Health Education England

With more patients now consulting with non-GPs there is a strong rationale for enabling non-medically qualified (NMQ) clinicians to request CXR in accordance with National Institute for Health and Care Excellence guidance.However, wider uptake requires reducing bureaucratic barriers and provision of access to proportionate and relevant IR(ME)R training.

The aim of the study was to comprehensively characterize the population of hypertrophic cardiomyopathy (HCM) patients in Poland in 2016-2021, including the analysis of annual incidence, prevalence, comorbidities, and therapeutic paths. A population-based cross-sectional study was conducted using data from the Polish National Health Fund database. The analysis included a registered annual incidence and prevalence rates, mortality, prognosis, and data on patients pathways in the healthcare system. In 2016, the registered annual incidence of HCM diagnosis in Poland was 1,494 cases (3.89/100,000), decreasing to 808 cases (2.11/100,000) in 2021. Despite the decline in new diagnoses, the registered prevalence of HCM increased from 13,271 cases (34.53/100,000) in 2016 to 13,880 cases (36.23/100,000) in 2021, indicating improved patient survival. Annual mortality rose from 824 deaths (2.14/100,000) in 2016 to 1,022 deaths (2.67/100,000) in 2021, with the highest mortality observed in older adults (60+ years). The study highlights significant underdiagnosis of HCM in Poland. Mortality in HCM population remains high, underscoring the need for improvement in earlier detection and comprehensive care strategies in Polish healthcare system.

Abstract Introduction: Cone Beam CT (CBCT) imaging is used for accurate patient positioning in radiotherapy; however, excess frame acquisition increases the patient dose from the imaging procedure unnecessarily. Previous investigations identified that breast imaging was most affected by excessive frames. Methods: Comparing all protocols, a modification was introduced to adjust the gantry start angle ± 5 degrees to ensure acquisitions commenced after acceleration, which aimed to reduce static frames and minimise unnecessary dose. Results: The protocol optimisation reduced the acquired frames by an average of 7 across Left and Right Breast Fast protocols and lowered delivered mAs by up to 4%. Using PCXMC simulation, the effective dose decreased from 3·0 to 2·8 mSv for the Left Breast protocol and from 2·9 to 2·8 mSv for the Right Breast, which is equivalent to 14 and 7 chest X-rays, respectively. Image quality metrics from the Catphan 503 phantom showed minimal changes in uniformity and contrast. Conclusion: The optimisation technique reduced excess CBCT frame acquisition and dose while maintaining image quality. The maximum deviations above tolerance reduced substantially from 16·1 to 8·5% for the Left Breast Fast S20 protocol and from18·6% to 12·1% for the Right Breast Fast S20 protocol.

This study aims to examine the effect of plyometric training on leg muscle strength, kicking speed, and agility of pencak silat athletes. The background of this study is based on the need to improve athlete performance through effective training methods. Plyometric training is known for its explosive movements that can increase muscle strength and speed. This research method involved a sample of pencak silat athletes who underwent a plyometric training program for eight weeks. Leg muscle strength measurements were carried out using a vertical jump test, kicking speed was assessed based on the number of kicks per minute, and agility was evaluated through a shuttle run test. The results showed a significant increase in both performance metrics. After eight weeks, there was a significant increase in leg muscle strength as measured by vertical jump height (sig = 0.001). In addition, kicking speed also increased significantly in the right leg (sig = 0.001) and left leg (sig = 0.041), as seen from the higher number of kicks per minute. However, athlete agility showed no significant improvement (sig = 0.71). Based on the results of special agility training. In conclusion, plyometric training has been shown to be an effective training method to improve key athletic attributes in pencak silat athletes. These significant increases in leg muscle strength, kicking speed, and agility contributed to improvements in the athletes’ overall performance. These findings emphasize the importance of incorporating plyometric training into the routine training regimen of martial arts athletes to achieve optimal athletic development and better competitive performance.

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 present the case of a 44-year-old male patient with a known history of pyloric stricture secondary to peptic ulcer disease who was admitted with quadriparesis, vomiting, and chest pain. He had a background of multiple endoscopic dilatations for gastric outlet obstruction and was severely malnourished at presentation. Clinical findings included markedly low serum potassium, phosphate, and magnesium, elevated creatine kinase, and ECG changes suggestive of myocardial strain. High-sensitivity troponin was also elevated, prompting evaluation for acute coronary syndrome and aortic dissection. Imaging ruled out structural cardiovascular pathology, and a diagnosis of type 2 myocardial infarction was made, likely secondary to electrolyte imbalance and volume depletion.Despite correction of electrolyte abnormalities, the patient’s neuromuscular weakness persisted, prompting neurologic evaluation and spinal imaging to exclude Guillain-Barré Syndrome and compressive pathology. MRI spine was unremarkable. Over the course of his intensive care admission, the patient received central electrolyte replacement, cautious nutritional rehabilitation, and multidisciplinary input from neurology, cardiology, gastroenterology, and dietetics. As electrolyte levels improved, so did his neurological function, and he regained significant muscle strength.He was subsequently transferred to the gastroenterology ward, where further endoscopic assessment confirmed ongoing pyloric narrowing. Given his history of multiple unsuccessful dilatations and persistent symptoms, he was referred to surgical services for consideration of a definitive gastrojejunostomy.This case highlights the importance of considering gastrointestinal causes of profound electrolyte disturbances and the potential for these metabolic abnormalities to mimic primary neuromuscular or cardiac pathologies. It also underscores the critical role of multidisciplinary collaboration in managing complex cases involving metabolic, nutritional, and functional decline. Early recognition and a systematic approach to diagnosis and treatment can prevent complications, improve outcomes, and avoid unnecessary interventions.

Non-muscle-invasive bladder cancers (NMIBC) are a heterogeneous subclass of bladder cancers consisting of carcinoma in situ, stage Ta disease, and stage T1 disease. Despite treatment by tumor resection, they have a high rate of recurrence and progression, which present unique management challenges. This scoping review discusses the management of NMIBC, including risk stratification, intravesical therapy, surveillance protocols, and developing treatments. A systematic search in different databases (PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science) was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Publications in English, from January 2010 to April 2025, were included. The final search was conducted on May 5, 2025. A total of 16 studies that met our inclusion criteria were reviewed. Different themes emerged, which include risk stratification and diagnosis, tumor resection, intravesical therapy, surveillance and follow-up, patient factors, and novel therapies. Substantial differences were found in clinical practice. Immediate postoperative chemotherapy was not adequately used, and the schedules of surveillance varied. Newer therapies, such as immune checkpoint inhibitors and novel intravesical agents, are promising. The role of enhanced cystoscopy and urinary biomarkers is also increasing for non-invasive disease monitoring. Despite this advancement, therapy standardization or a patient-centered view is still lacking. This review highlights the need for harmonized guidelines, wider access to innovative therapies, and collaborative research to improve outcomes in patients living with NMIBC.

ABSTRACT Background Professional Identity (PI) significantly influences how Healthcare Science (HCS) professionals perceive their roles and contributions within the NHS. Strong PI is closely linked to improved collaboration, resilience and patient care, yet research on PI among HCS professionals has been limited. Objectives This study aimed to investigate how HCS professionals in NHS Wales perceive their PI and identify factors that shape and support PI. Methods A mixed-methods approach was employed. 263 participants answered an initial survey and a further 42 participants attended focus groups to discuss attitudes and experiences in greater depth. Results Key findings highlight the essential role of professional recognition, the impact of professional bodies, the importance of language and the influence of mentorship and team culture in shaping PI. Conclusions The findings support recommendations for enhanced involvement of professional bodies, strategic changes in language and terminology, promotion of professional diversity and the development of robust mentorship and local leadership networks. KEY MESSAGES What is Already Known on This Topic? Healthcare science (HCS) professionals account for approximately 7% of the NHS Wales workforce. These professionals are essential to diagnostic services, patient care, quality management and leadership within the NHS. Previous research has found that professional identity (PI) is closely associated with enhanced job satisfaction, effective interprofessional collaboration, professional resilience and successful career progression. The literature also identifies the positive influence of professional recognition, regulatory structures, mentorship and research activities on PI. However, identity research with HCS professionals is limited, with HCS professionals continuing to experience limited visibility and challenges related to professional status and belonging. What this Study Adds This study fills a crucial gap in the research on PI among HCS professionals. While previous literature established the general importance of PI for job satisfaction, collaboration, and career progression, identity research specific to HCS professionals has been limited, with many facing challenges around visibility, status and belonging. By addressing the specific experiences and needs of HCS professionals, this research advances understanding of PI beyond broader healthcare contexts and acknowledges the challenges faced by smaller workforce groups who often feel underrepresented and overlooked. How this Study Might Affect Research, Practice or Policy The findings of this research offer practical directions for enhancing PI among HCS professionals. Strengthening links with professional bodies, revising language to better reflect the diversity and expertise of HCS roles, and building robust mentorship and leadership structures are likely to improve job satisfaction, multidisciplinary work and patient outcomes. Resulting actions have already been incorporated into the workplan for the national HCS workforce transformation programme (the ‘HCS Programme’) in NHS Wales.