WUTH publication: Robotic gynaecologic surgery: a tool or a toy?

Citation: BJOG. 2017, 124(2), 344
Author: Minas, V

Link to PubMed record

WUTH publication: On-scene treatment of spinal injuries in motor sports

Citation: European Journal of Trauma and Emergency Surgery. 2017, 43(2), 191-200
Author: Kreinest M, Scholz M, Trafford P
Abstract: Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated. If a competitor must first be extricated from the racing vehicle, the correct method of extrication must be chosen. To avoid secondary injury to the spine after a racing accident, in-line extrication from the vehicle and immobilization of the patient are standard procedures in motor sports and have been used for decades. Since immobilization can be associated with disadvantages and complications, the need for immobilization of trauma patients outside of motor sports medicine has become the subject of an increasing number of reports in the scientific literature. Even in motor sports, where specific safety systems that offer spinal protection are present, the indications for spinal immobilization need to be carefully considered rather than being blindly adopted as a matter of course. The aim of this article is to use recent literature to present an overview about the treatment of spinal injuries in motor sports. Further, we present a new protocol for indications for immobilizing the spine in motor sports that is based on the ABCDE principles and takes into account the condition of the patient.
KEYWORDS: Emergency; Extrication; Immobilization protocol; Out-of-hospital; Prehospital

Link to PubMed record

WUTH publication: The United Kingdom Diabetic Retinopathy Electronic Medical Record Users Group, Report 1: baseline characteristics and visual acuity outcomes in eyes treated with intravitreal injections of ranibizumab for diabetic macular oedema

Citation: The British Journal of Ophthalmology, 2017, 101(1), 75-80
Author: Egan C, Zhu H, Lee A, Sim D, Mitry D, Bailey C, Johnston R, Chakravarthy U, Denniston A, Tufail A, Khan R, Mahmood S, Menon G, Akerele T, Downey L, McKibbin M, Varma A, Lobo A, Wilkinson E, Fitt A, Brand C, Tsaloumas M, Mandal K, Kumar V, Natha S, Crabb D, UK AMD and DR EMR Users Group
Abstract: AIMS: To describe baseline characteristics and visual outcome for eyes treated with ranibizumab for diabetic macular oedema (DMO) from a multicentre database.METHODS: Structured clinical data were anonymised and extracted from an electronic medical record from 19 participating UK centres: age at first injection, ETDRS visual acuity (VA), number of injections, ETDRS diabetic retinopathy (DR) and maculopathy grade at baseline and visits. The main outcomes were change in mean VA from baseline, number of injections and clinic visits and characteristics affecting VA change and DR grade. RESULTS: Data from 12 989 clinic visits was collated from baseline and follow-up for 3103 eyes. Mean age at first treatment was 66 years. Mean VA (letters) for eyes followed at least 2 years was 51.1 (SD=19.3) at baseline, 54.2 (SD: 18.6) and 52.5 (SD: 19.4) at 1 and 2 years, respectively. Mean visual gain was five letters. The proportion of eyes with VA of 72 letters or better was 25% (baseline) and 33% (1 year) for treatment naïve eyes. Eyes followed for at least 6 months received a mean of 3.3 injections over a mean of 6.9 outpatient visits in 1 year.CONCLUSIONS: In a large cohort of eyes with DMO treated with ranibizumab injections in the UK, 33% of patients achieved better than or equal to 6/12 in the treated eye at 12 months compared with 25% at baseline. The mean visual gain was five letters. Eyes with excellent VA at baseline maintain good vision at 18 months.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: Macula; Public health; Retina; Treatment Medical; Treatment Surgery

Link to PubMed record

Healthcare Databases Advanced Search (HDAS) has changed

So how you search MEDLINE, EMBASE, CINAHL, PsycINFO, AMED, British Nursing Index, HMIC and Health Business Elite will be different.

Need some support to make the most of the new interface?

Need help with saved searches?

Come along to your Library & Knowledge service "Drop in" session at McArdle Library, APH at 3pm on Monday 24th October.

See demonstrations, ask questions and obtain support materials.

WUTH publication: Diagnostic Imaging of Diabetic Foot Disorders

Citation: Foot and Ankle International. 2017, 38(1), 86-95
Author: Peterson N, Widnall J, Evans P, Jackson G, Platt S
Abstract: LEVEL OF EVIDENCE: Level V, expert opinion.


Link to PubMed record

WUTH publication: Laparoscopic Management of a Ruptured Interstitial Pregnancy Associated With Massive Haemoperitoneum and History of Ipsilateral Salpingectomy

Citation: Journal of minimally invasive gynecology. 2015, 22(6S), S147
Abstract: Minas V, Ashraf K

Link to PubMed record

WUTH publication: The Introduction of "Mini-Touch" Microwave Endometrial Ablation in an Outpatient Setting in a UK District General Hospital

Citation: Journal of minimally invasive gynecology. 2015, 22(6S), S225-S226
Author: Alam MA, Steele G, Jones KE

Link to PubMed record

WUTH publication: Scaling Hemodialysis Target Dose to Reflect Body Surface Area, Metabolic Activity, and Protein Catabolic Rate: A Prospective, Cross-sectional Study

Citation: American Journal of Kidney Diseases. 2017, 69(3), 358-366
Author: Sridharan S, Vilar E, Davenport A, Ashman N, Almond M, Banerjee A, Roberts J, Farrington K
Abstract: BACKGROUND: Women and small men treated by hemodialysis (HD) have reduced survival. This may be due to use of total-body water (V) as the normalizing factor for dialysis dosing. In this study, we explored the equivalent dialysis dose that would be delivered using alternative scaling parameters matching the current recommended minimum Kt/V target of 1.2.
STUDY DESIGN: Prospective cross-sectional study.SETTING & PARTICIPANTS: 1,500 HD patients on a thrice-weekly schedule, recruited across 5 different centers.PREDICTORS: Age, sex, weight, race/ethnicity, comorbid condition level, and employment status. OUTCOMES: Kt was estimated by multiplying V by 1.2. Kt/body surface area (BSA), Kt/resting energy expenditure (REE), Kt/total energy expenditure (TEE) and Kt/normalized protein catabolic rate (nPCR) equivalent to a target Kt/V of 1.2 were then estimated by dividing Kt by the respective parameters. MEASUREMENTS: Anthropometry, HD adequacy details, and BSA were obtained by standard procedures. REE was estimated using a novel validated equation. TEE was calculated from physical activity data obtained using the Recent Physical Activity Questionnaire. nPCR was estimated using a standard formula.RESULTS: Mean BSA was 1.87m2; mean REE, 1,545kcal/d; mean TEE, 1,841kcal/d; and mean nPCR, 1.03g/kg/d. For Kt/V of 1.2, there was a wide range of equivalent doses expressed as Kt/BSA, Kt/REE, Kt/TEE, and Kt/nPCR. The mean equivalent dose was lower in women for all 4 parameters (P<0.001). Small men would also receive lower doses compared with larger men. Younger patients, those with low comorbidity, those employed, and those of South Asian race/ethnicity would receive significantly lower dialysis doses with current practice.LIMITATIONS: Cross-sectional study; physical activity data collected by an activity questionnaire. CONCLUSIONS: Current dosing practices may risk underdialysis in women, men of smaller body size, and specific subgroups of patients. Using BSA-, REE-, or TEE-based dialysis prescription would result in higher dose delivery in these patients.Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. KEYWORDS: Hemodialysis target dose; Kt/V; body size; dialysis adequacy; dialysis dosing; end-stage renal disease (ESRD); energy expenditure; metabolism; physical activity; sex differences


Link to PubMed record

Got Trust training to do?

Information Governance Training due?
E-learning or Blended Learning to complete?
Come to the McArdle Library at Arrowe Park and do it, tick it off you list!
Headphones provided!

NICE Evidence Search

Visit NICE Evidence Search at http://www.evidence.nhs.uk/ when you want to find web based health related information fast.
Don't forget you have some useful filters available including:
Guidance, Types of Information, Source of the Information, Medicines and a customised date range.
Want to know more email: mcardle.library@nhs.net

Your Library & Knowledge Service

Your Library & Knowledge Service can support you in so many ways:
Provide clinically appropriate information
Provide academically appropriate information
Help you to access clinical decision making tools and evidence summary products
Undertake literature searches with you or for you
Provide training such as:
First Steps in Searching
Finding the Evidence
Introduction to Critical Appraisal
Reflective Writing to support revalidation
Help you to keep up to date
Help you to benchmark your service when undertaking audits
Support you with your research
Facilitate your Journal Club
Provide a "Pop Up Library" session at your location, at a time to suit you
Answer your enquiries
All you have to do is ask!
To do that please email mcardle.library@nhs.net

Patient Information

Need help to improve your patient information?
Don't forget that UptoDate and Dynamed Plus offer Patient Information.
Your Library & Knowledge Service can help with your Patient Information needs. Just ask. Email: mcardle.library@nhs.net

Revalidation, Reflection, Reconsider

Faced with completing your Nurse Revalidation documentation ...
Been a while since you had any advice on how to undertake Reflection ...
Reconsider your needs.
Do you need training in:

• finding good evidence
• critically appraising evidence
• reflective writing

You can book a customised training session, delivered at a place and time convenient to you and your team by emailing: mcardle.library@nhs.net

Infection Control Information

Need to know more about Infection Prevention and Control?
Need to know about specific Infections e.g. MRSA, Clostridium difficile, or Carbapenemase- Producing Enterobacteriaceae (CPE)?
Your Library & Knowledge Service can help.
Email: mcardle.library@nhs.net

WUTH publication: Critical care in the Emergency Department: organ donation

Citation: Emergency Medicine Journal. 2017, 34(4), 256-263
Author: Gardiner DC, Nee MS, Wootten AE, Andrews FJ, Bonney SC, Nee PA
Abstract: Organ transplantation is associated with improved outcomes for some patients with end-stage organ failure; however, the number of patients awaiting a transplant exceeds the available organs. Recently, an extended role has been proposed for EDs in the recognition and management of potential donors. The present review presents an illustrative case report and considers current transplantation practice in the UK. Ethical and legal considerations, the classification of deceased donors and future developments promising greater numbers of organs are discussed.
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: clincial management; emergency department; forensic/legal medicine; intensive care


Link to PubMed record

WUTH publication: HELPING PARENTS/CARERS TO GIVE MEDICINES TO CHILDREN IN HOSPITAL

Citation: Archives of disease in childhood. 2016, 101(9), e2
Author: Williams L, Caldwell N, Collins E
Abstract: BACKGROUND: Medicines given to children in hospital are often prepared, checked and administered by two-registered nurses. Children are more likely to accept medicines given by a parent/carer1 but many hospital policies do not support such practice. Indeed the Trusts Medicines Management Policy allows single person medicines administration, except for children, but does not specify how medicine preparation and administration should take place or who should witness this. Our aim was to identify ways of increasing parent/carer involvement in giving medicines to children in hospital.
OBJECTIVES: ▸ Measure time delays with the current administration process▸ Identify obstacles that may prevent parent/carer involvement in giving medicines▸ Identify how to overcome potential/perceived problems with parent involvement▸ Determine parent/carer opinions of their involvement in giving medicines▸ Assess single nurse checking and parent administration of medicines
METHOD: Drug rounds were observed to identify time delays in medicines administration. A list of nineteen low risk medicines was proposed for parent administration with single nurse preparation. Focus groups were conducted, using structured questions, to get healthcare professionals perspective on the proposed changes and to approve a list of low risk medicines. Parents/carers were invited to complete a questionnaire regarding their involvement. Following Drug and Therapeutics Committee approval, parents/carers administered medicines with single nurse preparation during a trial period.
RESULTS: Administration of twenty-one medicines was observed under current practice. Delays were observed in all cases: average delay 6.5 minutes. Delays of 10 minutes were observed due to children fighting against having medicines administered by a nurse. Delays in 28% of cases were due to getting another nurse to check the preparation and seventeen of the twenty-one medicines observed where not in the medicines locker. Such delays often lead to parents administering medicines, despite the current policy not allowing such practice. Three focus groups, involving 12 staff, identified several problems and potential solutions to single nurse checking of medicines. The main concern was the risk of errors with dose calculations. Questionnaires were completed by 30 parents/carers and 97% wanted to be involved in administering medicines. The only parent/carer who did not, quoted: "My child will not take any medicine from me, this is part of the reason she has been admitted". Most parents/carers (80%) felt their child would be more at ease if they give the medicine. During the trial eight medicines were administered by parents and carers and no delays were observed.
CONCLUSION: Children often receive late medicines in hospital. Parents/carers want to be involved in giving their child medicines. They suggest children would be more at ease. Parents/carer would also gain experience to help when administering medicines at home. Nurses support parent's being more involved in giving medicines. Focus groups suggest that medicines requiring dose calculations should be removed from a list of low risk medicines and parents be encouraged to administer medicines.
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: Abstract; Oral

Link to PubMed record

WUTH publication: Initial UK experience with transversus abdominis muscle release for posterior components separation in abdominal wall reconstruction of large or complex ventral hernias: a combined approach by general and plastic surgeons

Citation: Annals of the Royal College of Surgeons of England. 2017, 99(4), 265-270
Author: Appleton ND, Anderson KD, Hancock K, Scott MH, Walsh CJ
Abstract: INTRODUCTION Large, complicated ventral hernias are an increasingly common problem. The transversus abdominis muscle release (TAMR) is a recently described modification of posterior components separation for repair of such hernias. We describe our initial experience with TAMR and sublay mesh to facilitate abdominal wall reconstruction. METHODS The study is a retrospective review of patients undergoing TAMR performed synchronously by gastrointestinal and plastic surgeons. RESULTS Twelve consecutive patients had their ventral hernias repaired using the TAMR technique from June 2013 to June 2014. Median body mass index was 30.8kg/m2 (range 19.0-34.4kg/m2). Four had a previous ventral hernia repair. Three had previous laparostomies. Four had previous stomas and three had stomas created at the time of the abdominal wall reconstruction. Average transverse distance between the recti was 13cm (3-20cm). Median operative time was 383 minutes (150-550 minutes) and mesh size was 950cm2 (532-2400cm2). Primary midline fascial closure was possible in all cases, with no bridging. Median length of hospital stay was 7.5 days (4-17 days). Three developed minor abdominal wall wound complications. At median review of 24 months (18-37 months), there have been no significant wound problems, mesh infections or explants, and none has developed recurrence of their midline ventral hernia. Visual analogue scales revealed high patient satisfaction levels overall and with their final aesthetic appearance. CONCLUSIONS We believe that TAMR offers significant advantages over other forms of components separation in this patient group. The technique can be adopted successfully in UK practice and combined gastrointestinal and plastic surgeon operating yields good results.

KEYWORDS: Hernia; Transversus abdominis muscle; Ventra

Link to PubMed record

WUTh publication: Rare case of gallbladder agenesis presenting with pancreatitis

Citation: BMJ Case Reports. 2016, Aug 8.
Author: Thornton L, Goh YL, Lipton M, Masters A
Abstract: Gallbladder agenesis (GA) is a rare congenital abnormality with an incidence of 0.01-0.09%. Majority of GA exist alone although it can be associated with other systemic malformations involving the gastrointestinal, genitourinary, cardiovascular and skeletal systems. It is thought that biliary and pancreatic pathologies coexist and this is the second case reported in the literature of GA presenting with pancreatitis.

Link to PubMed record

Upcoming webinar

NIHR will be hosting a live one hour webinar on ‘Writing for Publication’ on Tuesday 23 August at 2pm, which may be of interest to you.

This webinar aims to introduce tips for getting published in both academic, practice-led journals and other peer-reviewed publications. Whether you have written for publication before, or are just getting started, this session will provide valuable tips and will introduce the process from submission and peer review, through to, hopefully, acceptance. It is aimed at current and aspiring NIHR trainees who would like to learn more about writing for publication.

The webinar will cover:

·         Why/where/what do you want to publish?

·         Structuring the paper

·         Hints and tips on getting your article into print

·         A live Q&A session

The webinar will be presented by Jennifer Chubb, a researcher at the University of York studying for a PhD in the Department of Education. Jenn has 10 years’ experience delivering training and development opportunities for researchers nationally and internationally and has published in a range of medium.

As this is a live webinar, attendees will be able to send questions in to the speakers and we will try to answer as many as possible during the webinar. We encourage you to send your question in advance, please email tcc@nihr.ac.uk with the subject: ‘Writing for Publication webinar question’

You can register for the webinar via the following link:  http://bit.ly/writingforpublicationwebinar

Please share this information with any colleagues that may be interested in attending.

Anyone with issues around registering for the event should email tcc@nihr.ac.uk

WUTH publication: An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes

Citation: The British Journal of Dermatology. 2016, 175(1), 172-4
Author: Kirby LC, Banerjee A, Augustine T, Douglas JF
Abstract: Malignant melanoma is a high-risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end-stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation

Link to PubMed record

WUTH publication: Functional Connectivity with the Default Mode Network Is Altered in Fibromyalgia Patients

Citation: PloS one 2016, 11(7)
Author: Fallon N, Chiu Y, Nurmikko T, Stancak A
Abstract: Fibromyalgia syndrome (FMS) patients show altered connectivity with the network maintaining ongoing resting brain activity, known as the default mode network (DMN). The connectivity patterns of DMN with the rest of the brain in FMS patients are poorly understood. This study employed seed-based functional connectivity analysis to investigate resting-state functional connectivity with DMN structures in FMS. Sixteen female FMS patients and 15 age-matched, healthy control subjects underwent T2-weighted resting-state MRI scanning and functional connectivity analyses using DMN network seed regions. FMS patients demonstrated alterations to connectivity between DMN structures and anterior midcingulate cortex, right parahippocampal gyrus, left superior parietal lobule and left inferior temporal gyrus. Correlation analysis showed that reduced functional connectivity between the DMN and the right parahippocampal gyrus was associated with longer duration of symptoms in FMS patients, whereas augmented connectivity between the anterior midcingulate and posterior cingulate cortices was associated with tenderness and depression scores. Our findings demonstrate alterations to functional connectivity between DMN regions and a variety of regions which are important for pain, cognitive and emotional processing in FMS patients, and which may contribute to the development or maintenance of chronic symptoms in FMS.

Link to PubMed record

WUTH publication: The UK Neovascular AMD Database Report 3: inter-centre variation in visual acuity outcomes and establishing real-world measures of care

Citation: Eye. 2016, 30(11), 1462-1468
Author: Liew G, Lee AY, Zarranz-Ventura J, Stratton I, Bunce C, Chakravarthy U, Lee CS, Keane PA, Sim DA, Akerele T, McKibbin M, Downey L, Natha S, Bailey C, Khan R, Antcliff R, Armstrong S, Varma A, Kumar V, Tsaloumas M, Mandal K, Egan C, Johnston RL, Tufail A
Abstract: Purpose. International variations in visual acuity (VA) outcomes of eyes treated for neovascular age-related macular degeneration (nAMD) are well-documented, but intra-country inter-centre regional variations are not known. These data are important for national quality outcome indicators. We aimed to determine intra-country and inter-centre regional variations in outcomes for treatment of nAMD. Patients and methods Prospective multicentre national database study of 13 UK centres that treated patients according to a set protocol (three loading doses, followed by Pro-Re-Nata retreatment). A total of 5811 treatment naive eyes of 5205 patients received a total of 36 206 ranibizumab injections over 12 months. Results Mean starting VA between centres varied from 48.9 to 59.9 ETDRS letters. Mean inter-centre VA change from baseline to 12 months varied from +6.9 letters to -0.6 letters (mean of +2.5 letters). The proportion of eyes achieving VA of 70 letters or more varied between 21.9 and 48.7% at 12 months. Median number of injections (visits) at each centre varied from 5 to 8 (9 to 12), with an overall median of 6 (11). Age, starting VA, number of injections, and visits, but not gender were significantly associated with variation in these VA outcomes (P<0.01). Significant variation between centres persisted even after adjusting for these factors. Conclusion There are modest differences in VA outcomes between centres in the UK. These differences are influenced, but not completely explained, by factors such as patient age, starting VA, number of injections, and visits. These data provide an indication of the VA outcomes that are achievable in real-world settings..

Link to PubMed record

WUTH publication: Nomograms for calculating drug doses in obese adults

Citation: Anaesthesia. 2016, 71(8), 977-8
Author: Callaghan LC, Walker JD, Williams DJ

Link to PubMed record

Infection Prevention and control

Infection Prevention and control

Is everybody's responsibility. If you need to know more about:

Methicillin Resistant Staphylococcus Aureus (MRSA) bacteraemia, Clostridium difficile (C diff.) or

Carbapenemase-producing Enterobacteriaceae (CPE)

you can use clinical decision making systems such as Dynamed Plus or UpToDate.

You can also get these useful tools on your mobile devices so that you have them right at the bedside.

If you or your team need to know more your Library & Knowledge Service can provide a session for you. Email mcardle.library@nhs.net to book yours.

WUTH publication: Atypical Chronic Ankle Instability in a Pediatric Population Secondary to Distal Fibula Avulsion Fracture Nonunion

Citation: The Journal of Foot & Ankle Surgery. 2017, 56(1), 148-52
Author: El Ashry SR, El Gamal TA, Platt SR
Abstract: Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population. We present 2 cases of chronic ankle instability, 1 in a 12-year-old and 1 in a 9-year-old patient. Unlike the typical adult etiology, the cause of instability was a dysfunctional lateral ligamentous complex as a consequence of bony avulsion of the tip of the fibula. Both patients had sustained a twisting injury to the ankle. The fractures failed to unite. The nonunion resulted in dysfunction of the anterior talofibular ligament with consequent chronic ankle instability. At the initial clinical assessment, magnetic resonance imaging was requested for both patients. In patient 1 (12 years old), the fracture was fixed with 2 headless screws and was immobilized in a plaster cast for 6 weeks. In patient 2 (9 years old), because of the small size of the avulsed fragment, fixation was not possible. A modified Gould-Broström procedure was undertaken, facilitating repair of the avulsed fragment using anchor sutures.

Link to PubMed record

Behind the Headlines

Visit the "Behind the Headlines" section http://www.nhs.uk/news/Pages/NewsIndex.aspx of NHS Choices to get an unbiased and evidence-based analysis of health stories that make the news. Behind the Headlines aims to respond to news stories the day they appear in the media.

• explain the facts behind the headlines and give a better understanding of the science that makes the news,
• provide an authoritative resource for GPs that they can rely on when talking to patients, and
• become a trusted resource for journalists and others involved in the dissemination of health news.

The service is intended for both the public and health professionals, and endeavours to:
It can be a useful way of initially looking at how you might critically appraise health related information.

Training Session

Today Linda Taylor, our Outreach Services Librarian will be ensuring that the Trust's new Physician Associates are aware of all of the clinical decision making, evidence summary tools and information resources available to support them in undertaking their clinical roles.

 

If you would like a similar session please email: mcardle.library@nhs.net and we will provide a session at a time and place convenient to you and your team.

Information Searching

Do you need help with searching for information or evidence?

Do you have unanswered clinical questions?

Are you studying for a qualification and struggling to identify where the best electronic information is for academic or clinical purpose?

 

We can sit beside you and ensure that you are looking in the right places, in the best ways. You will leave more confident in your searching skills, finding better information and with helpful handouts to remind you later.

 

Contact your Library & Knowledge Service by emailing mcardle.library@nhs.net and ask to book an assisted search.

WUTH publication: Changes to the law on consent following Montgomery vs Lanarkshire Health Board

Citation: British Journal of Hospital Medicine. 2016, 77(6), 355-7
Author: Clearkin L
Abstract: The Supreme Court's determination on Montgomery (AP) (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) [2015] clarified UK law on consent. It is for the informed patient to determine which intervention, if any, they will undergo. All doctors must meet this standard and may need to reassess their practice to do so.

Link to PubMed record

WUTH publication: Skin lesions in calciphylaxis

Citation: British Journal of Hospital Medicine. 2016, 77(6), 371
Author: Kirby LC, Abdulnabi K

Link to PubMed record

Renew your Books Night or Day!

You can now renew your books online, reserve a book, or simply view your account, via the Library webpages

· Simple log in

· 24hr service

Ask Library staff to create your log in today

0151 6047223 or ex 8610

mcardle.library@nhs.net

Revalidation

Worried about revalidation?

Need some help with Reflective Writing?

Come and join our "Reflective Writing for Revalidation" session at 12.00 today in the McArdle Library IT Suite.

Critical Care Journal Club

Bright and early this morning

Critical Care Journal Club met to hear about

High Flow Oxygen and its effects on the timing of Intubation

Presenter: Sophie Miller

Staff from all departments welcome to attend future Journal Clubs.

For more information or if you are interested in presenting please contact Dr. P. Prashast

Consultant in Intensive Care

Please visit: http://therealjournalclub.wordpress.com/ to register to receive information about journal club activity and to view posts and presentations.

Training Sessions available

Your Library and Knowledge Service provides a range of training sessions to help you work smarter not harder.

• First Steps in Searching               (1 hour)
• Finding the Evidence                    (1 hour)
• Assisted searches                        (1 hour)
• Introduction to Critical Appraisal    (90 mins)
• Reflective writing                         (1 hour)

All of these sessions are customised to your specialty and needs.

To request this support at a time and location suitable for you or your team please email: mcardle.library@nhs.net

Resources available to you

Do you know about the Clinical Decision Making, Evidence Summary products which are available to you?

Have you used them to keep up to date and be an evidence based practitioner?

If not, why not?

WUTH staff have access to UpToDate and Dynamed and can have these products at their fingertips on their smartphones or iPads

Clatterbridge Cancer Centre staff have access to UpToDate and can also have it on their mobile devices.

If you or your team need a session about these products please email: mcardle.library@nhs.net and we will provide support at a time and location convenient to you.

WUTH publication: Endometriosis of the liver

Citation: British Journal of Hospital Medicine. 2016, 77(5), 310-1
Author: Adishesh M, Hawarden A, Rowlands D

Link to PubMed record

Health & Well-being Week

Yesterday Jennifer Perestrelo and Linda Taylor supported the Trust Health & Well-being Week by providing a market place stall to support the "Getting involved/support theme".

The stall highlighted important Library & Knowledge Services available to staff and showcased the work of the "Chronicles of Yarnia" Group which meets in the Library on Wednesday mornings 8.00-9.00 a.m.

Jennifer took the opportunity to teach Peter Bohan, Head of Organisational Health at WUTH and others how to crochet.

24-hour access

Friday 6^th May 2016 

Unfortunately 24 hour access is not currently available due to technical difficulties. 

Apologies for any inconvenience this may cause. 

If you have any queries please contact the Library and Knowledge Service at mcardle.library@nhs.net

WUTH Health and Wellbeing Week

The Library and Knowledge Service will be supporting the WUTH Health and Wellbeing week that starts on Monday 9th May.  For a whole five days there will be a range of activities dedicated to the wellbeing of staff and each day will have a separate theme, which will be lifestyle, safety, organisational support, getting involved and mind matters.  Details of the programme are below.
All WUTH staff are welcome to pop in to any session for as long as they can.

Lifestyle session Monday 9th May, Education Centre, APH 11am-1.15pm
FREE bag of fruit to first 100 visitors courtesy of URwhatueat
Marketplace to include
Invigor8 council gyms
Gravity gym – FREE day passes
UTS fitness
Holistic Hands – FREE Massage tasters
Colour therapy taster sessions (bit like reiki)
Smoking cessation advice from the Livewell team
Alcohol/substance misuse team (WUTH) available for support and advice
Acupuncture
FREE Health checks Occ health nurses, cholesterol and BP testing

Safety Tuesday 10th May Health and Safety Dept, Elm House CGH 11am-1pm
FREE “Mocktails” will be served on arrival
Marketplace to include
Sharps safety awareness
Musculoskeletal injuries and awareness
WUTH physiotherapy team will be on hand for advice support
Health and safety team, drop in advice

Organisational support Wednesday 11th May, Education Centre, APH
Given over to LiA and staff involvement team and to include
Schwartz round on 11 May on the topic ‘The smallest thing can make a big difference’, Main Lecture Theatre 12:45 -13:45
Culture/engagement Information Stand
Staff Guardian Information Stand
Coaching information Stand
Resilience Training Programme Information Stand
Learning and Development Opportunities Information Stand
Healthcare Staff Benefits – Scheme Launch Dining Room, APH
Health and Wellbeing Pledges (Those who pledge are entered into draw to win a smoothie maker, donated by Healthcare Staff Benefits)
Walk in the Park for staff to join in. Meeting Place Dining Room, Education Centre, APH 13:15

Getting involved/support Thursday 12th May, Education Centre, APH, 2-4pm
Market place of groups and organisations for support and to get involved with
Citizens Advice Bureau
Samaritans
Chaplaincy team (WUTH)
National Childbirth Trust
WUTH knitting group and library services
League of Friends
Soroptimists International
League of Friends
WUTH SingMe choir
Nurses day, HWB sessions including FREE massage, reiki, Indian head massage

Mind Matters Friday 13th May L&D training room and OHD CGH, 11.30 – 2pm
A repeat of our successful session previously run at APH
Talks on various topics
Stress awareness - Peter Bohan
Mindfulness - Sean Orford
FREE massage tasters - Holistic Hands
FREE Colour therapy tasters
WUTH chaplaincy team

Critical Care Journal Club

Dr. Grace McCrystal presented on "Transfusion Thresholds" to Critical Care Journal Club this morning.

The session was chaired by Dr. P. Prashast, Consultant in Intensive Care and was well attended with the audience including Consultants, Doctors, Nurses and Students.

 

The journal club meets monthly and future topics will include:

High Flow Oxygen therapy and its effect on intubation

Blood Pressure thresholds in septic patients

and Choice of anti-arrhythmic therapy in Fast Atrial Fibrillation (AF) in septic patients

 

Visit http://therealjournalclub.wordpress.com/ and register to receive information about journal club activity and view the presentations.

Critical Care Journal Club

Dr. P. Prashast

Consultant in Intensive Care invites you to attend

Critical Care Journal Club which will take place on

Friday 6th May 2016

8.00am-9.00am, Anaesthetics Seminar Room

Studies will be appraised and discussed on

Transfusion

Presenter: Grace McCrystal

All Staff from Critical Care and ED are welcome to attend.

For more information or if you are interested in presenting please contact Dr Prashast.

Don't forget

Your new collection of nursing and midwifery journals from the Mark Allen Group (MAG online) which will help to keep you up to date with practice, support your continuing professional development, and help you to gather evidence for your Revalidation portfolio is available alongside all the other electronic journals you have access to under the A/Z list of nationally available journals option at

https://www.nice.org.uk/about/what-we-do/evidence-services/journals-and-databases

To access all the electronic content you have available you need an OpenAthens account, then you can access all your content from work or from home.  When using the A/Z list link it is important that you are logged in (check on the top right of the screen) otherwise you won't see all the great stuff you can use!

The Mark Allen Group collection of journals includes the following titles:

African Journal of Midwifery and Women's Health

British Journal of Cardiac Nursing

British Journal of Community Nursing

British Journal of Healthcare Assistants

British Journal of Healthcare Management

British Journal of Hospital Medicine

British Journal of Mental Health Nursing

British Journal of Midwifery

British Journal of Neuroscience Nursing

British Journal of Nursing

British Journal of School Nursing

Dental Nursing

Gastrointestinal Nursing

Independent Nurse

International Journal of Palliative Nursing

International Journal of Therapy & Rehabilitation

International Paramedic Practice

Journal of Aesthetic Nursing

Journal of Health Visiting

Journal of Paramedic Practice

Journal of Renal Nursing

Journal of Wound Care

Nurse Prescribing

Nursing & Residential Care

Practice Nursing

Contact the Library and Knowledge Service for further information or support by emailing: mcardle.library@nhs.net

Reflective Writing

Reflective Writing for Nurse Revalidation group sessions are scheduled for:

 

Friday 3/6/16

12.00-1.00

and

Thursday 14/7/16

12.00-1.00

Both sessions will take place in the McArdle Library IT Suite

 

To book your place on one of these sessions, or to request a session for your team at a time and place convenient to you please email: mcardle.library@nhs.net

WUTH publication: Screening for cardiovascular risk factors in patients admitted for acute coronary syndrome

Citation: International Journal of Clinical Practice. 2014, 68(7), 929-30
Author: Banerjee M, White A, Pearson R, Balafsan T, Hama S, Yadav R, France M, Kwok S, Younis N, Soran H

Link to PubMed record

WUTH publication: A retrospective study of seven-day consultant working: reductions in mortality and length of stay

Citation: The Journal of the Royal College of Physicians of Edinburgh. 2015, 45(4), 261-7
Author: Leong KS, Titman A, Brown M, Powell R, Moore E, Bowen-Jones D
Abstract: Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown. Methods This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day postdischarge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits. Results Admission numbers increased from 6,304 (November 2011-July 2012) to 7,382 (November 2012-July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57% increase in early-warning score triggered calls was seen in 2013 (410 calls vs 262 calls in 2012; p<0.01). Seven-day consultant working was associated with a reduction in in-hospital mortality from 11.4% to 8.8% (p<0.001). Mortality within 30 days of discharge fell from 2.4% to 2.0% (p=0.12). Length of stay fell by 1.9 days (95% CI 1.1-2.7; p=0.004) for elderly medicine wards and by 1.7 days (95% CI 0.8-2.6; p=0.008) for medical wards. Weekend discharges increased from general medical wards (from 13.6% to 18.8%, p<0.001) but did not increase from elderly medicine wards. Conclusions Introduction of an enhanced, consultant-led model of working at weekends was associated with reduced in-hospital and 30-day post discharge mortality rates as well as reduced length of stay. These results require confirmation in rigorously designed prospective studies.
KEYWORDS: 30 day mortality; in-hospital; length of stay; mortality


Link to PubMed record

Library Support

Are you returning to learning, undertaking academic or clinical courses?

Your Library & Knowledge Service can help.

We can provide support with:

• Finding clinically and academically appropriate evidence
• Assisting you to critically appraising evidence
• Support you with referencing
• Assist with reflective writing

 

All you have to do is ask. We'll provide this support at a time and place convenient for you.

Act now and email mcardle.library@nhs.net to get your training, help and support.

Oxford Handbooks and Textbooks

You have access to over 200 of the Oxford Handbooks and Textbook e-book collection.
Recent updates include the new 2015 editions of  Oxford Handbook of Anaesthesia, Oxford Handbook of Children's and Young People's Nursing, Oxford Handbook of Mental Health Nursing, and Parkinson's Disease and Other Movement Disorders.
You can access them with your Open Athens account (Your institution is NHS England.) at http://www.oxfordhandbooks.com

WUTH publication: Unusual finding of concrescence

Citation: BMJ Case Reoprts. 2016 Mar 23
Author: Palermo D, Davies-House A
Abstract: Concrescence is a rare dental anomaly whereby adjacent teeth are united by cementum. It has been reported to occur in around 0.8% of permanent dental extractions and a correct diagnosis prior to surgical intervention is important to ensure that patients can make an informed decision about their treatment and to reduce the potential for dentolegal action against the responsible clinician. An 83-year-old woman was referred to the Oral and Maxillofacial Surgery Department at the Wirral University Teaching Hospital, for extraction of her upper left first molar tooth. The operator noted that, when the upper left first molar was extracted, the upper left second molar tooth was also removed. Clinically, the roots of the adjacent teeth appeared fused and a diagnosis of concrescence was established. The patient was informed of the complication and provided with a 1-week review appointment, at which stage she was discharged.
 
Link to PubMed record

BMJ Case Reports

WUTH has an institutional subscription to BMJ Case Reports. BMJ Case Reports is a peer-reviewed, valuable collection of case reports in all disciplines so that healthcare professionals, researchers and others can easily find clinically important information on common and rare conditions. This is the largest single collection of case reports online with more than 11,000 articles from over 70 countries.  Our Trust-wide subscription now means that as well as searching BMJ Case Reports, you can now submit a case report for free, allowing you to avoid the usual annual fellowship fee of £168.  To access BMJ Case Reports, all you need is a WUTH OpenAthens account.  Log in here with your OpenAthens.

If you’re interested in submitting a case report, take a look at the Instructions for Authors and contact the Library and Knowledge Service for the WUTH Fellowship code (you’ll need this to submit).  

WUTH publication: Patient-Reported Experience of Modified Transperineal Template Guided Saturation Biopsy Under General Anaesthesia and without Prophylactic Catheterisation

Citation: Urologia Internationalis. 2016, 96(4), 479-83
Author: Sarkar D, Ekwueme K, Parr N
Abstract: Results of patient feedback questionnaire following transperineal template guided saturation biopsy (TPSB) without prophylactic catheterisation.
INTRODUCTION AND OBJECTIVE: TPSB is increasingly utilised in the diagnosis and characterisation of prostate cancer. However, there is little data on patient experience after undergoing this procedure. We circulated a questionnaire to 511 consecutive patients from July 2007 to December 2014 and now analyse the responses.
MATERIALS AND METHODS:
The mean age for the cohort was 64 (range 43-82). A mean of 28 biopsy cores (range 13-43) were taken under general anaesthesia (GA), as day case procedure. Patients received diclofenac 100 mg suppository on completion of the procedure. The questionnaire explored symptoms at 1 h, 1, 3 and 7 days postoperatively.RESULTS:
There were 301 responses (59%). Following TPSB, 38% initially experienced rectal bleeding, falling significantly to 3% on day 7 (p < 0.001) and it was not a serious condition in all cases. A majority reported haematuria at 1 h but persisting at 1 week in over one quarter (p < 0.001). Nevertheless, although initially often dark, none had other than pale pink by the end of the reporting period. In contrast, the incidence of haematospermia increased over 7 days, rising significantly to 38% by this stage (p < 0.001). Several patients commented that the procedure was more tolerable than their previous conventional TRUS biopsy and 20 (6.6%) with voiding difficulty required catheterisation. In all, 23% patients felt pain, and out of these 23% only 5% required minor analgesia at day 7.CONCLUSION:
TPSB under GA without prophylactic catheterisation is well tolerated, carrying acceptable postoperative symptom rates. Interestingly, a significant proportion of patients ejaculate within 7 days, which again suggests good tolerance to the procedure. Patients should be provided with this data preoperatively when they are considering TPSB.
© 2016 S. Karger AG, Basel.

Link to PubMed record

WUTH publication: Life-threatening Petersen's hernia following open Beger's procedure

Citation: Journal of Surgical Case Reports. 2016, 3
Author: Goh YL, Haworth A, Wilson J, Magee CJ
Abstract: Petersen's hernia (an internal hernia between the transverse mesocolon and Roux limb following Roux-en-Y reconstruction) is well described following laparoscopic gastric bypass surgery. We describe a Petersen-type hernia in a patient who had undergone complex open upper gastrointestinal surgery for chronic pancreatitis.
Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

Link to PubMed record

WUTH publication:

Citation: Clinical interventions in aging. 2016, 11, 185-8
Author: Cheema MR, Ismaeel SM
Abstract: Temporal arteritis, also known as giant cell arteritis (GCA), is a systemic vasculitis that predominantly involves the temporal arteries. It is a medical emergency and should be treated promptly as it can lead to permanent loss of vision. It is very commonly associated with a raised erythrocyte sedimentation rate (ESR), usually >50 mm/h, one of the essential criteria defined by the American College of Rheumatology classification of GCA. Here, we describe the case of a 73-year-old male presenting with a 2-day history of a sudden onset of a severe left-sided headache, which had the signs and symptoms consistent with GCA but he had an ESR of only 27 mm/h. The patient was urgently treated with prednisolone 60 mg per day, and his symptoms dramatically improved within 24 hours of therapy. Temporal artery biopsy results were consistent with an inflammatory response, and withdrawal of treatment led to a relapse of the symptoms. The patient was slowly tapered off the high steroid dose and is now currently managed on a low steroid dose. We should keep a high index of suspicion for GCA in patients presenting with clinical symptoms of GCA even though the ESR is <50 mm/h as stated in the criteria for GCA diagnosis.
KEYWORDS: erythrocyte sedimentation rate; giant cell arteritis; prednisolone; temporal arteritis

Link to PubMed record

Library Training Sessions

Your Library & Knowledge Service is getting excellent feedback on its training sessions

So here is a quick reminder of what we offer:

• "First Steps in Searching"
• "Finding the Evidence"
• "Introduction to Critical Appraisal"
• "Reflective writing for revalidation"

all customised to your needs and provided at a time and place suitable for you or your team. To request a session please contact mcardle.library@nhs.net

BMJ Case Reports

BMJ Case Reports is a peer-reviewed, valuable collection of case reports in all disciplines so that healthcare professionals, researchers and others can easily find clinically important information on common and rare conditions. This is the largest single collection of case reports online with more than 11,000 articles from over 70 countries.  Our subscription means that as well as searching BMJ Case Reports, WUTH staff can now submit a case report for free, allowing you to avoid the usual annual fellowship fee of £168.  To access BMJ Case Reports, all you need is a WUTH OpenAthens account.  Log in here with your OpenAthens.  If you’re interested in submitting a case report, take a look at the Instructions for Authors and contact the Library and Knowledge Service for the WUTH Fellowship code (you’ll need this to submit).

BMA Critical Appraisal workshops

The BMA Library is running both a Basic Critical Appraisal Skills workshop and an Extended Critical Appraisal Skills workshop on dates in May and October.

For full details of these workshops, including how to book a place, please visit – http://www.bma.org.uk/librarycourses

If you have any queries about these workshops please contact Euphemia Abraham – eabraham@bma.org.uk

WUTH publication: Absence of extensor indicis tendon complicating reconstruction of the extensor pollicis longus

Citation: The Journal of Hand Surgery (European volume). 2017, 42(5), 528-29. [Epub 2016 Mar 2]
Author: Taylor J, Casaletto JA

Link to PubMed record

WUTH publication: Omega-3 fatty acids do not suppress atrial fibrillation even in the "inflamed" heart

Citation: International Journal of Cardiology. 2015, 187, 445-6
Author: Saravanan P, Calder PC, Davidson NC
Abstract: KEYWORDS: Arrhythmia; Atrial fibrillation; Inflamation; Omega-3 fatty acids

Link to PubMed record

Resources for Research

Are you a WUTH nurse involved in research? You have access to the Journal of Nursing Research as part of our OVID journal bundle; simply log in with your OpenAthens details. View more of our resources on nursing research here.

Your Library and Knowledge Service welcomes your feedback, actively considers it and implements enhancements based on your feedback, whenever practicable.

Here are some recent “You Said, We Did” actioned items.

You Said	We Did
You wanted to be able to issue, return and renew items during unstaffed times	We bid for and installed a new self service unit which allows the issuing, renewal and return of library items 24/7 The machine is conveniently located by the library counter Ask library staff if you would like a demonstration
You wanted to find the Library IT Suite easily	We bid for and now use colourful and fully customisable signage which is used to signpost training in the IT Suite
You wanted to access UpTodate & Dynamed Plus (clinical decision making support resources) on mobile devices. This previously was not allowed due to licencing restrictions	We have upgraded the licenses to allow access to these resources for Trust staff and students on placement on mobile devices.
You asked us for information on research generated by Trust employees, and where this was published	We set up a blog highlighting and disseminating the Trust research output which is indexed via PubMed, Medline or EMBASE. http://wuthlibraryresearchandebp.blogspot.co.uk/
You asked for the ability to submit Inter Library Loan requests from outside the Trust	We developed a web based Inter Library Loan request form that can be used from anywhere and is compliant with copyright legislation. http://www.wuth.nhs.uk/patients-andvisitors/services/l/library/document-book-supply/
You said you needed to listen to the sound on PCs to undertake staff development	We advertised the headphones that we supply for this purpose, so that you can hear the sound without disturbing other library users
You said you needed access to library forms outside of staffed times	We located library registration. Interlibrary Loan and Evidence Alerts registration forms outside the library door and enabled you to submit the forms via the Book return box for prompt processing at the next available staffed time.
You said you wanted to know what the Library did with deposits which were unclaimed	We adjusted the wording of the email which goes out to all library users when their accounts are due to expire which explains that deposits which are not reclaimed become part of library funds and are used to enhance our services and support.