‘It Was About as Far at Odds With Our Provider Failure Protocol…as You Can Get’. Untangling Care Policy When Care Homes Close

ABSTRACT This article takes an extreme case ‐ the emergency closure of a care home on a Friday evening ‐ to explore how a lack of coordination between national and local stakeholders led to a brutalising experience for frail residents and social care staff. Care home closures sit at the interface of multiple policy domains including funding, infrastructure, staffing, quality assurance and regulation. Drawing on interviews with managers and wider stakeholders, the article highlights how vertical and horizontal coordination mechanisms failed to deliver a timely and effective closure process. We explain this not as an extreme and atypical case but rather of an exemplar of what can happen when poor policy design creates risks that fail to provide adequate provision for vulnerable people. It also highlights that policy is not always a process of adding more layers and entanglements. Sometimes—often at a point of crisis—the mixed threads of policy need to be pulled apart to clarify legal responsibilities and liabilities. When this cannot be done effectively, people are exposed to unacceptable levels of risk and distress.

Generative AI in Mathematics, Science, and STEM Education: Research, Applications, and Emerging Themes

Implementing an Interprofessional Simulation Program for Paediatric Patient Safety

ABSTRACT Background Simulation‐based medical education is a widely recognised tool to improve patient safety culture and outcomes. Many preventable clinic errors are specific to the unit where they occur. We planned and conducted an interprofessional in situ simulation program aligned with unit‐specific errors and report its design, implementation and evaluation. Approach This prospective, survey‐based study was conducted at a paediatric tertiary care centre on a medical–surgical inpatient ward. Incident and accident reports were reviewed; the most frequent and/or severe events were identified. Eight in situ simulations were implemented over 8 months. Participants, including residents, medical students, nurses, pharmacists and physicians completed a survey exploring perceptions of the program's ability to improve patient safety. Evaluation Incident reports over 12 months were reviewed ( n  = 329). Four most frequent and serious errors were identified: intravenous solutions selection, enteral feeding rate or type selection, medication transcription and IV infiltration. Simulation participation rate was 86%; survey response rate was 65%. We evaluated the program using Kirkpatrick's model of educational training, assessing reaction through self‐reported surveys and results through changes in incident report frequency. Overall, 86% of participants responded positively regarding the program's potential impact to enhance patient safety. This is supported by an increase in incident reporting the year following program implementation and a decrease in each simulation‐targeted medical error, albeit not statistically significant. Implications Our experience in creating an in situ simulation program that aligns with unit‐specific needs and addresses implementation challenges may provide valuable insights for other centres seeking enhance patient safety.

‘Dragon's Den’: Gamifying Handover Skills Teaching

ABSTRACT Background Effective communication during patient handovers is critical to ensuring patient safety. While previous teaching methods locally have been successful, they have typically relied on substantial faculty input and resources. Drawing inspiration from contemporary approaches to small group learning, this study explores the impact of a gamified clinical simulation—delivered through an interactive, ‘Dragon’s Den’‐style format—on medical students’ self‐reported confidence and preparedness in handover and referral skills. Approach A 90‐min workshop was developed incorporating a ‘Dragon’s Den’‐inspired activity. Students assumed the role of ‘investors’, in teams, using a structured checklist to evaluate pre‐recorded video handovers. This was followed by paired practice of referrals with fictional clinical scenarios, during which students gave and received peer feedback, using the same checklist. Paired pre‐ and postsession responses were collected via Wooclap to assess changes in self‐reported confidence and preparedness. An anonymous free‐text feedback form was also distributed following the session. Evaluation Quantitative analysis revealed a statistically significant improvement in both confidence and preparedness. Thematic analysis of qualitative feedback highlighted that students found the session engaging, relevant, and valuable; however, some expressed a desire for additional resources and suggested the session may be beneficial if scheduled earlier in the curriculum. Implications This study supports the use of gamified clinical simulation as an effective method for teaching handover skills. The peer‐led, experiential format offers a scalable, low‐resource approach that aligns well with the constraints of modern medical curricula. Moreover, this model carries potential for broader application in wider educational settings.

Spaces of Liminality, Places of Creative Assemblage: A Multi‐Arts Setting for People Living with Dementia in Northwest England

Abstract Researchers are increasingly exploring the practicalities of ‘ageing in place’ for community‐dwelling older adults with dementia. Going beyond the parameters of home and local neighbourhood, community‐based creative arts designed for dementia are promoted for their wellbeing potential. This paper presents findings from a doctoral project conducted between 2017 and 2021, which explored a multi‐arts setting at Theatre by the Lake (Cumbria, Northwest England) designed for people with dementia and caregivers. The study combined a participatory action research (PAR) and sensory ethnography design, adopting an ‘in‐the‐moment’ theoretical lens that included assemblage and relational wellbeing concepts. The findings explore the creative opportunity afforded by the liminal setting(s) and the person‐centred meaning‐making that creative arts encourage. The study recognises the importance of place outside of the home and how an in‐between, transient, creative assemblage can contribute to ‘ageing in place’ as a microcosm of a neighbourhood, without the unpredictability of the public sphere.

A framework checklist for implementing bedside electronic transfusion systems

Abstract Background Every time a unit of blood is given to a patient, it is essential that all steps in the transfusion pathway are executed correctly to ensure that the right blood is transfused to the right patient. Bedside transfusion checks at the point of sampling for compatibility testing, sample labelling and blood administration are an essential part of the delivery of safe transfusion and avoidance of the wrong blood being given, which can have serious consequences. Implementation of bedside electronic transfusion systems that use barcode matching of patients' wristbands and blood units is now recommended as the best practice to ensure patients' safety in transfusion. However, there is limited information in the literature to guide hospitals on what aspects they should consider when introducing a bedside electronic transfusion system. Aims and Methods This paper aims to support hospitals considering implementing a bedside electronic transfusion system by providing a comprehensive checklist addressing planning, stakeholder coordination, device integration, and compliance with national standards and safety requirements. Results The checklist is based on the experiences of two NHS Trusts in the UK and aims to provide organisations with a resource to support this change and reduce avoidable delays.

Integrative Profiling of Antimicrobial Resistance Risks in a Philippine Peri‐Urban Community: Insights From Clinical Data, Wastewater Analysis and Community Engagement

ABSTRACT Antimicrobial resistance (AMR) is a growing global health threat, particularly in low‐ and middle‐income countries such as the Philippines, where limited resources and regulatory challenges heighten the risk. Community‐level assessments are critical for developing a context‐specific evidence base that informs local decision‐making. This study assessed the community AMR risk in a peri‐urban community (Mandug, Davao City, Philippines) using an integrated approach that combined wastewater detection of antimicrobial resistance genes (ARGs), community survey and interviews on knowledge, practices, perceived hazards and the capacities of local government and clinical antimicrobial use (AMU). The β‐lactam antibiotics, particularly cephalosporins from the nearest tertiary hospital and amoxicillin, commonly used for self‐medication and livestock treatment, were identified as widely available in the area. These findings were supported by wastewater surveillance conducted at three sampling sites that represent Mandug's primary land use patterns: residential, agricultural and mixed‐use areas. Quantitative polymerase chain reaction (qPCR) analysis detected multiple ARGs in both residential and agricultural wastewater samples, with blatTEM , blaSHV and aac ( 6′ ) ‐lb‐cr more prevalent in domestic use, and ermB, aac(6′)‐lb‐cr and tet genes in agricultural areas. Multinomial regression analysis suggests that domestic ARG sources in Mandug may contribute more significantly to community wastewater ARG abundance than agricultural and commercial sources. The community survey indicated moderate knowledge of antibiotics, and existing knowledge gaps may contribute to unsafe practices like self‐medication and the indiscriminate use of antimicrobials. Despite basic health infrastructure, factors such as population growth, backyard farming and insufficient implementation of national AMR policies increase vulnerability to AMR threats. Addressing AMR effectively requires a community‐centered, multidimensional One Health approach. Priorities include building local capacity, executing targeted public education campaigns, strengthening surveillance systems and enforcing local policy reforms within the local government unit.

Association between group B major ABO ‐incompatible platelet or plasma transfusion and severe allergic reactions: A nationwide haemovigilance analysis suggesting a role for α‐gal syndrome. A Biomedical Excellence for Safer Transfusion Collaborative study

Abstract Background and Objectives Severe transfusion reactions to group B–incompatible platelets and plasma possibly related to the α‐gal syndrome ( AGS ) have been recently described. AGS is a potentially severe Immunoglobulin E mediated allergy to mammalian meat and meat‐derived products associated with tick bites. The involved allergen, galactose‐α‐1,3‐galactose (α‐gal), is antigenically similar to the blood group B antigen. To further assess a potential association between AGS and allergic transfusion reactions (ATRs), we comparatively assessed the frequency of ATRs after plasma or platelet concentrate (PC) transfusion in relation to the degree of ABO compatibility between the recipient and the involved blood component in France. Materials and Methods In France, all transfusions are centrally recorded, and ATR reporting is mandatory. Frequencies of severe ATRs involving PC or plasma in relation to ABO group distributions were analysed between 1 January 2022 and 31 December 2024. Results Among 981,955 PC and 580,230 plasma evaluable transfusions, severe ATRs were significantly higher in group O recipients transfused with group B or AB platelets (relative risk [RR]: 5.06, 95% confidence interval [CI]: 3.27–7.83, p  < 0.001) and plasma (RR: 2.15, 95% CI: 1.37–3.36, p  < 0.001) while not in group A recipients of group B or AB platelets (RR: 0.95, 95% CI: 0.30–2.96) or plasma (RR: 0.92, 95% CI: 0.45–1.88), when compared to ATR rates in all other recipients of PC or plasma, respectively. Conclusion In this national retrospective haemovigilance analysis, group B or AB PC or plasma transfused to group O recipients is associated with an increased risk of severe ATRs . Further studies will establish whether AGS is involved in this increased risk.

Including patient insights to improve the information materials provided to serum eye drop recipients

Abstract Background and Objectives Severe dry eye disease is a commonly diagnosed condition that can be treated with serum eye drops (SEDs). SEDs are manufactured from the serum obtained from whole‐blood donation. Patient information provided with SEDs has not been evaluated so far. This study aims to understand patients' views on SED materials and identify possible improvements. Materials and Methods The study period was between 1 November 2021 and 30 June 2022. Eligible patients were supplied with either autologous SED (AutoSED) or patient‐tailored (allogeneic) SED (PT SED) manufactured by Australian Red Cross Lifeblood. Patients were invited to participate via email or post and completed an online survey or participated in a semi‐structured telephone interview. Results A total of 64 patients supplied with AutoSED and 18 with PT SED completed the survey, of whom 10 and 8, respectively, were interviewed. More AutoSED (89.1%) than PT SED (58.8%) patients reported that the instructions on the carton were helpful. More AutoSED patients (78.1%) than PT SED (55.6%) reported receiving the SED brochure and that the information was easy to understand. Information on how to dispose the eye drops and the risk of treatment was easy to understand. Sixteen patients reported accessing the quick‐response code to view the SED video and indicated that it was easy to understand. Conclusion Patient views on the materials provided with SEDs were generally positive. Suggested improvements included changing the location of sealing stickers on the carton, providing further detailed information on shelf‐life after power supply challenges and natural disasters and storage and handling during travel.

International Society of Blood Transfusion Working Party on Red Cell Immunogenetics and Blood Group Terminology Report of Gothenburg, Barcelona and four virtual business meetings: Update on blood group systems

Abstract Background and Objectives The International Society of Blood Transfusion (ISBT) Working Party (WP) on Red Cell Immunogenetics and Blood Group Terminology (RCI&BGT) held six business meetings between December 2021 and June 2024. This report describes the new blood group systems and antigens ratified during these meetings. Materials and Methods Candidate systems and antigens were reviewed according to serological, genetic and biological evidence. This evidence was matched against defined criteria, and the acknowledged systems/antigens were assigned a unique identifier. Results Four new systems, ER (ISBT 044), CD36 (ISBT 045), ATP11C (ISBT 046) and MAL (ISBT 047), were ratified. CD36 and ATP11C were de novo entries, while ER and MAL systems resolved the genetic basis for the Er and AnWj antigens. Thirteen antigens were added to existing systems: one each to LU (005), YT (011), SC (013), LW (016), KN (022), GLOB (028); an antithetical pair to KEL (006); two antigens to RHAG (030); and three to CTL2 (039). Two CTL2 antigens defined the hitherto unresolved antithetical antigens, Cs a /Cs b , whose genetic basis coincides with those of variants responsible for the HNA‐3a/3b neutrophil antigens, respectively. Conclusion As of June 2024, the ISBT has acknowledged 47 blood group systems, comprising 366 antigens. The WP continues to ratify new systems and antigens, which are available on the ISBT website ( http://www.isbtweb.org/working-parties/red-cell-immunogenetics-and-blood-group-terminology/ ).