Staff Publication

OWEN Model Staff Bereavement Support Service (2023)

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Type of publication:

Post on the Academy of Fab NHS Stuff website

Author(s):

*Lewis, Jules; *Lock, Jules

Full text:

The OWEN Model (2022) has been created by the SWAN End of Life Care Lead Nurse Jules Lewis and SWAN Lead End of Life Care Volunteer Jules Lock. The service to deliver this staff bereavement intervention has been mapped out, please see attached poster for evidence.

O- Openness. Staff are given the time and space, to share their feelings about the death of a loved one or a patient they have cared for.

W- Wellbeing. The wellbeing of the staff is at the centre of the support we give. Signposting to other services is offered as appropriate. The needs of the staff will vary greatly.

E- Empathy. Compassion, kindness, understanding and support, are at the centre of the model. The use of appropriate and kind language is key to everything we do.

N- New Beginnings – Recognise that grief can remain with us for the rest of our lives. Enabling staff to move forward with hope, whilst never forgetting the person who has died. (SaTH 2022).

Bereavement and grief can impact all our lives at some time. The way we cope with grief and loss is unique and people will react in so many ways. There is no time scale to grief and support can be needed at many different times along that journey. Health care staff can be affected by personal grief and through their professional life. Staff who look after patients with long term conditions, will form friendships with those patients and the families. The loss of these patients can be very upsetting, and this should be factored into the care provided within a trust.

The OWEN Model offers one to one support and signposting as appropriate and ongoing peer support in the form of staff bereavement support cafes (as seen on BBC1 Extraordinary Portraits series 3 episode 4) & supported by The Good Grief Trust, help & hope in one place. Looking after our staff at the hardest of times, so they can look after others. This work is in memory of Joan Owen a kind, caring and much loved & missed lady. Thank you to Joan’s family for their support. Thank you to Penny Watson our SWAN End of Life Care Administrator who supports this work & Debbie Snooke and Miriam Gilbert both SWAN End of Life Care Specialist Nurses.

Link to Academy of Fabulous Stuff 

CT guided percutaneous lung biopsy - self-audit (2025)

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Type of publication:

Audit

Author(s):

*Abayaratne, Chulangani

Citation:

Shrewsbury and Telford Hospital NHS Trust, 2025

Abstract:

CT-guided percutaneous lung biopsy is a widely practiced interventional radiology procedure for
obtaining tissue samples from pulmonary lesions. Regular self-audit of such procedures is good
clinical practice and is recommended to ensure high diagnostic adequacy and low complication
rates, in line with national benchmarks.

In the UK, the British Thoracic Society (BTS) and the Royal College of Radiologists (RCR)
recommend regular audits to evaluate local diagnostic yield and complication rates and compare
them with national standards.

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A survey of the current state of training in inflammatory disease (IBD) surgery in the United Kingdom (UK) (2025)

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Type of publication:

Conference abstract

Author(s):

Argyriou O.; *El-Sayed C.; Drami I.; Celentano V.; Reza L.

Citation:

Colorectal Disease. Conference: 20th Scientific and Annual Conference of the European Society of Coloproctology, ESCP 2025. Paris France. 27(Supplement 1) (no pagination), 2025. Date of Publication: 01 Aug 2025.

Abstract:

Aim: Inflammatory Bowel Disease (IBD) surgery demands advanced technical skills due to the complexity and variability of procedures. High-quality training is essential, not only for the management of acute IBD-related emergencies but also for the development of a specialist IBD practice. This survey, developed by the Dukes' Club for UK colorectal surgery trainees and the IBD Subcommittee of the Association of Coloproctology of Great Britain and Ireland (ACPGBI), aims to evaluate the current state of IBD surgical training in the UK and to identify key areas and potential interventions for improvement. Method(s): An electronic survey was designed by members of the Dukes' Club executive committee and the ACPGBI IBD subcommittee, followed by dissemination via various professional networks, between September 2024 and April 2025.The survey investigated a number of key domains, including exposure to IBD procedures (routine/complex), participation in multidisciplinary team (MDT) meetings and joint surgical-gastroenterological clinics, career and fellowship intentions, as well as access to training resources. Result(s): The survey was completed by 103 participants (70% in training, 30% early years consultants).Senior trainees (ST6-ST8) represented 58.4% of the trainee participants.58.4% of trainees reported lack of exposure to IBD MDTs, with only 5.6% undertaking an active role in the MDT.Trainees reported minimal exposure to ileoanal pouch surgery and complex procedures such as strictureplasties and Kono-S anastomosis. In contrast, higher levels of exposure were noted for subtotal colectomies, ileo-caecal resections for Crohn's Disease, and IBD-related perianal fistula procedures. Conclusion(s): The survey demonstrated a lack of focus in IBD surgical training. Apart from high-quality educational activities that are delivered by the Dukes' Club and ACPGBI, a structured approach to ensure better exposure, through the training curriculum, is called for.

DOI: 10.1111/codi.70174

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Incidence and Survival Outcomes of Primary Parotid Follicular Lymphoma (PPFL): a Seer-Based Retrospective Analysis (2025)

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Type of publication:

Conference abstract

Author(s):

Backer G.; *Arunachalam J.

Citation:

HemaSphere. Conference: 30th Congress of theEuropean Hematology Association Annual Congress, EHA2025. Milan Italy. 9(Supplement 1) (pp 1214-1215), 2025. Date of Publication: 01 Jun 2025.

Abstract:

Background Primary malignant lymphomas of the parotid glands are rare, estimated to account for just 0.6% to 5% of all tumors of the parotid gland. Primary Parotid Follicular Lymphoma (PPFL) is a rare subtype of non-Hodgkin lymphoma (NHL) originating in the parotid gland, often associated with autoimmune disorders such as Sjogren's syndrome. Due to its low incidence, comprehensive population-based studies are scarce, limiting our understanding of epidemiological factors associated with PPFL and how they impact survival outcomes. Aims Using a large, population-based cancer registry, we aimed to evaluate the incidence trends and survival patterns of PPFL for the past 20 years in the US. Methods We conducted a retrospective population-based study utilizing data between 2000-2021 from the SEER (Surveillance, Epidemiology, and End Results) database. SEER is a program of the National Cancer Institute that collects epidemiological and survival data from cancer registries across the United States. We identified and extracted data from patients diagnosed with PPFL using ICD codes specific for primary tumors of the parotid gland (C07.9) and for follicular lymphoma (ICD codes 9690, 9691, 9695, 9698). Demographic data collected included year of diagnosis, age, sex, race, and area of residence. Incidence rates (IR) were calculated per 100,000 population and were age adjusted to the US standard population using SEER*stat 8.4.4. Using GraphPad Prism software, Kaplan-Meier survival analysis was done to calculate overall survival (OS) and cancer specific survival (CSS). Log rank (Mantel-Cox) test was used to compare survival outcomes between different groups. Results 793 patients with primary parotid follicular lymphoma were identified. 52% were male. 56% were older than 65 years at the time of diagnosis. 79% of patients were white, 10% were Hispanic, and 5% were black. 18% of patients had metastatic disease at initial presentation. IR was 0.050 (SE 0.002, 95% CI 0.045-0.055) for the years 2000-2010 and 0.036 (SE 0.002, 95% CI 0.032-0.040) from 2011 to 2021. Incidence was 29.7% higher in males compared to females with p = 0.0001(IR 0.048 vs 0.037, respectively). IR was 0.049 amongst white patients (SE 0.002, 95% CI 0.046 – 0.054), 0.021 amongst black patients (SE 0.003, 95% CI 0.015 – 0.029), and 0.031 amongst hispanic patients (SE 0.004, 95% CI 0.024-0.038). Patients between the ages of 75-79 years had the highest IR of 0.241 (SE 0.024, 95% CI 0.197- 0.293). Median overall survival (mOS) was 174 months. 5-year and 10-year CSS was 90% and 84%, respectively. mOS was 180 months in patients who received chemotherapy. mOS was 106 months in adults older than 65 years, compared to those younger (p<0.0001). White patients had the poorest mOS of 161 months (p=0.0042). There was no statistically significant difference in survival outcome based on gender. mOS was 109 months in patients residing in non metropolitan counties compared to mOS of 187 months in patients residing in metropolitan counties (p=0.0005). Summary/Conclusion PPFL primarily affects older adults, with high incidences in males and white patients. Though CSS rates are generally favorable, overall survival was found to be worse in white patients, adults aged > 65, and people residing in non metropolitan counties. These differences highlight potential disparities in disease outcomes and suggest the need for future research into factors influencing survival and access to care for patients with PPFL.

DOI: 10.1002/hem3.70152

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Exploring Disparities in Survival Outcomes of Primary Cardiac Diffuse Large B-Cell Lymphoma (DLBCL): a Seer Database Analysis (2025)

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Type of publication:

Conference abstract

Author(s):

Arvind S.; Shaikh G.; *Arunachalam J.; Naagendran M.S.; Meleveedu K.

Citation:

HemaSphere. Conference: 30th Congress of theEuropean Hematology Association Annual Congress, EHA2025. Milan Italy. 9(Supplement 1) (pp 3452-3453), 2025. Date of Publication: 01 Jun 2025.

Abstract:

Background Primary Cardiac Diffuse Large B-cell lymphoma (DLBCL) representing only 1.3% of cardiac tumors and 0.5% of extranodal lymphomas is an uncommon but aggressive malignancy that exclusively involves the heart or the pericardium. Favorable clinical outcomes depend on early detection and timely treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Little research currently exists on the impact of healthcare access, socioeconomic and demographic factors on survival rates in primary cardiac DLBCL. Aims This study aims to provide an overview of survival outcomes of primary cardiac DLBCL and their association with demographic and clinical factors. Methods We collected data from SEER (Surveillance, Epidemiology, and End Results), which is a program of the National Cancer Institute (NCI) with statistical information on cancer incidence and survival in the United States. From the Research plus data (17 registries, 2000 – 2021), we extracted patients diagnosed with Diffuse large B-cell lymphoma (DLBCL) using the ICD code 9680/3 and having the primary cancer site as heart using code C38.0. Analysis was stratified based on age, sex, race, marital status, median household income and residency. Survival analysis was done with Graphpad Prism software, and survival outcomes were compared using the Log-rank test. Kaplan-Meier curves were used to visualize the data. Results 134 patients with cardiac DLBCL were identified. 64% of the patient population was 65 and older at diagnosis. 56% males and 44% females. 64% White, 14% Hispanic, 5% Black. 92% of patients lived in counties in metropolitan areas with a population ranging from 250,000 to 1 million. The marital status distribution at the time of diagnosis was as follows: 18% were single (never married), 16% were widowed, 4% were divorced, 2% were separated, 0.75% were in a domestic partnership and 54.5% were married. 72% of patients received chemotherapy, and 10% received external beam radiation therapy. Median overall survival (mOS) for primary cardiac DLBCL was 42 months. Cancer-specific survival (CSS) was 130 months. mOS was 144 months in patients under 65 years, and mOS was 26 months in patients aged 65 and older with p value=0.0010 (HR 2.402, 95% CI 1.470 to 3.926). In stage I disease, mOS was 144 months in < 65 and 33.5 months in 65+ (p = 0.0157). In stage IV, mOS was only 9 months in the 65+ age group, compared to those younger with p = 0.0254. mOS were 109 months in those who were married at the time of diagnosis, compared to a mOS of 25 months in those who were not (p value = 0.0030, HR 0.4825 95% CI 0.2867 to 0.8118). No statistically significant difference was found in overall survival when stratified based on sex, race, residency or median household income. Summary/Conclusion While the median cancer-specific survival of cardiac DLBCL was excellent (~ 10 years), the median overall survival was noted to be significantly lower (3.5 years), highlighting non-cancer causes of mortality. However, our analysis shows that advanced age (>65 yrs) has a significant negative impact on survival. While marital status seemed to be associated with better survival, reflecting the role of social support during cancer care, a firm conclusion requires understanding of additional factors. Future studies should explore the factors contributing to the non-cancer causes of mortality in cardiac DLBCL and poorer survival outcomes in the elderly to assist develop strategies to improve outcomes for this subset.

DOI: 10.1002/hem3.70152

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Epidemiological and Survival Trends of Alk-Positive Large B-Cell Lymphoma: a Seer (Surveillance, Epidemiology, and End Results) Study (2025)

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Type of publication:

Conference abstract

Author(s):

*Arunachalam J.; Meleveedu K.

Citation:

HemaSphere. Conference: 30th Congress of the European Hematology Association Annual Congress, EHA2025. Milan Italy. 9(Supplement 1) (pp 1319-1321), 2025. Date of Publication: 01 Jun 2025.

Abstract:

Background Anaplastic lymphoma kinase-positive (ALK+) large B-cell lymphoma (LBCL) is a rare subtype of diffuse large B-cell lymphoma (DLBCL), representing < 1% of all DLBCLs. Tumor growth is driven by ALK gene rearrangements which lead to proto-oncogene activation. Unlike ALK-positive anaplastic large-cell lymphoma (ALCL), ALK+ LBCL shows plasmablastic immunophenotype and often lacks typical T cell (CD2, CD3) and B-cell (CD20, CD79a) markers. It is known to be more aggressive than typical DLBCL due to limited response to conventional systemic chemotherapies like R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), with a dismal 5-year OS of 8% in advanced stage disease. Off-label use of ALK inhibitors has demonstrated encouraging results in multiple case studies. Aims This study aims to analyze the incidence trends, and survival outcomes of ALK+ LBCL using the Surveillance, Epidemiology, and End Results database. SEER provides population-based data on cancer incidence, survival, and treatment outcomes by compiling various cancer registries across the U.S. Methods We conducted a retrospective population-based study between 2010-2021 utilizing the SEER database. Using ICD code 9737/3, we identified patients diagnosed with ALK+ LBCL. Demographic data, including age, sex, race, and stage, were collected. Incidence rates (IR) were calculated per 100,000 and age adjusted to the US standard population. Kaplan-Meier survival analysis was performed using GraphPad Prism to estimate overall survival (OS) and cancer specific survival (CSS). Log rank test was used to detect factors associated with survival outcomes. Results A total of 58 cases of ALK+ LBCL were included. IR was 0.0049 (SE 0.0010, 95% CI 0.0031-0.0073) during the years 2010-2015 and 0.0067 (SE 0.0011, 95% CI 0.0047-0.0094) from 2016-2021. IR was 0.0025 (SE 0.0007, 95% CI 0.0013-0.0044), 0.0035 (SE 0.0007, 95% CI 0.0022-0.0053), 0.0028 (SE 0.0008, 95% CI 0.0015-0.0049), and 0.0052 (SE 0.0015, 95%CI 0.0027-0.0091) in the age groups <20 years, 20-44 years, 45-64 years, and 65+ years respectively. Incidence rate ratio (IRR) was 4.08 (95% CI 2.08 – 7.98) when comparing males and females, indicating that incidence rate in males was 4 times higher than in females. 65% of patients presented with advanced stage disease at the time of diagnosis. Median time from diagnosis to treatment was 13 days. mOS median overall survival was 101 months. The 1-year and 10- year CSS rates were 86%, and 68% respectively. mOS was 53 months for those with advanced stage disease at initial presentation. mOS was 17 months for ages >65 years (p=0.0002), compared to those aged less than 65 years. In Ann Arbor stage I disease, mOS was 144 months in patients < 65 years and 33.5 months in 65+ age group (p = 0.0157). In Ann Arbor stage IV disease, mOS was only 9 months in 65+ age group with p value of 0.0254 when comparing with the younger age group. There was no statistically significant difference in survival outcomes based on sex, and race. Summary/Conclusion This is one of the largest retrospective studies on ALK+ LBCL. We found that incidence of anaplastic lymphoma kinase-positive large B-cell lymphoma is more common in males and adults older than 65. Survival outcomes continue to be poor, especially in older adults. Further multicenter research is warranted to explore the genomic framework and discover novel combination therapies, to improve patient outcomes.

DOI: 10.1002/hem3.70152

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Accuracy and Timeliness of Prehospital Global Triage System Protocols in Mass Disasters: A Systematic Review of Systematic Reviews (2025)

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Type of publication:

Systematic Review

Author(s):

Shaltout, Amr Essam; Elfatih Elbadri, Mohammed; Kaur, Kiranjot; Alsharif, Mohammed M; Alkhazendar, Aliaa H; *Hassouba, Omar Nasr; Ahmad, Muhammad Nabeel; Osman, Mazin; Zahid, Areeba; Banjamin, Shaun.

Citation:

Cureus. 17(9):e92796, 2025 Sep.

Abstract:

This systematic review evaluated the accuracy and timeliness of global prehospital triage systems in mass disasters, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020
guidelines. A comprehensive search of PubMed/MEDLINE, Embase, Scopus, and Cochrane Library up to June 2025 identified 344 records, of which four studies met eligibility criteria after screening and full-text assessment. Included studies analyzed conventional systems such as Simple Triage and Rapid Treatment (START), JumpSTART, Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT), and Modified Physiological Triage Tool (MPTT), as well as artificial intelligence (AI)-assisted approaches and diagnostic adjuncts like portable ultrasound. Sample sizes ranged from targeted reviews of 30-60 studies (systematic and evidence-based reviews) to practical evaluations of triage innovations involving prehospital and emergency responders. Data extraction captured accuracy, timeliness, and resource allocation, while risk of bias was assessed using the A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2) and the Scale for the Assessment of Narrative Review Articles (SANRA), with ratings ranging from low to moderate. Results demonstrated that traditional systems such as START and SALT provide rapid categorization but remain prone to over- and under-triage depending on responder training and situational factors. AI-driven models and portable diagnostic technologies significantly improved decision speed, diagnostic precision, and prioritization of life-saving interventions, reducing delays in critical care. Overall, while no single algorithm proved universally superior, integration of training, simulation-based preparedness, and emerging AI-supported tools was consistently associated with improved triage performance in chaotic, resource-limited disaster environments.

DOI: 10.7759/cureus.92796

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Microvascular Outcomes of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Type 2 Diabetes: A Systematic Review of Retinopathy and Nephropathy Evidence (2025)

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Type of publication:

Systematic Review

Author(s):

Arif, Atia; Lama, Sanu; Singla, Bhavna; Singla, Shivam; Kumawat, Sunita; Tharwani, Anusha; Usman, Muhammad; Khalid, Hamna; Kanukollu, Venkata Madusudana Rao; *Ekomwereren, Osatohanmwen; Khan, Shabir.

Citation:

Cureus. 17(9):e92976, 2025 Sep.

Abstract:

This systematic review evaluated randomized controlled trials examining the effects of glucagon-like peptide-1 (GLP-1) receptor agonists on microvascular outcomes in type 2 diabetes, focusing on diabetic retinopathy and nephropathy. Four eligible RCTs, enrolling over 27,000 patients with follow-up periods ranging from 32 weeks to 5.4 years, were included. GLP-1 receptor agonists consistently demonstrated renal protective effects, primarily driven by reductions in new or worsening nephropathy and acroalbuminuria, with more modest and inconsistent effects on estimated glomerular filtration rate (eGFR) decline. In contrast, their impact on retinopathy remained inconclusive. A transient signal of worsening retinopathy has been reported in the context of rapid glycemic improvement; however, across large outcome trials, effects on retinopathy have been inconsistent and remain inconclusive. Overall, the evidence for retinopathy risk is limited by small event numbers, heterogeneity in assessments, and exploratory analyses. The certainty of renal benefit was strengthened by rigorous trial designs and low risk of bias, whereas retinopathy outcomes were generally secondary and less robust. These findings suggest that GLP-1 receptor agonists can be prioritized for patients at high renal risk, but careful monitoring of individuals with pre-existing retinopathy remains warranted

DOI: 10.7759/cureus.92976

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Transport – Test of Change (2025)

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Type of publication:

Service improvement case study

Author(s):

*S. Fenton-Cook; *L. Brewin

Citation:

SaTH Improvement Hub, September 2025

SMART Aim:

During the week of 14th July 2025 improve patient flow, reduce failed discharges due to transport delays, improve end of day position and reduce risk of escalation in areas that normally remain closed.

Link to PDF poster