Implementation of total laparoscopic hysterectomy as day case surgery.

Elective surgeries within the National Health Service are frequently cancelled due to shortages of inpatient beds due to acute emergency admissions, and more recently, the COVID-19 pandemic. The aim of this quality improvement project was to initiate a day case hysterectomy pathway, prospectively collecting data on a group of selected motivated patients to assess its feasibility and safety. Interventions to maximise the chance of same day discharge included preoperative education and hydration, alterations in anaesthetic and surgical techniques and collaborative working between surgeons and recovery nurses to safely discharge patients. In change cycle 1, 93% of patients were discharged on the same day as surgery. In change cycle 2, 100% of patients were discharged on the same day as surgery. In a patient questionnaire, 90% of patients would recommend a day case hysterectomy to their friends or family. Day case hysterectomy was safely introduced to our unit, through leaders actively encouraging contributions and feedback throughout the initiation of the pathway from different components of the multidisciplinary team, from conception to roll out of the guideline for use by other gynaecological surgical teams within the trust.

Impact of Changes in Time Left Alone on Separation-Related Behaviour in UK Pet Dogs.

Separation-related behaviours (SRBs), including but not limited to vocalisation, pacing, destruction and toileting, occur in the absence of human company. As well as being problematic for the dogs' owners, such behaviours indicate that the dogs' emotional state is compromised. As part of the COVID-19 pandemic, time spent alone decreased considerably for many pet dogs, leading to concerns about the development of SRBs when dogs are left alone more again. The main aim of this study was to test the hypothesis that dogs whose time left alone decreased most (compared to a February 2020 pre-COVID baseline) would be at greatest risk of developing new signs of SRB when time left alone increased again. To achieve this aim, we utilised survey data gathered from dog owners between 4th May and 3rd July 2020, during the first COVID-19 'lockdown' period in the United Kingdom (UK), and a follow-up survey of the same dog-owner cohort, completed when restrictions had eased between 10th October and 2nd November 2020. Individual dogs fluctuated considerably in whether they showed signs of SRB or not across the study period (n = 1807). Overall, the prevalence of SRB in the population decreased from 22.1% to 17.2%, as did the time dogs were left alone for between February and October 2020. However, 9.9% of dogs had developed new signs of SRB by the follow-up survey in October 2020, with dogs whose leaving hours decreased most during lockdown restrictions being at increased risk of developing SRBs. These findings have implications for our understanding of the etiology of SRB, by showing a link between changes in owner routine and SRB risk.

Impact of the First COVID-19 Lockdown on Management of Pet Dogs in the UK.

Initial COVID-19 lockdown restrictions in the United Kingdom (23rd March-12th May 2020) prompted lifestyle changes for many people. We explored the impact of this lockdown phase on pet dogs using an online survey completed by 6004 dog owners, who provided information including dog management data for the 7 days prior to survey completion (4th-12th May 2020), and for February 2020 (pre-lockdown). We explored associations between potential predictors and four outcomes relating to changes pre-/during lockdown (reduction in number and duration of walks; increased frequency of play/training, and provision of toys). Most owners (79.5%) reported their dog's routine had changed compared to pre-lockdown. There was a four-fold increase in the proportion not left alone for >5 min on any day during a weekly period (14.6% pre-lockdown, 58.0% during lockdown), with the proportion being left for ≥3 h at a time decreasing from 48.5% to 5.4%. Dogs were walked less often and for less time daily during lockdown, with factors related to the dog, owner, household, and home location associated with changes to walking practices. Many dogs had more play/training sessions and were given toys more frequently during lockdown. Decreased walk duration was associated with increased odds of play/training opportunities and toy provision. These changes to dog management have the potential for immediate and longer-term welfare problems.

Impact of the First COVID-19 Lockdown on Management of Pet Dogs in the UK

Initial COVID-19 lockdown restrictions in the United Kingdom (23 March–12 May 2020) prompted lifestyle changes for many people. We explored the impact of this lockdown phase on pet dogs using an online survey completed by 6004 dog owners, who provided information including dog management data for the 7 days prior to survey completion (4–12 May 2020), and for February 2020 (pre-lockdown). We explored associations between potential predictors and four outcomes relating to changes pre-/during lockdown (reduction in number and duration of walks;increased frequency of play/training, and provision of toys). Most owners (79.5%) reported their dog’s routine had changed compared to pre-lockdown. There was a four-fold increase in the proportion not left alone for >5 min on any day during a weekly period (14.6% pre-lockdown, 58.0% during lockdown), with the proportion being left for ≥3 h at a time decreasing from 48.5% to 5.4%. Dogs were walked less often and for less time daily during lockdown, with factors related to the dog, owner, household, and home location associated with changes to walking practices. Many dogs had more play/training sessions and were given toys more frequently during lockdown. Decreased walk duration was associated with increased odds of play/training opportunities and toy provision. These changes to dog management have the potential for immediate and longer-term welfare problems.