scholarly journals Incidence of severe critical events in paediatric anaesthesia in the United Kingdom: secondary analysis of the anaesthesia practice in children observational trial (APRICOT study)

Anaesthesia ◽  
2018 ◽  
Author(s):  
T. Engelhardt ◽  
D. Ayansina ◽  
G. T. Bell ◽  
V. Oshan ◽  
J. S. Rutherford ◽  
...  
Keyword(s):  
United Kingdom ◽  
Secondary Analysis ◽  
Paediatric Anaesthesia ◽  
Critical Events ◽  
Observational Trial ◽  
The United Kingdom ◽  
Anaesthesia Practice ◽  
Apricot Study

scholarly journals Access to personal protective equipment in healthcare workers during the COVID-19 pandemic in the United Kingdom: results from a nationwide cohort study (UK-REACH)

2021 ◽  
Author(s):  
Christopher A Martin ◽  
Daniel Pan ◽  
Joshua Nazareth ◽  
Avinash Aujayeb ◽  
Luke Bryant ◽  
...  
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Secondary Analysis ◽  
Protective Equipment ◽  
Primary Analysis ◽  
Questionnaire Response ◽  
The United Kingdom ◽  
The Uk

Abstract Objectives: To determine the prevalence and predictors of self-reported access to appropriate personal protective equipment (aPPE) for healthcare workers (HCWs) in the United Kingdom (UK) during the first UK national COVID-19 lockdown (March 2020) and at the time of questionnaire response (December 2020 - February 2021). Design: Two cross sectional analyses using data from a questionnaire-based cohort study. Setting: Nationwide questionnaire from 4th December 2020 to 28th February 2021. Participants: A representative sample of HCWs or ancillary workers in a UK healthcare setting aged 16 or over, registered with one of seven main UK healthcare regulatory bodies. Main outcome measure: Binary measure of self-reported aPPE (access all of the time vs access most of the time or less frequently) at two timepoints: the first national lockdown in the UK (primary analysis) and at the time of questionnaire response (secondary analysis). Results: 10,508 HCWs were included in the primary analysis, and 12,252 in the secondary analysis. 3702 (35.2%) of HCWs reported aPPE at all times in the primary analysis; 6806 (83.9%) reported aPPE at all times in the secondary analysis. After adjustment (for age, sex, ethnicity, migration status, occupation, aerosol generating procedure exposure, work sector, work region, working hours, night shift frequency and trust in employing organisation), older HCWs (per decade increase in age: aOR 1.2, 95% CI 1.16 - 1.26, p<0.001) and those working in Intensive Care Units (1.61, 1.38 - 1.89, p<0.001) were more likely to report aPPE at all times. Those from Asian ethnic groups compared to White (0.77, 0.67 - 0.89, p<0.001), those in allied health professional (AHPs) and dental roles (vs those in medical roles; AHPs: 0.77, 0.68 - 0.87, p<0.001; dental: 0.63, 0.49 - 0.81, p<0.001), and those who saw a higher number of COVID-19 patients compared to those who saw none (≥21 patients 0.74, 0.61 - 0.90, p=0.003) were less likely to report aPPE at all times in the primary analysis. aPPE at all times was also not uniform across UK regions (reported access being better in South West and North East England than London). Those who trusted their employing organisation to deal with concerns about unsafe clinical practice, compared to those who did not, were twice as likely to report aPPE at all times (2.18, 1.97 - 2.40, p<0.001). With the exception of occupation, these factors were also significantly associated with aPPE at all times in the secondary analysis. Conclusions: We found that only a third of HCWs in the UK reported aPPE at all times during the period of the first lockdown and that aPPE had improved later in the pandemic. We also identified key sociodemographic and occupational determinants of aPPE during the first UK lockdown, the majority of which have persisted since lockdown was eased. These findings have important public health implications for HCWs, particularly as cases of infection and long-COVID continue to rise in the UK.

scholarly journals Estudio APRICOT sobre la seguridad de los más pequeños

2019 ◽  
Vol 11 (10) ◽  
pp. 2
Author(s):  
Patricia Navarro Echevarría ◽  
Daniel Arnal Velasco
Keyword(s):  
Observational Cohort Study ◽  
Critical Events ◽  
Neurological Damage ◽  
Cardiovascular Instability ◽  
Anaesthesia Practice ◽  
Factores De Riesgo ◽  
Observational Cohort ◽  
Apricot Study ◽  
Drug Errors ◽  
Sobre Todo

El manejo anestésico del paciente pediátrico requiere de una formación y unas estructuras específicas, debido a las situaciones adversas que se pueden producir. El estudio APRICOT (Anaesthesia PRactice In Children Obervational Trial) con una muestra de más de 30.000 pacientes de 33 países europeos y a través de un minucioso análisis observacional de cohortes prospectivo, recoge la naturaleza, la incidencia y los factores de riesgo de los evento críticos más comprometedores; desde los más comunes como el laringoespasmo o el broncoespasmo, la bradicardia hasta la parada cardiaca, pasando por fenómenos neurológicos, anafilaxia o errores de medicación. Obtiene unos resultados que distan en algunos aspectos de lo estudiado hasta ahora. La diversidad de los datos analizados permite identificar aquellos factores de riesgo relacionados con los eventos críticos, entre ellos el anestesista y el centro hospitalario. Pero sobre todo da pie a la necesidad de crear guías de manejo anestésico pediátrico encaminadas hacia una Anestesia más segura. ABSTRACT APRICOT report about our yougest´s safety The perioperative care of infants and children demands special training and facilities due to possible critical events. The APRICOT study (Anaesthesia PRactice In Children Obervational Trial) analyses more than 30.000 anaesthetic procedures from 33 different European countries. Through a detailed prospective observational cohort study, this trial identifies the incidence, the nature and the outcomes of severe critical events in children, including laryngospasm, bronchospasm, cardiovascular instability and cardiac arrest, neurological damage, anaphylaxis or drug errors. Some reported results differ from what was previously published in the literature. Large variation of the collected data allows to identify those risk factors contributing to the severe critical events, among them, the anaesthetist and the centre. This study especially motivates to create clinical practice guidelines of paediatric anaesthesia management for a safer Anaesthesia.

scholarly journals Influence of the SARS-CoV-2 Outbreak on the Uptake of a Popular Smoking Cessation App in UK Smokers: Interrupted Time Series Analysis

10.2196/19494 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e19494 ◽  
Author(s):  
Olga Perski ◽  
Aleksandra Herbeć ◽  
Lion Shahab ◽  
Jamie Brown
Keyword(s):  
Time Series ◽  
Smoking Cessation ◽  
United Kingdom ◽  
Secondary Analysis ◽  
Interrupted Time Series ◽  
Step Change ◽  
Outcome Variable ◽  
Primary Analysis ◽  
The United Kingdom ◽  
Increasing Trend

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out mobile health support, such as smartphone apps. Objective We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free. Methods Data were from daily and nondaily adult smokers in the United Kingdom who had downloaded the Smoke Free app between January 1, 2020, and March 31, 2020 (primary analysis), and January 1, 2019, and March 31, 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalized as March 1, 2020 (primary analysis), and January 15, 2020 (secondary analysis). Generalized additive mixed models adjusted for relevant covariates were fitted. Results Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. Calculation of Bayes factors (BFs) indicated that the data for the primary analysis favored the null hypothesis compared with large associations (for level, BF=0.25; for slope, BF=0.26) but were insensitive to the detection of small associations (for level, BF=0.78; for slope, BF=1.35). Conclusions In the United Kingdom, between January 1, 2020, and March 31, 2020, and between January 1, 2019, and March 31, 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a large step change or increasing trend in downloads of a popular smoking cessation app. Findings on the association of the SARS-CoV-2 outbreak with a small step change or increasing trend were inconclusive.

scholarly journals Understanding and using health experiences to improve healthcare—examples from the United Kingdom

2018 ◽  
pp. 263-271
Author(s):  
Lisa Hinton ◽  
Louise Locock ◽  
Sue Ziebland
Keyword(s):  
United Kingdom ◽  
Research Agenda ◽  
Secondary Analysis ◽  
Service Development ◽  
Service Improvement ◽  
The United Kingdom ◽  
Patient Narratives ◽  
Traditional Research ◽  
Health Experiences ◽  
Design Projects

This chapter explores the variety of ways in which people’s narrative accounts of their health experiences can be harnessed to inform practice, service development, and health policy, as well as a more traditional research agenda. The case has been made that collecting data on patient experience as an activity in isolation is not enough. Health experiences should be used to improve care. But what are the most effective ways to achieve this? This chapter presents examples of projects conducted in the United Kingdom where patient narratives collected as part of the Healthtalk project (www.healthtalk.org) were used for health service improvement. Examples include secondary analysis, and co-design projects using experience based co-design and an accelerated approach to co-design.

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