scholarly journals Consistency between the Eatwell Guide and nutrient profiling models in the UK: an observational study

The Lancet ◽  
2021 ◽  
Vol 398 ◽  
pp. S71
Author(s):  
Ana-Catarina Pinho-Gomes ◽  
Asha Kaur ◽  
Peter Scarborough ◽  
Mike Rayner
Keyword(s):  
Observational Study ◽  
Nutrient Profiling ◽  
The Uk

scholarly journals Thrombotic and haemorrhagic complications in critically ill patients with COVID-19: a multicentre observational study

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Akshay Shah ◽  
Killian Donovan ◽  
Anna McHugh ◽  
Manish Pandey ◽  
Louise Aaron ◽  
...  
Keyword(s):  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
White Cell Count ◽  
Laboratory Data ◽  
Outcome Data ◽  
Icu Length Of Stay ◽  
Tertiary Hospitals ◽  
Thrombotic Complications ◽  
The Uk

Abstract Background Optimal prophylactic and therapeutic management of thromboembolic disease in patients with COVID-19 remains a major challenge for clinicians. The aim of this study was to define the incidence of thrombotic and haemorrhagic complications in critically ill patients with COVID-19. In addition, we sought to characterise coagulation profiles using thromboelastography and explore possible biological differences between patients with and without thrombotic complications. Methods We conducted a multicentre retrospective observational study evaluating all the COVID-19 patients received in four intensive care units (ICUs) of four tertiary hospitals in the UK between March 15, 2020, and May 05, 2020. Clinical characteristics, laboratory data, thromboelastography profiles and clinical outcome data were evaluated between patients with and without thrombotic complications. Results A total of 187 patients were included. Their median (interquartile (IQR)) age was 57 (49–64) years and 124 (66.3%) patients were male. Eighty-one (43.3%) patients experienced one or more clinically relevant thrombotic complications, which were mainly pulmonary emboli (n = 42 (22.5%)). Arterial embolic complications were reported in 25 (13.3%) patients. ICU length of stay was longer in patients with thrombotic complications when compared with those without. Fifteen (8.0%) patients experienced haemorrhagic complications, of which nine (4.8%) were classified as major bleeding. Thromboelastography demonstrated a hypercoagulable profile in patients tested but lacked discriminatory value between those with and without thrombotic complications. Patients who experienced thrombotic complications had higher D-dimer, ferritin, troponin and white cell count levels at ICU admission compared with those that did not. Conclusion Critically ill patients with COVID-19 experience high rates of venous and arterial thrombotic complications. The rates of bleeding may be higher than previously reported and re-iterate the need for randomised trials to better understand the risk-benefit ratio of different anticoagulation strategies. Graphical abstract

scholarly journals Bend it like Beckham or fix them like Florence—proportional representation of healthcare in New Year honours: an observational study

BMJ ◽  
2019 ◽  
pp. l6721
Author(s):  
John A Emelifeonwu ◽  
James E Hazelwood ◽  
Oscar Nolan ◽  
Emma Sharland ◽  
Anna O’Donald ◽  
...  
Keyword(s):  
Observational Study ◽  
Absolute Risk ◽  
Proportional Representation ◽  
Relative Risks ◽  
The Arts ◽  
Gender Biases ◽  
Significant Difference ◽  
And Gender ◽  
The Uk ◽  
To Receive

AbstractObjectivesTo compare the proportional representation of healthcare workers in receipt of New Year honours (NYHs) with workers in other industries and to determine whether the NYH system has gender or geographical biases.DesignObservational study of the UK honours system with a comparative analysis of proportional representation of the UK workforce and subgroup analyses of gender and geographical representations.ParticipantsRecipients of NYHs from 2009 to 2018.Main outcome measuresAbsolute risk of receiving an NYH based on industry, gender, or region of the UK. Relative risk of receiving an NYH for services to healthcare compared with other industries.Results10 989 NYHs were bestowed from 2009 to 2018, 47% of which were awarded to women. 832 awards (7.6%) were for services to healthcare. People working in sport and in the arts and media were more likely to receive NYHs than those working in healthcare (relative risks of 22.01 (95% confidence interval 19.91 to 24.34) and 5.84 (5.31 to 6.44), respectively). There was no significant difference between the rate of receiving honours for healthcare and for science and technology (P=0.22). 34% (3741) of awards were issued to people living in London and in the southeast of England, and only 496 of 1447 (34%) higher order awards (knighthoods, damehoods, companions of honour, and commanders of the order of the British empire) were received by women.ConclusionsIn relation to the size of its workforce, a career in healthcare is not as “honourable” as careers in certain other industries. Geographical and gender biases might exist in the honours system.

scholarly journals Investigating Wilms’ Tumours Worldwide: A Report of the OxPLORE Collaboration—A Cross-Sectional Observational Study

2019 ◽  
Vol 44 (1) ◽  
pp. 295-302 ◽  
Author(s):  
K. Ford ◽  
S. Gunawardana ◽  
E. Manirambona ◽  
G. S. Philipoh ◽  
B. Mukama ◽  
...  
Keyword(s):  
Medical Students ◽  
Observational Study ◽  
Research Collaboration ◽  
Multidisciplinary Treatment ◽  
High Income ◽  
Junior Doctors ◽  
Paediatric Surgery ◽  
Cross Sectional ◽  
Oncology Research ◽  
The Uk

Abstract Background Childhood cancer is neglected within global health. Oxford Pediatrics Linking Oncology Research with Electives describes early outcomes following collaboration between low- and high-income paediatric surgery and oncology centres. The aim of this paper is twofold: to describe the development of a medical student-led research collaboration; and to report on the experience of Wilms’ tumour (WT). Methods This cross-sectional observational study is reported as per STROBE guidelines. Collaborating centres included three tertiary hospitals in Tanzania, Rwanda and the UK. Data were submitted by medical students following retrospective patient note review of 2 years using a standardised data collection tool. Primary outcome was survival (point of discharge/death). Results There were 104 patients with WT reported across all centres over the study period (Tanzania n = 71, Rwanda n = 26, UK n = 7). Survival was higher in the high-income institution [87% in Tanzania, 92% in Rwanda, 100% in the UK (X2 36.19, p < 0.0001)]. Given the short-term follow-up and retrospective study design, this likely underestimates the true discrepancy. Age at presentation was comparable at the two African sites but lower in the UK (one-way ANOVA, F = 0.2997, p = 0.74). Disease was more advanced in Tanzania at presentation (84% stage III–IV cf. 60% and 57% in Rwanda and UK, respectively, X2 7.57, p = 0.02). All patients had pre-operative chemotherapy, and a majority had nephrectomy. Post-operative morbidity was higher in lower resourced settings (X2 33.72, p < 0.0001). Methodology involving medical students and junior doctors proved time- and cost-effective. This collaboration was a valuable learning experience for students about global research networks. Conclusions This study demonstrates novel research methodology involving medical students collaborating across the global south and global north. The comparison of outcomes advocates, on an institutional level, for development in access to services and multidisciplinary treatment of WT.

scholarly journals Incidence of paediatric unplanned day-case admissions in the UK and Ireland: a prospective multicentre observational study

2020 ◽  
Vol 124 (4) ◽  
pp. 463-472
Author(s):  
Zoe Green ◽  
Natasha Woodman ◽  
David J. McLernon ◽  
Thomas Engelhardt
Keyword(s):  
Observational Study ◽  
Day Case ◽  
The Uk

scholarly journals The Case for Standardisation of the Management of Gallstones Spilled and not Retrieved at Laparoscopic Cholecystectomy

2008 ◽  
Vol 90 (4) ◽  
pp. 310-312 ◽  
Author(s):  
J Mullerat ◽  
K Cooper ◽  
B Box ◽  
B Soin
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Great Britain ◽  
Observational Study ◽  
General Practitioners ◽  
Annual Conference ◽  
Review Of The Literature ◽  
The Uk ◽  
Uncommon Complication

INTRODUCTION This observational study was carried out to establish how surgeons performing laparoscopic cholecystectomy currently deal with the issue of spilled gallstones. MATERIALS AND METHODS A questionnaire was circulated amongst laparoscopic surgeons attending the annual conference of the Association of Laparoscopic Surgery of Great Britain and Ireland in November 2006. RESULTS Eighty-two surgeons completed the questionnaire. Only half of surgeons inform patients when gallstones are spilled. Less than 30% of surgeons inform general practitioners (GPs) of this complication, when it occurs. Less than a quarter of surgeons include this information in the consent literature provided to patients. CONCLUSIONS We recommend that trusts review their policy towards spilled stones either by local audit or adopt the guidance given by the UK Healthcare Commission. While some surgeons feel informing patients and GPs may unnecessarily heighten anxiety from an uncommon complication, our review of the literature suggests this position is not tenable in the current medicolegal climate.

scholarly journals Safety netting in routine primary care consultations: an observational study using video-recorded UK consultations

2019 ◽  
Vol 69 (689) ◽  
pp. e878-e886 ◽  
Author(s):  
Peter J Edwards ◽  
Matthew J Ridd ◽  
Emily Sanderson ◽  
Rebecca K Barnes
Keyword(s):  
Primary Care ◽  
Logistic Regression ◽  
Observational Study ◽  
Confidence Interval ◽  
Treatment Planning ◽  
Odds Ratio ◽  
Adult Patients ◽  
Specific Advice ◽  
The Uk ◽  
Safety Netting

BackgroundSafety-netting advice is information shared with a patient or their carer designed to help them identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health.AimTo assess when and how safety-netting advice is delivered in routine GP consultations.Design and settingThis was an observational study using 318 recorded GP consultations with adult patients in the UK.MethodA safety-netting coding tool was applied to all consultations. Logistic regression for the presence or absence of safety-netting advice was compared between patient, clinician, and problem variables.ResultsA total of 390 episodes of safety-netting advice were observed in 205/318 (64.5%) consultations for 257/555 (46.3%) problems. Most advice was initiated by the GP (94.9%) and delivered in the treatment planning (52.1%) or closing (31.5%) consultation phases. Specific advice was delivered in almost half (47.2%) of episodes. Safety-netting advice was more likely to be present for problems that were acute (odds ratio [OR] 2.18, 95% confidence interval [CI] = 1.30 to 3.64), assessed first in the consultation (OR 2.94, 95% CI = 1.85 to 4.68) or assessed by GPs aged ≤49 years (OR 2.56, 95% CI = 1.45 to 4.51). Safety-netting advice was documented for only 109/242 (45.0%) problems.ConclusionGPs appear to commonly give safety-netting advice, but the contingencies or actions required on the patient’s part may not always be specific or documented. The likelihood of safety-netting advice being delivered may vary according to characteristics of the problem or the GP. How to assess safety-netting outcomes in terms of patient benefits and harms does warrant further exploration.

Sign in / Sign up

Export Citation Format

Share Document