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Article ; Online: The 'take-5 theatre brief': Group mindfulness practice for operating theatre teams.

Schuster-Bruce, James / Crossley, Eleanor / Peters, David / Sathyanath, Ananth / Rajasingam, Daghni / Shylaja, Venu / Syed, Irfan / Lakhani, Raj

The clinical teacher

2024 , Page(s) e13735

Abstract: Background: A surgical team works in a high-performance environment and is exposed to stress. Mindfulness practice is evidenced to reduce symptoms of stress, as well as burnout, which is high amongst health workers. The operating theatre is unique, with ...

Abstract	Background: A surgical team works in a high-performance environment and is exposed to stress. Mindfulness practice is evidenced to reduce symptoms of stress, as well as burnout, which is high amongst health workers. The operating theatre is unique, with many job-roles, needs and time-critical tasks. It is plausible that group mindfulness may benefit the surgical team. This evaluates the take-5 theatre brief, consisting of a 'check-in' and short breathwork, when used by two surgical teams as part of the regular theatre team brief. Approach: The take-5 theatre brief was evaluated using domains of acceptability and implementation. Data were collected at two district general hospitals in the United Kingdom using 5-point Likert scales hosted on electronic surveys Thematic analysis was performed of participant voice notes, strategic meeting notes and transcripts of interviews between key informants. Evaluation: There were 17 participants. Ten were from site A (59%), with the remainder being from site B (41%) and covered a range of roles within the theatre team. Participants found the take-5 theatre brief helpful (median Likert 5) and felt that it would benefit themselves (median Likert 5) as well as the team (median Likert 5) and that it fitted into the day easily (median Likert 4). There was a high demand, no financial investment was required and overall it was easy to implement; however, it became challenged in theatre lists that were late to start. Implication: The take-5 theatre brief is an acceptable initiative for these two operating theatre teams.
Language	English
Publishing date	2024-01-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2151518-9
ISSN	1743-498X ; 1743-4971
ISSN (online)	1743-498X
ISSN	1743-4971
DOI	10.1111/tct.13735
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Article ; Online: A high-definition, low cost endoscope to video record head and neck surgery- our experience.

Schuster-Bruce, James / Spiteri, Marija / Mistry, Rakesh / Ofo, Enyi

Journal of visual communication in medicine

2021 Volume 45, Issue 1, Page(s) 2–5

Abstract: Head and neck surgery is a challenging speciality to video-record due to its open, small and sometimes deep operative field. Consequently current commercial technologies yield a high financial cost. This study explores how a low-cost, commercially ... ...

Abstract	Head and neck surgery is a challenging speciality to video-record due to its open, small and sometimes deep operative field. Consequently current commercial technologies yield a high financial cost. This study explores how a low-cost, commercially available endoscope, called a borescope, may be used to overcome these challenges. It was hypothesised that due to its size, versatility and low-cost, it may be an accessible tool to circumnavigate the pitfalls of previously trialled recording devices. We report two cases in which a borescope was used intra-operatively. We found that the borescope can capture images suitable for teaching and training purposes but not when mounted as a headcam. As such the borescope is unable to provide a surgeons point of view.
MeSH term(s)	Endoscopes ; Humans ; Surgeons ; Video Recording
Language	English
Publishing date	2021-12-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2195926-2
ISSN	1745-3062 ; 1745-3054
ISSN (online)	1745-3062
ISSN	1745-3054
DOI	10.1080/17453054.2021.2008231
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Article: Coblation debulking of a paediatric laryngeal plexiform neurofibroma: a pragmatic response to a rare tumour.

Schuster-Bruce, James / Kelly, Mairead / Bernic, Ana / Brar, Sabrina / Barber, Joy / Modayil, Prince

Journal of surgical case reports

2022 Volume 2022, Issue 1, Page(s) rjab646

Abstract: Laryngeal neurofibroma is a rare but important differential diagnosis in a patient presenting with stridor. In paediatric patients, these lesions present a management conundrum: complete surgical resection is the established treatment of choice, but an ... ...

Abstract	Laryngeal neurofibroma is a rare but important differential diagnosis in a patient presenting with stridor. In paediatric patients, these lesions present a management conundrum: complete surgical resection is the established treatment of choice, but an aggressive approach can be detrimental to developing anatomy. We report the case of a plexiform neurofibroma affecting the right hemilarynx of a 3-year-old boy. Endoscopy revealed a large tumour, involving the right aryepiglottic fold and extending into the piriform sinus, ventricle and the false cord. Given the patient's young age and the challenging tumour location, the lesion was debulked, rather than resected, using coblation (low-temperature plasma radiofrequency ablation). At 30 months follow-up, the neurofibroma has mildly increased in size-in line with expectations that these lesions exhibit slow growth throughout childhood-but there are no significant respiratory symptoms and there is no functional impairment.
Language	English
Publishing date	2022-01-26
Publishing country	England
Document type	Case Reports
ZDB-ID	2580919-2
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjab646
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Article ; Online: A systematic review of endotracheal stenting in patients with locally advanced thyroid cancer.

Schuster-Bruce, James / Sargent, Pippa / Madden, Brendan / Ofo, Enyinnaya / Allin, David

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

2022 Volume 47, Issue 3, Page(s) 414–423

Abstract: Objective: Locally aggressive thyroid cancer can result in airway obstruction secondary to tracheal compression or vocal cord palsy. A tracheal stent provides an alternative to surgical resection, tracheostomy or conservative management in patients with ...

Abstract	Objective: Locally aggressive thyroid cancer can result in airway obstruction secondary to tracheal compression or vocal cord palsy. A tracheal stent provides an alternative to surgical resection, tracheostomy or conservative management in patients with compressive symptoms. This systematic review synthesises the current evidence associated with tracheal stenting in locally advanced thyroid cancer. Design, setting and participants: We conducted a systematic review of tracheal stenting in locally advanced thyroid cancers. We searched MEDLINE, Embase and Web of Science for studies until 22 September 2020. Inclusion criteria were studies involving patients who had received tracheal stents to treat laryngotracheal stenosis secondary to locally advanced thyroid cancer. Single case reports or single cases were not included. Main outcome measures: We assessed studies for data on the performance of tracheal stenting; defined as symptomatic relief, spirometry data, complication rates and mortality. We also extracted data pertaining to the use of different types of stent. Results: We identified eight full-text articles from 325 titles found in our search. These were all single-centre retrospective studies that lacked homogeneity of thyroid cancer histotypes. The number of patients in each study ranged from 4 to 35 patients. Stenting improved performance status (two of two studies), symptoms (five of five studies) and spirometry (two of three studies). The most common complications were tracheal granulation, tumour overgrowth, stent migration and sputum retention. Conclusion: There is a lack of evidence in the literature of tracheal stents in locally advanced thyroid cancer. However, the evidence available suggests tracheal stenting may be a useful treatment adjunct in advanced thyroid cancer-causing symptomatic airway obstruction.
MeSH term(s)	Airway Obstruction/complications ; Airway Obstruction/surgery ; Humans ; Retrospective Studies ; Stents/adverse effects ; Thyroid Neoplasms/complications ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/surgery ; Tracheal Stenosis/etiology ; Tracheal Stenosis/surgery ; Treatment Outcome
Language	English
Publishing date	2022-04-05
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2205891-6
ISSN	1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
ISSN (online)	1749-4486
ISSN	1749-4478 ; 0307-7772 ; 1365-2273
DOI	10.1111/coa.13923
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Article ; Online: Understanding the role of Foundation doctors through a self-reported time-mapping pilot study.

Schuster-Bruce, James / Lingam, Gita / Love, Ryan Laurence / Kerstein, Ryan

Postgraduate medical journal

2020 Volume 96, Issue 1136, Page(s) 316–320

Abstract: Introduction: There is a reduction in Foundation trainee applications to speciality training and this is attributed to an administrative job role, with subsequent fears of burnout. This pilot study presents the findings of a real-time self-reporting ... ...

Abstract	Introduction: There is a reduction in Foundation trainee applications to speciality training and this is attributed to an administrative job role, with subsequent fears of burnout. This pilot study presents the findings of a real-time self-reporting tool to map a group of Foundation doctors' elective activities. Self-reporting is efficient, low cost to run and allows for repeated measures and scalability. It aimed to example how a time-map could be used by departments to address any work imbalances and improve both well-being and future workforce planning. Method: Foundation doctors', at a busy District General Hospital, were asked to contemporaneously report their work activities over an 'elective' day. Outcomes measures included the mean duration per task and the time of day these were performed. Results: Nine Foundation doctors' returned 26 timesheet days. Foundation doctors' time was split between direct patient tasks (18.2%, 106.8 min per day), indirect patient tasks (72.9%, 428.6 min per day) and personal or non-patient activities. Indirect tasks were the most frequent reason for Foundation doctors leaving late. No clinical experience was recorded at all and only an average of 4% (23.4 min per day) of a Foundation doctors' time was spent in theatre. Conclusions: This particular cohort performed a high proportion of indirect tasks. These have been associated with burnout. Time-mapping is a low-cost, acceptable and seemingly scalable way to elucidate a clearer understanding of the type of activities Foundation doctors may perform. This methodology could be used to modernise the traditional Foundation doctor job description.
MeSH term(s)	Burnout, Professional/prevention & control ; Burnout, Professional/psychology ; Female ; Hospital-Physician Relations ; Hospitals, General/organization & administration ; Humans ; Male ; Medical Staff, Hospital/education ; Medical Staff, Hospital/organization & administration ; Medical Staff, Hospital/psychology ; Outcome Assessment, Health Care ; Patient Care/methods ; Patient Care/statistics & numerical data ; Personnel Administration, Hospital/methods ; Personnel Staffing and Scheduling ; Pilot Projects ; Self Report ; Surgery Department, Hospital/organization & administration ; Task Performance and Analysis ; Teaching/organization & administration ; Teaching/standards ; United Kingdom ; Workload
Language	English
Publishing date	2020-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2020-137506
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Article: Unilateral nasal obstruction: a rare presentation of acute myeloid leukaemia.

Kelly, Mairead / Advani, Rajeev / Schuster-Bruce, James / Crossley, Eleanor / Lakhani, Raj

Journal of surgical case reports

2021 Volume 2021, Issue 12, Page(s) rjab581

Abstract: Myeloid sarcoma, and, with it, Acute Myeloid Leukaemia (AML), is a rare but important differential diagnosis in the consideration of unilateral nasal blockage. These lesions are often misdiagnosed as lymphoma or poorly differentiated carcinoma. We report ...

Abstract	Myeloid sarcoma, and, with it, Acute Myeloid Leukaemia (AML), is a rare but important differential diagnosis in the consideration of unilateral nasal blockage. These lesions are often misdiagnosed as lymphoma or poorly differentiated carcinoma. We report the case of a patient with unilateral nasal blockage who underwent Endoscopic Sinus Surgery and biopsy. Histology revealed myeloid sarcoma and she was diagnosed with AML. Genetic testing could not be fully undertaken as the biopsy samples were preserved in formalin, which can degrade the quality of the DNA required for the more sensitive fms-like tyrosine kinase 3-internal tandem duplication (FLT3 ITD) test. Given that these levels have a significant impact on treatment decisions, a further biopsy, preserved in saline, was required. This case exemplifies the need for Ear, Nose and Throat clinicians to have a high index of suspicion for this lesion, and a working knowledge of the testing requirements for samples taken.
Language	English
Publishing date	2021-12-28
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjab581
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Article ; Online: Trends in neck of femur fracture incidence in EU15+ Countries from 1990-2017.

Sugand, Kapil / Ali, Ramla / Goodall, Richard / Salciccioli, Justin / Marshall, Dominic / Schuster-Bruce, James / Abdul-Jabar, Hani B / Shalhoub, Joseph

Injury

2022 Volume 54, Issue 2, Page(s) 645–651

Abstract: Background: Neck of femur fractures (NOFF) pose significant socio-economic costs to society with a high degree of morbidity and mortality. Its incidence rate has been collated within the Global Burden of Disease (GBD) database; however, to date, no ... ...

Abstract	Background: Neck of femur fractures (NOFF) pose significant socio-economic costs to society with a high degree of morbidity and mortality. Its incidence rate has been collated within the Global Burden of Disease (GBD) database; however, to date, no comparison across countries has been reported. Methods: NOFF age-standardised incidence rates (ASIR) per 100,000 population were extracted from the GBD database for European Union (EU) 15+ countries over the period 1990 to 2017. Joinpoint regression analysis of the data identified trends in ASIR and associated estimated annual percentage changes (EAPC). These were analysed by specified timeframe, country and gender. Results: Of the 19 EU15+ countries, 11 (58%) had overall increases in NOFF ASIRs in 2017 compared to 1990. The median ASIRs were 240/100,000 and 322/100,000 for males and females, respectively, in 1990. By 2017, this had increased to 259/100,000 and 325/100,000, respectively. Females consistently had relatively higher NOFF ASIRs with a median gender fracture gap of 62/100,000 in 2017. Males had a higher percentage change in increasing ASIRs, with a smaller percentage change in decreasing ASIRs for all included countries. The highest national ASIRs was observed in Australia, followed by Finland and Belgium. Conversely the Mediterranean countries demonstrated the lowest ASIRs, closely followed by the USA. Conclusion: Despite significant advances in primary and secondary hip fracture prevention strategies over the 28-year study period, significant increases in NOFF ASIRs among most EU15+ countries were observed, especially with respect to gender.
MeSH term(s)	Male ; Female ; Humans ; Incidence ; Belgium ; European Union ; Hip Fractures ; Femoral Neck Fractures/epidemiology
Language	English
Publishing date	2022-11-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2022.11.038
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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: A Comparison of the Burden of Thyroid Cancer Among the European Union 15+ Countries, 1990-2019: Estimates From the Global Burden of Disease Study.

Schuster-Bruce, James / Jani, Chinmay / Goodall, Richard / Kim, Dae / Hughes, William / Salciccioli, Justin D / Marshall, Dominic / Shalhoub, Joseph

JAMA otolaryngology-- head & neck surgery

2022 Volume 148, Issue 4, Page(s) 350–359

Abstract: Importance: The global incidence of thyroid cancer has been increasing rapidly, and this increase has had an attendant burden on health systems. However, it is unclear how the burden of this disease differs among the pre-2004 countries of the European ... ...

Abstract	Importance: The global incidence of thyroid cancer has been increasing rapidly, and this increase has had an attendant burden on health systems. However, it is unclear how the burden of this disease differs among the pre-2004 countries of the European Union (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the UK), US, Australia, Canada, and Norway (EU15+). Objective: To assess the trends in mortality, incidence, and disability-adjusted life-years (DALYs) associated with thyroid cancer between 1990 and 2019 in EU15+ nations. Data analysis was conducted from July 11 to October 11, 2021. Design, setting, and participants: Observational cross-sectional analysis of the incidence of thyroid cancer was conducted using data obtained from the Global Burden of Disease Study database. Nineteen countries of the EU15+ were included. Exposures: Thyroid cancer. Main outcomes and measures: Age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs) and DALYs were extracted for individual EU15+ countries per sex for each of the years from 1990 to 2019, and mortality-to-incidence indexes were computed. Joinpoint regression analysis was used to describe the trends. Results: Thirteen of 19 countries (68%) showed an average annual percentage change increase in ASIR across the study period (range, 0.2%-2.5%). Joinpoint regression analysis revealed largely plateauing ASIR trends in recent years across most EU15+ nations since 1990. Between 2011 and 2019, the estimated annual percentage change in the US was 0. Australia, Denmark, and the US were the only countries with increasing ASMR trends with positive average annual percentage changes: Australia, 0.6 (95% CI, 0.2-1.0); Denmark, 1.0 (95% CI, 0.8-1.3); and US, 0.4 (95% CI, 0.4-0.5); the remaining 16 countries showed negative trends (range, -0.2 to -2.1). Disability-adjusted life-years decreased in all EU15+ countries except Australia, Denmark, and the US. Conclusions and relevance: This cross-sectional analysis found that overall, the burden of thyroid cancer across EU15+ countries appears to be decreasing, evidenced by plateauing incidence rates and reductions in mortality and DALYs over the 30-year study period. However, the US and Australia appear to have increasing ASMR and DALY trends. Ongoing observation is required to monitor how changes in international clinical practice guidelines affect thyroid cancer DALYs and mortality.
MeSH term(s)	Cross-Sectional Studies ; European Union ; Global Burden of Disease ; Global Health ; Humans ; Incidence ; Quality-Adjusted Life Years ; Thyroid Neoplasms/epidemiology
Language	English
Publishing date	2022-03-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2021.4549
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Article ; Online: A letter in response to the article entitled 'Utility of a smartphone-enabled otoscope in the instruction of otoscopy and middle ear anatomy'.

Schuster-Bruce, James / Davies, Angharad / Conchie, Henry / Shamil, Eamon / Waddell, Angus

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

2020 Volume 277, Issue 5, Page(s) 1551–1552

MeSH term(s)	Ear, Middle ; Otolaryngology ; Otoscopes ; Otoscopy ; Smartphone
Language	English
Publishing date	2020-01-07
Publishing country	Germany
Document type	Letter ; Comment
ZDB-ID	1017359-6
ISSN	1434-4726 ; 0937-4477
ISSN (online)	1434-4726
ISSN	0937-4477
DOI	10.1007/s00405-019-05775-0
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Article ; Online: Comparative performance of prediction model, non-expert and telediagnosis of common external and middle ear disease using a patient cohort from Cambodia that included one hundred and thirty-eight ears.

Schuster-Bruce, James / Shetty, Prajwal / O'Donovan, James / Mandavia, Rishi / Sokdavy, Touch / Bhutta, Mahmood F

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

2021 Volume 46, Issue 3, Page(s) 635–641

MeSH term(s)	Adult ; Cambodia ; Child ; Ear Diseases/diagnosis ; Female ; Humans ; Male ; Predictive Value of Tests ; Sensitivity and Specificity ; Surveys and Questionnaires ; Telemedicine
Language	English
Publishing date	2021-01-09
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2205891-6
ISSN	1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
ISSN (online)	1749-4486
ISSN	1749-4478 ; 0307-7772 ; 1365-2273
DOI	10.1111/coa.13695
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