The military spouse experience of living alongside their serving/veteran partner with a mental health issue: A systematic review and narrative synthesis.

INTRODUCTION: Military healthcare studies have reported a wide range of mental health issues amongst military personnel. Globally, mental health issues are one of the main causes of ill health. Military personnel have a greater prevalence of mental health issues than that of the general population. The impact of mental health issues can be wide and far reaching for family and carers. This systematic narrative review explores the military spouse experience of living alongside their serving or veteran partner with a mental health issue. METHODS: The systematic review performed was based on the PRISMA guide for searching, screening, selecting papers for data extraction and evaluation. Studies were identified from CINHAL, ASSIA, Proquest Psychology, Proquest Nursing & Allied Health source, Proquest Dissertations & Theses, ETHOS, PsychArticles, Hospital collection, Medline, Science Direct Freedom Collection and hand searching of citations and reference lists. RESULTS: Twenty-seven studies were included in the narrative synthesis. Five overarching themes from the experiences of military spouses' living alongside their serving/veteran partners mental health issue were identified: caregiver burden, intimate relationships, psychological/psychosocial effects on the spouse, mental health service provision and spouse's knowledge and management of symptoms. CONCLUSIONS: The systematic review and narrative synthesis identified that the majority of studies focused on spouses of veterans, very few were specific to serving military personnel, but similarities were noted. Findings suggest that care burden and a negative impact on the intimate relationship is evident, therefore highlight a need to support and protect the military spouse and their serving partner. Likewise, there is a need for greater knowledge, access and inclusion of the military spouse, in the care and treatment provision of their serving partner's mental health issue.

Public health: PART 4 Behaviour change tools.

Lynn Craig, Subject Lead, Adult Nursing, and Senior Lecturer ( L.craig@northumbria.ac.uk ), Emma Senior, Senior Lecturer/Programme Lead, Adult Nursing, and Michelle Mitchel, Graduate Teacher, Northumbria University, Newcastle upon Tyne, discuss tools used to help patients change health behaviours.

Public health: PART 2 Brief interventions.

Emma Senior, Senior Lecturer/Programme Lead, Adult Nursing ( emma.senior@northumbria.ac.uk ), and Lynn Craig, Subject Lead, Adult Nursing, and Senior Lecturer, Northumbria University, Newcastle upon Tyne, discuss how nurses can use brief interventions during their interactions with patients.

Public health: PART 3 Behaviour change.

Emma Senior, Senior Lecturer/Programme Lead, Adult Nursing ( emma.senior@northumbria.ac.uk ), Lynn Craig, Subject Lead, Adult Nursing, and Senior Lecturer, and Michelle Mitchel, Graduate Teacher, Northumbria University, Newcastle upon Tyne, discuss the models used to help patients change health-related behaviours.

Public health: PART 1 Making Every Contact Count.

Lynn Craig, Subject Lead, Adult Nursing, and Senior Lecturer ( L.craig@northumbria.ac.uk ) and Emma Senior, Senior Lecturer/Programme Lead, Adult Nursing, Northumbria University, Newcastle upon Tyne, discuss the nurse's role in public health interventions using the Making Every Contact Count approach.

Healthcare students' experiences when integrating e-learning and flipped classroom instructional approaches.

This article describes the experiences of undergraduate healthcare students taking a module adopting a 'flipped classroom' approach. Evidence suggests that flipped classroom as a pedagogical tool has the potential to enhance student learning and to improve healthcare practice. This innovative approach was implemented within a healthcare curriculum and in a module looking at public health delivered at the beginning of year two of a 3-year programme. The focus of the evaluation study was on the e-learning resources used in the module and the student experiences of these; with a specific aim to evaluate this element of the flipped classroom approach. A mixed-methods approach was adopted and data collected using questionnaires, which were distributed across a whole cohort, and a focus group involving ten participants. Statistical analysis of the data showed the positive student experience of engaging with e-learning. The thematic analysis identified two key themes; factors influencing a positive learning experience and the challenges when developing e-learning within a flipped classroom approach. The study provides guidance for further developments and improvements when developing e-learning as part of the flipped classroom approach.

The experiences of students in interprofessional learning.

This article explores the experiences of undergraduate healthcare students within interprofessional education (IPE) using a qualitative research study. The motive to undertake this study was as a result of mixed evaluations of IPE sessions. The study aimed to analyse student experiences of IPE, and as a result provide greater insight into how this type of education could be enhanced. Participants were selected through voluntary recruitment and data were collected using a focus group involving 12 participants who responded. Data analysis identified two key themes highlighting the barriers to engagement in IPE and factors that enable participants to engage. The study provides guidance for further developments and improvements when designing and delivering IPE.

An unusual presentation of adenoid cystic carcinoma of the breast with metastatic disease in the clavicle.

Adenoid cystic carcinoma (ACC) of the breast is a rare subtype of invasive breast cancer. Prognosis is excellent with low rates of recurrence and metastatic disease compared with other triple-negative forms of breast carcinoma and other non-breast forms of ACC. We present a case of a 63-year-old female with metastatic disease in the clavicle 13 years after excision of the breast primary. Metastasis to bone is rare, and this is the first case described in the clavicle. There are no specific radiological features of breast primaries but imaging usually reveals a circumscribed mass, often without microcalcifications. Histology is similar to that of non-breast forms of ACC. Mastectomy or wide local excision is curative in virtually all cases without lymph node involvement. However, as our case demonstrates, the presence of bone pain with a history of ACC of the breast should prompt musculoskeletal imaging. Discussion at a multidisciplinary team meeting is essential for accurate diagnosis.

Using an integrated teaching and learning approach to deliver inter-professional practice in Public Health.

In order to address health inequalities an interprofessional approach is required. To recreate this experience for pre-registration healthcare students an innovative model utilising integrated approaches to teaching and learning was developed. This incorporated interprofessional education, threshold concepts, virtual learning and narrative pedagogy.

Added value of dynamic contrast-enhanced magnetic resonance imaging in predicting advanced stage disease in patients with endometrial carcinoma.

AIM: To assess the added value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting advanced stage disease in patients with endometrial carcinoma. MATERIALS AND METHODS: Fifty patients with endometrial carcinoma underwent preoperative MRI assessment in a single gynecological cancer center during a 2-year period. Magnetic resonance imaging examinations included high-resolution sagittal, axial, and axial-oblique T2-weighted images (T2WI) of the pelvis, and axial T1-weighted images (T1WI) of the pelvis and upper abdomen followed by DCE-MRI using a multiphase 3-dimensional gradient refocused echo T1WI sequence. The T2W images were evaluated initially, and local and overall staging was assigned according to the FIGO classification. An identical scoring system was used to evaluate the combination of DCE-MRI and T2WI. The presence of potential pitfalls in the accurate assessment of depth of myometrial invasion (leiomyoma, adenomyosis, loss of junctional zone definition, polypoid tumor, poor tumor-to-myometrium contrast, and tumor extension to uterine cornu) was also recorded. Surgical histology constituted the standard of reference. RESULTS: The depth of myometrial invasion was correctly determined in 78% (39/50) of the cases on T2WI alone, increasing to 92% (46/50) with the addition of DCE-MRI (95% confidence interval for improvement, 4.4%-23.6%, P = 0.016). The addition of DCE-MRI led to the correct detection of deep myometrial invasion in all cases. Tumor extension to uterine cornu was the only variable significantly associated (P = 0.014) with incorrect estimation of depth of myometrial invasion. CONCLUSIONS: The addition of multiphase 3-dimensional DCE-MRI to T2WI can effectively assess the depth of myometrial invasion in endometrial carcinoma and may be a useful tool to guide the surgical approach.

Acute small bowel obstruction due to impacted bone: a case report.

A 71-year-old man was admitted with features of intestinal obstruction. His past surgical history included an appendicectomy as a child and three laparotomies. A CT scan of the abdomen revealed a high attenuation foreign body impacted in the distal ileum, associated with small bowel obstruction. At laparotomy, a bone was removed from the terminal ileum.

MRI of malignant neoplasms of the uterine corpus and cervix.

OBJECTIVE: In this article, we review the role of MRI in the imaging of malignant neoplasms of the uterine corpus and cervix, describing its role in staging, treatment planning, and follow-up. CONCLUSION: MRI is not officially incorporated in the International Federation of Gynecology and Obstetrics (FIGO) staging system, but is already widely accepted as the most reliable imaging technique for the diagnosis, staging, treatment planning, and follow-up of both endometrial and cervical cancer. MRI protocols need to be optimized to obtain the best results and avoid pitfalls.