2016

Prevention and control of multiresistant Gram-negative bacteria: recommendations from a Joint Working Party (2016)

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Type of publication:
Journal article

Author(s):
Wilson, A P R, Livermore, D M, Otter, *J A, Warren, R E, Jenks, P, Enoch, D A, Newsholme, W, Oppenheim, B, Leanord, A, McNulty, C, Tanner, G, Bennett, S, Cann, M, Bostock, J, Collins, E, Peckitt, S, Ritchie, L, Fry, C, Hawkey, P

Citation:
The Journal of Hospital Infection, Jan 2016, vol. 92 Suppl 1, p. S1

 

Factors contributing to student nurses'/midwives' perceived competency in spiritual care (2016)

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Type of publication:
Journal article

Author(s):
Ross, Linda, Giske, Tove, van Leeuwen, René, Baldacchino, Donia, *McSherry, Wilfred, Narayanasam y, Aru, Jarvis, Paul, Schep-Akkerman, Annemiek

Citation:
Nurse education today, Jan 2016, vol. 36, p. 445-451

Abstract:
The spiritual part of life is importa nt to health, well-being and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. To explore factors contributing to undergraduate nurses'/midwives 9; perceived competency in giving spiritual care. A pilot cross-sectional, multinational, correlational survey design. Questionnaires were completed b y 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwive s from six universities in four countries in 2010. Bivariate and multivaria te analyses were performed. Differences between groups were small. Two fact ors were significantly related to perceived spiritual care competency: perc eption of spirituality/spiritual care and student's personal spiritual ity. Students reporting higher perceived competency viewed spirituality/spi ritual care broadly, not just in religious terms. This association between perceived competency and perception of spirituality is a new finding not pr eviously reported. Further results reinforce findings in the literature that own spirituality was a strong predictor of perceived ability to provide spiritual care, as students reporting higher perceived competency engaged in spiritual activities, were from secular universities and had previous healthcare experience. They were also religious, practised their faith/belief and scored highly on spiritual well-being and spiritual attitude/involvement . The challenge for nurse/midwifery educators is how they might enhance spi ritual care competency in students who are not religious and how they might encourage students who hold a narrow view of spirituality/spiritual care t o broaden their perspective to include the full range of spiritual concerns that patients/clients may encounter. Statistical models created predicted factors contributing to spiritual care competency to some extent but the picture is complex requiring further investigation involving a bigger and mor e diverse longitudinal sample.

Clinical Validation of the UKMS Register Minimal Dataset utilising Natural Language Processing (2016)

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Type of publication:
Poster presentation

Author(s):
Rod Middleton, Ashley Akbari, Hazel Lockhart-Jones, Jemma Jones, *Charlotte Owen, Stella Hughes, Richard Gain, David Ford

Citation:
IPDLNC 2016

Abstract:
Objectives
The UK MS Register is a research project that aims to capture real world data about living with Multiple Sclerosis(MS) in the UK. Launched in 2011, identified data sources were: Directly from People with MS (PwMS) via the internet, from NHS treatment centers via ‘traditional’ database capture and by linkage to routine datasets from the SAIL databank. Data received from the NHS, though ‘gold standard’ in terms of diagnosis, is dependent on clinical staff finding both time and information to enter into a clinical system. System implementations across the NHS are variable, as is clinical time. Therefore, we looked to other complementary methodologies.

Approach
The Clix enrich natural language processing (NLP) software was chosen to see if it could capture a portion of the MS Register minimum clinical dataset, the software matches clinical phrases against SNOMED-CT. 40 letters, from 2 NHS Trusts, from 28 patients were loaded. The letters were a mix of MS patients with differing disease subtypes and were dictated by Neurologists, Specialist General Practitioners and MS Specialist Nurses. 20 of the letters were in docx format and 20 as PDF.
The letters were parsed by a domain expert for clinical content, scored by data item for sensitivity and specificity. Next the output from the software was scored by another researcher to see if the 12 relevant clinical concepts from the Register dataset had been elicited. Lastly a ruleset was created to look for particular clinical concepts and scored in the same way.

Results
Of the 40 letters one failed to load, the rest were analysed for the specific data items. Date related items were clearly challenging, with only 7% of appointment dates being matched and 22% for date of diagnosis. MS Type (93.3%) and EDSS score (93.75%) were well recognised, additionally symptoms of MS that would be poorly reported in traditional databases were recognised, with fatigue being well highlighted (78.5%) and gait and walking issues (68.7%) Of concern, were a number of false positive results in DMT’s with 15% patients being identified as being on a DMT when this was just being ‘considered’.

Conclusion
The NLP pathway could be extremely useful for obtaining hard to capture clinical data for the Register. Further work is needed to reduce errors, even with the current minimal configuration, it's possible to ascertain MS Type, functional score of MS, current medication and potentially disabling symptomology within the condition.

External beam radiotherapy in differentiated thyroid carcinoma: A systematic review. (2016)

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Type of publication:
Systematic Review

Author(s):
*Fussey JM, Crunkhorn R, Tedla M, Weickert MO, Mehanna H.

Citation:
Head Neck. Volume38, IssueS1, April 2016, Pages E2297-E2305

Abstract:
External beam radiotherapy (EBRT) is not a first line treatment in differentiated thyroid carcinoma (DTC), but is recommended as an adjuvant treatment in certain cases. The evidence for EBRT in DTC is limited. A comprehensive literature search was performed. Data on patient demographics, disease stage, treatment characteristics, and outcomes were collected from included articles after quality appraisal. Sixteen articles met the inclusion criteria, with a pooled population of 5114. Only 1 study was prospective and there were no randomized controlled trials. Most of the evidence suggests that EBRT improves locoregional control in patients at high risk of locoregional recurrence. This was corroborated by analysis of pooled patient data. Available evidence suggests an improvement in locoregional control when EBRT is used in patients over the age of 45 at high risk for locoregional recurrence. However, there is a need for long-term prospective multicenter research on the subject.

Investigation of the Role of Semen in Embryo Implantation: a pilot study (2016)

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Type of publication:
Poster presentation

Author(s):
*Cloete H., *Binnersley S., *Henderson A., *Mitchell A., *Kasraie J.

Citation:
Poster presentation at the ACE Annual Conference, 5-6 January 2016.

Abstract:
Aim: To investigate the effect of unprotected intercourse on embryo implantation in patients undergoing fertility treatment. Evidence suggests that seminal plasma elicits an endometrial immune response that promotes tolerance towards an invading conceptus. However, in assisted reproductive techniques (ART), seminal plasma is usually excluded and does not come into contact with the female reproductive tract. In humans, investigators have shown that intra-vaginal and/or intra-cervical application of seminal plasma at the time of fertility treatment may improve pregnancy outcomes.
Method: Women were asked to share information about timing and frequency of intercourse in the week of, and 2 weeks prior to, fresh and frozen embryo transfer (FET). Women who had unprotected intercourse in the 5 days prior to ovulation and up to the day of embryo transfer were assigned to the study group (n = 40). Women who abstained in this period were assigned to the control group (n = 66).
Main study outcomes: Biochemical pregnancy rate, clinical pregnancy rate and implantation rate. Statistical analysis showed no significant difference in main outcomes between groups when results were pooled for all treatment types (in vitro fertilisation (IVF)/intra-cytoplasmic sperm injection (ICSI) and FET cycles). However, a significantly reduced implantation rate was observed in the study group when considering the IVF/ICSI stratum alone (24% versus 44%, p = 0.03).
Conclusion: This pilot study supports intercourse abstinence during fertility treatment, however study limitations such as small sample size and patient recall means further investigation is recommended.