Stigma exists in society towards mental health and is also demonstrated by healthcare professionals. It develops early on in careers and impacts the delivery of care which further stigmatises this already disadvantaged population. Up to 75% of individuals with mental illness refuse treatment because of stigma leading to negative outcomes.1 Problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination)...

Postdischarge surveys are critical in collecting patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs), but response rates vary and are often low.

To assess determinants that are associated with survey completion by phone in a complex medical care setting.

Secondary analysis of a prospective controlled interrupted time series analysis.

As part of the non-randomised controlled In-HospiTOOL trial, a survey was conducted to gather data on PREMs and PROMs in multimorbid patients from seven hospitals in Switzerland.

31 103 medical acute care hospitalisations among seven intervention hospitals who were eligible for the survey.

Over a 6-month pre-intervention phase (August 2017 through January 2018) and a subsequent 12-month intervention phase (February 2018 through January 2019), patients were contacted by phone 30 days after hospital admission.

The primary outcome was responsiveness to the survey. We assessed group differences between responders and non-responders, and associations of patient characteristics with survey completion were estimated using generalised estimating equations.

Of 31 103 eligible patients, 25 557 (82.2%) completed the survey 30 days after hospital admission. Responders were marginally older than non-responders (median (IQR) age, 73 (60–82) years vs 72 (57–82); standardised mean difference (SMD), –0.08), were more likely to be Swiss (81.9% vs 74.4%; SMD, –0.18), to have private healthcare insurance (22.9% vs 17.9%; SMD, 0.12), to be living at home before admission (85.7% vs 78.6%; SMD, 0.18) and to be less frail (67.4% vs 59.1%; SMD, 0.18). A longer length of stay (OR 0.98; 95% CI 0.97 to 0.99), discharge to a non-home institution (OR 0.50; 95% CI 0.46 to 0.54) and rehospitalisation within 30 days (OR 0.78; 95% CI 0.68 to 0.89) is associated with a decreased responsiveness.

The study shows that achieving a high survey response rate among vulnerable acute care patients is feasible, which in turn allows for the effective identification of key determinants and enhances the collection of information on patients’ experiences and outcomes.

ISRCTN83274049.

The impact of anaesthesia modality on oncological outcomes in patients with high-risk non-muscle invasive bladder cancer (NMIBC) remains uncertain. Emerging evidence suggests that anaesthetic agents and techniques may influence tumour biology and recurrence through immunomodulatory and neuroendocrine pathways. However, prospective randomised trials comparing spinal and general anaesthesia in this population are lacking.

This single-centre, prospective, parallel-arm randomised controlled trial will enrol 370 patients with clinically suspected high-risk NMIBC undergoing transurethral resection of bladder tumour. Participants will be randomised 1:1 to receive either spinal or general anaesthesia. The primary endpoint is time to recurrence over a 104-week follow-up period. Secondary endpoints include time to progression, Bacillus Calmette–Guérin (BCG) unresponsiveness and a composite oncological event. Additional secondary outcomes include postoperative opioid consumption (morphine equivalents), obturator jerk occurrence, acute urinary retention and tolerance to immediate intravesical chemotherapy. Safety outcomes will include treatment-emergent adverse events, Clavien-Dindo graded surgical complications, haemorrhagic events and anaesthesia-related risks. Exploratory endpoints involve perioperative biomarker analyses. Data will be analysed on an intention-to-treat basis.

Recruitment has not yet started. It is expected to begin in December 2025 and to be completed by June 2029. The planned follow-up period for each participant is 104 weeks. This manuscript is based on protocol V.1.0, dated March 2025. Results will be disseminated through peer-reviewed journals and conference presentations

NCT06982690.

Peripheral arterial disease (PAD) commonly coexists with chronic kidney disease (CKD). Patients with symptomatic PAD often require endovascular revascularisation to relieve pain or salvage limbs. However, the iodinated intra-arterial contrast routinely used in these procedures is nephrotoxic, placing patients with CKD at increased risk of acute kidney injury (AKI) and long-term renal decline. Carbon dioxide (CO₂) delivered via automated injection is a potential alternative imaging contrast medium. This trial will evaluate whether using CO₂ instead of iodinated contrast reduces the risk of AKI and short-term renal function decline in this high-risk group.

This is a multicentre, open-label, prospective randomised controlled trial across six secondary-care National Health Service (NHS) vascular surgery centres. A total of 174 patients with PAD and CKD undergoing endovascular intervention will be randomised 1:1 to receive iodinated contrast (standard of care) or CO₂ via automated injector (Angiodroid). All perioperative care will follow local NHS protocols.

The primary outcome is log serum creatinine at 2, 30 and 90 days postprocedure. Key secondary outcomes include: incidence and severity of AKI within 48 hours postprocedure, major adverse kidney events (death, dialysis or >25% estimated glomerular filtration rate decline) by 90 days, inpatient length of stay, procedural pain, quality of life, procedural success, reinterventions, acceptability and feasibility (patient/practitioner questionnaires) of using CO₂, and cost-effectiveness (healthcare resource use analysis). A mixed-methods process evaluation will be undertaken with patients and clinicians.

The trial has been approved by an NHS ethical review committee (24/WA/0332) and patients have been involved in trial design. Findings will be disseminated to participants, clinicians and the wider public through patient groups, lay summaries, social media, conferences, peer-reviewed journals and NHS policy channels.

ISRCTN23564393.

There is a high prevalence of psychiatric disorders among individuals with intellectual disability. In keeping with deinstitutionalisation, this population has also been moved from hospital to community but not necessarily accompanied by the specialised resources required. Consequently, there are high admission rates, however, this has been associated with traumatic experience (for patients and caregivers), potential neglect and abuse. Community crisis care has been studied for other patient groups but...