Thought disorder

SummaryWe review thought disorder in psychopathology, including how one can assess it clinically, useful psychometric measures and its clinical importance. In the final section we discuss how recent studies in neuropsychology and neuroimaging have helped understand the mechanisms of abnormal speech and languages in psychotic illnesses.</jats:p

A United Kingdom-wide study to describe resource consumption and waste management practices in skin surgery including Mohs micrographic surgery

This is the first United-Kingdom wide cross-sectional study reporting real-world data on the heterogenicity in the set-up and waste management practices of skin surgery, including Mohs micrographic surgery. Twelve participating sites from England, Northern Ireland, Scotland and Wales provided data from 115 skin surgery lists involving 495 patients and 547 skin surgery procedures between 1 March 2022 to 30 June 2022. The mean total weight of non-sharps skin surgery waste was 0.52kg per procedure (0.39kg clinical waste, 0.05kg general waste and 0.08kg recycling waste). Data from a single site using disposable surgical instruments only reported an average of 0.25kg of sharps waste per procedure. The recycling rate ranged between 0-44% across the cohort with a mean recycling rate of 16%. We advocate staff to transition to the British Society of Dermatological Surgery 2022 sustainability guidance which made wide-ranging recommendations to facilitate staff to transition to sustainability skin surgery

Students' participation in collaborative research should be recognised

Letter to the editor

Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.</p