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1.
Routledge Handbook of Sport and COVID-19 ; : 331-340, 2022.
Article in English | Scopus | ID: covidwho-2294277

ABSTRACT

The first chapter in the global and national sport events section, Chapter 31 analyses the impact of COVID-19 on international sport events that were staged or postponed in 2020. This includes the major golf tournaments, grand slam tennis events, the Tour de France, major city marathons and long-course triathlons. Other sport competitions and events considered in this chapter include horse racing and the mixed martial arts organisation, otherwise known as the UFC. Key issues and themes discussed in this chapter include bio-secure (bubble) environments established for athletes and officials, logistical and scheduling challenges and the extensive financial impacts that occurred. © 2023 selection and editorial matter, Stephen Frawley and Nico Schulenkorf;individual chapters, the contributors.

2.
British Journal of Surgery ; 109(Supplement 9):ix56, 2022.
Article in English | EMBASE | ID: covidwho-2188335

ABSTRACT

Background: Surgical consent forms can be difficult for patients to read and understand. Important points including procedure details, relevant complications and alterative treatment options are often lost in the communication process. Furthermore, surveys have found that patients struggle to grasp basic surgical concepts. Procedure specific consent forms (PSCFs) have been shown to improve the process of surgical consent. This is partly because they provide a standardised list of complications and their incidence, presented in a uniform, legible format without any abbreviations. However, despite their benefits, PSCFs are nationally underused. Cholecystectomy is one of the most common operations performed in the United Kingdom. Due to the pandemic disrupting elective surgical lists, the backlog of patients with biliary pathology has increased. More patients are therefore presenting to the on-call surgical team with biliary disease. Many trusts employ an Emergency Surgery Ambulatory Care (ESAC) list to offload the stretched emergency service. Our aim was to assess the variability of cholecystectomy consent forms amongst this cohort of patients, subsequently review patient understanding and evaluate whether the introduction of a procedure specific consent form improved this understanding. Method(s): We performed a prospective audit of laparoscopic cholecystectomy consent forms using the ESAC service. These consent forms were all obtained from patient's paper notes and assessed individually for variables. The first loop of the audit assessed the consent form used for the first 20 patients allocated to the ESAC list. Subsequently, each patient was telephoned post-operatively and asked a series of standardised questions which were adapted from a published questionnaire. Following this, we introduced a Procedure Specific Consent Form (PCSF) for laparoscopic cholecystectomies, with the agreement of all consultant surgeons who perform this operation in the trust. The second loop of the audit assessed another 20 patients from the emergency list, after the introduction of the PCSF. Similarly, patients were later telephoned to assess understanding. Over both loops, each consent form was assessed for the scope of their included complications and measured against the NHS-recognised list of potential adverse outcomes. Secondly, the legibility of the consenter's writing and the use of any abbreviations was noted. Legibility was evaluated by two doctors independently to reduce subjectivity. Result(s): The first loop revealed that all forms contained infection and bleeding;90% included injury to bile duct;80% included injury to viscera and risks from general anaesthetic;75% included blood clots and bile leak;and only 55% included post-cholecystectomy syndrome. The additional complications included were pain, herniae, covid risk, retained stone, collection, pancreatitis, failure and death;with an even higher degree of variability. The 20 forms were 95% legible, with 50% of them containing one or more acronyms. Relating to the post-op questionnaire, >80% of patients remembered details surrounding their operation, however only 60% could recall basic potential complications. After PCSF introduction, itwas used in 10 of the second loop cases,with the remaining 10 using traditional Consent Form 1 (non-PSCF). The non-PSCF group demonstrated similar variability in the complications included, with identical legibility rates and acronym usage. Again, only 60% of patients were able to accurately define the associated complications. Of the PSCFs, 100% were legible and 0% used acronyms, and the list of complications was standardised with 100% compliance with NICE and RCS England guidance. Notably, 90% of patients accurately recalled potential complications and nearly all were satisfied with their level of understanding prior to signing the consent form. Conclusion(s): This Quality Improvement Project demonstrated that hand written Consent Forms are highly variable, especially regarding the list of complications. We also found that while the were largely legible, half of the consent forms contained acronyms. Lastly, patients were satisfied with the information provided to them and could recall knowledge on the nature of the surgery, but many were not able to recollect important potential complications. The use of a PSCF allowed for a standardised, easily accessible, legible consent form devoid of misinterpretable acronyms. This was reflected in the patient questionnaire, where patients were able to recall details of the surgery and were satisfied with their level of understanding. This was reaffirmed by their grasp of the complications, where 90% of patients could recall potential adverse risks, compared to 60% in the Form 1 groups. This audit demonstrates the benefit of PSCFs from a legislative and litigative standpoint, but more importantly from the standpoint of patient understanding and holistic care. We recommend the use of PSCFs in the process of all surgical consent, to help ensure patient understanding and subsequent satisfaction.

5.
Journal of Clinical Urology ; 15(1):70, 2022.
Article in English | EMBASE | ID: covidwho-1957016

ABSTRACT

Introduction: Hydroceles could cause discomfort, scrotal heaviness, cosmetic problems or adversely impact quality of life. Conventional treatment involves open surgical repair under general anaesthetic. Aspiration and injection sclerotherapy is however an attractive alternative since literature suggests it has comparable outcomes, lower complication rates and can be performed under local anaesthetic (LA) in timely manner. Patients and Methods: Consenting patients were prospectively recruited following necessary approvals. The procedure was carried out under LA and ultrasound guidance at our urology clinic. The hydrocele was drained and sclerosant (3% sodium tetradecyl sulphate) immediately injected into the tunica vaginalis. Post-procedure followup ranged from 3-12months. Results: Thirty-two patients with 35 procedures (2 re-do, 1 bilateral) were studied. Average volume drained was 283ml (18-1000ml). Overall success rate was 77.1% (complete resolution- 21 [60.0%], mild re-accumulation without need for re-intervention- 4 [11.4%], moderate re-accumulation successfully treated with re-do sclerotherapy- 2 [5.7%]). Large/significant recurrence was noted in 8 (22.9%) patients- they all had large (>200ml) hydroceles ab-initio and went on to have straightforward open surgical repair. One procedure was abandoned due to traumatic aspiration and was excluded. Conclusions: Hydrocele aspiration and injection sclerotherapy under LA is safe, easy to set-up and effective, with trend towards better outcomes for smaller hydroceles. This treatment could ease waiting-list pressures occasioned by the COVID-19 pandemic and should be considered as part of informed consent process for all men with hydroceles. Further data is required to define most suitable patients and also to fully assess ease of hydrocele repair after failed sclerotherapy.

6.
Annals of Behavioral Medicine ; 56(SUPP 1):S247-S247, 2022.
Article in English | Web of Science | ID: covidwho-1848795
7.
British Journal of Surgery ; 108:2, 2021.
Article in English | Web of Science | ID: covidwho-1539414
8.
Journal of the Arkansas Medical Society ; 117(12):282-283, 2021.
Article in English | MEDLINE | ID: covidwho-1527257

ABSTRACT

By December 2020, SARS-CoV-2 caused the deaths of nearly 1.5 million people worldwide. A common strategy to mitigate spread of the virus is mask wearing. Considerable data demonstrate that masks can create an effective barrier to the respiratory droplets that can carry the virus. However, the effectiveness of consumer masks for this purpose varies, and there are currently no minimum standards that mask manufacturers must meet. Therefore, a need exists for an at-home test of mask barrier function. Here, we demonstrate a simple test to compare the function of selected masks using widely available materials and resources.

9.
Annals of Behavioral Medicine ; 55:S37-S37, 2021.
Article in English | Web of Science | ID: covidwho-1250319
10.
Annals of Behavioral Medicine ; 55:S124-S124, 2021.
Article in English | Web of Science | ID: covidwho-1250318
11.
International Journal of Environmental Research & Public Health [Electronic Resource] ; 18(8):07, 2021.
Article in English | MEDLINE | ID: covidwho-1208469

ABSTRACT

The study investigated if rurality, area deprivation, access to outside space (Study 1), and frequency of visiting and duration in green space (Study 2) are associated with mental health during the COVID-19 pandemic and examined if individual demographics (age, gender, COVID-19 shielding status) and illness beliefs have a direct association with mental health during the COVID-19 pandemic. A serial, weekly, nationally representative, cross-sectional, observational study of randomly selected adults was conducted in Scotland during June and July 2020. If available, validated instruments were used to measure psychological distress, individual demographics, illness beliefs, and the following characteristics: Rurality, area deprivation, access to residential outside space, frequency of visiting, and duration in green space. Simple linear regressions followed by examination of moderation effect were conducted. There were 2969 participants in Study 1, of which 1765 (59.6%) were female, 349 (11.9%) were in the shielding category, and the median age was 54 years. There were 502 participants in Study 2, of which 295 (58.60%) were female, 58 (11.6%) were in shielding category, and the median age was 53 years. Direct effects showed that psychological distress was worse if participants reported the following: Urban, in a deprived area, no access to or sharing residential outside space, fewer visits to green space (environment), younger, female, in the shielding category (demographics), worse illness (COVID-19) representations, and greater threat perception (illness beliefs). Moderation analyses showed that environmental factors amplified the direct effects of the individual factors on psychological distress. This study offers pointers for public health and for environmental planning, design, and management, including housing design and public open space provision and regulation.

13.
Journal of Molecular Diagnostics ; 22(11):S41-S41, 2020.
Article in English | Web of Science | ID: covidwho-1070236
14.
Hepatology ; 72(1 SUPPL):264A-265A, 2020.
Article in English | EMBASE | ID: covidwho-986115

ABSTRACT

Background: COVID-19 lockdown began in Scotland on 23rd March 2020. This was followed by a significant reduction in unselected medical admissions to Scottish hospitals with increased illness severity and in-patient mortality This study aimed to investigate the specific effect of lockdown on admissions with liver disease in Scotland Methods: Patients admitted to 7 major Scottish hospitals with chronic liver disease in April 2020 were identified and compared with admissions in April 2017, 2018 and 2019 (n=459) Data was collected on patient demographics and disease characteristics Socioeconomic deprivation was derived from the Scottish Index of Multiple Deprivation (SIMD) in quintiles for analysis (1=most deprived;5=least deprived) Statistical analysis was done using SPSS version 22 Results: The median age of the whole cohort was 58 years (IQR: 49-66) They were predominantly male (n=267;58 2%) 204 (44 4%) were from the most deprived quintile of the population The median MELD was 16 (IQR: 12-21) 354 (77 1%) had alcoholic liver disease (ALD) as either the primary or a contributory factor to their disease Median length of stay was 7 days (IQR: 4-14) 46 patients died in hospital giving an inpatient mortality of 9 8% Table 1 outlines the comparisons between patients admitted in April 2020 (n=111) and the previous 3 years (n=348) No difference was seen in age (59 years vs 58;p=0 88) or gender (59 men (53 2%) vs 208 men (59 8%);p=0 22) Severity of liver disease on admission was similar (MELD 15 vs 16;p=0 68) Although serum sodium was reduced in the pre-COVID era group (135 (130-138), n=348) compared with the COVID-lockdown cohort (137 (132-140), n=111) (p=0.01) no significant differences were seen in other blood parameters Length of stay (7 days vs 8 days;p=0 093), inpatient mortality (8 3% vs 10 4%;p=0 51) and socioeconomic deprivation by SIMD (p=0 41) were not significantly different between the two cohorts. There was not a significant difference between the number of patients admitted in each year (poisson regression analysis p=0 37) Conclusion: The lockdown introduced to control the COVID pandemic in Scotland did not have a significant impact on the number, severity of liver disease at presentation or outcomes in patients admitted with chronic liver disease, in contrast with unselected medical admissions in the immediate post lockdown period(Table Presented).

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