Eight hundred and eighty-three strains of Campylobacter spp. isolated between 1982 and 1989 from human stools and poultry products were screened for quinolone resistance. In this period the prevalence of resistant strains isolated from poultry products increased from 0% to 14%. During the same period the prevalence in man increased from 0% to 11%. The emergence of quinolone resistance has implications for the identification of campylobacter up to species level: the susceptibility for nalidixic acid can no longer be used as a criterion for identification in the laboratory. The rapid emergence of resistant campylobacter may also have important implications for the treatment and prophylaxis of diarrhoeal disease. The increase of quinolone resistance coincides with the increasing use of fluoroquinolones in human and veterinary medicine. Extensive use of enrofloxacin in poultry and the almost exclusive transmission route of campylobacter from chicken to man, in The Netherlands, suggests that the resistance observed is mainly due to the use of enrofloxacin in the poultry industry.

Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

Summary There is growing evidence that anaesthetic trainees experience, and may be particularly susceptible to, high levels of work stress, burnout and depression. This is concern for the safety and wellbeing of these doctors and for the patients they treat. To date, there has been no in‐depth evaluation of these issues among UK anaesthetic trainees to examine which groups may be most affected, and to identify the professional and personal factors with which they are associated. We conducted an anonymous electronic survey to determine the prevalence of perceived stress, risk of burnout/depression and work satisfaction among anaesthetic trainees within South‐West England and Wales, and explored in detail the influence of key baseline characteristics, lifestyle and anaesthetic training variables. We identified a denominator of 619 eligible participants and received 397 responses, a response rate of 64%. We observed a high prevalence of perceived stress; 37% (95%CI 32–42%), burnout risk 25% (21–29%) and depression risk 18% (15–23%), and found that these issues frequently co‐exist. Having no children, > 3 days sickness absence in the previous year, ≤ 1 h.week−1 of exercise and > 7.5 h.week−1 of additional non‐clinical work were independant predictors of negative psychological outcomes. Although female respondents reported higher stress, burnout risk was more likely in male respondents. This information could help in the identification of at‐risk groups as well as informing ways to support these groups and to influence resource and intervention design. Targeted interventions, such as modification of exercise behaviour and methods of reducing stressors relating to non‐clinical workloads, warrant further research.

Cardiac arrest in the peri-operative period is rare but associated with significant morbidity and mortality. Current reporting systems do not capture many such events, so there is an incomplete understanding of incidence and outcomes. As peri-operative cardiac arrest is rare, many hospitals may only see a small number of cases over long periods, and anaesthetists may not be involved in such cases for years. Therefore, a large-scale prospective cohort is needed to gain a deep understanding of events leading up to cardiac arrest, management of the arrest itself and patient outcomes. Consequently, the Royal College of Anaesthetists chose peri-operative cardiac arrest as the 7th National Audit Project topic. The study was open to all UK hospitals offering anaesthetic services and had a three-part design. First, baseline surveys of all anaesthetic departments and anaesthetists in the UK, examining respondents' prior peri-operative cardiac arrest experience, resuscitation training and local departmental preparedness. Second, an activity survey to record anonymised details of all anaesthetic activity in each site over 4 days, enabling national estimates of annual anaesthetic activity, complexity and complication rates. Third, a case registry of all instances of peri-operative cardiac arrest in the UK, reported confidentially and anonymously, over 1 year starting 16 June 2021, followed by expert review using a structured process to minimise bias. The definition of peri-operative cardiac arrest was the delivery of five or more chest compressions and/or defibrillation in a patient having a procedure under the care of an anaesthetist. The peri-operative period began with the World Health Organization `sign-in´checklist or first hands-on contact with the patient and ended either 24 h after the patient handover (e.g. to the recovery room or intensive care unit) or at discharge if this occured earlier than 24 h. These components described the epidemiology of peri-operative cardiac arrest in the UK and provide a basis for developing guidelines and interventional studies.

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