Assessing the impact of an urgent dental care centre on the oral health-related quality of life of patients during the COVID-19 pandemic

Introduction: An urgent dental care centre (UDCC) was set up at Queen Mary's Hospital in Sidcup, in response to the COVID-19 pandemic. Alongside the reporting of clinical outcomes, it is important to determine the success of a service from a patient's perspective. The aim of this study was to ascertain patient reported outcome measures (PROMs) and patient reported experienced measures (PREMs) of our service. Method(s): The Oral Health Impact Profile 14 (OHIP-14) tool was used to assess the Oral Health-Related Quality of Life (OHRQoL) of patients, and completed before and after attending our UDCC for treatment. Patients were also asked to complete a patient satisfaction questionnaire. Result(s): 146 patients were recruited for our study, with 95 patients completing the OHIP-14 questionnaires pre- and post intervention at our UDCC and 136 patients completing a patient satisfaction questionnaire. A statistically significant reduction in OHIP score when comparing pre- and post-intervention was found across all OHIP-14 domains. The mean positive response rate (strongly agree or agree) for the patient satisfaction questionnaire was 97.1%. Conclusion(s): A significant improvement in OHRQoL was found after treatment at our UDCC, with the majority of patients reporting a positive experience. We conclude that PROMs and PREMs are vital tools to assess service efficacy, help with the planning of service provision and should remain at the forefront even during a crisis such as the COVID-19 pandemic.Copyright © 2021

Investigating neutrophil function during SARS-CoV2 infection in human airway epithelial cells from elderly and young individuals

The COVID-19 pandemic caused by the SARS-CoV2 virus poses a global health threat with over 5 million deaths recorded. There is little understanding regarding SARS-CoV2 pathogenesis in the human airways and disease severity increases with age. Neutrophils are white blood cells found in large numbers in the airways of the lungs in severe COVID-19 patients. It is not known whether this influx of neutrophils into the airway has a protective or detrimental effect. We aim to understand the role of neutrophils during COVID-19 pathology, using an experimental infection model of the airway epithelium from the eldelry and children. To do this, we collect nasal airway cells from healthy elderly and children and grow them at air-liquid interface. Once differentiation and ciliation of these cells is reached, we infect the cells with SARS-CoV2 virus and allow neutrophils to migrate from the basolateral (blood) to the apical (air) side of the epithelium, similar to a physiological airway. Using flow cytometric analyses, we measure the expression of activation markers and the number of neutrophils that migrate across the epithelium of different ages in response to SARS-CoV2 infection. Preliminary work shows less viable neutrophils recovered from the elderly epithelium, more activated neutrophils when migrating through the elderly epithelium, as well as increased numbers of neutrophils remaining on the basolateral (blood) side of the elderly epithelium. These findings point to an inflammatory neutrophil phenotype influenced by the damaged elderly epithelium and supports the hypothesis that neutrophils are responsible for the severity of disease.

Managerial decision-making during the COVID-19 pandemic and its impact on the sustainability initiatives of Canadian foodservice businesses. (Special Issue: The impact of the covid-19 pandemic and the foodservice industries.)

COVID-19 had a major impact on the Canadian foodservice sector. Like most countries, the pandemic in Canada resulted in various periods of lockdown. The pandemic placed great strain on many establishments and had a major impact on the pre-COVID-19 sustainability initiatives of the Canadian foodservice sector. The purpose of this study was to observe managerial decision-making in Canadian foodservice businesses during lockdown and reopening, focusing on the impact of those decisions on pre-COVID-19 sustainability initiatives. We linked the outcomes to the theory of decision-making by objection during times of crises. This study used semi-structured interviews over a two-month period in mid-2020 with three Canadian foodservice establishments. Our results showed that decision-making impacted the environmental sustainability initiatives in foodservice establishments by imposing a throwaway culture for food and personal protective equipment. The pandemic also impacted social and economic initiatives, created higher operation costs, a complexity of government intervention and the managing of mental health. This study showed that the COVID-19 pandemic provided an opportunity to develop theories of managerial decisions during crises and disasters that are natural, versus human-based crises, with pandemics situated between those two concepts. Future research could investigate the impact of decision-making on other initiatives within foodservice businesses.

The Impact of COVID-19 Lockdowns on Public Libraries in the UK: Findings from a National Study

This paper explores how public libraries in the United Kingdom were impacted by the lockdowns imposed as a result of the COVID-19 pandemic. Freedom of Information requests were made to all UK public library services. The data received indicated that almost 65% of UK library services saw a reduction in physical loans of between 70% and 90% of pre-pandemic borrowing levels. The cumulative data also revealed that almost 120 million books that were issued in pre-pandemic years were not issued in the 2020/21 lockdown period. Meanwhile, 47% of library services saw their e-loan provision rise between 100% and 200% on pre-pandemic levels, although these numbers rose from a low base and were comparatively small when measured against physical loan losses. The data also highlighted that active membership of the public library services (members who had borrowed an item in the previous year) dropped to 40% of pre-pandemic levels across the UK. The evidence highlights that while e-loan provision rose significantly while physical library services were largely unavailable, this rise was from a very low base, and this rise in digital usage did not come close to mitigating the drop in physical borrowing that occurred across the UK. The findings of the paper suggest that even when the public had no choice but to move to digital, they did so in limited numbers when compared to usage of physical library buildings and collections. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

FAMILY CAREGIVING IN LTC SETTINGS DURING THE PANDEMIC: COMMUNICATION CHALLENGES AND LEVERAGING TECHNOLOGY

COVID19 related lockdown and protocols caused disruptions in family caregiving for older adults living in LTC settings. However, there is a paucity of research on the challenges and experiences of family caregivers in maintaining their caregiving role during the pandemic. Hence, this qualitative study explores family caregivers' communication challenges and the role technology played in performing their caregiving roles. One-on-one in-depth interviews (N=25) were conducted with family caregivers (Mean age= 59.7;92% female;76% child) via phone/Zoom. Interviews were transcribed and thematically analyzed using Nvivo12. Findings demonstrate that family caregivers of older adults in LTC settings experienced severe communication barriers with staff at those facilities in the early onset of the pandemic, including delays of important information about their care recipients. Participants highlighted high staff turnover, inadequate training, staff unfamiliarity with technology, and poor internet connections as perpetuating communication barriers. During this time, their older care recipients experienced visual and hearing impairments that affected their ability to communicate, as well as cognitive decline. Despite this, family caregivers were able to successfully utilize various forms of technology to continue providing care supports and social support to their loved ones. Although participants relied on phone calls and email communications, they also used other platforms including Zoom, FaceTime, Nixplay, and TextNow. Participants used devices including landline phones, cellphones, computers, tablets, Ipads, and walkie-talkies to execute their communication. Implications of this study suggest that improving access and utilization of technology in LTC settings can enhance family caregiving during unprecedented events like the COVID19 pandemic.

FAMILY CAREGIVING FOR OLDER ADULTS IN LONG-TERM CARE DURING THE PANDEMIC: STRESS, SOCIAL SUPPORT, AND ADAPTATION

Older adults residing in long-term care (LTC) are especially vulnerable to the COVID-19 pandemic. Federal and local health officials have issued strict visitation guidelines, including family caregivers. Given that family caregivers are essential in the well-being for older adults in LTC, these measures have had an enormous impact. As little is known about the experiences of family caregivers, the purpose of this study was to explore how the COVID-19 pandemic impacted family caregivers' roles, mental health, and adaptation. Semi-structured interviews (N=25) were conducted with family caregivers of older adults in LTC (Mean age= 59.7;92% female) via phone/Zoom. An interview guide led the question asking process and participants were asked open-ended questions about the impact of COVID-19 related protocols on their caregiving, mental health, and sources of social support. Interviews were transcribed verbatim and analyzed in Nvivo, guided by Grounded Theory methods. The majority of participants (76%) identified as a child of their care recipient. Findings highlight that most participants experienced numerous changes to their caregiving tasks, such as assisting with activities of daily living (ADLs), limited monitoring for their loved ones, and a reduction of social support provided to the care recipient. Family caregivers also reported other changes in their roles that resulted in increased stress and mental health concerns. These concerns were discussed in detail, including ways in which family caregivers adapted to their new roles and managed their stress. Findings from this study will inform interventions geared to better support family caregivers, particularly during times of crisis.

Assessing the Effect of the COVID-19 Pandemic on the Rate and Management of Ectopic Pregnancy

Study Objective To evaluate the impact of the COVID-19 pandemic on the rate and management of ectopic pregnancies. With the decrease of in-person wellness visits, there is concern for decreased STI screening and treatment of asymptomatic infections that may contribute to ectopic pregnancy rate. In addition, patient delay in presentation to care leads to later diagnoses of ectopic pregnancy and increased need for utilization of surgical management. Design This is a retrospective cohort study. The pre-Covid-19 data were collected from March 2019 through February 2020 and compared to data from October 2020 through September 2021. Data compared included the number of ectopic pregnancies and management strategy. Setting Tertiary care, academic medical center. Patients or Participants 54 diagnosed ectopic pregnancies in the pre-pandemic phase and 66 diagnosed ectopic pregnancies in post-pandemic phase. Interventions Billing diagnosis codes and surgical cases were reviewed for the pre-COVID-19 period and from the post-COVID-19 period. Data for each ectopic subject included site of ectopic, laterality, quantitative HCG, ultrasound findings of free fluid and whether surgical or medical management was performed. Measurements and Main Results 54 ectopic pregnancies were diagnosed pre-COVID-19 and 66 were diagnosed post-COVID. The rate of surgical management in the post-COVID-19 group was 77.8% vs 61.1% in the pre-COVID-19 group (p < 0.05). Thus, ectopic pregnancies in post-pandemic period were more likely to require surgery. Further, the total rate of ectopic pregnancy is also rising to a statistically significant degree. Conclusion There is a statistically significant increase in rate of ectopic pregnancies requiring surgical management since the start of the COVID-19 pandemic. This is significant as early diagnosis and management of ectopic pregnancies can oftentimes prevent surgical management. Further study to be completed to evaluate the reasons for this during a time when resource management and allocation has been so tightly managed.

Hands-On Mathematics: Preservice Teachers Supporting Home Learning During COVID-19

Mathematics manipulatives, or the physical objects and concrete materials that children use to make sense of concepts, have long been incorporated in early childhood classrooms to support children in building mathematical reasoning skills. During the pandemic, as schooling shifted to the home context, schoolteachers of young children confronted dilemmas in planning hands-on mathematics lessons as commercially prepared manipulatives were not available in the home setting. In this chapter, we draw from data collected in a multiple case study of ten preservice teachers planning lessons during an alternative practicum focused on supporting home learning during school closures. Our findings detail how preservice teachers included common household materials for hands-on mathematical experiences and invited family members to participate in the activities they designed for children in kindergarten to Grade 2 (4–7 years). Our exploration was guided by constructivist theories that identify the importance of young children’s active and purposeful manipulation of objects supported through conversations to build mathematical understandings. The results of the study illustrate that the preservice teachers attempted to support hands-on learning in different ways;the variation of these afford new ways of thinking about the configuration of pedagogies, children, families, and materials. This chapter offers insights into how early childhood educators in a variety of settings may redesign mathematics learning opportunities to support young children’s knowledge construction through flexible lessons that invite young children and families to use whatever materials are available to engage in hands-on mathematics activities. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

What Do We Need to Know About Musculoskeletal Manifestations of COVID-19?: A Systematic Review.

¼: COVID-19 is a disease that is challenging science, health-care systems, and humanity. An astonishingly wide spectrum of manifestations of multi-organ damage, including musculoskeletal, can be associated with SARS-CoV-2. ¼: In the acute phase of COVID-19, fatigue, myalgia, and arthralgia are the most common musculoskeletal symptoms. ¼: Post-COVID-19 syndrome is a group of signs and symptoms that are present for >12 weeks. The associated musculoskeletal manifestations are fatigue, arthralgia, myalgia, new-onset back pain, muscle weakness, and poor physical performance. ¼: Data on COVID-19 complications are growing due to large absolute numbers of cases and survivors in these 2 years of the pandemic. Additional musculoskeletal manifestations encountered are falls by the elderly, increased mortality after hip fracture, reduced bone mineral density and osteoporosis, acute sarcopenia, rhabdomyolysis, Guillain-Barré syndrome, muscle denervation atrophy, fibromyalgia, rheumatological disease triggering, septic arthritis, adhesive capsulitis, myositis, critical illness myopathy, onset of latent muscular dystrophy, osteonecrosis, soft-tissue abscess, urticarial vasculitis with musculoskeletal manifestations, and necrotizing autoimmune myositis. ¼: A wide range of signs and symptoms involving the musculoskeletal system that affect quality of life and can result in a decrease in disability-adjusted life years. This powerful and unpredictable disease highlights the importance of multimodality imaging, continuing education, and multidisciplinary team care to support preventive measures, diagnosis, and treatment.

Delivering services in the new normal: Recording the experiences of UK public library staff during the COVID-19 pandemic

This paper reports the results of a survey undertaken in December 2021 and January 2022 related to public library staff in the United Kingdom and their experiences of COVID-19, exploring the lockdowns that were enabled, the subsequent re-openings, their mental health and their views for the future of the service post-COVID-19. Over 200 responses were received, and the findings indicate a range of views. The importance of the library as a community resource is evident in the comments from staff, and their observations of patrons on library re-openings. Findings also indicate concern for the future of the library service, and fear that new technologies like e-books may be seen as adequate replacements for the traditional library service. Findings also indicate staff face stress and mental health issues in terms of dealing with patrons while the virus remains highly prevalent. © The Author(s) 2022.

Efficacy, immunogenicity, and safety of a quadrivalent HPV vaccine in men: results of an open-label, long-term extension of a randomised, placebo-controlled, phase 3 trial.

BACKGROUND: The quadrivalent human papillomavirus (HPV) vaccine was shown to prevent infections and lesions related to HPV6, 11, 16, and 18 in a randomised, placebo-controlled study in men aged 16-26 years. We assessed the incidences of external genital warts related to HPV6 or 11, and external genital lesions and anal dysplasia related to HPV6, 11, 16, or 18, over 10 years of follow-up. METHODS: The 3-year base study was an international, multicentre, double-blind, randomised, placebo-controlled trial done at 71 sites in 18 countries. Eligible participants were heterosexual men (aged 16-23 years) or men who have sex with men (MSM; aged 16-26 years). Men who had clinically detectable anogenital warts or genital lesions at screening that were suggestive of infection with non-HPV sexually transmitted diseases, or who had a history of such findings, were excluded. Eligible participants were randomly assigned (1:1) to receive three doses of either quadrivalent HPV vaccine or placebo on day 1, month 2, and month 6, administered as a 0·5-mL injection into the deltoid muscle. The 7-year, open-label, long-term follow-up extension study was done at 46 centres in 16 countries. Participants who received one or more doses of the quadrivalent HPV vaccine in the base study were eligible for enrolment into the long-term follow-up study (early vaccination group). Placebo recipients were offered the three-dose quadrivalent HPV vaccine at the end of the base study; those who received one or more quadrivalent HPV vaccine doses were eligible for enrolment into the long-term follow-up study (catch-up vaccination group). The primary efficacy endpoints were the incidence of external genital warts related to HPV6 or 11 and the incidence of external genital lesions related to HPV6, 11, 16, or 18 in all participants and the incidence of anal intraepithelial neoplasia (including anal warts and flat lesions) or anal cancer related to HPV6, 11, 16, or 18 in MSM only. The primary efficacy analysis was done in the per-protocol population for the early vaccination group, which included participants who received all three vaccine doses, were seronegative at day 1 and PCR-negative from day 1 through month 7 of the base study for the HPV type being analysed, had no protocol violations that could affect evaluation of vaccine efficacy, and had attended at least one visit during the long-term follow-up study. For the catch-up vaccination group, efficacy was assessed in the modified intention-to-treat population, which included participants who had received at least one vaccine dose, were seronegative and PCR-negative for HPV types analysed from day 1 of the base study to the final follow-up visit before receiving the quadrivalent HPV vaccine, and had at least one long-term follow-up visit. Safety was assessed in all randomised participants who received at least one vaccine dose. This study is registered with ClinicalTrials.gov, NCT00090285. FINDINGS: Between Aug 10, 2010, and April 3, 2017, 1803 participants were enrolled in the long-term follow-up study, of whom 936 (827 heterosexual men and 109 MSM) were included in the early vaccination group and 867 (739 heterosexual men and 128 MSM) were included in the catch-up vaccination group. Participants in the early vaccination group were followed up for a median of 9·5 years (range 0·1-11·5) after receiving the third dose of the quadrivalent HPV vaccine, and participants in the catch-up vaccination group were followed up for a median of 4·7 years (0·0-6·6) after receiving the third dose. In early vaccine group participants during long-term follow-up compared with the placebo group in the base study, the incidence per 10 000 person-years of external genital warts related to HPV6 or 11 was 0·0 (95% CI 0·0-8·7) versus 137·3 (83·9-212·1), of external genital lesions related to HPV6, 11, 16, or 18 was 0·0 (0·0-7·7) versus 140·4 (89·0-210·7), and of anal intraepithelial neoplasia or anal cancer related to HPV6, 11, 16, or 18 in MSM only was 20·5 (0·5-114·4) versus 906·2 (553·5-1399·5). Compared with during the base study (ie, before quadrivalent HPV vaccine administration), during the long-term follow-up period, participants in the catch-up vaccination group had no new reported cases of external genital warts related to HPV6 or 11 (149·6 cases per 10 000 person-years [95% CI 101·6-212·3] vs 0 cases per 10 000 person-years [0·0-13·5]) or external genital lesions related to HPV6, 11, 16, or 18 (155·1 cases per 10 000 person-years [108·0-215·7] vs 0 cases per 10 000 person-years [0·0-10·2]), and a lower incidence of anal intraepithelial neoplasia or anal cancer related to HPV6, 11, 16, or 18 (886·0 cases per 10 000 person-years [583·9-1289·1] vs 101·3 cases per 10 000 person-years [32·9-236·3]). No vaccine-related serious adverse events were reported. INTERPRETATION: The quadrivalent HPV vaccine provides durable protection against anogenital disease related to HPV6, 11, 16, and 18. The results support quadrivalent HPV vaccination in men, including catch-up vaccination. FUNDING: Merck Sharp & Dohme.

The assessment and management of breathing dysfunction in musculoskeletal conditions: A survey of current United Kingdom physiotherapy practice

Keywords: Breathing dysfunction, Evolving musculoskeletal practice, Survey Purpose: The prevalence of breathing dysfunction (BD) is estimated at 10% of the United Kingdom (UK) adult population, and higher in those with asthma (Thomas et al., 2005), while an estimated 20% of adults attend primary care each year with musculoskeletal conditions (Department of Health and Social Care, 2019). Current research indicates a possible relationship between BD and musculoskeletal conditions including alterations in thoracic mechanics, respiratory muscle strength and spirometry, however, there is a lack of evidence regarding the most appropriate BD assessment and management strategies. Therefore, this study investigated physiotherapists’ use of BD assessment and management strategies for patients with musculoskeletal conditions and explored relationships between professional characteristics and current practice variation. Methods: An observational cross-sectional online survey was utilised. UK-based musculoskeletal physiotherapists were invited to participate via social media, professional networks and email. The survey consisted of 28 closed and 16 open questions informed by similar surveys and relevant BD literature. The survey was piloted by five musculoskeletal physiotherapists and was open for eight weeks between 22/05/2020 - 17/07/2020 with a half-way reminder. Data analysis included descriptive statistics and Fishers exact test. Results: 257 questionnaires were completed. 81% (n = 208) of participants worked within the NHS and 31.1% (n = 80) in private practice, with the majority working at an equivalent band 6 (23%, n = 58), band 7 (33%, n = 84) and band 8a (31%, n = 79). 13.2% (n = 34) reported a special interest in BD. 72% (n = 185) of participants did not assess or manage BD, 28% (n = 72) did. In this latter group 100% (n = 72) assessed using subjective indicators and patient observation, while muscle-length testing (69%, n = 50), physical assessment (68%, n = 49), respiratory parameters (26%, n = 19) and BD specific questionnaires (14%, n = 10) were less commonly reported. BD management consistently included breathing retraining (94%, n = 68), general exercise and BD education (89%, n = 64). The inclusion of BD assessment and management in musculoskeletal conditions was statistically significantly associated with BD special interest (p < 0.001), NHS equivalent banding (p = 0.034) and post-graduate BD training including self-directed learning, in-service training, online training, formal lectures, short courses and PhD level study (p < 0.001-0.049). Conclusion(s): This is the first survey of BD assessment and management in musculoskeletal conditions and indicates infrequent assessment and management of BD. For physiotherapists who do assess and manage BD, subjective indicators and observation were the most commonly assessed, while breathing retraining was the most frequent management strategy. BD special interest, relevant post-graduate training and NHS equivalent banding were statistically significantly associated with use of BD assessment and management. Impact: Findings will inform future survey design including international surveys comparing findings across a more diverse sample. Qualitative work or use of vignettes could explore rationales regarding the inclusion of BD assessment and management in musculoskeletal practice. Due to the potentially detrimental clinically important reduced respiratory muscle function associated with mechanical ventilation (Lu et al., 2016;Nassar et al., 2018) and COVID-19 illness (Brosnahan et al., 2020), future quantitative research could investigate whether there is an association between COVID-19 and BD or the effect of long COVID on breathing mechanics. Funding acknowledgements: Project was unfunded.

Ultrasound characteristics, serum biochemistry and outcome of ectopic pregnancies presenting during COVID-19 pandemic.

OBJECTIVE: To describe and compare the characteristics of ectopic pregnancies (EPs) in the year prior to vs during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This was a retrospective analysis of women diagnosed with an EP on transvaginal sonography conducted at a center in London, UK, providing early-pregnancy assessment, between 1 January 2019 and 31 December 2020. Women were identified via the Astraia ultrasound reporting system using coded and non-coded outcomes of EP or pregnancy outside the uterine cavity. Data related to predefined outcomes were collected using Astraia and Cerner electronic reporting systems. Main outcome measures included clinical, ultrasound and biochemical features of EP, in addition to reported complications and management. RESULTS: There were 22 683 consultations over the 2-year period. Following consultation, a similar number and proportion of EPs were diagnosed in 2019 (141/12 657 (1%)) and 2020 (134/10 026 (1%)). Both cohorts were comparable in age, ethnicity, weight and method of conception. Gestational age at the first transvaginal sonography scan and at diagnosis were similar, and no difference in location, size or morphology of EP was found between the two cohorts. Serum human chorionic gonadotropin (hCG) levels at the time of EP diagnosis were higher in 2020 than in 2019 (1005 IU/L vs 665 IU/L; P = 0.03). The proportions of women according to type of final EP management were similar, but the rate of failed first-line management was higher during vs before the pandemic (16% vs 6%; P = 0.01). The rates of blood detected in the pelvis (hemoperitoneum) on ultrasound (23% vs 26%; P = 0.58) and of ruptured EP confirmed surgically (9% vs 3%; P = 0.07) were similar in 2019 vs 2020. CONCLUSIONS: No difference was observed in the location, size, morphology or gestational age at the first ultrasound examination or at diagnosis of EP between women diagnosed before vs during the COVID-19 pandemic. Complication rates and final management strategy were also unchanged. However, hCG levels and the failure rate of first-line conservative management measures were higher during the pandemic. Our findings suggest that women continued to access appropriate care for EP during the COVID-19 pandemic, with no evidence of diagnostic delay or an increase in adverse outcome in our population. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

'Teach Trolley' teaching: A simple solution to teaching during a pandemic?

The impact of the COVID-19 pandemic on medical education has been widely documented [1] but its effect on workplace training for healthcare professionals is yet to be determined. As the pandemic eases, opportunities for formal teaching outside of the clinical environment may remain limited with the need to escalate elective surgery. Before the pandemic, there were bi-annual and drop-in sessions for multidisciplinary (anaesthetists and operational department practitioners (ODPs)) airway teaching at St Helens and Knowsley Teaching Hospitals NHS Trust. Since March 2020, this was suspended, limiting opportunities for training updates. We aimed to deliver teaching in the workplace, avoiding the need to remove staff from their clinical duties, flexible in its delivery and focused on equipment relevant to the challenges faced with the pandemic. Methods We implemented 'Teach Trolley' teaching sessions for ODPs and anaesthetists in their anaesthetic rooms, offering more experience and familiarity with 'Glidescope' videolaryngoscopy, Aintree intubation catheter using fibreoptic scope via supraglottic airway and 'ScalpelCric' front of neck access equipment. At an agreed time, patient care was handed over to some of the teaching team and teaching delivered in 15-min slots, focused on the equipment of their choice. Equipment was decontaminated after each use. A questionnaire was completed to assess confidence in using the equipment and convenience of the teaching format. Results The session was attended by ODPs (50%) and anaesthetists (50%). All participants felt more confident using the equipment that they had received teaching on and 90% would attend similar sessions in the future. Seventy per cent of respondents last had teaching on the equipment > 12 months ago with none within the last 6 months. Some respondents mentioned 'the ease' and 'convenience' of this format due to the 'difficulty' of attending teaching. Discussion The results show the importance of ongoing development and finding simple ways to ensure relevant teaching is delivered during times of increased pressure. This session allowed focused teaching whilst minimising disruption to clinical duties and improving engagement within the workforce. In the future we would like to increase session frequency, cover more topics relevant to the theatre environment and involve ODPs in their delivery, which will help lead transformation of the services provided [2].