Day case mini percutaneous nephrolithotomy (mini-PCNL): feasibility, safety, efficacy and patient acceptability study

Introduction: The objective was to investigate the feasibility, safety, efficacy, and patient acceptability of performing mini-PCNL as a day case procedure. To our knowledge, this is the first reported series in the UK. Method Mini-PCNL data was prospectively collected between April- December 2021. Renal access was achieved by the operating surgeon under fluoroscopic guidance in the prone position. The MIP-M system (Karl Storz, Germany) was used. Stones were fragmented using holmium LASER and retrieved by the Vortex effect and basket. Drainage was via a 6 Fr antegrade stent or 10 Fr nephrostomy tube. Patients suitable for same day discharge were identified using defined preoperative selection criteria. Stone related outcomes, duration of surgery, length of stay, readmission rate and complications were recorded. Results: Fifty patients underwent mini-PCNL (34 male,16 female) with a mean age of 60 years. Mean stone size was 24 mm with a mean operating time of 90 minutes. Twenty patients were suitable for same day discharge. Thirty patients stayed overnight (15 for social reasons, 13 for medical comorbidities and 2 for complications). We recorded 1 case of post-operative sepsis and bleeding requiring embolization. The readmission rate was 0% and 85% were stone free on post-operative CT KUB. Conclusion: Our study shows that day case mini-PCNL is safe, feasible and acceptable in selected group of patients. With the ever-rising pressures on stone services to drive efficiency particularly pertinent with the COVID pandemic, day case mini-PCNL represents an ideal therapeutic option in suitable cases.

Job loss and food insecurity during the Covid-19 pandemic

Purpose: Living a nutritious lifestyle requires that people get a sufficient amount of nutrients, vitamins and minerals every day. Healthy dietary practices are related to a stronger immune system, better prevention and easier recovery from illnesses, lower blood pressure, healthy weight, lower risk of diabetes, heart problems and other medical conditions and improved overall well-being (WHO, 2020). Therefore, to maintain a strong immune system able to prevent diseases and ease recovery, optimal nutrition and healthy habits are of increased importance during a pandemic such as Covid-19. However, according to the Bureau of Labor Statistics, more than 22 million Americans have lost a job between February and October 2020, increasing the unemployment rate from 3.5% in February 2020 to 6.9% in October 2020, reaching a peak of 14.7% in April 2020. Job losses during the Covid-19 crisis are likely to put lots of families at risk of malnutrition and food insufficiency and to further deteriorate the already existing food insecurity (Gundersen et al., 2018). This research explores the effect of a recent job loss between August and October 2020 on food sufficiency. Design/methodology/approach: This research examines the impact of a job loss on nutrition and food safety. Specifically, this study explores the effect of a job loss during the Covid-19 pandemic on the level of family and child food sufficiency as perceived by the respondent, confidence about meeting family’s dietary needs in the four weeks following the interview, and an indicator of whether the food sufficiency status of the family has deteriorated or not. This study also determines the differential effect of a job loss by individuals who are still employed despite the loss relative to workers who remained unemployed after a job loss during the Covid-19 crisis. Subsample analyses based on ethnicities, genders and educational attainment are also performed to identify the most vulnerable groups. Findings: The results provide evidence that a job loss is associated with a highly statistically significant deterioration of food sufficiency for families and children and a reduction in the confidence in food security for the near future. This effect is observed for all job losers, but from them, it is larger for the ones who are currently unemployed compared to those who are working. The association between a job loss and family’s nutrition insecurity is the greatest for Hispanic, males and people with some college. Children’s nutrition suffers the most for children whose parents have not completed high school. These results provide an insight into the adverse effect of Covid-19 on food security. Practical implications: From a policy perspective, the results indicate that federal nutrition programs whose goal is to ensure that the dietary needs of Americans, and especially children, are met, which are most likely to benefit the Hispanic population, individuals with low educational attainment and individuals who remained unemployed after losing a job. Originality/value: This study makes several contributions to the growing literature on food security. First, this study is novel in that it examines the effect of an ongoing event, specifically a labor market disruption as a result of a health and economic crisis, on families’ nutrition, and does so using the newest publicly available data designed to track the impact of Covid-19 on the American population. This is one of the first studies that investigates the forementioned impacts in the context of the Covid-19 pandemic. This study further contributes to the literature by distinguishing between employed versus unemployed individuals despite a job loss and by studying distinct groups on the population. In addition, this study compares the effects of interest in the onset of the pandemic to a year later to examine the population’s adjustment to the crisis. The importance and relevance of the results for policy decision-making are also discussed in the paper. © 2022, Emerald Publishing Limited.

Education in the times of a pandemic: parental socioeconomic characteristics and time spent educating children

Purpose: This research explores the impact of parental educational attainment, race, ethnicity, gender and employment on the time parents spend educating their children during the COVID-19 pandemic. Design/methodology/approach: School closures to prevent the spread of COVID-19 have affected billions of students worldwide, and have had an impact on the economy and the society. With classes being cancelled or taught remotely, the importance of parental intervention in children's education has accelerated. Findings: The authors find that more educated parents allocate more time on child education, while higher income and employment have an adverse effect. Fathers are likely to spend more time than mothers in teaching and educating their children during COVID-19. Practical implications: The findings have implications in identifying children whose education suffers the most in times of a pandemic and determining the main target group of policies designed to train children, encourage parental involvement and support children's educational development. Originality/value: This is the first paper that examines the variations in parental time with children across social and economic subgroups during the COVID-19 pandemic. The authors also focus on the time parents spend educating their children rather than just supervising them. The authors additionally examine the determinants of the time children study on their own. Finally, the analysis is novel because it is based on the newest available data collected to examine the trends and experiences of individuals in the United States triggered by COVID-19. © 2021, Emerald Publishing Limited.