The integration of the multitude of ultrasound techniques into a "one-stop" liver clinic model will revolutionize the management of liver diseases. This approach streamlines patient care by providing immediate imaging assessment, facilitating prompt diagnosis, and expediting treatment plans. The traditional ultrasound methods of B-mode imaging and Doppler techniques have been supplemented by the newer techniques of tissue elastography, fat quantification, and contrast-enhanced ultrasound-termed multiparametric ultrasound. The deployment of these techniques to establish in more detail the underlying status of liver disease has been profound. The encompassing ultrasound techniques have allowed the ultrasound practitioner to establish a comprehensive assessment of liver disease, allowing further accurate management, and negating the need for additional, often more expensive, imaging to establish the diagnosis. This paper explores the implementation, benefits, and challenges of ultrasound-based one-stop liver clinics, emphasizing their impact on patient outcomes and healthcare efficiency. A detailed assessment of the techniques and their position in the diagnostic armamentarium is reviewed with a comprehensive overview established. CRITICAL RELEVANCE STATEMENT: Multiparametric liver ultrasound integrating B-mode, Doppler, CEUS, elastography and fat quantification provides a practical, low-cost one-stop pathway for staging chronic liver disease, assessing portal hypertension surrogates and characterizing incidental lesions, thereby speeding up treatment. KEY POINTS: Ultrasound is the first-line imaging investigation for liver disease, with established criteria on B-mode imaging for steatosis and cirrhosis. Multiparametric ultrasound integrates morphology, hemodynamics, fibrosis, steatosis, and lesion assessment. A one-stop liver ultrasound clinic accelerates decisions and reduces additional imaging.
Growing evidence reveals relative stability in long-term clinical and functional outcomes of schizophrenia spectrum disorders (SSD), and links poor premorbid adjustment (PA) to worse prognoses. This study investigated associations between PA across developmental stages and long-term outcomes. Data on 496 participants (age 26.8 ± 6.5, male 58.5
Non-suicidal self-injury (NSSI) is common in inpatient mental health care and poses challenges for staff, patients, and organizations. While training programs can improve knowledge and attitudes, less is known about how staff collectively experience implementing new strategies for managing self-harm and how such strategies influence ward culture and professional practice. This qualitative study was part of a broader evaluation of implementing a regional self-harm strategy in a Danish inpatient mental health service. The strategy included staff training, clinical tools, and supervision. Four focus group interviews with 25 staff members from five inpatient units were conducted in 2024. Data were analyzed using reflexive thematic analysis. The analysis generated four interrelated themes: (1) Relational work as invisible yet essential: Staff valued listening and dialogue as crucial for preventing escalation but described these practices as undervalued and the first to be dropped under pressure. (2) Diagnostic hierarchies: psychosis as the legitimate inpatient diagnosis, self-harm as responsibility: Psychotic patients were viewed as genuinely ill and beyond control, while patients who self-harm were often framed as responsible, sustaining moralized hierarchies of care. (3) Cultural change – from control to dialogue: The strategy disrupted routines of restraint in relation to self-harm. Initially perceived as “doing nothing,” the new strategy was increasingly legitimized as staff witnessed calmer units, reduced coercion, and clearer professional roles grounded in relational practice. (4) Responsibility, guilt, and emotional distance — Staff struggled with the emotional and moral burden of refraining from coercion, negotiating professional boundaries, and managing feelings of guilt and emotional withdrawal. Implementing a self-harm strategy requires more than new clinical tools. It depends on staff integrating the approach into everyday practice, supported by structural and cultural change. Sustainable implementation relies on legitimizing relational care as skilled clinical work, creating space for reflection, and addressing the emotional demands placed on staff. The findings also show that diagnostic hierarchies continue to shape how legitimacy and responsibility are distributed within psychiatric care.
The purpose of this study is to objectively quantify physical activity and sedentary behaviour in children and adolescents during hospital admission using device-based monitoring and investigate the association between sedentary behaviour and pain, constipation, surgery status, movement restrictions, 30-day readmission, and length of stay. Children and adolescents aged 2 ≤ 17 years admitted between March and September 2025 to three paediatric departments at a Danish hospital were eligible for this prospective observational study. Children and adolescents scheduled for day surgery and wheelchair users were excluded. All participants wore two triaxial accelerometers throughout their hospital stay. In total, 103 hospitalised children and adolescents were included. The participants spent 45 min per day (interquartile range 20–125) in upright position (standing and walking time combined) and were sedentary (sitting and lying time combined) for 23.3 h per day (21.8–23.7). Adolescents undergoing spine surgery were sedentary for 23.6 h per day (23.5–23.7), of which 22.6 h (21.8–23.0) were spent lying in bed. Sedentary behaviour was significantly associated with higher age (p < 0.001), opioid consumption beyond standardised analgesia (p = 0.028), and orthopaedic procedures (p < 0.001). No associations between sedentary behaviour and length of stay (p = 0.391), 30-day readmission (p = 0.467), laxative use (p = 0.695), and postoperative movement restrictions (p = 0.637) were found. Conclusion: Hospitalised children and adolescents in this study exhibited high levels of sedentary behaviour. The findings highlight that mobilisation strategies are needed across all paediatric surgical procedures, but adolescents, patients undergoing orthopaedic or spine procedures, and those prescribed opioids beyond standardised analgesia require particular attention. There is a need for further evidence of the consequences of sedentary behaviour during hospitalisation among children and adolescents.
Chronic kidney disease (CKD) complicates insulin dosing and increases glycaemic instability in diabetes. We aimed to compare feasibility, safety and efficacy of automated insulin delivery (AID) with usual care in people with diabetes and advanced CKD. We conducted a prospective, open-label, randomised crossover trial at five tertiary hospitals in Australia and one tertiary centre in Denmark. Adults aged ≥18 years with type 1 diabetes or insulin-treated type 2 diabetes and advanced CKD (stage 3b or higher, including dialysis) were eligible. Participants were randomly assigned in a 1:1 sequence to receive either AID followed by usual care with real-time continuous glucose monitoring (CGM), or the reverse sequence, each for 8 weeks. Allocation was generated centrally using computerised randomisation. Due to the nature of the intervention, participants and clinicians were aware of treatment assignment. The primary outcome was percentage time in range (3.9–10.0 mmol/l) during the final 3 weeks of each treatment period. Forty participants (24 type 1 diabetes, 16 type 2 diabetes; median [IQR] age 60 [55, 69] years; HbA1c 64 [54, 73] mmol/mol [8.0
