ABSTRACT
Consequent to the COVID-19 pandemic and the reopening of international borders, tourists are increasingly concerned about sanitation and hygiene practices in tourism destinations. There is an evident need to investigate how the COVID-19 pandemic has transformed tourist choices. This paper investigates the perceptions of hotel staff and tourists on the influence of inclusive water, sanitation, and hygiene (WASH) practices on tourists' hotel choices in Fiji. This study explores the value of Q-methodology through a case study of Fiji with data collected from 80 hotel staff and 75 tourists. The findings demonstrate that Q-methodology is effective in identifying three tourist types who have a strong interest in WASH impacts and aspects of their safety including concerns about how their visit impacts the local community and environment. Similarly, the Q method was useful in identifying four perspectives of staff understanding on WASH impacts that are significant to tourists' choice of hotel. The findings suggest a significant potential for hotel operators to enact socially inclusive WASH practices to enhance their appeal in the ‘new normal'. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
ABSTRACT
Black and brown communities suffer disproportionately in the wake of catastrophic events. The COVID-19 crisis is no different. Healthcare inequity continues to surface, in terms of physical health and mental health and well-being. Higher comorbidity rates have been rightly attributed (in part) to oppressive social, political, and economic structures. Less discussed, however, are the underlying historical and cultural narratives that have traditionally justified and propped up structures of systemic oppression. These controlling narratives—often hegemonic and internalized—tend to benefit the psychological health of white communities, while simultaneously undermining the psychological and emotional health of black and brown communities. This can lead to a sense of personal and communal hopelessness and nihilism, the onset of cultural trauma, and further exacerbate health disparities in black and brown communities. This essay reflects on how black religion, viewed as a therapeutic container in the current COVID-19 pandemic crisis, can yield indigenous psychological resources that enable persons and communities to construct counter-narratives in a way that is accretive to black mental health and curtails hopelessness and nihilism. © 2002 Taylor and Francis.
ABSTRACT
Background: The delay of the General Pharmaceutical Council (GPhC) pharmacist registration assessments in England due to COVID-19 created a need for innovative assessment methods. Peer assessment was identified as a potential method for use across the sector and geographical boundaries. The aim was to establish a model for a national peer assessment tool to support Early Careers Pharmacists (ECPs) development. Method: Participating ECP submitted cases using a standard template to be anonymised and distributed to three peer reviewers. An external supervisor provided a final agreement on the feedback given. Results: Two hundred and fifty pharmacists participated in peer assessment from a range of sectors and locations. 75.5% (n=566) of potential peer reviews were completed with an average score at expected standard for an ECPs. Commonality of sector experience between submitter and peer did not affect scoring. Conclusion: These findings support acceptability and feasibility of asynchronous pharmacy peer assessment across sector and geographical boundaries.
ABSTRACT
Introduction: The COVID pandemic has exerted unprecedented pressure on hospital resources. Resulting in cancellation of elective operative services, increased patient waiting lists, limited surgical training opportunities along with reduced availability of staff, theatre, and inpatient bed capacity. A novel approach for day case forefoot surgery under ankle block, to mitigate the pandemic service limitations without compromising care, was developed. Method: This is a 3-month, multi-centre, prospective cohort study evaluating the novel ankle block day case forefoot surgery pathway. Patients had a minimum of three months clinical follow up with outcome scores. They were matched to a cohort undergoing similar surgery prior to the COVID pandemic. Results: The utilisation of an ankle block pathway resulted in an average reduction of inpatient stay by 2 days per patient. Over the study period conservative savings of £26,659 were calculated. Anecdotally we observed a reduction in morbidity (wound complications, SSI's) although not statistically significant. Conclusions: Our novel surgical pathway has enabled continued elective operating for procedures that previously required hospital admission during a period of severe restrictions within the NHS. We observed significant reductions in cost, surgical inpatient bed utilisation and total operative time with staff, resource, and time savings. We hypothesise that prehabilitation with physiotherapy, ankle instead of thigh tourniquets and early mobilisation may have contributed to improved morbidity scores. The findings of this project have implications for training, upper limb services and are transferrable as a template to improve service efficiency while maintaining high quality care.
ABSTRACT
Background and Aim: Post-marketing studies comparing low-volume polyethylene glycol (PEG)-based regimens are limited. The aim of this randomized controlled non-inferiority study was to compare the efficacy and tolerability of two commercially available low-volume PEG-based preparations: PLENVU (Norgine) macrogol 3350, sodium ascorbate, sodium sulfate, ascorbic acid, sodium chloride and potassium chloride and Prepkit-C (Fresenius Kabi) macrogol 3350, sodium chloride, potassium chloride and sodium sulfate, sodium picosulfate, magnesium oxide, citric acid and aspartame in an unselected adult colonoscopy outpatient population. Methods: Patients undergoing outpatient colonoscopy were randomized to receive either split-dose Prepkit-C or PLENVU. Patient compliance, satisfaction, and tolerability were captured using a standardized questionnaire on the day of the procedure. A blinded endoscopist assessed the quality of bowel preparation using the Boston Bowel Preparation Scale (BBPS) and Aronchick Scale during the colonoscopy. The procedure times, rates of cecal intubation, and polyp detection rates were also recorded. Results: The study was terminated at 19 months, as recruitment was halted due to the coronavirus disease 2019 pandemic, and an unplanned interim analysis was performed. A total of 164 patients were randomly assigned to either Prepkit-C (n = 82) or PLENVU (n = 82). In the PLENVU group, 89% of patients achieved satisfactory preparation (total BPPS score ≥6 and each subscore ≥2), compared with 85.4% in the Prepkit-C group, resulting in an estimated difference of 3.7% (95% CI, -6.6% to 13.9%;P = 0.48). The median BBPS score with PLENVU was significantly better in the right, middle, and left colonic subsegments with PLENVU (BBPS score, 3;IQR, 2-3) than with Prepkit-C (BBPS score, 2;IQR, 2-3) (P < 0.001). A significantly higher proportion of patients in the PLENVU group had a BBPS score of ≥7, compared with patients in the Prepkit-C group (80% vs 57%;P = 0.002). A significantly greater proportion of patients had good-excellent quality of bowel preparation in the PLENVU group compared with the Prepkit-C group (84% vs 57%;P < 0.001) (Fig. 1). More patients in the PLENVU group reported moderate to severe nausea compared with those in the Prepkit-C group (P = 0.028);however, there were no other differences in patient satisfaction or tolerability between the two groups. Conclusion: The quality of bowel preparation achieved with PLENVU is at least non-inferior to that with Prepkit-C in a real-world unselected group of colonoscopy outpatients, with equivalent tolerability outcomes. This is despite a lower volume of preparation (by 500 mL) that is required to be ingested with PLENVU. Further studies are required in patients at risk of suboptimal bowel preparation.