scholarly journals Endonasal surgery in the coronavirus era – Birmingham experience

2020 ◽  
pp. 1-4
Author(s):  
P P Naik ◽  
G Tsermoulas ◽  
A Paluzzi ◽  
L McClelland ◽  
S K Ahmed
Keyword(s):  
Skull Base Surgery ◽  
High Viral Load ◽  
Anterior Skull Base ◽  
World Health ◽  
Nasal Surgery ◽  
University Hospitals ◽  
Endonasal Surgery ◽  
Health Organization ◽  
The Uk ◽  
Endoscopic Nasal Surgery

Abstract Background The World Health Organization declared coronavirus disease 2019 a pandemic on 11th March 2020. There is concern regarding performing endonasal surgical procedures because of a high viral load in the nasopharynx. This paper describes our experience in conducting emergency and urgent endonasal operations during the peak of the coronavirus disease 2019 pandemic in the UK. Objectives To show the outcome of endonasal surgery during the peak of the coronavirus disease 2019 pandemic and to assess the post-operative rate of nosocomial coronavirus disease 2019 infection. Methods A retrospective cohort study was conducted of all patients who underwent high priority endoscopic nasal surgery or anterior skull base surgery between 23rd March and 15th June 2020 at University Hospitals Birmingham NHS Trust. Results Twenty-four patients underwent endonasal surgery during the study period, 12 were males and 12 were females. There was no coronavirus-related morbidity in any patient. Conclusion This observational study found that it is possible to safely undertake urgent endonasal surgery; the nosocomial risk of coronavirus disease 2019 can be mitigated with appropriate peri-operative precautions.

scholarly journals Comprehensive physiotherapy management in covid-19 – a narrative review

2020 ◽  
Vol 30 (1) ◽  
pp. 38030 ◽  
Author(s):  
Deivendran Kalirathinam ◽  
Raj Guruchandran ◽  
Prabhakar Subramani
Keyword(s):  
Narrative Review ◽  
World Health ◽  
Evidence Based ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Related Quality ◽  
Health Related ◽  
Novel Coronavirus ◽  
Health Organization ◽  
The Uk

The 2019 novel coronavirus officially named as coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization, has spread to more than 180 countries. The ongoing global pandemic of severe acute respiratory syndrome coronavirus, which causes COVID-19, spread to the United Kingdom (UK) in January 2020. Transmission within the UK was confirmed in February, leading to an epidemic with a rapid increase in cases in March. As on April 25- 2020, there have been 148,377 confirmed cases of COVID-19 in the UK and 20,319 people with confirmed infection have died. Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy and community rehabilitation of COVID-19 patients has recently been identified as an essential therapeutic tool and has become a crucial evidence-based component in the management of these patients. This comprehensive narrative review aims to describe recent progress in the application of physiotherapy management in COVID 19 patients. Assessment and evidence- based treatment of these patients should include prevention, reduction of adverse consequences in immobilization, and long-term impairment sequelae. A variety of techniques and modalities of early physiotherapy in intensive care unit are suggested by clinical research. They should be applied according to the stage of the disease, comorbidities, and patient’s level of cooperation.

Pharmaceutical Data Integrity: issues, challenges and proposed solutions for manufacturers and inspectors

2020 ◽  
Vol 9 (4) ◽  
pp. 171-182
Author(s):  
Sia Chong Hock ◽  
Vernon Tay ◽  
Vimal Sachdeva ◽  
Chan Lai Wah
Keyword(s):  
Manufacturing Industry ◽  
Management Practices ◽  
Data Integrity ◽  
Database Management System ◽  
World Health ◽  
Record Management ◽  
Guidance Documents ◽  
Health Organization ◽  
Biopharmaceutical Manufacturing ◽  
The Uk

Data Integrity, which is data deemed Attributable, Legible, Contemporaneous, Original, Accurate, Complete, Consistent, Enduring, and Available (ALCOA-plus), has been the focus of the pharmaceutical industry in recent years. With the growing use of computerized systems and rising prevalence of outsourcing manufacturing processes, ensuring data integrity is becoming more challenging in an increasingly complex pharmaceutical manufacturing industry. To address this issue, multiple legislation and guidance documents such as ‘Data Integrity and Compliance with CGMP Guidance for Industry’ from the US Food and Drug Administration (FDA), ‘GxP’ Data Integrity Guidance and Definitions from the UK Medicines & Healthcare products Regulatory Agency (MHRA), and ‘Guidance on Good Data and Record Management Practices’ from the World Health Organization (WHO), have been published in recent years. However, with rising data integrity issues observed by FDA, WHO, MHRA and other pharmaceutical inspectors even after these guidance documents have been published, their overall effectiveness is yet to be determined. This paper compares and evaluates the legislation and guidance currently in existence; and discusses some of the potential challenges pharmaceutical manufacturers face in maintaining data integrity with such legislation and guidance in place. It appears that these legislation and guidance are insufficient in maintaining data integrity in the industry when used alone. Last, but not least, this paper also reviews other solutions, such as the need for a company culture of integrity, a good database management system, education and training, robust quality agreements between contract givers and acceptors, and performance of effective audits and inspections, to aid in maintaining data integrity in the manufacturing industry. These proposed solutions, if successfully implemented, can address the issues associated with data integrity, and raise the standard of pharmaceutical and biopharmaceutical manufacturing worldwide.

scholarly journals Mental healthcare in Hungary: contradictions and possibilities

2010 ◽  
Vol 7 (2) ◽  
pp. 36-38 ◽  
Author(s):  
Tamás Kurimay
Keyword(s):  
Health Spending ◽  
Mental Healthcare ◽  
World Health ◽  
Minority Population ◽  
Official Language ◽  
The European Union ◽  
Middle Income ◽  
The Republic ◽  
Health Organization ◽  
The Uk

The Republic of Hungary is a landlocked country of 93000 km2 in central Europe; it is bordered by Austria, Slovakia, Ukraine, Romania, Serbia, Croatia and Slovenia. Its official language is Hungarian. Hungary joined the European Union (EU) in 2004. About 90% of the population of c. 10 million is ethnically Hungarian, with Roma comprising the largest minority population (6–8%). Currently classified as a middle-income country with a gross domestic product (GDP) of $191.7 billion (2007 figure), Hungary's total health spending accounted for 7.4% of GDP in 2007, less than the average of 8.9% among member states of the Organisation for Economic Co-operation and Development (OECD, 2009). The proportion of the total health budget for mental health is 5.1%, which is low when compared with, for instance, the UK (England and Wales 13.8%, Scotland 9.5%) (World Health Organization, 2008, p. 118, Fig. 8.1).

Client perspectives on choice of abortion method in England and Wales

2021 ◽  
pp. bmjsrh-2021-201242
Author(s):  
Rebecca Blaylock ◽  
Shelly Makleff ◽  
Katherine C Whitehouse ◽  
Patricia A Lohr
Keyword(s):  
Treatment Options ◽  
Medical Abortion ◽  
Study Data ◽  
World Health ◽  
Care Providers ◽  
Perceptions Of Risk ◽  
Surgical Methods ◽  
Appointment Availability ◽  
Health Organization ◽  
The Uk

IntroductionThe National Institute for Health and Care Excellence, the Royal College of Obstetricians and Gynaecologists and the World Health Organization recommend that services provide a choice between medical and surgical methods of abortion. We analysed qualitative study data to examine patient perspectives on abortion method choice and barriers to meeting them.MethodsIn-depth interviews with 24 clients who had an abortion at British Pregnancy Advisory Service clinics were carried out between December 2018 and July 2019 to examine perspectives of quality of abortion care. In this article we focus on client perspectives on choice of abortion method. We performed thematic analysis of data relating to choice of abortion method, refined the analysis, interpreted the findings, and organised the data into themes.ResultsParticipants’ preferences for abortion method were shaped by prior experience of abortion, accessibility and privacy, perceptions of risk and experiences of abortion method, and information gathering and counselling. Participants’ ability to obtain their preferred method was impacted by intersecting constraints such as appointment availability, service location and gestational age.ConclusionsOur findings show that many factors shape participants’ preferences for abortion method. In response to the COVID-19 pandemic, some abortion services have constrained abortion method choices, with an emphasis on medical abortion and ‘no-touch’ care. Providers in the UK and beyond should aim to restore and expand more treatment options when the situation allows.

Healthwise, Part 3. The importance of remaining active

2021 ◽  
Vol 15 (8) ◽  
pp. 384-391
Author(s):  
Linda Nazarko
Keyword(s):  
World Health Organization ◽  
Cause Of Death ◽  
Physical Inactivity ◽  
World Health ◽  
Activity Levels ◽  
The Third ◽  
Health Organization ◽  
The Uk

The old adage, ‘sitting will be the death of you’, is proving to be a grim prediction that is borne out by research. Globally, physical inactivity leads to approximately 5 million deaths per year and is the fourth leading cause of death and disability ( Kohl et al, 2012 ; World Health Organization (WHO), 2020 ). Evidence suggests that, in the UK, inactivity leads to around 69 000 preventable deaths annually ( Heron et al, 2019 ). This article, the third in a series, explores inactivity, its consequences and how readers can remain healthy and well by maintaining or increasing activity levels.

Understanding Bone Conditions

2012 ◽  
Author(s):  
Anne Sutcliffe ◽  
Cameron Swift
Keyword(s):  
Hip Fracture ◽  
Wide Spectrum ◽  
Bone Fragility ◽  
World Health ◽  
Nursing Management ◽  
Skeletal Disease ◽  
Secondary Care Setting ◽  
Definition Of ◽  
Health Organization ◽  
The Uk

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with bone conditions in an evidence-based and person-centred way. Bone conditions (a major category of musculoskeletal conditions) cover a wide spectrum of diseases, some of which may be considered mild and self-limiting, while others may have a significant impact upon the individual’s quality of life and ability to function. It is estimated that up to 30% of all GP consultations are about musculoskeletal complaints; many are age-associated, and population ageing will continue to increase this demand (Oliver, 2009). The chapter will focus on osteoporosis, hip fracture (perhaps the most serious and costly consequence of osteoporosis or osteopaenia), Paget’s disease, and osteoarthritis, respectively. The chapter will provide a broad overview of these common conditions, enabling a proactive approach to patient care within a multidisciplinary context, whether in the primary or secondary care setting. The nursing management of the symptoms and common health problems associated with bone conditions can be found in several Part 2 chapters, and these are highlighted throughout the chapter. Osteoporosis has been defined as:...A progressive systemic skeletal disease characterised by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. (WHO, 1994)…The World Health Organization (WHO) has recommended a clinical definition of osteoporosis based on a bone mineral density (BMD) measurement of the spine or hip, expressed in standard deviation (SD) units called T scores. Using this definition, an individual is classified as having osteoporosis if his or her T score is ≤–2.5 SD at the spine or hip (WHO, 1994). It is estimated that osteoporosis occurs in approximately 3 million people in the UK, resulting in more than 230,000 fractures per annum, the most frequent being hip, vertebral body, and forearm fractures. In total, 75,000 hip fractures occur annually (British Orthopaedic Association, 2007), with the average age of incidence being 84 and 83 in men and women, respectively (National Hip Fracture Database, 2010).

Evaluation of the use of a Healthy Weight Discussion Tool by a health visiting team

2019 ◽  
Vol 7 (6) ◽  
pp. 272-278
Author(s):  
Tess Hickson
Keyword(s):  
Focus Group ◽  
Universal Service ◽  
Excess Weight ◽  
World Health ◽  
Service Improvement ◽  
Healthy Weight ◽  
Group Evaluation ◽  
Increased Risk ◽  
Health Organization ◽  
The Uk

A quarter of children in the UK are entering primary school either overweight or obese ( NHS Digital, 2017 ). These children have an increased risk of serious health consequences during their childhood years, which often continues into adulthood ( World Health Organization (WHO, 2017 ). A Healthy Weight Discussion Tool was created and introduced into a health visiting service to assist staff to identify and manage children presenting with excess weight. Three teams trialled its use, but uptake of this tool was low. A focus group evaluation was therefore carried out to examine the experience of staff using the tool. Although the tool was effective when implemented as intended, certain factors prevented its use in practice. These findings need to be addressed and the use of the tool re-evaluated to ascertain whether this service improvement will enhance the management of children with excess weight within the Universal service.

Marketing matters

2020 ◽  
Vol 8 (7) ◽  
pp. 280-280
Author(s):  
Ruth Oshikanlu
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Health Visitors ◽  
The World ◽  
Health Organization ◽  
The Uk

When 2020 was declared by the World Health Organization as the International Year of the Nurse and Midwife, health visitors in the UK planned events to celebrate nursing. How can we raise the profile of our honourable profession more effectively?

Have interventions been effective at increasing the rates of breastfeeding in the UK?

2019 ◽  
Vol 27 (5) ◽  
pp. 312-319
Author(s):  
Elizabeth Shortis
Keyword(s):  
World Health Organization ◽  
Exclusive Breastfeeding ◽  
Literature Search ◽  
World Health ◽  
Exclusion Criteria ◽  
The World ◽  
Breastfeeding Rates ◽  
Health Organization ◽  
The Uk ◽  
Combined Interventions

Background The World Health Organization recommends exclusive breastfeeding for the first 6 months of life; however, UK breastfeeding rates are some of the lowest worldwide. As such, various interventions have been trialled, aiming to increase breastfeeding rates. Aims To evaluate the effectiveness of interventions to increase breastfeeding rates in the UK and determine the features of successful interventions. Methods A literature search was performed, using four databases. The results were refined by applying inclusion and exclusion criteria. Two additional articles were recognised by scanning the references sections of identified studies, resulting in 12 articles for review. Findings Support-based interventions had predominantly insignificant effects upon breastfeeding rates. Incentives were associated with increases in rates, while combined interventions had mixed success. The interventions were well received by mothers and clinicians and may help to normalise breastfeeding. Conclusions Future interventions should provide targeted, personalised support to overcome breastfeeding difficulties, and reward mothers for their efforts.

scholarly journals Alcohol skin preparation causes surgical fires

2012 ◽  
Vol 94 (2) ◽  
pp. 87-89 ◽  
Author(s):  
B Rocos ◽  
LJ Donaldson
Keyword(s):  
Fire Risk ◽  
World Health ◽  
Training Curriculum ◽  
Skin Preparation ◽  
Us States ◽  
National Patient Safety Agency ◽  
The Us ◽  
National Patient ◽  
Health Organization ◽  
The Uk

INTRODUCTION Surgical fires are a rare but serious preventable safety risk in modern hospitals. Data from the US show that up to 650 surgical fires occur each year, with up to 5% causing death or serious harm. This study used the National Reporting and Learning Service (NRLS) database at the National Patient Safety Agency to explore whether spirit-based surgical skin preparation fluid contributes to the cause of surgical fires. METHODS The NRLS database was interrogated for all incidents of surgical fires reported between 1 March 2004 and 1 March 2011. Each report was scrutinised manually to discover the cause of the fire. RESULTS Thirteen surgical fires were reported during the study period. Of these, 11 were found to be directly related to spirit-based surgical skin preparation or preparation soaked swabs and drapes. CONCLUSIONS Despite manufacturer's instructions and warnings, surgical fires continue to occur. Guidance published in the UK and US states that spirit-based skin preparation solutions should continue to be used but sets out some precautions. It may be that fire risk should be included in pre-surgical World Health Organization checklists or in the surgical training curriculum. Surgical staff should be aware of the risk that spirit-based skin preparation fluids pose and should take action to minimise the chance of fire occurring.

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