156 Could a Cohort of Patients be Listed Directly from Video Clinic to Surgery with Assessment on Day of Surgery? The Implementation of Video Clinic in Surgical Patients During the COVID-19 Lockdown

Abstract Aim To report the feasibly and the safety of utilizing video Clinic during the 2020 pandemic in scheduling a cohort of patients to laparoscopic cholecystectomy (LC) without the need of face-to-face assessment. Method A retrospective audit from May to October 2020 was conducted on patients with symptomatic biliary colic disease and selected low risk demographics who were vetted and scheduled for laparoscopic cholecystectomy through video clinic under one of the general surgeons (AC) in a large district hospital. All patients were given the option to have their face-to-face assessment on the day of surgery and if there would be any concerning signs, they would be postponed or investigated if required. Results 33 patients agreed on the proposed option and were scheduled to LC based on virtual assessment, mean age of 42(±13) years old and 26(79%) were females. 16 (49%) patients had their surgery with average waiting time of 2.1(±1) months and mean BMI of 29.9(±7). 17 (51%) patients are pending future surgery dates. there was no cancellation based on surgery day assessment and or unexpected events intraoperatively. Conclusions As virtual clinics played a major role in providing healthcare services during the global pandemic, scheduling patients to surgery without face-to-face assessment was applicable and safe in selected demographics. This could have the potential of reducing waiting time, travelling costs and hospital visits. Moreover, communications with patients regarding the proposed same day assessment played a vital role in reaching a mutual agreement.

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P-EGS14 From Gallstone Disease to Cholecystectomy: An audit looking at the waiting times for cholecystectomy in a small District General Hospital

British Journal of Surgery ◽

10.1093/bjs/znab430.074 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Jacob Mewse ◽

Virginia Ledda ◽

Ellie Connor ◽

Peter Frank Mason

Keyword(s):

Laparoscopic Cholecystectomy ◽

Waiting Time ◽

Negative Impact ◽

Elective Surgery ◽

Waiting Times ◽

Gallstone Disease ◽

Gastrointestinal Surgery ◽

Emergency Operation ◽

Biliary Colic ◽

Emergency General Surgery

Abstract Background Gallstone-related disease accounts for a third of emergency general surgery admissions and referrals. The average waiting time for acute gallstone presentations to laparoscopic cholecystectomy is about 7 days in England. This audit aims to identify emergency admissions and compare local management to the Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS) guidelines standards with a focus on waiting times for laparoscopic cholecystectomy (LC). Where AUGIS standards were not met, number of re-admissions and complications were identified. A cost analysis was also completed looking at the overall costs of delayed treatment. Methods We identified all patients admitted as an emergency between September 2019 and September 2020 with gallstone-related pathology. Patients not referred to the surgical team, with negative Ultrasound Scans (USS) or known HPB malignancy were excluded. The patients were divided into a pre- COVID -19 and during COVID-19 category (respectively before and after March 2020), to identify whether the cancellation to non- urgent elective surgery (due to COVID-19) had caused further delays or complications. Each patient’s management was compared to AUGIS guidelines depending on their diagnosis at presentation (biliary colic, cholecystitis, cholangitis, gallstone-related pancreatitis), focusing on the timing between presentation and LC. Results A total of 99 patients were identified. Of the patients presenting with biliary colic (n = 9 pre-COVID, n = 5 during COVID), none underwent LC within 72 hours from presentation as recommended by AUGIS. Of the patients presenting with cholecystitis (n = 20 pre-COVID and n = 16 during COVID), none had LC within the recommended 72 hours. 5 patients in each COVID group had LC, with a significantly longer waiting time compared to the pre-COVID group. Re-admissions and complications were similar for the cholecystitis patients in both COVID groups. In the gallstone-related pancreatitis group, only 1 patient underwent LC within the recommended 2 weeks. Conclusions This audit showed that locally we are failing to meet AUGIS guidelines for LC within 72 hrs, 2 weeks or 6 weeks both pre and during COVID. This has caused re-admissions of patients with cholecystitis, pancreatitis and perforated gallbladders. Factors that cause delay are limited access to USS, limited staff and theatre availability. To improve outcomes, it is necessary to implement a hot gallbladder service with dedicated theatre slots. A change in the overall perception of LC is also needed: this is should be considered an emergency operation as its delay has a significant negative impact on patients’ outcomes.

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Novel Coronavirus SARS-CoV-2 (COVID-19) and Pregnancy: A hypothetical view

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666201023124843 ◽

2020 ◽

Vol 20 ◽

Author(s):

Ahmed RG

Keyword(s):

Immune System ◽

Cellular Therapy ◽

Early Stage ◽

Control Strategies ◽

Vital Role ◽

Healthy Life ◽

Global Pandemic ◽

Maternal Immune System ◽

Perinatal Management ◽

Novel Coronavirus

Background: The complications of the SARS-CoV-2 infection and its COVID-19 disease on mothers and their offspring are less known. Objective: The aim of this review was to determine the transmission, severity, complications of SARS-CoV-2 infection during the pregnancy. This review showed the influence of COVID-19 disease on the neonatal neurogenesis. Owing to no specific vaccines or medicines that were reported for the treatment of COVID-19 disease, this review suggested some control strategies like treatments (medicinal plants, antiviral therapy, cellular therapy, and immunotherapy), nutrition uptake, prevention, and recommendations. Discussion: This overview showed in severely states that SARS-CoV-2 infection during the early stage of pregnancy might increase the risk of stress, panic, and anxiety. This disorder can disturb the maternal immune system, and thus causing a neurodevelopmental disturbance. This hypothesis may be depending on the severity and intensity of the SARS-CoV-2 infection during pregnancy. However, vertical transmission of SARS-CoV-2 from dams to their fetuses is absent until now. Conclusion: During this global pandemic disease, maintaining safety during pregnancy, vaginal delivery, and breastfeeding may play a vital role in a healthy life for the offspring. Thus, international and national corporations should be continuing for perinatal management, particularly during the next pandemic or disaster time.

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Toward establishing telepsychology guideline: Turning the challenges of COVID-19 into opportunity (Preprint)

10.2196/preprints.24287 ◽

2020 ◽

Author(s):

Mohammed M. J. Alqahtani

Keyword(s):

Mental Health ◽

Health Care Services ◽

Task Force ◽

Healthcare Services ◽

Psychological Services ◽

Face To Face ◽

Care Services ◽

Governance Model ◽

Provision Of Services ◽

Temporary Response

BACKGROUND The COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19. OBJECTIVE This document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities. METHODS A professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices. RESULTS The practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples. CONCLUSIONS Telepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.

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Hand Surgery in Thailand

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1721900 ◽

2021 ◽

Vol 13 (01) ◽

pp. 35-41

Author(s):

Sunyarn Niempoog ◽

Kiat Witoonchart ◽

Woraphon Jaroenporn

Keyword(s):

World War Ii ◽

Traffic Accidents ◽

Hand Surgery ◽

Vital Role ◽

Second Phase ◽

World War ◽

Third Phase ◽

Foreign Countries ◽

General Surgeons ◽

Set Up

AbstractModern hand surgery in Thailand started after the end of World War II. It is divided into 4 phases. In the initial phase (1950-1965), the surgery of the hand was mainly performed by general surgeons. In 1965-1975, which was the second phase, many plastic surgeons and orthopaedic surgeons graduated from foreign countries and came back to Thailand. They played a vital role in the treatment of the surgery of the hand and set up hand units in many centers. They also contributed to the establishment of the “Thai Society for Surgery of the Hand,” which still continues to operate. In the third phase (1975-2000), there was a dramatic development of microsurgery because of the rapid economic expansion. There were many replantation, free tissue transfers, and brachial plexus surgeries in traffic and factory-related accidents. The first hand-fellow training program began in 1993. In the fourth phase (since 2000), the number of hand injuries from factory-related accidents began declining. But the injury from traffic accidents had been increasing both in severity and number. Moreover, the diseases of hand that relate to aging and degeneration had been on the rise. Thai hand surgeons have been using several state-of-the-art technologies such as arthroscopic and endoscopic surgery. They are continuing to invent innovations, generating international publications, and frequently being invited as speakers in foreign countries.

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Teaching Mathematics during the COVID-19 Lockdown in a Context of Historical Disadvantage

Education Sciences ◽

10.3390/educsci11040177 ◽

2021 ◽

Vol 11 (4) ◽

pp. 177

Author(s):

Brantina Chirinda ◽

Mdutshekelwa Ndlovu ◽

Erica Spangenberg

Keyword(s):

South Africa ◽

South African ◽

Mathematics Teachers ◽

Education System ◽

Teaching And Learning ◽

Face To Face ◽

Global Pandemic ◽

Education Community ◽

South African Education

The COVID-19 global pandemic widely affected education across the world and engendered unprecedented scenarios that required expeditious responses. In South Africa, the pandemic came on top of pre-existing inequalities in the education system. Using a qualitative research method of exploratory and descriptive nature, this study engaged a social justice framework to explore the teaching and learning of mathematics during the COVID-19 lockdown in a context of historical disadvantage. A sample of twenty-three Grade 12 mathematics teachers at various public secondary schools in Gauteng, South Africa was used in the study. The teachers were selected through purposive sampling. A Google-generated open-ended questionnaire and follow-up telephonic interviews were used to collect data. Data were analysed thematically in five steps. The findings revealed that the WhatsApp platform is a valuable tool that can support the teaching and learning of mathematics beyond the classroom in the contexts of historical disadvantage. The findings also provided insights into how mathematics teachers became learners themselves during emergency remote teaching (ERT) as they had to adapt to digital teaching, find solutions to unfamiliar problems and acquire knowledge from a larger mathematics education community around the globe. The article discusses these findings and teachers’ challenges of transitioning from traditional face-to-face classrooms to ERT and how they were addressed. At the time of publishing the article, most learners in South Africa had started going to school on a rotational basis. Nonetheless, the study reported in this article is of importance as ERT in the context of historical disadvantage has foregrounded issues of inequality in the South African education system that must be dealt with urgently.

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Impact of a Telemedicine Program on the Reduction in the Emission of Atmospheric Pollutants and Journeys by Road

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224366 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4366 ◽

Cited By ~ 7

Author(s):

Josep Vidal-Alaball ◽

Jordi Franch-Parella ◽

Francesc Lopez Seguí ◽

Francesc Garcia Cuyàs ◽

Jacobo Mendioroz Peña

Keyword(s):

Nitric Oxide ◽

Primary Care ◽

Environmental Sustainability ◽

Atmospheric Pollutants ◽

Fuel Reduction ◽

Environmental Footprint ◽

Time Saving ◽

Face To Face ◽

Total Travel Time ◽

Hospital Visits

This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants, thanks to a reduction in the number of hospital visits involving journeys by road. Between January 2018 and June 2019, a total of 12,322 referrals were made to telemedicine services in the primary care centers, avoiding a total of 9034 face-to-face visits. In total, the distance saved was 192,682 km, with a total travel time saving of 3779 h and a total fuel reduction of 11,754 L with an associated cost of €15,664. This represents an average reduction of 3248.3 g of carbon dioxide, 4.05 g of carbon monoxide, 4.86 g of nitric oxide and 3.2 g of sulphur dioxide. This study confirms that telemedicine reduces the environmental impact of atmospheric pollutants emitted by vehicles by reducing the number of journeys made for face-to-face visits, and thus contributing to environmental sustainability.

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Cholecystectomy for Biliary Hyperkinesia

The American Surgeon ◽

10.1177/000313481908500232 ◽

2019 ◽

Vol 85 (2) ◽

pp. 219-222 ◽

Cited By ~ 2

Author(s):

Joshua Gazzetta ◽

Betty Fan ◽

Paul Bonner ◽

John Galante

Keyword(s):

Laparoscopic Cholecystectomy ◽

Chart Review ◽

Gallbladder Disease ◽

Retrospective Chart Review ◽

Biliary Colic ◽

Study Cohort ◽

Final Pathology ◽

Pathology Reports ◽

Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

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Is this mine? Psychological ownership and the social media follower

Young Consumers Insight and Ideas for Responsible Marketers ◽

10.1108/yc-11-2020-1256 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Caroline S.L. Tan

Keyword(s):

Social Media ◽

Design Methodology ◽

Vital Role ◽

Psychological Ownership ◽

Structured Interviews ◽

Content Type ◽

Face To Face ◽

The Social ◽

Social Currency ◽

Different Levels

Purpose The purpose of this study is to examine psychological ownership (PO) experienced by followers of social media influencers toward both influencer and the product. Design/methodology/approach Data were collected using face-to-face semi-structured interviews that were conducted with 30 respondents and analyzed using thematic analysis. Findings The study demonstrated that the PO experienced by the follower changes under different conditions resulting from perceived value, social currency and follower activity. Social currency plays a vital role in determining the target of PO, often affecting the narrative by the follower. Originality/value To the best of the author’s knowledge, this is the first paper to examine the transference of PO between product and influencer as experienced by the follower. It provides an understanding on PO that is experienced in different levels of intensity and changes depending on the motive of the follower; hence, transference of PO occurs and it is not a static.

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