scholarly journals Evaluation of postoperative surveillance strategies for esophago-gastric cancers in the UK and Ireland

2021 ◽  
Author(s):  
Swathikan Chidambaram ◽  
Viknesh Sounderajah ◽  
Nick Maynard ◽  
Tim Underwood ◽  
Sheraz R Markar
Keyword(s):  
Surgical Care ◽  
High Volume ◽  
High Recurrence Rate ◽  
Allied Health Professionals ◽  
Web Based ◽  
Postoperative Surveillance ◽  
Gastric Cancers ◽  
Standardized Protocol ◽  
Major Factors ◽  
The Uk

Abstract Esophago-gastric malignancies are associated with a high recurrence rate; yet there is a lack of evidence to inform guidelines for the standardization and structure of postoperative surveillance after curatively intended treatment. This study aimed to capture the variation in postoperative surveillance strategies across the UK and Ireland, and enquire the opinions and beliefs around surveillance from practicing clinicians. A web-based survey consisting of 40 questions was sent to surgeons or allied health professionals performing or involved in surgical care for esophago-gastric cancers at high-volume centers in the UK. Respondents from each center completed the survey on what best represented their center. The first section of the survey evaluated the timing and components of follow-ups, and their variation between centers. The second section evaluated respondents perspective on how surveillance can be structured. Thirty-five respondents from 27 centers consisting 28 consultants, 6 senior trainees and 1 specialist nurse had completed the questionnaire; 45.7% of responders arranged clinical follow-up at 2–4 weeks. Twenty responders had a specific postoperative surveillance protocol for their patients. Of these, 31.4% had a standardized protocol for all patients, while 25.7% tailored it to patient needs. Patient preference, comorbidities and chance of recurrence were considered as major factors for necessitating more intense surveillance than currently practiced. There is a significant variation in how patients are monitored after surgery between centers in the UK. Randomized controlled trials are necessary to link surveillance strategies to both survival outcomes and quality of life of patients and to evaluate the prognostic value of different postoperative surveillance strategies.

scholarly journals P-OGC04 Evaluation of post-operative surveillance strategies for oesophago-gastric cancers in the United Kingdom

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Swathikan Chidambaram ◽  
Viknesh Sounderajah ◽  
Nick Maynard ◽  
Tim Underwood ◽  
Sheraz Markar
Keyword(s):  
United Kingdom ◽  
Surgical Care ◽  
High Volume ◽  
High Recurrence Rate ◽  
Allied Health Professionals ◽  
Gastric Cancers ◽  
The United Kingdom ◽  
Major Factors ◽  
Randomised Controlled ◽  
The Uk

Abstract Background Oesophago-gastric malignancies are associated with a high recurrence rate, yet there is a lack of  evidence to inform guidelines for the standardisation and structure of post-operative surveillance after curatively intended treatment. This study aimed to capture the variation in post-operative surveillance strategies across the United Kingdom and Ireland, and enquire the opinions and beliefs around surveillance from practicing clinicians.  Methods A web based survey consisting of forty questions was sent to surgeons or allied health professionals performing or involved in surgical care for oesophago-gastric cancers at high volume centers in the United Kingdom (UK). Respondents from each centre completed the survey on what best represented their centre. The first section of the survey evaluated the timing and components of follow-ups, and their variation between centres. The second section evaluated respondents perspective on how surveillance can be structured.  Results Thirty five surgeons from 25 centers consisting 28 consultants, 6 senior trainees and 1 specialist nurse had completed the questionnaire. 45.7% of responders arranged clinical follow-up at 2-4 weeks. Twenty responders had a specific post-operative surveillance protocol for their patients. Of these, 31.4% had a standardised protocol for all patients, while 25.7% tailored it to patient needs. Patient preference, comorbidities and chance of recurrence were considered as major factors for necessitating more intense surveillance than currently practised.  Conclusions There is a significant variation in how patients are monitored after surgery between centers in the UK. Randomised controlled trials are necessary to link surveillance strategies to both survival outcomes and quality of life of patients and to evaluate the prognostic value of different post-operative surveillance strategies. 

scholarly journals Public Interest in Knee Pain and Knee Replacement during the SARS-CoV-2 Pandemic in Western Europe

2021 ◽  
Vol 10 (5) ◽  
pp. 1067
Author(s):  
Arne Kienzle ◽  
Lara Biedermann ◽  
Evgeniya Babeyko ◽  
Stephanie Kirschbaum ◽  
Georg Duda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Public Interest ◽  
Western Europe ◽  
Surgical Care ◽  
Number Of Patients ◽  
Primary Knee Arthroplasty ◽  
The Uk

Due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, a large number of elective knee replacement procedures had to be postponed in both early and late 2020 in most western countries including Germany and the UK. It is unknown how public interest and demand for total knee arthroplasties was affected. Public interest in knee pain, knee osteoarthritis and knee arthroplasty in Germany and the UK was investigated using Google Trend Analysis. In addition, we monitored for changes in patient composition in our outpatient department. As of early March in Germany and of late March in the UK, until the lockdown measures, a 50 to 60% decrease in relative search frequency was observed in all categories investigated compared to the beginning of the year. While public interest for knee pain rapidly recovered, decreased interest for knee osteoarthritis and replacement lasted until the easing of measures. Shortly prior to and during the first lockdown mean search frequency for knee replacement was significantly decreased from 39.7% and 36.6 to 26.9% in Germany and from 47.7% and 50.9 to 23.7% in the UK (Germany: p = 0.022 prior to lockdown, p < 0.001 during lockdown; UK: p < 0.0001 prior to and during lockdown). In contrast, mean search frequencies did not differ significantly from each other for any of the investigated time frames during the second half of 2020 in both countries. Similarly, during the first lockdown, the proportion of patients presenting themselves to receive primary knee arthroplasty compared to patients that had already undergone knee replacement declined markedly from 64.7% to 46.9%. In contrast, patient composition changed only marginally during the lockdown measures in late 2020 in both Germany and the UK. We observed a high level of public interest in knee arthroplasty despite the ongoing pandemic. The absence of a lasting decline in interest in primary knee arthroplasty suggests that sufficient symptom reduction cannot be achieved without surgical care for a substantial number of patients.

Can you measure IT? The UK experience of TechQual+

2014 ◽  
Vol 15 (1/2) ◽  
pp. 32-40 ◽  
Author(s):  
Ian Hall ◽  
Jessica Stephens ◽  
Sarah Kennedy
Keyword(s):  
Data Protection ◽  
Senior Managers ◽  
Web Based ◽  
Content Type ◽  
Survey Tool ◽  
Technology Services ◽  
Protection Legislation ◽  
The Uk ◽  
The University

Purpose – The University of York Library, part of its Information Directorate, has successfully run an annual user survey using LibQUAL+ since 2008. The tool has proven invaluable in understanding user needs and measuring improvements. The ability to benchmark performance has been well received by university senior managers. Following this positive experience, the Directorate piloted the TechQual+ survey to assess its technology services. TechQual+ is a total market-survey tool developed on the same principles as LibQUAL+. York was the first university in the UK to do this. The purpose of this paper is to reflect upon the experience and its relevance to information services. Design/methodology/approach – A team was established to co-ordinate the distribution of the survey, which was e-mailed to all university members. The survey was conducted over a period of three weeks in December 2011 using their web-based tool. The team worked with the survey providers to make amendments in order to comply with UK Data Protection legislation. Findings – The TechQual+ tool provided a rich set of data on the IT needs of University of York students and staff, including a wealth of comments. As the first use of the tool in the UK, a number of outcomes arose from the pilot: methods for running the survey in order to meet UK data protection requirements; feedback on the tool itself, with some questions not understood from a UK context; a rich set of results data, with some similarities (and several differences) to those available through LibQUAL+. Originality/value – The paper presents the first application of the TechQual+ survey in UK and discusses the issues faced when implementing it in a UK context. The case study will be of interest to libraries or converged services interested in assessing their IT provision.

Primary Uterine Cancer in Maryland: Impact of Distance on Access to Surgical Care at High-Volume Hospitals

2013 ◽  
Vol 23 (7) ◽  
pp. 1244-1251 ◽  
Author(s):  
Camille C. Gunderson ◽  
Ana I. Tergas ◽  
Aimee C. Fleury ◽  
Teresa P. Diaz-Montes ◽  
Robert L. Giuntoli
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Uterine Cancer ◽  
Multivariable Analysis ◽  
Community Setting ◽  
Surgical Care ◽  
High Volume ◽  
High Volume Hospital ◽  
To Receive ◽  
Zip Code

ObjectiveTo evaluate the influence of distance on access to high-volume surgical treatment for patients with uterine cancer in Maryland.MethodsThe Maryland Health Services Cost Review Commission database was retrospectively searched to identify primary uterine cancer surgical cases from 1994 to 2010. Race, type of insurance, year of surgery, community setting, and both surgeon and hospital volume were collected. Geographical coordinates of hospital and patient’s zip code were used to calculate primary independent outcomes of distance traveled and distance from nearest high-volume hospital (HVH). Logistic regression was used to calculate odds ratios and confidence intervals.ResultsFrom 1994 to 2010, 8529 women underwent primary surgical management of uterine cancer in Maryland. Multivariable analysis demonstrated white race, rural residence, surgery by a high-volume surgeon and surgery from 2003 to 2010 to be associated with both travel 50 miles or more to the treating hospital and residence 50 miles or more from the nearest HVH (allP< 0.05). Patients who travel 50 miles or more to the treating hospital are more likely to have surgery at a HVH (odds ratio, 6.03; 95% confidence interval, 4.67–7.79) In contrast, patients, who reside ≥50 miles from a HVH, are less likely to have their surgery at an HVH. (odds ratio, 0.37; 95% confidence interval, 0.32–0.42).ConclusionIn Maryland, 50 miles or more from residence to the nearest HVH is a barrier to high-volume care. However, patients who travel 50 miles or more seem to do so to receive care by a high-volume surgeon at an HVH. In Maryland, Nonwhites are more likely to live closer to an HVH and more likely to use these services.

Safety and efficacy of nurse led intravitreal injection service with Precivia® injection assist device

2021 ◽  
pp. 112067212110609
Author(s):  
Ibrar Ahmed ◽  
Panayiotis Maghsoudlou ◽  
Hani Hasan ◽  
Allaaeldin Abumattar ◽  
Nimish Shah
Keyword(s):  
Intravitreal Injection ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Annual Number ◽  
Assist Device ◽  
Allied Health Professionals ◽  
Safe Delivery ◽  
Anti Vegf ◽  
Age Related ◽  
The Uk

Introduction Intravitreal anti-VEGF injections are the most frequently performed outpatient procedure in the UK. Ophthalmic allied healthcare professionals are replacing medical professionals in delivering injections nationwide. The use of injection assist devices such as Precivia® has been well established and increasingly adopted to aid in their safe delivery. We present outcomes of nurse-led intravitreal injections using the Precivia® injection assist device over a five-year period in the UK. Methods A retrospective review was completed of all anti-VEGF intravitreal injections delivered at the Great Western Hospital between May 2015 and May 2020. Results Over the five-year study period, 2318 patients underwent a total of 26,923 intravitreal injections; 20,421 (75.8%) of which were delivered by appropriately trained ophthalmic nurses. The annual number of injections increased year-on-year from 2112 injections in 2015-2016 to 5410 injections in 2019-2020. The mean age of patients was 75.7±12.2 years with a female-to-male ratio was 1.17:1. Wet age-related macular degeneration represented the major indication for injections followed by retinal vein occlusion and diabetic maculopathy respectively. Three cases of post-injection endophthalmitis out of 20,421 (0.015%) injections in nurse injection group were identified during the study period. There were no cases of lens touch, retinal detachment or systemic thromboembolic events. Conclusion Use of the Precivia® intravitreal injection assist device by trained ophthalmic allied health professionals is a safe and cost-effective way to deliver intravitreal injections service.

scholarly journals The UK Paediatric Ocular Trauma Study 1 (POTS1): development of a global standardized protocol for prospective data collection in pediatric ocular trauma

2017 ◽  
Vol Volume 11 ◽  
pp. 449-452 ◽  
Author(s):  
Freda Sii ◽  
Robert Barry ◽  
Richard Blanch ◽  
Joseph Abbott ◽  
Caroline MacEwen ◽  
...  
Keyword(s):  
Data Collection ◽  
Ocular Trauma ◽  
Prospective Data ◽  
Standardized Protocol ◽  
The Uk ◽  
Pediatric Ocular Trauma

CEU chief awarded professorship

2008 ◽  
Vol 90 (9) ◽  
pp. 299-299
Author(s):  
Matthew Worrall
Keyword(s):  
Health Services Research ◽  
Clinical Epidemiology ◽  
Surgical Care ◽  
Clinical Effectiveness ◽  
London School ◽  
Services Research ◽  
Senior Lecturer ◽  
The Uk ◽  
Key Staff

Since 1998 the College has been working in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM) to understand better the quality of surgical care in the UK, through our Clinical Effectiveness Unit (CEU). Now the unit has gained further recognition through the promotion of key staff by the LSHTM as Jan van der Meulen, CEU head, has been appointed professor of clinical epidemiology (a new chair) and David Cromwell promoted to senior lecturer in health services research. To mark this, I interviewed Jan on the achievements of the department and on what challenges lie ahead.

scholarly journals Exploration of implementation, financial and technical considerations within allied health professional (AHP) telehealth consultation guidance: a scoping review including UK AHP professional bodies’ guidance

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055823
Author(s):  
Enza Leone ◽  
Nicola Eddison ◽  
Aoife Healy ◽  
Carolyn Royse ◽  
Nachiappan Chockalingam
Keyword(s):  
Scoping Review ◽  
Allied Health ◽  
Data Extraction ◽  
Collaborative Work ◽  
Occupational Therapists ◽  
Legal Aspects ◽  
Future Research ◽  
Allied Health Professionals ◽  
Study Selection ◽  
The Uk

ObjectivesThe COVID-19 pandemic has resulted in a shift to remote consultations, but telehealth consultation guidelines are lacking or inconsistent. Therefore, a scoping review was performed to chart the information in the articles exploring telehealth for the UK allied health professionals (AHPs) and compare them with the UK AHP professional bodies’ guidelines.DesignScoping review following Aksey and O’ Malley methodological framework.Data sourcesCINHAL and MEDLINE were searched from inception to March 2021 using terms related to ‘telehealth’, ‘guidelines’ and ‘AHPs’. Additionally, the UK AHP professional bodies were contacted requesting their guidelines.Study selectionArticles exploring telehealth for patient consultations, written in English and published in peer-reviewed journal or guidelines available from UK AHP professional bodies/their websites were considered eligible for review.Data extractionOne reviewer extracted data concerning three overarching domains: implementation, financial and technological considerations.Results2632 articles were identified through database searches with 21 articles eligible for review. Eight guidelines were obtained from the UK AHP professional bodies with a total of 29 included articles/guidelines. Most articles were published in the last two years; there was variety in telehealth terminology, and most were developed for occupational therapists, physiotherapists and speech and language therapists. Information was lacking about the assessment of telehealth use and effectiveness, barriers and limitations, the logistical management, the family’s and caregiver’s roles and the costs. There was lack of clarity on the AHPs’ registration requirements, costs and coverage, and legal aspects.ConclusionThis study identified gaps in current guidelines, which showed similarities as well as discrepancies with the guidance for non-AHP healthcare professionals and revealed that the existing guidelines do not adequately support AHPs delivering telehealth consultations. Future research and collaborative work across AHP groups and the world’s leading health institutions are suggested to establish common guidelines that will improve AHP telehealth services.

scholarly journals A framework to support the design and cultivation of embedded research initiatives

2021 ◽  
Author(s):  
Vicky Ward ◽  
Tricia Tooman ◽  
Benet Reid ◽  
Huw Davies ◽  
Breid O’ Brien ◽  
...  
Keyword(s):  
Literature Review ◽  
Extensive Study ◽  
Web Based ◽  
Research And Practice ◽  
Visual Metaphors ◽  
Separate Area ◽  
Research Initiative ◽  
Reflective Questions ◽  
The Uk ◽  
Research Initiatives

Background: Embedded research involves co-locating researchers within non-academic organisations to better link research and practice. Embedded research initiatives are often complex and emergent with a range of underlying intents, structures and processes. This can create tensions within initiatives and contributes to ongoing uncertainty about the most suitable designs and the effectiveness of different approaches.Aims and objectives: We aimed to devise a practical framework to support those designing and cultivating embedded research by operationalising findings from an extensive study of existing initiatives.Key conclusions: The underpinning research on embedded initiatives – a literature review and scoping exercise of initiatives in health settings across the UK – showed that such initiatives share ten common sets of concerns in relation to their intent, structure and processes. We used these insights during a co-production workshop with embedded researchers and their managers that made use of a range of creative activities.The workshop resulted in a practical framework (and associated web-based tools) that draw on the metaphor of a garden to represent the growing, emergent nature of embedded research initiatives and the active work which individuals and organisations need to put into planning and maintaining such initiatives. Each of the aspects is represented as a separate area within the garden using relevant visual metaphors. Building on this, we also present a series of reflective questions designed to facilitate discussion and debate about design features, and we link these to the wider literature, thereby helping those involved to articulate and discuss their preferences and expectations.<br />Key messages<br /><ul><li>Embedded research initiatives are becoming increasingly popular across public sector organisations;</li><br /><li>There are many choices to be made when designing an embedded research initiative, and fresh challenges and tensions emerge as initiatives unfold;</li><br /><li>We present a structured, multilayered framework to support those designing, analysing and managing embedded research initiatives;</li><br /><li>The framework can support transparency, dialogue, agreement of expectations and ongoing learning within and between initiatives.</li></ul>

scholarly journals Self-care use patterns in the UK, US, Australia, and Japan: a multinational web-based survey

2016 ◽  
Vol 5 (2) ◽  
pp. 151-160 ◽  
Author(s):  
Sujeong Mun ◽  
Jeong-Hwan Park ◽  
Seung-Min Baek ◽  
Minhee Lee ◽  
Sun-Mi Choi ◽  
...  
Keyword(s):  
Self Care ◽  
Web Based ◽  
Use Patterns ◽  
The Uk
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