The Ulster medical journal最新文献

{"title":"Perceptions of resident doctors on how digital clinical decision support influences decisions on use of resources.","authors":"George West, Jonathan Foo, Dragan Ilic, Kieran Walsh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>There is a growing interest in the use of digital learning and clinical decision support (CDS) in medical education and clinical practice. However, until recently there has been little interest in the potential cost savings that could emerge from the use of digital CDS in clinical practice. This study attempted to fill this gap by asking frontline resident doctors by means of a questionnaire to what extent they value digital CDS resources as a way of saving costs.</p><p><strong>Methods: </strong>We developed a questionnaire to examine the perceptions of frontline resident doctors on CDS use. Topics explored included the use of CDS to save costs by avoiding unnecessary interventions; if and how CDS assisted with decision making, and barriers and enablers to achieving these outcomes. We emailed the questionnaire to frontline resident doctors.</p><p><strong>Results: </strong>A total of 170 resident doctors were invited to participate in the study, with 105 completing the questionnaire (response rate 62%). Resident doctors are doctors who are in postgraduate training, but who have not yet achieved consultant status. A total of 42 respondents (40%) agreed or strongly agreed that CDS helped them avoid unnecessary referrals. Overall, 32 respondents (31%) agreed or strongly agreed that using the resource helped them reduce length of stay in hospital. A total of 44 respondents (42%) agreed or strongly agreed that using the resource helped them avoid unnecessary admissions. 76 respondents (72%) agreed or strongly agreed that CDS helped them avoid unnecessary investigations or treatments.</p><p><strong>Discussion: </strong>The findings from this study show that some resident doctors can use CDS to reduce resource use. Resident doctors may find CDS a supportive tool to assist decision making and so to avoid some unnecessary tests and treatments.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217885","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}

{"title":"Excellence by Design? Resident Doctors' Perceptions of Curriculum Transition.","authors":"William McKeown, Camille Harron, Mairead Boohan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Resident doctors (RDs) transition to new training curricula on several occasions throughout their medical careers. We evaluated the perceptions of RDs who had transitioned to new training curricula.</p><p><strong>Methods: </strong>A qualitative approach was adopted to understand RDs' perceptions of curriculum transition (CT). RDs in stage two of internal medicine training (IMT) in Northern Ireland who had moved to a new training curriculum in the past 18 months were invited to participate in focus groups.</p><p><strong>Results: </strong>16 RDs participated in four focus groups. Data were transcribed and underwent thematic analysis. RDs have high levels of uncertainty about their new training curricula. CT was found to have a negative emotional impact on RDs and be influenced by individual factors. Peer support was highly valued by RDs. RD-led solutions for improving CT were identified.</p><p><strong>Conclusions: </strong>RDs are significantly impacted by CT and have valuable insights into improving the process of CT.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"82-86"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217913","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}

{"title":"A GAMECHANGER IN ORGAN TRANSPLANTATION: THE <i>SENTINEL</i> TRIAL - A VISIBLE SENTINEL FOR AN INVISIBLE THREAT.","authors":"Jamie Clements, Daniel Saleh, Andrew Fisher, Henk Giele","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"98-99"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217854","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}

{"title":"The bacteriology of fallen leaves (Phylloplane) from council parks and green spaces in Northern Ireland: Clinical significance for at risk people living with cystic fibrosis (CF).","authors":"Beverley Cherie Millar, Aliyu Ibrahim Dabai, Jonathan Stirling, Alan Murphy, Laura Jenkins, Juluri R Rao, John E Moore","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;People living with cystic fibrosis (CF) may suffer from chronic respiratory infections due to acquired environmental organisms, ultimately leading in increased morbidity and mortality. Consequently, parents of children living with CF frequently ask their CF healthcare professional about sources and potential routes of transmission of environmental organisms to their child. This allows parents to make an informed decision regarding risk assessment/risk management of outdoor/ nature-based activities. Mitigations can then be put in place to help minimise or absolutely avoid exposure of the child to these sources, thereby helping to reduce/eliminate the potential for acquisition of a respiratory infection with such environmental organisms.Northern Ireland enjoys 96,470 hectares of green spaces along with just under 2,000 miles of off-road trials. To date, there has not been any scientific reports on the microbiology of fallen leaves, which children enjoy playing with during Autumn time. The aim of this study was therefore to examine the microbiology of fallen leaves from multiple public parks and green spaces in Northern Ireland, collected at Autumn time and to correlate these organisms with the microbiology from the Northern Ireland CF paediatric population, of shared bacterial genera and species, in order to ascertain the relative clinical importance of organisms identified from leaf litter to the CF paediatric population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fallen leaves were collected from 22 public parks and greenspace sites in Northern Ireland during the Autumn 2023, which represented all 11 Council areas in Northern Ireland, with two sites per council area being sampled. Total viable counts (TVCs) were performed on each leaf litter and all organisms cultured were identified molecularly using 16S rRNA PCR and gene sequencing techniques. Direct antimicrobial susceptibility testing (DAST) of bacteria isolated from fallen leaves was determined for six antibiotics (four antibiotic classes), including the aminoglycosides, gentamicin; the fluoroquinolones, ciprofloxacin; the betalactams, ampicillin, piperacillin-tazobactam and meropenem, as well as the potentiated sulphonamides, cotrimoxazole (sulphamethoxazole & trimethoprim). Routine service microbiological records of respiratory specimens from 183 paediatric individuals with cystic fibrosis attending the Northern Ireland Paediatric Cystic Fibrosis Centre, Royal Belfast Hospital for Sick Children, Belfast Health and Social Care Trust, Belfast, were compared anonymously with organisms isolated from leaf litter. Comparisons were recorded at both genus and species levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean TVC was log 7.35 ± 0.57/g leaves (standard deviation) and ± 0.12 (standard error of mean). The median TVC was log 7.23/g leaves. Patrician Villas Play Park, Strabane had the lowest count (log 6.49/g leaves) and Wallace Park, Lisburn had the highest count (log 9.38/g","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"54-65"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217838","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}

{"title":"Investigating the Role of Tetranectin in Ischaemic Heart Disease and Heart Failure.","authors":"Alisha Bhandari, Kevin Edgar, Nadia Glezeva, Joe Gallagher, Aidonis Rammos, Mark Ledwidge, Ken McDonald, Katerina Naka, David Grieve, Chris Watson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cardiac diseases represent 32% of deaths globally1. Ischaemic heart disease (IHD) is a leading cause of heart failure (HF). Progressive fibrosis in IHD contributes to the dysfunction in HF2. Investigation of novel proteins with prior association to extracellular remodelling provide invaluable information behind the underlying pathology of cardiac disease. Tetranectin is a plasma protein previously linked to cardiac remodelling. Recent literature highlighted its potential to compete against N-Terminal pro Brain Natriuretic Peptide as a diagnostic biomarker for HF3. This study aimed to investigate whether tetranectin is protective or contributory to IHD, and its potential as a diagnostic or prognostic biomarker of acute heart failure (AHF).</p><p><strong>Methods: </strong>Environments of normoxia (21% O₂) and hypoxia (1% O₂) with cultured human cardiac fibroblasts (HCFs) were used to mimic ischaemia within the myocardium and determine the hypoxic response of tetranectin. Assessment of myocardial repair using in vivo studies of wild type and tetranectin gene knockout mice undergoing experimental myocardial infarction through coronary artery ligation surgery. Assessment of tetranectin as a biomarker in a breathless nonHF population and those with AHF was undertaken using enzyme linked immunosorbent assay assessing the ability to predict disease using plasma tetranectin levels.An illustration of the role of cardiac fibroblasts in myocardial infarction. The diagram highlights how the research was carried out an in vitro level and at an in vivo level for the purpose of clinical translation. Clinical translation of this research will aim to provide further insight into the mechanisms and effects of cardiac fibrosis due to fibroblast in the heart. The figure was created using BioRender.</p><p><strong>Conclusions: </strong>The results of this study will help clarify the attributes of tetranectin and its relationship with fibrosis and inflammation following myocardial injury. The use of plasma tetranectin may serve as a potential biomarker in HF, specifically differentiating between patients presenting with symptoms of breathlessness but have normal heart function or AHF.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"96-97"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217851","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}

{"title":"Demystifying Lyme disease.","authors":"H Blundell, E Hunter","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217857","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}

{"title":"A Test for the Profession: Medicine in Nazi Germany.","authors":"Michael Trimble","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this paper I will chart the development of the medical sub-culture within Nazi German society. I intend to show that ethical regulation provided by professional societies, state, and the legal system were inadequate and failed to prevent the atrocities perpetrated by Nazi doctors and that the acceptance of the concept of \"a life not worth living\" was a key turning point in medical culture and practice.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217877","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}

{"title":"Curiositas - O&G in the Headlines.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"100-101"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217829","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}

{"title":"Evaluating the introduction of a practical thyroid ultrasound teaching session for medical students.","authors":"Isobel Austin, Catherine Denver, Twisha Girisankar, Titus Cvasciuc, Peter Ellis, Philip C Johnston","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and aims: </strong>The use of thyroid ultrasound is gaining in popularity at postgraduate level. However, it has not been broadly incorporated into the UK undergraduate medical curriculum. Thyroid ultrasound can help augment students understanding of both anatomy and endocrinology. We aimed to embed a hands-on thyroid ultrasound practical teaching session as part of the QUB (Queen's University Belfast) 3^rd year medical students' endocrine and diabetes rotation. Students completed a questionnaire on the effectiveness of the teaching.</p><p><strong>Methods: </strong>Fifty 3^rd year medical students completed a questionnaire (15 questions) assessing various aspects of teaching effectiveness. Mean Likert scale scores ranging from 1 (very good) to 5 (very poor) were calculated for each of the questions to gauge perceptions of competence, relevance, and alignment of assessments with learning objectives. The hybrid session consisted of didactic teaching followed by a practical thyroid ultrasound hands-on session. Thyroid ultrasound was performed using a GE V-scan Air wireless handheld ultrasound.</p><p><strong>Results: </strong>Notably, students initially reported low confidence levels in their clinical knowledge of thyroid ultrasound indications (mean score: 3.10) and in using the ultrasound machine (mean score: 3.79). However, following the session, the mean confidence level in using the ultrasound machine significantly improved to 1.96. Positive scores were noted for the clarity of learning objectives (mean score: 1.50) and opportunities for practice (mean score: 1.74). Instructor competence and approachability both received relatively favourable scores (mean score: 1.65), and students felt they had sufficient opportunities to ask questions (mean score: 1.18). The course's relevance to students' future careers was also rated positively (mean score: 1.24).</p><p><strong>Summary: </strong>The introduction of a novel thyroid ultrasound practical teaching session represents an advancement in integrating ultrasound imaging techniques into undergraduate medical education. It has the potential to offer an alternative to traditional teaching methods on thyroid anatomy and pathology. Students broadly welcomed the exposure to 'hands on' ultrasound which appeared to be beneficial for their procedural skills and confidence in interpreting thyroid images.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"76-81"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217907","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}

{"title":"Challenges in Cancer Pain Assessment.","authors":"Ryan Peter McKenna","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>James Alexander Logan, a second-year medical student at the Barts and The London School of Medicine and Dentistry, died in February 2001 after a distressing illness of three months duration. His family, friends and interested professionals subsequently set up the James Logan Trust to encourage doctors and others to have the confidence to recognise and treat cancer pain. The James Logan Trust has provided funds for an annual prize for the best essay on \"The challenges of cancer pain assessment and management\" to be submitted by a Queen's University of Belfast undergraduate medical student after completion of their fourth-year palliative medicine teaching.</p>","PeriodicalId":94250,"journal":{"name":"The Ulster medical journal","volume":"95 2","pages":"92-95"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217867","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}