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1.
British Journal of Surgery ; 109:vi35, 2022.
Article in English | EMBASE | ID: covidwho-2042538

ABSTRACT

Introduction: There has been a rise in trainee-led trauma & orthopaedic multi-centre research collaborative projects globally. These increase trainee involvement in research with an opportunity to deliver highly generalisable results on a particular topic. Objective: To evaluate the number of trauma & orthopaedic trainee-led research collaborative projects that took part since the start of the COVID-19 pandemic in the UK and compare them to projects from 2019. Methods: This was a retrospective study that evaluated trauma & orthopaedic trainee-led national collaborative projects within the UK since the start of the COVID-19 pandemic lockdown (March 2020 to June 2021). Our exclusion criteria included any regional collaborative projects, pre Covid- 19 projects and projects of other surgical specialities. Results: In 2019, 0 trainee-led collaborative projects were commenced nationally in the UK. Since the COVID-19 pandemic, we identified 10 trainee-led collaborative trauma & orthopaedic projects with 6 being published so far. The level of evidence ranged between 3 and 4 and included 5 Audits and 5 cohort studies. The patients that were included in the studies ranged from 927 to 140,231 from a total of 2249 centres. Conclusion: Covid-19 has placed significant challenges across healthcare. However, one positive aspect is the increase in multi-centre trainee-led collaborative projects within the UK. Our study highlights the feasibility of a trainee-led high quality collaborative research projects in the UK and the availability of new tools such as social media and centralised confidential online databases such as Redcap® facilitates such projects. Therefore, we recommend expanding this trainee-led collaborative platform in the field of trauma & orthopaedics worldwide.

2.
Computer Journal ; : 12, 2022.
Article in English | Web of Science | ID: covidwho-1895809

ABSTRACT

Disease diagnosis is an exciting task due to many associated factors. Inaccuracy in the measurement of a patient's symptoms and the medical expert's expertise has some limitations capacity to articulate cause affects the diagnosis process when several connected variables contribute to uncertainty in the diagnosis process. In this case, a decision support system that can assist clinicians in developing a more accurate diagnosis has a lot of potentials. This work aims to deploy a fuzzy inference-based decision support system to diagnose various diseases. Our suggested method distinguishes new cases based on illness symptoms. Distinguishing symptomatic disorders becomes a time-consuming task in most cases. It is critical to design a system that can accurately track symptoms to identify diseases using a fuzzy inference system (FIS). Different coefficients were used to predict and compute the severity of the predicted diseases for each sign of disease. This study aims to differentiate and diagnose COVID-19, typhoid, malaria and pneumonia. The FIS approach was utilized in this study to determine the condition correlating with input symptoms. The FIS method demonstrates that afflictive illness can be diagnosed based on the symptoms. Our decision support system's findings showed that FIS might be used to identify a variety of ailments. Doctors, patients, medical practitioners and other healthcare professionals could benefit from our suggested decision support system for better diagnosis and treatment.

4.
British Journal of Surgery ; 109(SUPPL 1):i3-i4, 2022.
Article in English | EMBASE | ID: covidwho-1769191

ABSTRACT

Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Method: A protocol was developed by the clinical team on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories;discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Conclusions: BOA guidelines state all patients must be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient and make the most of the resources available.

5.
British Journal of Surgery ; 109(SUPPL 1):i13, 2022.
Article in English | EMBASE | ID: covidwho-1769164

ABSTRACT

Introduction: There has been a significant rise in trainee-led trauma & orthopaedic (T&O) multi-centre research collaborative projects globally. Since the start of the COVID-19 pandemic, more emphasis has been on global collaborative research efforts to tackle important research questions. The aim was to evaluate the number of T&O trainee-led research collaborative projects that took part since the start of the COVID-19 pandemic in the UK. Method: A retrospective study that evaluated T&O trainee-led national collaborative projects within the UK since the start of the COVID-19 pandemic lockdown (March 2020 to June 2021). Our exclusion criteria included any regional collaborative projects, projects that were started pre-COVID and projects of other surgical specialities. The number of projects identified was compared to that in 2019. Results: In 2019, 0 trainee-led collaborative projects were commenced nationally in the UK. Since the COVID-19 pandemic, we identified 10 trainee-led collaborative trauma & orthopaedic projects with 3 being published so far. The level of evidence ranged between 3 and 4. Conclusions: Covid has placed significant challenges across healthcare. One positive aspect that has been noted is the increase in multi-centre trainee-led collaborative projects within the UK. Our study highlights the feasibility of a trainee-ledhigh quality collaborative research projects in the UK, emphasising the growing contribution of trainees towards research. Wide-spreadavailability ofnewtechnological toolssuchas social media and Redcap® facilitates such projects in terms of recruitment and data collection. We would, therefore, recommend expanding this trainee-led collaborative platform across in Europe and Worldwide.

6.
European Respiratory Journal ; 58:2, 2021.
Article in English | Web of Science | ID: covidwho-1708886
7.
British Journal of Surgery ; 108(SUPPL 7):vii75, 2021.
Article in English | EMBASE | ID: covidwho-1585060

ABSTRACT

Aim: The Postgraduate Virtual Learning Environment (PGVLE) is a digital platform developed by HEEWM in response to the COVID-19 pandemic to deliver a virtual teaching programme to surgical trainees. The programme is delivered through the BigBlueButton;an integrated virtual classroom. All teaching sessions are recorded and archived to allow trainees to review content at their convenience. We performed a contemporaneous study to review the effectiveness and quality of the platform in delivering teaching and suggest its future role in the surgical curriculum. Method: Anonymised feedback was gathered of trainee's perspective of the platform experience, the quality of teaching and the archived content. All trainees were General Surgery higher trainees (HST) (ST3- ST8). The data from sequential teaching days was analysed. Results: Of 90 HST, on average 40 attended each monthly training day (consistent with pre-COVID attendance). 122 trainee responses were completed. 68% of respondents were between ST3-ST5. 91% rated the administration and delivery of the teaching sessions as excellent or very good. 16% of trainees watched the archived sessions after the teaching day of which 46% felt it met their educational expectations. Conclusions: The PGVLE is an effective platform for the delivery of a virtual surgical teaching programme. It met with high levels of trainee satisfaction in the context of the pandemic. The archived content provides advantages to consolidation of learning. It is thought that the PGVLE platform will become a key feature of the surgical training programme in a hybrid learning model, related to relevant curricula, in the future.

8.
British Journal of Surgery ; 108(SUPPL 6):vi223, 2021.
Article in English | EMBASE | ID: covidwho-1569628

ABSTRACT

Introduction: Surgical conferences are invaluable events for healthcare professionals;they provide opportunities to engage with upcoming scientific discoveries, network professionally with peers as well as expand learning through lectures and workshops. For medical students, conferences provide an opportunity to expand understanding beyond the undergraduate curriculum in an interactive manner. COVID-19 has caused disruption to the organisation and attendance of in-person conferences (IPCs). Virtual conferences (VCs) offer a viable solution, allowing delegates to attend from the comfort of their own homes. Method: The aim of our study was to evaluate an organised VC and explore the perceived benefits and limitations of VCs compared to IPCs. A virtual one-day trauma & orthopaedics (T&O) conference was organised involving lectures, workshops, poster, and oral presentations. Anonymous questionnaire forms were distributed to delegates following the conference to assess the aims of our paper. Results: From 106 responses, 96.2% rated the conference as 'Excellent' or 'Good' with 92.5% stating that it increased their passion for T&O surgery. Based on a five-point Likert scale (5= strongly agree, 1= strongly disagree), mean score of agreement for preferring VCs to IPCs was 3.30(± 1.24). Key advantages of the VC were a lower cost (70.8%) and not having to travel (77.4%), whereas the main limitation was the inability to participate in hands-on workshops (84.9%). Conclusions: Despite the success of our VC, delegate feedback indicates a mixed response comparing VCs to IPCs. We share our findings to encourage similar events to be organised and for other specialties.

9.
British Journal of Surgery ; 108(SUPPL 6):vi195, 2021.
Article in English | EMBASE | ID: covidwho-1569616

ABSTRACT

Introduction: Good Surgical Practice from RCS England encourages the use of e-health records and detailed typed operative notes. The Covid- 19 pandemic has led to multi-site operating. ENT operations in our trust were split over three sites including the private sector leading to potential disruption in continuity of patient care. Physical operation notes are difficult to access in emergencies, telephonic clinics or for audit purposes. We aim to have operative notes available on patients' erecords which adhere to RCSEng guidelines. Method: In this QIP, we reviewed all ENT operations over a retrospective one-month period recording percentage of notes uploaded to patient e-record and the number of surgeons in theatre. We created two novel RCSEng compliant e-operative notes with a user guide, generic and tonsillectomy-specific, and prospectively collected data to complete the cycle. Results: 261 patients were included in both study periods. Only 36/ 134(27%) had e-operative pre-intervention improving to 71/127(56%) post-intervention. In the latter period, 76% of operations included a registrar and were more likely to have e-operative notes(72%) compared to when a consultant was operating alone(6%). There was low uptake of our tonsillectomy e-proforma(33%). Conclusions: Our QIP has already proved effective with our templates increasing operative documentation on e-records. Increased use of etemplate was more likely with the presence of a registrar in theatre. Room for improvement remains and we will re-audit after the introduction of further user-friendly operative templates and IT training. This QIP has also revealed additional operative training opportunities of which registrars can take advantage.

10.
British Journal of Surgery ; 108(SUPPL 6):vi57, 2021.
Article in English | EMBASE | ID: covidwho-1569593

ABSTRACT

Aim: Good Surgical Practice (RCS England) and GMC guidelines inform a surgeon's practice in the consent process for an operation. Since the Covid-19 pandemic, many surgical departments have converted from face-to-face to telephonic consultations. The clinic letter is of increased importance given that it forms a key part of the medical record which the patient should receive to ensure sufficient time and information to make an informed decision. Method: Clinic letters of patients undergoing elective ENT surgery at our trust over a four-week period were examined in this retrospective audit of compliance with RCSEng and GMC guidelines. Additional data was collected on clinician grade and proportion of letters sent to patients. Patients rated satisfaction with consultation on a five-point Likert scale. Results: 135 eligible patients were included in our audit and the majority were listed by a consultant (57%). In all domains, consultant letters were more likely to be comprehensive as compared to registrars. Overall quality of clinic letters was highly variable regarding documentation of diagnosis (52%), surgical risks (50%), discussion of alternative or no treatment (30%) and registrar discussion with consultant (31%). There was also a stark difference between registrars and consultants sending patients copies of clinic letters (10% vs 47%). Only 10% of patients received a leaflet on their condition. 90% of patients were either satisfied or very satisfied with their clinic consultation. Conclusions: Refresher sessions on consent, updated template letters and increased provision of patient information leaflets will be introduced to the ENT department, and improvements monitored with further re-audit.

11.
British Journal of Surgery ; 108:1, 2021.
Article in English | Web of Science | ID: covidwho-1539368
12.
Thorax ; 76(Suppl 2):A178, 2021.
Article in English | ProQuest Central | ID: covidwho-1505966

ABSTRACT

BackgroundBlood eosinopaenia was one of the earliest reported findings in hospitalised patients with COVID-19, questioning whether eosinophils could have an anti-viral or deleterious role in the immune response against SARS-CoV2. Benralizumab is an anti-IL5R monoclonal antibody licensed for the treatment of severe eosinophilic asthma (SEA) and causes the near-complete depletion of blood and tissue eosinophils. As such, it offers the opportunity to explore the impact of eosinopaenia at the time of infection on outcome with COVID-19.MethodPatients started on treatment with benralizumab (up until April 2021) for SEA at our regional asthma centre were contacted by telephone throughout May and June 2021 to establish whether they had experienced a confirmed (PCR-positive) SARS-CoV2 infection since commencing benralizumab. Clinical and demographic characteristics were recorded along with the outcome of infection, including the need for hospitalisation or intensive care admission. Patients requiring hospitalisation were compared to those experiencing mild infections.ResultsData on 268 patients treated with benralizumab was collected with 24/268 (9%) confirming SARS-CoV2 infection with a positive PCR test. Of these 18/24 (75%) experienced mild infections that did not require hospitalisation. Of the 6/24 requiring hospitalisation, the median (IQR) length of stay was 6 (1–8) days. No patients required ICU admission or mechanical ventilation. There was no significant difference in baseline characteristics between hospitalised and non-hospitalised patients. However, it is noteworthy that a higher proportion of hospitalised patients were male (50.0% vs 38.9%) and had a higher mean BMI (32.1 vs 29.5).DiscussionIn the context of drug-induced eosinopaenia with benralizumab, 75% of patients with severe asthma experienced mild COVID-19 disease. This is likely to be an underestimate given that other patients may have experienced an asymptomatic infection or not pursued PCR testing in the context of mild infection. Although caution is needed due to the small sample size, these results do not support a significant role for eosinophils in SARS-CoV2 infection.

13.
Sustainability (Switzerland) ; 13(13), 2021.
Article in English | Scopus | ID: covidwho-1304711

ABSTRACT

Entrepreneurship is essential in contributing to economic growth, job creation, technological advances, etc. in all countries, including Kazakhstan. Hence, the purpose of this study was to find out how to further facilitate the development of (foreign) entrepreneurship in Kazakhstan. In doing so, the authors attempted to identify factors influencing entrepreneurial intention (EI), specifically among the foreigners in Kazakhstan, and highlight the role of government support (GS) in general and under COVID-19. The study conceptualized the extended “TPB + Moderator (GS)” model. The hypotheses were tested on a sample of 362 new and established foreign entrepreneurs in Kazakhstan by means of descriptive analysis, Pearson’s correlation analysis, and multiple regression analysis. The study found that the foreigners’ personal attitude (PA) toward entrepreneurship was the strongest factor motivating their EI, followed by their perceived behavioral control (PBC) as the second strongest factor. The role of GS strengthened each effect of PA and PBC on EI. The moderating effect of GS and PA is greater than that of GS and PBC;each of the moderating effects is lower in magnitude than each of the direct effects. Their subject norms (SNs) and the moderating effect of GS and SNs are both insignificant. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

14.
Academy of Strategic Management Journal ; 20(SpecialIssue2):1-19, 2021.
Article in English | Scopus | ID: covidwho-1273929

ABSTRACT

The intent of this paper is to assess the impact on sustainability due to the outbreak of pandemic. The paper has been carried out on the basis of theoretical review. The outbreak of COVID-19 threw the whole world into a deep crisis. In this time of crisis during the pandemic, enterprises have been through many challenges, so as to say;to the degree that impact of sustainability needed engaging attention. As a result, this avant-garde paper attempts to do a studyof the extent to what COVID-19 all in all;as well as specifically lockdown has impacted sustainability. The researchers have carried out discussion on the many challenges faced by the organizations and economy as a whole and the need to overcome it. The research carried out additionally summaries the lessons learnt from this outbreak and investigate the risk management strategies that emerged as a result of this catastrophic pandemic. © 2021. Academy of Strategic Management Journal. All Rights Reserved.

15.
Rheumatology (United Kingdom) ; 60(SUPPL 1):i43, 2021.
Article in English | EMBASE | ID: covidwho-1266169

ABSTRACT

Background/AimsTelemedicine has not previously been a regular part of routinerheumatology services.Our department adopted telephone clinicsduring the COVID-19 pandemic. We assessed patient satisfaction byconducting a feedback survey. Our aim was to obtain a patientperspective on remote consultations and on preferred future follow upoptions including video or face-to-face consultations.MethodsThe cohort included 160 rheumatology patients who had a telephoneconsultation between May and mid-June 2020. All patients consentedto receive a further phone call by a different member of the team.Patients had to answer a questionnaire about recent consultation andto rate this on a scale of 1-5. Other questions included whether all theirqueries were answered;clear action plan made;perceived benefits ordisadvantages of telephone consultation;and views about futurefollow up and any additional comments.Results71.9% of 160 patients were females while 28.1 % males. Mean age58.6 yrs. More than half of the patients (60.6%) had a diagnosis ofinflammatory arthritis, followed by connective tissue disease (19.3%), other diagnosis (8.1% ) & vasculitis (5.6%). 94.4 % of the patients inthis study were return appointments-the remainder new. Feedbackresults revealed 92.5% patients were satisfied with their consultationwith mean score of 4.3/5 (5=best, 1= worst). More than 80% agreedthat all their queries were answered and a clear action plan wasformed during consultation. However , 71.2% would want a face toface consultation if given choice while 54 % happy to have furtherfollow up over the phone. 65% of patients preferred not to have videoconsultation. Subgroup analysis showed that majority of patients whowould accept video consultation were aged between 30-39. Mostcommon benefits described were noted to be convenience;reducedtime of work;travel time and safety during pandemic, whilst difficulty indescribing symptoms;hearing problems;and severity of disease weredisadvantages raised, but numbers were small in our cohort.ConclusionTelephone clinics were the mainstay during the COVID-19 pandemic.Thelarge majority of the rheumatology patients in our cohort were highlysatisfied with this form of consultation. However, interestingly themajority (71% ) would still prefer face-to-face consultation as follow up inthe future. Regular follow up in carefully selected patient groups cansuccessfully be performed by telephone clinics with good patientsatisfaction. This would help increase capacity within the clinic setting.

16.
British Journal of Surgery ; 108(SUPPL 2):ii50, 2021.
Article in English | EMBASE | ID: covidwho-1254542

ABSTRACT

Introduction: Postgraduate medical education in the wake of a pandemic has sparked creativity, evolving novel platforms concordant with socially distanced learning. Inevitably, evaluation is critical in navigating improvements in content delivery. However, as culture continues to shift away from didactic teaching, students are at risk of 'feedback overload'. We propose a novel emoji scale to facilitate rapid appraisal. Method: A three-point emoji scale was developed within the novel virtual learning environment for core surgical training in the West Midlands. Engagement with the emoji system was assessed and correlated with conventional post-course questionnaires. Results: The novel emoji systemprovided a rapid mechanism for trainees to express opinion on individual modules immediately following completion. Parallels to social media meant this modality felt familiar to trainees. Simplification of feedback permitted prompt, targeted review of modules for improvement, as opposed to laborious collection and analysis of standard post-course questionnaires. Literature review revealed limited research regarding similar emoji-based responses, or the validity of Likert or free-text based feedback systems. Conclusion: As virtual learning evolves following COVID-19, feedback systems help guide evolution. Emoji-based feedback may provide the key to prompt, accessible evaluation of VLE platforms.

17.
Br Dent J ; 230(4): 186, 2021 02.
Article in English | MEDLINE | ID: covidwho-1201913
18.
Uncertain Supply Chain Management ; 9(1):79-88, 2021.
Article in English | Scopus | ID: covidwho-1016339

ABSTRACT

The objective of this study was to examine the role of green Human Resources Management (HRM) in the green supply chain (SC) and firm performance. The relationships between green HRM, green SC, lockdown, and firm performance were examined. In addition to this, the mediating role of green SC and the moderating role of lockdown was examined. The population of the study was based on the food industry of Bahrain and various companies were selected for data collection. Therefore, data were collected from the food supply companies in Bahrain. A questionnaire was used for data collection in which cluster sampling was applied. The findings of the study highlighted that green HRM has major importance for food supply companies. It has a positive role in promoting the performance of food supply companies in Bahrain. Furthermore, green SC also plays a vital contribution to the performance of food supply companies. However, COVID-19 has a negative role in firm performance. The situation of lockdown due to COVID-19 has a negative effect on the performance of these companies. © 2021 by the authors;license Growing Science, Canada.

19.
International Journal of Pharmaceutical Research ; 12(4):1927-1934, 2020.
Article in English | EMBASE | ID: covidwho-732416

ABSTRACT

COVID-19 happened to be a pandemic, affecting billions of people across the globe. Parallel to all other sectors, pharmaceutical businesses also faced several problems whereby MR faced the most due to strict social distancing measures and individuals concerns. Resultantly, MR experienced hindrance in their sales and marketing efforts, causing them to express burnout and lower engagement levels. Bearing the severity, the current study attempted to investigate the issue to help facilitate the pharmaceutical industry to understand how they can effectively find a way out to ensure medical reps continue to remain engaged with their work. Through applying structural equation modelling, the study proposed and found the significance of social support resources towards work engagement. Accordingly, the study also found a significant relationship between innovative work behavior and work engagement. However, IWB did not pose any moderating effect on the associations of supervisor support, coworker support with work engagement. The study forwards implications for policy and practice.

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