Braintree Community Hospital

Objective To evaluate the current practice of diagnosing and managing Helicobacter pylori infection in children across UK centres and compare to European and North American Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)-North American Society For Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guidelines. Design/method We conducted a retrospective, multicentre audit across nine National Health Service (NHS) trusts between April 2023 and June 2024 on stool antigen tests performed in children ≤16 years. Information collected included test indication, demographics, treatment regimens and follow-up. Practices were compared with international guideline recommendations. Further data were collected from one of the trusts with regards to symptoms when tests were performed, and primary care data were gathered from a single-practice retrospective audit. Results From over 1900 stool antigen tests, 249 (13%) were positive, with a mean age of the patients investigated of 9.6 years. Of the 249 positive tests, 209 (84%) were for initial diagnosis and 38 (15%) for eradication confirmation. Empirical eradication therapy was common; however, 88% of primary treatment and 60% of re-treatment courses deviated from ESPGHAN-NASPGHAN guidance, particularly in treatment duration. Follow-up stool antigen testing was performed in only 53% of initial diagnosis cases and 64% of eradication therapy cases, often outside the recommended timeframe. Symptom profiles varied between primary and secondary care referrals, but abdominal pain remained the most frequent indication for testing. Conclusion UK paediatric practice in managing H. pylori infection frequently diverges from international guidelines. The findings underscore the need for harmonisation of national guidance with international paediatric-specific recommendations and to improve clinician education in order to promote consistent, evidence-based care and responsible antibiotic use.

We developed and validated an abbreviated version of the Coma Recovery Scale-Revised (CRS-R), the CRS-R For Accelerated Standardized Testing (CRSR-FAST), to detect conscious awareness in patients with severe traumatic brain injury in the intensive care unit. In 45 consecutively enrolled patients, CRSR-FAST administration time was approximately one-third of the full-length CRS-R (mean [SD] 6.5 [3.3] vs 20.1 [7.2] minutes, p < 0.0001). Concurrent validity (simple kappa 0.68), test-retest (Mak's ρ = 0.76), and interrater (Mak's ρ = 0.91) reliability were substantial. Sensitivity, specificity, and accuracy for detecting consciousness were 81%, 89%, and 84%, respectively. The CRSR-FAST facilitates serial assessment of consciousness, which is essential for diagnostic and prognostic accuracy. ANN NEUROL 2023;94:919-924.

AimTo evaluate healthcare provider awareness and uptake of the Centers for Medicare & Medicaid Services (CMS) billing for coronavirus disease 2019 (COVID‐19) prevention counselling and the delivery of prevention counselling to patients awaiting severe acute respiratory syndrome coronavirus 2 test results.DesignCross sectional survey of US‐based healthcare providers in February 2021.MethodsAnalysis of associations with healthcare provider‐reported awareness of CMS prevention counselling guidance and billing with provider type, specialty, and work setting.ResultsA total of 1919 healthcare providers responded to the survey. Overall, 38% (726/1919) of providers reported awareness of available CMS reimbursement for COVID‐19 patient counselling and 29% (465/1614) of CMS billing‐eligible providers reported billing for this counselling. Among physicians, those aware of CMS guidance were significantly more likely to bill (58%) versus those unaware (10%). Among RNSights respondents eligible for CMS billing (n = 114), 31% of those aware of the guidance reported billing as compared to 0% of those not aware.

"Taranto and Naval Air Warfare in the Mediterranean, 1940–1945." The Mariner's Mirror, 107(2), pp. 252–253

Collaboration is fundamental to our society, but how should we best build teamsƒ We investigate by applying optimisation to an agent-based model of collaboration. The model takes inspiration from particle swarm optimisation, abstracting a shared goal as a shared optimisation task, and modelling the personality differences in team members as strategies for moving within, interpreting and sharing information about the solution space. We update the model and add a genetic algorithm in order to investigate the effects of differing initial ideas within teams of different personality combinations as they attempt to collaborate to achieve their shared task. We run experiments on homogeneous teams with similar personalities and heterogeneous teams with random personalities and find that increased diversity in team members’ initial ideas significantly improves teamwork, and more so for teams comprising individuals with similar personalities.

Change is inevitable in this fast-moving world. As the environment and people’s needs continuously change, so must the project. In our previous work, we developed an agent-based model of human coll...