of centres currently offer MRI directly from the ED for patients with a suspected scaphoid fracture. Further research is needed to investigate the facilitators and barriers to the implementation of NICE guidance. Cite this article: Bone Jt Open 2021;2(11):997–1003.

scholarly journals A Cross-Sectional Study of Experiences and Attitudes towards Clinical Audit of Farm Animal Veterinary Surgeons in the United Kingdom

2018 ◽  
Vol 5 (4) ◽  
pp. 84
Author(s):  
Katie Waine ◽  
Rachel S. Dean ◽  
Chris Hudson ◽  
Jonathan Huxley ◽  
Marnie L. Brennan
Keyword(s):  
Clinical Audit ◽  
Nationwide Survey ◽  
Clinical Work ◽  
Cross Sectional Study ◽  
Farm Animal ◽  
Sectional Study ◽  
Cross Sectional ◽  
Protected Time ◽  
Veterinary Surgeons ◽  
The Uk

Clinical audit is a quality improvement tool used to assess and improve the clinical services provided to patients. This is the first study to investigate the extent to which clinical audit is understood and utilised in farm animal veterinary practice. A cross-sectional study to collect experiences and attitudes of farm animal veterinary surgeons in the UK towards clinical audit was conducted using an online nationwide survey. The survey revealed that whilst just under three-quarters (n = 237/325; 73%) of responding veterinary surgeons had heard of clinical audit, nearly 50% (n = 148/301) had never been involved in a clinical audit of any species. The participants’ knowledge of what a clinical audit was varied substantially, with many respondents reporting not receiving training on clinical audit at the undergraduate or postgraduate level. Respondents that had participated in a clinical audit suggested that protected time away from clinical work was required for the process to be completed successfully. This novel study suggests that clinical audit is undertaken to some extent in farm animal practice and that practitioner perception is that it can bring benefits, but was felt that more resources and support were needed for it to be implemented successfully on a wider scale.

scholarly journals Association between home birth and breast feeding outcomes: a cross-sectional study in 28 125 mother–infant pairs from Ireland and the UK

BMJ Open ◽  
2016 ◽  
Vol 6 (8) ◽  
pp. e010551 ◽  
Author(s):  
Clare Quigley ◽  
Cristina Taut ◽  
Tamara Zigman ◽  
Louise Gallagher ◽  
Harry Campbell ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Home Birth ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Uk

scholarly journals A cross-sectional study of all clinicians’ conflict of interest disclosures to NHS hospital employers in England 2015-2016

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019952 ◽  
Author(s):  
Harriet Ruth Feldman ◽  
Nicholas J DeVito ◽  
Jonathan Mendel ◽  
David E Carroll ◽  
Ben Goldacre
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Current System ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Freedom Of Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Gift ◽  
The Uk

ObjectiveWe set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.DesignCross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.SettingNHS Trusts (secondary/tertiary care organisations) in England.Participants236 Trusts were contacted, of which 217 responded.Main outcome measuresWe assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.ConclusionOverall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US ‘Sunshine Act’.

scholarly journals Political views of doctors in the UK: a cross-sectional study

2018 ◽  
Vol 72 (10) ◽  
pp. 880-887 ◽  
Author(s):  
Kate L Mandeville ◽  
Rose-Marie Satherley ◽  
Jennifer A Hall ◽  
Shailen Sutaria ◽  
Chris Willott ◽  
...  
Keyword(s):  
Online Survey ◽  
Cross Sectional Study ◽  
Urgent Care ◽  
The European Union ◽  
Left Wing ◽  
Sectional Study ◽  
Cross Sectional ◽  
Political Views ◽  
The Uk ◽  
The Impact

BackgroundLittle is known about the political views of doctors in the UK despite doctors' importance in the functioning of the National Health Service (NHS).MethodsThis is a survey-based, cross-sectional study in which we asked questions about voting behaviour in 2015 and 2017 UK general elections and 2016 referendum on leaving the European Union (EU) (Brexit), and questions relating to recent health policies.Results1172 doctors (45.1% women) from 1295 responded to an online survey. 60.5% described their political views as ‘left-wing’ and 62.2% described themselves as ‘liberal’. 79.4% of respondents voted to remain in the EU in the 2016 referendum compared with 48.1% of voters as a whole (χ2=819.8, p<0.001). 98.6% of respondents agreed that EU nationals working in the NHS should be able to remain in the UK after Brexit. The median score for the impact of Brexit on the NHS on a scale of 0 (worst impact) to 10 (best impact) was 2 (IQR=1–4). Most respondents agreed with the introduction of minimum alcohol pricing in the UK (73.9%), charging patients who are not eligible for NHS treatment for non-urgent care (70.6%) and protecting a portion of national spending for the NHS (87.1%). 65.8% thought there was too much use of NHS-funded private sector provision in their medical practice. Specialty, income and grade were associated with divergent opinions.ConclusionsUK doctors are left-leaning and liberal in general, which is reflected in their opinions on topical health policy issues. Doctors in the UK voted differently from the general electorate in recent polls.

scholarly journals Survey of the effect of viewing an online e-cigarette advertisement on attitudes towards cigarette and e-cigarette use in adults located in the UK and USA: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027525 ◽  
Author(s):  
Paula Booth ◽  
Ian P Albery ◽  
Sharon Cox ◽  
Daniel Frings
Keyword(s):  
Online Survey ◽  
Cross Sectional Study ◽  
Social Acceptability ◽  
Cigarette Use ◽  
Sectional Study ◽  
Cross Sectional ◽  
Likert Scales ◽  
Post Exposure ◽  
Smoking Group ◽  
The Uk

ObjectivesThis study explored the potential for e-cigarette advertisements to (1) enhance attitudes towards cigarettes and/or (2) reduce barriers to e-cigarettes uptake. The study tested whether exposure to an online electronic cigarette advertisement changed attitudes towards cigarettes and e-cigarettes in smokers, non-smokers, e-cigarette users and dual users (smokers who also use e-cigarettes).DesignCross-sectional studySettingOnline surveyParticipantsAdults (n=964) aged 18 to 65 years old (M=36 years, SD=11.6) from the UK and USA. Participants were grouped into current non-smokers, e-cigarette users, dual users and smokers.InterventionsParticipants viewed 1 of 15 randomly assigned online e-cigarette advertisements.Primary measuresThree single seven-point Likert scales measuring health, desirability, social acceptability were completed pre and post advertisement exposure.ResultsPost exposure all smoking groups showed a decrease or no change in how socially acceptable or desirable they rated cigarettes. Paradoxically, dual users rated cigarettes as being significantly healthier after viewing the advertisement (p=0.01) while all other smoking group ratings remained the same. There was an increase or no change in how all smoking groups perceived the healthiness and desirability of e-cigarettesConclusionsWe observed no evidence that exposure to an e-cigarette advertisement renormalises or encourages smoking in smokers, non-smokers or e-cigarette users. However, there is some indication that viewing an e-cigarette advertisement may increase duals users’ perceptions of the health of smoking.

scholarly journals Engagement, not personal characteristics, was associated with the seriousness of regulatory adjudication decisions about physicians: a cross-sectional study

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Javier A. Caballero ◽  
Steve P. Brown
Keyword(s):  
Personal Characteristics ◽  
Statistical Modelling ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Legal Representation ◽  
Apparent Relationship ◽  
The Uk ◽  
Relationship Of ◽  
To Receive

Abstract Background Outcomes of processes questioning a physician’s ability to practise —e.g. disciplinary or regulatory— may strongly impact their career and provided care. However, it is unclear what factors relate systematically to such outcomes. Methods In this cross-sectional study, we investigate this via multivariate, step-wise, statistical modelling of all 1049 physicians referred for regulatory adjudication at the UK medical tribunal, from June 2012 to May 2017, within a population of 310,659. In order of increasing seriousness, outcomes were: no impairment (of ability to practise), impairment, suspension (of right to practise), or erasure (its loss). This gave adjusted odds ratios (OR) for: age, race, sex, whether physicians first qualified domestically or internationally, area of practice (e.g. GP, specialist), source of initial referral, allegation type, whether physicians attended their outcome hearing, and whether they were legally represented for it. Results There was no systematic association between the seriousness of outcomes and the age, race, sex, domestic/international qualification, or the area of practice of physicians (ORs p≥0.05), except for specialists who tended to receive outcomes milder than suspension or erasure. Crucially, an apparent relationship of outcomes to age (Kruskal-Wallis, p=0.009) or domestic/international qualification (χ2,p=0.014) disappeared once controlling for hearing attendance (ORs p≥0.05). Both non-attendance and lack of legal representation were consistently related to more serious outcomes (ORs [95% confidence intervals], 5.28 [3.89, 7.18] and 1.87 [1.34, 2.60], respectively, p<0.001). Conclusions All else equal, personal characteristics or first qualification place were unrelated to the seriousness of regulatory outcomes in the UK. Instead, engagement (attendance and legal representation), allegation type, and referral source were importantly associated to outcomes. All this may generalize to other countries and professions.

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