Ryan McFall, Victoria England, Fionan McBride, Hannah McPhee, Mhairi Cowan, Riley Westwood, Sam Scholes
{"title":"Planetary Health Report Card for Queen's University Belfast - update.","authors":"Ryan McFall, Victoria England, Fionan McBride, Hannah McPhee, Mhairi Cowan, Riley Westwood, Sam Scholes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"92 3","pages":"170-172"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Verbal probability expressions such as 'likely' and 'possible' are commonly used to communicate uncertainty in diagnosis, treatment effectiveness as well as the risk of adverse events. Probability terms that are interpreted consistently can be used to standardize risk communication. A systematic review was conducted. Research studies that evaluated numeric meanings of probability terms were reviewed. Terms with consistent numeric interpretation across studies were selected and were used to construct a Visual Risk Scale. Five probability terms showed reliable interpretation by laypersons and healthcare professionals in empirical studies. 'Very Likely' was interpreted as 90% chance (range 80 to 95%); 'Likely/Probable,' 70% (60 to 80%); 'Possible,' 40% (30 to 60%); 'Unlikely,' 20% (10 to 30%); and 'Very Unlikely' with 10% chance (5% to 15%). The corresponding frequency terms were: Very Frequently, Frequently, Often, Infrequently, and Rarely, respectively. Probability terms should be presented with their corresponding numeric ranges during discussions with patients. Numeric values should be presented as X-in-100 natural frequency statements, even for low values; and not as percentages, X-in-1000, X-in-Y, odds, fractions, 1-in-X, or as number needed to treat (NNT). A Visual Risk Scale was developed for use in clinical shared decision making.
{"title":"Verbal Probability Terms for Communicating Clinical Risk - a Systematic Review.","authors":"M Jawad Hashim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Verbal probability expressions such as 'likely' and 'possible' are commonly used to communicate uncertainty in diagnosis, treatment effectiveness as well as the risk of adverse events. Probability terms that are interpreted consistently can be used to standardize risk communication. A systematic review was conducted. Research studies that evaluated numeric meanings of probability terms were reviewed. Terms with consistent numeric interpretation across studies were selected and were used to construct a Visual Risk Scale. Five probability terms showed reliable interpretation by laypersons and healthcare professionals in empirical studies. 'Very Likely' was interpreted as 90% chance (range 80 to 95%); 'Likely/Probable,' 70% (60 to 80%); 'Possible,' 40% (30 to 60%); 'Unlikely,' 20% (10 to 30%); and 'Very Unlikely' with 10% chance (5% to 15%). The corresponding frequency terms were: Very Frequently, Frequently, Often, Infrequently, and Rarely, respectively. Probability terms should be presented with their corresponding numeric ranges during discussions with patients. Numeric values should be presented as X-in-100 natural frequency statements, even for low values; and not as percentages, X-in-1000, X-in-Y, odds, fractions, 1-in-X, or as number needed to treat (NNT). A Visual Risk Scale was developed for use in clinical shared decision making.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"93 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.1136/leader-2023-FMLM.15
R. Evans, Sophie Davidson, Amy Taylor, M. Macartney, Sarah Small, W. Elbaroni, Therese McCartney, Peter McMurray, Ian Steele
ABSTRACT Introduction The Achieve, Develop, Explore Programme for Trainees (ADEPT) Clinical Leadership Fellowship Programme was established in response to growing recommendations to underpin healthcare reconfiguration in Northern Ireland with a collective leadership strategy. The fellowship combines a leadership development programme with a project carried out within a host organisation. With the fellowship now in its sixth year, a need was identified to assess its impact on the fellows’ leadership skills, career choices, achievements, and views on both the fellowship and how to develop future leaders. Methods Demographic data for all ADEPT fellows was held centrally through Northern Ireland Medical and Dental Training Agency (NIMDTA) and assessed anonymously. A mixed-methods questionnaire was composed using Smart Survey. Likert scale questions were designed to determine the extent to which participants believed ADEPT supported their development of strong and exemplary elements of the nine dimensions of the NHS Healthcare Leadership Model. The questionnaire was distributed electronically to all ADEPT alumni in November 2021 and remained open for 4 weeks. Results There have been 46 ADEPT fellows to date (72% female; all fellows were white). ADEPT fellows were most commonly from Psychiatry (33%), Paediatrics (17%) and Obstetrics and Gynaecology (15%). There were 19 responses from the alumni cohort of 46 (41%). 75% of respondents reported that their project resulted in publication, presentation or award. Leadership skill development was identified as best in “Evaluating Information” and “Engaging the Team”, whereas skills in “Sharing the Vision” and “Developing Capability” saw less improvement. The majority felt that the fellowship had been useful in securing their position as a consultant or general practitioner and 50% went on to pursue senior leadership positions. Conclusion The ADEPT Clinical Leadership Fellowship delivers effective leadership training as measured by the nine domains of the NHS Healthcare Leadership Model. It provides value for host organisations through the projects undertaken and by developing doctors who are more likely to engage in future formal leadership roles. ADEPT alumni saw the value in their leadership experience and felt it should be embedded in standard postgraduate training schemes to reach a wider audience.
{"title":"A Six Year Experience of a National Leadership Fellowship in Northern Ireland: Achieve, Develop, Explore Programme for Trainees (ADEPT)","authors":"R. Evans, Sophie Davidson, Amy Taylor, M. Macartney, Sarah Small, W. Elbaroni, Therese McCartney, Peter McMurray, Ian Steele","doi":"10.1136/leader-2023-FMLM.15","DOIUrl":"https://doi.org/10.1136/leader-2023-FMLM.15","url":null,"abstract":"ABSTRACT Introduction The Achieve, Develop, Explore Programme for Trainees (ADEPT) Clinical Leadership Fellowship Programme was established in response to growing recommendations to underpin healthcare reconfiguration in Northern Ireland with a collective leadership strategy. The fellowship combines a leadership development programme with a project carried out within a host organisation. With the fellowship now in its sixth year, a need was identified to assess its impact on the fellows’ leadership skills, career choices, achievements, and views on both the fellowship and how to develop future leaders. Methods Demographic data for all ADEPT fellows was held centrally through Northern Ireland Medical and Dental Training Agency (NIMDTA) and assessed anonymously. A mixed-methods questionnaire was composed using Smart Survey. Likert scale questions were designed to determine the extent to which participants believed ADEPT supported their development of strong and exemplary elements of the nine dimensions of the NHS Healthcare Leadership Model. The questionnaire was distributed electronically to all ADEPT alumni in November 2021 and remained open for 4 weeks. Results There have been 46 ADEPT fellows to date (72% female; all fellows were white). ADEPT fellows were most commonly from Psychiatry (33%), Paediatrics (17%) and Obstetrics and Gynaecology (15%). There were 19 responses from the alumni cohort of 46 (41%). 75% of respondents reported that their project resulted in publication, presentation or award. Leadership skill development was identified as best in “Evaluating Information” and “Engaging the Team”, whereas skills in “Sharing the Vision” and “Developing Capability” saw less improvement. The majority felt that the fellowship had been useful in securing their position as a consultant or general practitioner and 50% went on to pursue senior leadership positions. Conclusion The ADEPT Clinical Leadership Fellowship delivers effective leadership training as measured by the nine domains of the NHS Healthcare Leadership Model. It provides value for host organisations through the projects undertaken and by developing doctors who are more likely to engage in future formal leadership roles. ADEPT alumni saw the value in their leadership experience and felt it should be embedded in standard postgraduate training schemes to reach a wider audience.","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"4 1","pages":"93 - 97"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76352099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01DOI: 10.1136/thorax-2021-btsabstracts.125
A. Watson, H. Barnard, A. Shanmugarajah, P. Antoine-Pitterson, R. Mukherjee
NIV is a lifesaving treatment in chronic obstructive pulmonary disease (COPD). Prompt NIV treatment in hypercapnic COPD exacerbations allows for improved physiological outcomes, reduced intubation rates and shortened hospital stay in (1, 2). Therefore, consensus expert opinion is that prompt application of acute NIV substantially reduces the risk of death and should be started without delay in appropriately selected patients with acute hypercapnic respiratory failure (AHRF).The ‘door-to-mask’ time (hospital arrival to NIV commencement: target ≤120 minutes) has been widely used to measure the quality of acute NIV services as per the 2018
{"title":"RESPONSE TIMES FOR ACUTE NON-INVASIVE VENTILATION SET-UPS","authors":"A. Watson, H. Barnard, A. Shanmugarajah, P. Antoine-Pitterson, R. Mukherjee","doi":"10.1136/thorax-2021-btsabstracts.125","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.125","url":null,"abstract":"NIV is a lifesaving treatment in chronic obstructive pulmonary disease (COPD). Prompt NIV treatment in hypercapnic COPD exacerbations allows for improved physiological outcomes, reduced intubation rates and shortened hospital stay in (1, 2). Therefore, consensus expert opinion is that prompt application of acute NIV substantially reduces the risk of death and should be started without delay in appropriately selected patients with acute hypercapnic respiratory failure (AHRF).The ‘door-to-mask’ time (hospital arrival to NIV commencement: target ≤120 minutes) has been widely used to measure the quality of acute NIV services as per the 2018","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"1 1","pages":"169 - 170"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83115559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ankur Gupta, Peter Thorson, Krishnam R Penmatsa, Pritam Gupta
Rhabdomyolysis (RML) is a pathological entity characterized by symptoms of myalgia, weakness and dark urine (which is often not present) resulting in respiratory failure and altered mental status. Laboratory testing for myoglobinuria is pathognomonic but so often not present during the time of testing that serum creatine kinase should always be sent when the diagnosis is suspected. Kidney injury from RML progresses through multiform pathways resulting in acute tubular necrosis. Early treatment (ideally<6 hoursfrom onset) is needed with volume expansion of all non-overloaded patients along with avoidance of nephrotoxins. There is insufficient data to recommend any specific fluid. The mortality rate ranges from 10% to up to 50% with severe AKI, so high index of suspicion and screening should be in care plan of seriously ill patients at risk for RML.
{"title":"Rhabdomyolysis: Revisited.","authors":"Ankur Gupta, Peter Thorson, Krishnam R Penmatsa, Pritam Gupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rhabdomyolysis (RML) is a pathological entity characterized by symptoms of myalgia, weakness and dark urine (which is often not present) resulting in respiratory failure and altered mental status. Laboratory testing for myoglobinuria is pathognomonic but so often not present during the time of testing that serum creatine kinase should always be sent when the diagnosis is suspected. Kidney injury from RML progresses through multiform pathways resulting in acute tubular necrosis. Early treatment (ideally<6 hoursfrom onset) is needed with volume expansion of all non-overloaded patients along with avoidance of nephrotoxins. There is insufficient data to recommend any specific fluid. The mortality rate ranges from 10% to up to 50% with severe AKI, so high index of suspicion and screening should be in care plan of seriously ill patients at risk for RML.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"90 2","pages":"61-69"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/73/umj-90-02-61.PMC8278949.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-08DOI: 10.1093/humrep/11.suppl_1.163
M. L. Moore
The prevention and clinical management of RDS are discussed in detail, of particular interest being the details of the use of Swan-Ganz catheters, anticoagulants in the management of intravascular coagulation, post end-expiratory pressure and intravenous nutrition. Not everyone will agree with the opinions expressed but their rational presentation supported by an excellent bibliography are certainly stimulating.
{"title":"REPRODUCTIVE ENDOCRINOLOGY","authors":"M. L. Moore","doi":"10.1093/humrep/11.suppl_1.163","DOIUrl":"https://doi.org/10.1093/humrep/11.suppl_1.163","url":null,"abstract":"The prevention and clinical management of RDS are discussed in detail, of particular interest being the details of the use of Swan-Ganz catheters, anticoagulants in the management of intravascular coagulation, post end-expiratory pressure and intravenous nutrition. Not everyone will agree with the opinions expressed but their rational presentation supported by an excellent bibliography are certainly stimulating.","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"47 1","pages":"99 - 99"},"PeriodicalIF":0.0,"publicationDate":"2020-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74264485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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