The Channel Islands are a small archipelago of British dependencies just off the coast of Normandy at the western end of the English Channel. There were only three records for stygobitic Crustacea [Niphargus fontanus Bate, 1859 and N. kochianus Bate, 1859 from Jersey...
Atrial fibrillation prevalence and predictors in patients with diabetes: a cross-sectional screening study
Prevalence of atrial fibrillation (AF) and diabetes is increasing worldwide. Diabetes is a risk factor for AF and both increase stroke risk. Previous AF screening studies have recruited highrisk patient groups, but not with diabetes as the target group. This study...
Improving fracture detection in the Emergency Department: A pilot study of participation and accuracy in radiographer preliminary clinical evaluation
Introduction: Missed fractures in the Emergency Department (ED) can lead to delayed treatment and patient harm. Radiographer preliminary clinical evaluation (PCE) aims to support referrers when interpreting radiographs in the absence of a definitive clinical report. This pre-implementation study evaluated radiographer participation and diagnostic accuracy in a department without an existing radiographer abnormality detection system. Methods: A prospective service evaluation study was conducted in a general hospital. Radiographers were asked to provide PCE for consecutive ED musculoskeletal trauma radiographs. Participation was recorded. PCEs were compared with the clinical report, and sensitivity, specificity and accuracy were calculated with 95% confidence intervals. Accuracy was evaluated against a fixed performance standard using a non- inferiority test. Differences in proportions between the first and second halves of the study period, in participation and accuracy, were assessed using z-tests. Results: Of 937 eligible examinations, 412 contained a PCE comment (44.0% participation), increasing significantly from 39.3% (182/463) in the first half of the study period to 48.5% (230/474) in the second half (p = 0.0045). After exclusions, 369 PCEs were analysed. Sensitivity, specificity and accuracy were 80.2%, 94.2% and 89.3%, respectively. The lower bound of the accuracy confidence interval (85.7%) exceeded the non-inferiority margin (82% accuracy), confirming PCE accuracy was statistically non inferior to the 92% benchmark. Median time from examination attendance to PCE entry was 12 min. Conclusion: Radiographers provided timely, accurate PCEs, achieving performance comparable with published standards, demonstrating the feasibility of implementing a PCE service. Implications for practice: This study contributes to the evidence supporting PCE in departments without a 24-h hot- reporting service. Even without a dedicated training package, radiographers performed well, but this study emphasises that sensitivity remains a key area for further improvement.
A Clinical Audit of compliance with NICE NG50: NICE Guidance NG50, recommendations for assessing liver fibrosis and cirrhosis in the Jersey Alcohol Pathway Team.
Background: Alcohol use, alongside viral hepatitis and obesity, are leading causes of liver disease. Progression of alcoholic liver disease (ALD) is associated with cirrhosis, hepatic failure, hepatocellular carcinoma, and increased mortality. In 2022, there were 5,776 premature deaths attributed to ALD in the UK. NICE guidance NG50 recommends the use of transient elastography (TE) to assess liver fibrosis and detect cirrhosis in individuals who consume alcohol at harmful levels for several months, enabling early detection. This is particularly relevant for the UK and Jersey populations where hazardous and harmful patterns of alcoholconsumption are prevalent. The early identification of liver disease offers an opportunity for timely intervention and improved clinical outcomes. Aims: This study aims to explore whether patients accessing the Jersey Alcohol Pathway Team (APT) within the Alcohol and Drugs Service (A&D) are appropriately referred for TE in line with NICE NG50 recommendations. Project design: This study constitutes a clinical audit using a etrospective observational methodology. The study uses a total population sampling approach, looking at a sample of 50 patient records, of referrals received by the A&D service in the year of 2025. Findings: The audit revealed that although most individuals presented AUDIT scores between 20-25 and reported prolonged alcohol consumption at harmful levels, there was a low level of documented diagnoses of ALD and a limited number of referrals for TE assessment. Conclusion: The findings suggest suboptimal adherence to NICE Guidance NG50 within the Jersey APT. Furthermore, despite existing evidence of ALD on abdominal ultrasound, documented diagnoses of ALD were limited. To address this gap, the implementation of an Advanced Clinical Practitioner (ACP) led service for the diagnosis and management of ALD and Alcohol use disorders (AUD) is proposed to improve guideline compliance and patient outcomes.
A Clinical Audit of compliance with NICE NG50: NICE Guidance NG50, recommendations for assessing liver fibrosis and cirrhosis in the Jersey Alcohol Pathway Team.
Background: Alcohol use, alongside viral hepatitis and obesity, are leading causes of liver disease. Progression of alcoholic liver disease (ALD) is associated with cirrhosis, hepatic failure, hepatocellular carcinoma, and increased mortality. In 2022, there were 5,776 premature deaths attributed to ALD in the UK. NICE guidance NG50 recommends the use of transient elastography (TE) to assess liver fibrosis and detect cirrhosis in individuals who consume alcohol at harmful levels for several months, enabling early detection. This is particularly relevant for the UK and Jersey populations where hazardous and harmful patterns of alcoholconsumption are prevalent. The early identification of liver disease offers an opportunity for timely intervention and improved clinical outcomes. Aims: This study aims to explore whether patients accessing the Jersey Alcohol Pathway Team (APT) within the Alcohol and Drugs Service (A&D) are appropriately referred for TE in line with NICE NG50 recommendations. Project design: This study constitutes a clinical audit using a etrospective observational methodology. The study uses a total population sampling approach, looking at a sample of 50 patient records, of referrals received by the A&D service in the year of 2025. Findings: The audit revealed that although most individuals presented AUDIT scores between 20-25 and reported prolonged alcohol consumption at harmful levels, there was a low level of documented diagnoses of ALD and a limited number of referrals for TE assessment. Conclusion: The findings suggest suboptimal adherence to NICE Guidance NG50 within the Jersey APT. Furthermore, despite existing evidence of ALD on abdominal ultrasound, documented diagnoses of ALD were limited. To address this gap, the implementation of an Advanced Clinical Practitioner (ACP) led service for the diagnosis and management of ALD and Alcohol use disorders (AUD) is proposed to improve guideline compliance and patient outcomes.
Full mindfulness-teacher training pathway and courses on pain management programmes: why it mayall be worth it
provide full 8-week mindfulness courses within a multidisciplinary secondary outpatient pain management and rehabilitation service. We will also reflect on how we have grown to align to these high standards of training for There is a growing appetite for the provision of mindfulness training in order for staff to deliver mindfulness teaching on Pain Management Programmes (PMPs). With this, there is also a debate around what should be the minimum required standards for training pain management staff to teach mindfulness. In addition, the recent guidance on chronic primary pain made recommendations for more research into both the clinical effectiveness and cost-effectiveness of mindfulness. In this article, we will share our experience from our ongoing audit of clinical outcomes of having various members of our multidisciplinary team (MDT) trained in the necessary competences to provide full 8-week mindfulness courses within a multidisciplinary secondary outpatient pain management and rehabilitation service. We will also reflect on how we have grown to align to these high standards of training for PMP staff wishing to teach mindfulness, bearing in mind that they are believed to be the good practice standards required by most registered mindfulness teachers and supervisors.