scholarly journals COVID-19 and the return to head and neck outpatient activity in the United Kingdom: what is the new normal?

2020 ◽  
Author(s):  
Sumrit Bola ◽  
Dominic Jaikaransingh ◽  
Stuart C Winter
Keyword(s):  
United Kingdom ◽  
Head And Neck ◽  
Natural Ventilation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Safety Measures ◽  
Web Based ◽  
Face To Face ◽  
The United Kingdom ◽  
The Uk

Abstract Purpose As surgical specialties now begin the graduated return to elective activity and face-to-face clinics, this paper investigates the current head and neck outpatient practices across the United Kingdom. Methods A cross-sectional study comprised of an online 20-item survey was distributed to members of the British Association of Head & Neck Oncologists (BAHNO). The survey was open on a web-based platform and covered topics including safety measures for patients, protective equipment for healthcare staff and protocols for the use of flexible nasendoscopy in the clinic. Results The survey was completed by 117 participants covering 66 NHS Trusts across the UK. There was a significant reduction in face-to-face Otolaryngology, Maxillofacial and Speech and Language clinic patients when compared to pre-pandemic numbers (p < 0.0001). Risk assessments for flexible nasendoscopy were done for 69% of clinics and 58% had an established protocol. Room downtime after flexible nasendoscopy ranged from 0 to 6 h and there was a significant increase in allocated downtime after a patient had coughed/sneezed (p < 0.001). Natural ventilation existed in 36% of clinics and the majority of responders didn’t know the Air Change Per Hour (ACPH) of the clinic room (77%). Where ACPH was known, it often did not match the allocated room downtime. Conclusion There is a wide variation in outpatient activity across the United Kingdom, but adaptations are being made to try and maintain staff and patient safety. However, more can still be done by liaising with allied teams to clarify outpatient protocols.

scholarly journals 417 COVID-19 and the Return to Head and Neck Outpatient Activity in The United Kingdom: What Is the New Normal?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Jaikaransingh ◽  
S Bola ◽  
S Winter
Keyword(s):  
United Kingdom ◽  
Head And Neck ◽  
Natural Ventilation ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Safety Measures ◽  
Face To Face ◽  
The United Kingdom ◽  
The Uk

Abstract Background We aim to investigate current head and neck outpatient practices across the United Kingdom during the COVID-19 pandemic. Method A cross-sectional study comprising of an online 20-item survey was emailed to members of the British Association of Head and Neck Oncologists (BAHNO). Topics covered included safety measures, protective equipment used and protocols around the use of flexible nasendoscopy (FNE) in clinic. Results 117 participants completed the survey covering 66 Trusts across the UK. There was a significant reduction in face-to-face clinic patients compared to pre-pandemic numbers. Room down-time after FNE ranged from 0-6 hours and there was a significant increase in allocated down-time after the patient had coughed or sneezed. Natural ventilation existed in 36% of clinics and the majority of responders didn’t know the calculated Air Change Per Hour (ACPH) of the room (77%). Where ACPH was known, it often did not match the allocated room down-time. Conclusions Adaptations are being made across the UK to maintain staff and patient safety, but more can still be done by liaising with hospital infectious diseases and the hospital estates team to clarify outpatient protocols.Outpatient activity will likely remain limited and alternative strategies will need to develop to manage the backlog in face-to-face clinics.

scholarly journals Screening for Cancer-Related Neuropathic Pain in the Oncology Outpatient Setting in the United Kingdom

2013 ◽  
Vol 6 (1) ◽  
pp. 208-216 ◽  
Author(s):  
Alison Birtle ◽  
Susan Davidson ◽  
Gary Atkinson ◽  
Chantal van Litsenburg
Keyword(s):  
Neuropathic Pain ◽  
United Kingdom ◽  
Clinical Judgment ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
Cross Sectional ◽  
The United Kingdom ◽  
The Uk ◽  
Survey Responses

This article reports the outcomes of a sub-analysis of United Kingdom (UK) data collected during a noninterventional, cross-sectional study conducted in five European countries. The primary aim was to estimate the prevalence of cancer-related neuropathic pain (CRNP) in an outpatient sample of adult cancer patients visiting oncology clinics in the UK for standard care. Secondary aims were to report the nature and characteristics of the cancer and the pain in the patients with CRNP. This sub-analysis also assessed the usefulness of the PainDETECT screening tool as an aid for physicians in identifying the neuropathic component of cancer-related pain in daily practice. Based on physicians’ clinical judgment before reviewing the scores on the PainDETECT tool, the estimated number of outpatients with cancer experiencing chronic pain and considered to have CRNP was 104 of 195 patients (53.3%; 95% confidence interval [CI]: 46.3%- 60.3%). After reviewing patients’ scores on the tool, the estimate was 90 of 195 patients (46.2%; 95% CI: 39.2%-53.2%). Physicians changed from a positive (yes) to a negative (no) diagnosis of CRNP for 16 of 127 patients who had a low PainDETECT end score (<13; indicating that neuropathic pain was unlikely). Of the 11 physicians who completed the usefulness of PainDETECT survey, eight indicated that they would use the questionnaire in future for at least some of their patients, although they also indicated that in the majority of cases (63%), the PainDETECT tool did not help them evaluate whether a patient had CRNP. Because of missing data arising from missing or incomplete survey responses, however, these data should be interpreted with caution, and further studies are required to assess the usefulness of this tool.

A cross-sectional study of geriatric horses in the United Kingdom. Part 1: Demographics and management practices

2010 ◽  
Vol 43 (1) ◽  
pp. 30-36 ◽  
Author(s):  
J. L. IRELAND ◽  
P. D. CLEGG ◽  
C. M. McGOWAN ◽  
S. A. McKANE ◽  
G. L. PINCHBECK
Keyword(s):  
United Kingdom ◽  
Management Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The United Kingdom

scholarly journals Closer to the Truth on National Fistula Prevalence After Unilateral Complete Cleft Lip and Palate Repair? The Cleft Care UK Study

2019 ◽  
Vol 57 (1) ◽  
pp. 5-13
Author(s):  
Arthur S. Yang ◽  
Bruce M. Richard ◽  
Andrew K. Wills ◽  
Osama Mahmoud ◽  
Jonathan R. Sandy ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Palatal Fistula ◽  
The United Kingdom ◽  
Palate Repair

Objectives: To (1) determine the prevalence of nonperialveolar palatal fistula up to age 5 following repair of unilateral cleft lip and palate (UCLP) in the United Kingdom, (2) examine the association of palatoplasty techniques with fistula occurrence, and (3) describe the frequency of fistula repairs and their success. Design: Cross-sectional study. Setting: All 11 centralized regional cleft centers in the United Kingdom. Participants: Two hundred sixty-eight children born between 2005 and 2007 recruited by Cleft Care UK, a nationwide cross-sectional study of all 5-year-old children born with nonsyndromic UCLP. Main Outcome Measure: Nonperialveolar palatal fistula prevalence up to age 5. Results: Fistulas were found in 72 children (31.3%, 95% confidence interval: 25.4%-37.7%) and had no significant association with palate repair sequences. Twenty-four fistulas were repaired by age 5, 12 of which had data showing 10 (83.3%) successful repairs. Conclusion: The prevalence of nonperialveolar fistulas following primary palatoplasty of UCLP in the United Kingdom was higher than previously reported. This information should be part of the preoperative discussion with families. Prospective collection of the presence of fistulas will be necessary before we can associate the occurrence of fistulas with a surgeon, institution, surgical technique, or protocol of care.

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