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We deliver training to groups or individuals, at a time and in a location convenient to you. We can tailor the content of the sessions below to suit your requirements. Please contact us for more details.

First Steps in SearchingDo you need to take the first steps in understanding how to find evidence, for example to gain an overview of a clinical condition, treatment or for revalidation purposes?

•       How to find information and evidence via:

–      NICE Evidence Search

–      UpToDate

–      Dynamed

–      Google Advanced Search

Anyone can do it.

You can then go on to do:

Finding the Evidence Do you need to find the evidence (guidelines, journal articles etc.) to support your daily clinical practice, research or audit activities, to prepare for a presentation or teaching, or simply to keep up to date? On this session you’ll learn:

• How to develop a research or clinical question into an effective search strategy
• How to apply search techniques effectively (using AND/OR, wildcards, applying limits, using the thesaurus)
• Key health information resources (NICE Evidence, Pubmed, The Cochrane Library, Medline, CINAHL and other health databases)
• Searching Google effectively

Introduction to Critical Appraisal Do you need to develop your critical reading skills? Interested in finding out how to spot the strengths and weaknesses of research studies?

On this session you’ll learn:
• The benefits of critical appraisal 
• The key features of different study types
• How to apply critical appraisal techniques to a published piece of research
• How to access critical appraisal tools and resources to help you

WUTH publication: The introduction of an outpatient hysteroscopic polyp morcellation clinic at a district general hospital

Citation: Gynecological Surgery. 2015, 12(1) SUPPL. 1(S395-S396), 1613-2076
Author: Gillian S.; Alam M.
Abstract:  Background Endometrial polyps are a common hysteroscopic finding when investigating
women with abnormal uterine bleeding. They have been found in up to 40% of
symptomatic pre- menopausal women and are associated with menorrhagia, metrorrhagia,
intermenstrual bleeding and subfertility. They are also associated with post- menopausal
bleeding and found in women with malignant tissue changes.(1) In symptomatic women
who undergo polypectomy, it is reported that there is 75%-100% improvement. For
women who are asymptomatic , a polypectomy is recommended for those with risk
factors for endometrial cancer.(2) The introduction of hysteroscopic polyp morcellation
has allowed for a fast, safe and convenient procedure to remove polyps within an
outpatient setting. The use of small scopes, minimal dilatation and little or no local
anaesthetic has impoved the experience for patients and medical staff.(1) At Arrowe Park
Hospital we have introduced polyp morcellation using Hologic Myosure tissue removal
system and Aquilex fluid control system Methods Aim To review the implementation and
outcomes of a Myosure hysteroscopic polypectomy clinic within our outpatient
department performed by consultant and nurse practitioner Method A retrospective data
collection of patients who attended the clinic between September 2014 and May 2015
Results 28 patients were referred to the clinic. 4 patients had not undergone previous
hysteroscopy and were found not to have a polyp, 1 patient refused treatment and was
listed for general anaesthetic. 22 patients had successful polypectomy and 1 patient had
partial polypectomy due to loss of vision. All patients tolerated procedure well and left
clinic within 10 minutes of finishing. There were no complications during or following
polypectomy. 1 histology was reported as atypical hyperplasia, 21 were benign polyps,1
was benign fibroid Conclusions Myosure polypectomy is proving to be a fast, efficient,
safe and well tolerated procedure that is easily performed within an outpatient setting
allowing fast recovery and minimal disruption for patients.

WUTH publication: Conversion of abdominal hysterectomy to laparoscopic hysterectomy-the reverse paradigm. 5 year experience of a large UK district teaching hospital between 2010/11 and 2014/15

Citation: Gynecological Surgery. 2015, 12(1) SUPPL. 1(S471), 1613-2076
Author: Rowlands D.; Gul N.; Minas V.; King S.
Abstract: Background The EVALUATE study previously reported that for benign conditions and small moderatety enlarged uteri that vaginal hysterectomy was preferable to abdominal or
laparoscopic hysterectomy. And that laparoscopic hysterectomy is preferable to
abdominal. We have previously reported (RCOG World Congress 2015) that <8% of
hysterectomies performed in our unit in a sample size of 327 of 1258 hysterectomies
performed in our unit between 1/1/2010 and 31/12/14 would have been eligible for the
EVALUATE study. We postulate that this is as a consequence of less invasive treatments
such as endometrial ablation and the Mirena IUS. In the UK, despite evidence, the
majority of hysterectomies are still performed abdominally. We describe the difference
that a cultural attitude to laparoscopic surgery has had in reducing our abdominal
hysterctomy rates to under 10% . Methods Review of all hysterectomies performed at
Wirral University Teaching Hospital 1/1/2010 - 31/12/2010 and 1/1/2014 - 31/12/2014 by
type. There were no exclusions . Hysterectomies performed for ovarian cancer, cervical
cancer and high grade endometrial cancer are performed in the Regional Cancer Centre.
Results Results will show an extremely low abdominal hysterectomy rate which has
further fallen within this 5 year period as a consequence of training and education within
the unit. The unit has an inclusive approach towards safe laparoscopic surgery with an
ethos not to perform abdominal procedures wherever possible. With retirements, new
appointments, and education and traing we present results which we believe are
unparalleled in any other UK large hospital but demonstrate that with commitment
support and education we believe this is possible anywhere. Conclusions Abdominal
hysterectomy is in many cases an unnecessary major operation which can be succesfully
and safely achieved through minimal access surgery in almost all cases

WUTH publication: ANNALS EXPRESS: Validation of Serum Free Light Chain Reference Ranges in Primary Care Patients

Citation: Annals of Clinical Biochemistry. 2015 Nov 13
Author: Galvani L, Flanagan J, Sargazi M, Neithercut WD
Abstract: BACKGROUND: The demand for measurement of serum immunoglobulin free kappa (κ) and lambda (λ) light chains has increased. The κ:λ ratio is used to assist in diagnosis/monitoring of plasma cell disorders. The Binding Site reference range for serum free light chain (FLC) κ:λ ratios of 0.26-1.65 was derived from healthy volunteers. Subsequently a reference range of 0.37-3.1 for patients with chronic kidney disease (CKD) has been proposed. Elevated FLC concentrations and borderline raised FLC ratios also may be found in polyclonal gammopathies and with other non-renal illnesses. This assessment was conducted to validate the established FLC reference ranges in individuals from primary care.
METHOD: A total of 130 samples were identified from routine blood samples collected in primary care for routine biochemistry testing and eGFR calculation.
RESULTS: The median and range of κ:λ ratios found in each eGFR group used for CKD classification was higher than previously described. This was the case for individuals with normal or essentially normal renal function with eGFRs > 90, (0.58-1.76) and eGFR of 60-90 mL/min/1.73m², (0.71-1.93). Individuals with eGFR 15-30, (0.72-4.50) and eGFR <15ml/min/1.73m² (0.71-4.95) also had higher values when compared to the current renal reference range of 0.37-3.10.
CONCLUSIONS: Elevation of FLC-κ:λ ratios may occur in the absence of a reduced renal function shown by a normal eGFR and in the presence of reduced renal function by eGFR when comparing results with the established reference ranges. Explanations include choice of analytical systems or the presence of other concurrent non plasma cell illness

Link to PubMed record

‘New look’ Evidence Alerts

The Evidence Alerts service, delivered by the Library and Knowledge Service, has a new look.  We’ve added new topics to our collection of e-bulletins that aim to keep you up to date with new new innovations, improvements, best practice, news and evidence in your area of interest.

New topics include: leadership, health & wellbeing, integrated care and emerging technologies.

Find out more and subscribe here.

WUTH publication: A simple technique to achieve parallel transverse cuts in the scarf osteotomy

Citation: Annals of the Royal College of Surgeons of England. 2015, 97(3), 238-9
Author: Brookes-Fazakerley SD, Platt SR, Jackson GE

Link to PubMed record

WUTH publication: 'Rain chain' for ankle arthroscopy

Citation: Annals of the Royal College of Surgeons of England 2015, 97(5), 397
Author: Ramavath AL, Geary N

Link to PubMed record

WUTH publication: Where are we with RSV prophylaxis?

Citation: Archives of Disease in Childhood. Education and practice edition. 2016, 101(1), 38-42
Author: Caldwell NA, Townsend C
Abstract: Respiratory syncytial virus (RSV) is a predictable, seasonal disease with significant morbidity and mortality in children below 24 months. Prophylaxis, which decreases hospitalisation in those most vulnerable to the disease, has been available since 1998. Pharmacological prophylaxis is however, expensive and requires good infrastructure to deliver. It is out of reach for many patients in low-income and middle-income countries where mortality is highest. This article looks at the pathophysiology and risk factors for RSV. It also outlines what agents are currently available for prophylaxis and prevention.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: General Paediatrics; Immunisation; Infectious Diseases; Virology

Link to PubMed record