scholarly journals EP.WE.1Hybrid Surgical Hot Clinic (HSHC): evaluation of Surgical Hot Clinic services during COVID-19 lockdown

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Adeel Abbas Dhahri ◽  
Raheel Ahmad ◽  
Bilal Fazal Shaikh ◽  
Olubunmi Sajinyan ◽  
Ibrahim Warrag ◽  
...  
Keyword(s):  
Emergency Service ◽  
Symptomatic Treatment ◽  
Radiology Department ◽  
Outpatient Basis ◽  
Surgical Service ◽  
Face To Face ◽  
The United Kingdom ◽  
Novel Coronavirus ◽  
Discharge From Hospital

Abstract Aims Surgical Hot Clinic (SHC) is an acute emergency service for management provided on an outpatient basis in the United Kingdom. Following the start of global Novel Coronavirus (COVID-19) pandemic and as per the statement released by the Association of Surgeons of Great Britain and Ireland (ASGBI), we modified SHC service to mainly provide telephonic follow-up with an occasional face-to-face service. Methods After developing a local pathway for SHC services during COVID-19 lockdown, a quality improvement audit was conducted from 30th March till 26th May 2020. Through this pathway, telephonic consultation carried out in most patients while for selective face-to-face consultation designated Medical Ambulatory area used. The analysis then performed using SPSS version 20 to assess the serviceability of modified hybrid SHC. Results Among 149 patients, 54(36.2%) were male, and 95(63.8%) were female, referred during Coronavirus lockdown. Out of these 149, 87(58.3%) referred from Accident & Emergency (A&E), 2(1.3%) from GP, 9(6.04%) after scan through radiology department while 51(34.2%) after discharge from hospital. Out of those who have telephonic consultation (n = 98), 12 patients were called in for review with either blood tests or further clinical examination. In total, only 10 out of 149 patients required admission to the hospital, either for intervention or symptomatic treatment. Conclusion Hybrid surgical hot clinic (HSHC) with both telephonic & face-to-face consultation, as per requirement, is flexible, effective and safe patient-focused acute surgical service during COVID-19 like a crisis.

Discharge from hospital and early supported discharge

2020 ◽  
pp. 345-352
Author(s):  
Catherine Gaynor
Keyword(s):  
Discharge Planning ◽  
Models Of Care ◽  
Effective Discharge ◽  
The United Kingdom ◽  
Early Supported Discharge ◽  
Hospital To Home ◽  
Discharge From Hospital ◽  
Applied Health Research

‘Discharge from hospital and early supported discharge’ provides some useful guidance and outlines the issues that we encounter in facilitating effective discharge from hospital following a stroke. Hospital discharge is an important milestone in a stroke patient’s journey. It marks the end of the acute hospital episode, and the start of a new life living with and adjusting to their stroke and its sequelae. It can be a stressful time for patients and their carers, but careful and thorough discharge planning can help to ease the transition from hospital to home. The chapter explores the timing of discharge, models of care after discharge, early supported discharge, the evidence from SSNAP (Sentinel Stroke National Audit Programme) in the United Kingdom, the initiative of CLAHRC (Collaborative for Leadership in Applied Health Research and Care), guidance from the National Institute for Health and Care Excellence (NICE), institutionalization, role of capacity, role of IMCA (independent mental capacity advocate), communication with primary care, and follow-up after discharge from hospital.

scholarly journals Suicide Risk in Schizophrenia - a follow-up study after 20 years. Part 2: Symptomatology and pharmacotherapy

2009 ◽  
Vol 15 (4) ◽  
pp. 7
Author(s):  
G Lippi ◽  
D J Smit ◽  
J C Jordaan ◽  
J L Roos
Keyword(s):  
Suicide Risk ◽  
Depression Scale ◽  
Original Study ◽  
Psychological Autopsy ◽  
Illness Onset ◽  
Face To Face ◽  
Factors Associated ◽  
Poor Social Support ◽  
Discharge From Hospital

<p><strong>Objective: </strong> This study prospectively re-evaluated, after a period of 20 years, a cohort of patients with schizophrenia who had been considered to be at high risk for suicide. The outcome and social factors associated with their suicide risk were investigated over the 2 decades. Method Subjects were contacted and interviewed face-to-face by following a questionnaire devised for this purpose. The Beck Hopelessness Scale (BHS) was administered and ratings were compared to those from the original study. The Calgary Depression Scale for Schizophrenia (CDSS) was administered. Cross tabulations were performed to identify factors associated with increased suicide risk. A psychological autopsy was performed, for those subjects who had committed suicide since the original study.</p><p><strong>Results:</strong>Fourteen of the original 33 high suicide risk schizophrenia patients were found. Three subjects committed suicide during the 20 year period. Among the living subjects, risks for suicide were found to be lower than 20 years ago. Male gender, poor social support, early age of illness onset, current admission to or recent discharge from hospital and a higher level of education were all factors associated with increased suicide risk. <strong></strong></p><p><strong>Conclusion:</strong> Demographic factors and those related to illness course, found in this study to be associated with suicide risk in patients with schizophrenia, are congruous with those mentioned in the literature.</p>

The disparate management of superficial venous thrombosis in primary and secondary care

2014 ◽  
Vol 30 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Tristan RA Lane ◽  
Kaji Sritharan ◽  
J Rosalind Herbert ◽  
Ian J Franklin ◽  
Alun H Davies
Keyword(s):  
Venous Thrombosis ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Symptomatic Treatment ◽  
Benign Condition ◽  
Electronic Survey ◽  
The United Kingdom ◽  
Inflammatory Drugs ◽  
E Mail

Objectives Superficial venous thrombosis is common and traditionally considered a benign condition requiring only symptomatic treatment. Recent evidence, however, advocates more aggressive management. Extensive guidance is available but actual practice is unknown. This study aimed to assess the management of superficial venous thrombosis by general practitioners (primary care physicians) and vascular surgeons. Methods A 19-question validated electronic survey was created and circulated by e-mail to general practitioners and vascular surgeons in the United Kingdom. The survey evaluated presentation, investigation and treatment of superficial venous thrombosis. Results Three hundred sixty-nine surveys were returned from 197 vascular surgeons and 172 general practitioners. Most clinicians saw less than 20 cases a year, with 40% of clinicians not performing any investigations. Venous duplex was the investigation of choice in over 55%. Treatment with anti-inflammatory drugs was widespread, but anticoagulation and compression were seldom prescribed. Follow-up and treatment duration were disparate. Discussion The management of superficial venous thrombosis varies widely despite good levels of evidence and guidance. Investigation and treatment of superficial venous thrombosis show marked differences both between and within groups. Improvements in education are required to optimise the treatment pathway and advance patient care.

scholarly journals Effectiveness of personal protective health behaviour against COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chon Fu Lio ◽  
Hou Hon Cheong ◽  
Chin Ion Lei ◽  
Iek Long Lo ◽  
Lan Yao ◽  
...  
Keyword(s):  
High Risk ◽  
Health Behaviour ◽  
The United States ◽  
Physical Contact ◽  
Individual Level ◽  
Face To Face ◽  
The United Kingdom ◽  
Novel Coronavirus ◽  
The Individual ◽  
Duration Of Protection

Abstract Background Novel coronavirus disease 2019 (COVID-19) has become a pandemic, and over 80 million cases and over 1.8 million deaths were reported in 2020. This highly contagious virus is spread primarily via respiratory droplets from face-to-face contact and contaminated surfaces as well as potential aerosol spread. Over half of transmissions occur from presymptomatic and asymptomatic carriers. Although several vaccines are currently available for emergency use, there are uncertainties regarding the duration of protection and the efficacy of preventing asymptomatic spread. Thus, personal protective health behaviour and measures against COVID-19 are still widely recommended after immunization. This study aimed to clarify the efficacy of these measures, and the results may provide valuable guidance to policymakers to educate the general public about how to reduce the individual-level risk of COVID-19 infection. Methods This case-control study enrolled 24 laboratory-confirmed COVID-19 patients from Centro Hospitalar Conde de São Januário (C.H.C.S.J.), which was the only hospital designated to manage COVID-19 patients in Macao SAR, China, and 1113 control participants who completed a 14-day mandatory quarantine in 12 designated hotels due to returning from high-risk countries between 17 March and 15 April 2020. A questionnaire was developed to extract demographic information, contact history, and personal health behaviour. Results Participants primarily came from the United Kingdom (33.2%), followed by the United States (10.5%) and Portugal (10.2%). Independent factors for COVID-19 infection were having physical contact with confirmed/suspected COVID-19 patients (adjusted OR, 12.108 [95% CI, 3.380–43.376], P < 0.005), participating in high-risk gathering activities (adjusted OR, 1.129 [95% CI, 1.048–1.216], P < 0.005), handwashing after outdoor activity (adjusted OR, 0.021 [95% CI, 0.003–0.134], P < 0.005), handwashing before touching the mouth and nose area (adjusted OR, 0.303 [95% CI, 0.114–0.808], P < 0.05), and wearing a mask whenever outdoors (adjusted OR, 0.307 [95% CI, 0.109–0.867], P < 0.05). The daily count of handwashing remained similar between groups. Only 31.6% of participants had a sufficient 20-s handwashing duration. Conclusions Participating in high-risk gatherings, wearing a mask whenever outdoors, and practising hand hygiene at key times should be advocated to the public to mitigate COVID-19 infection.

scholarly journals 331 COVID-19 Mortality After Vascular Procedures During the Initial UK Surge: Moving Forward with Elective Vascular Work

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Liu ◽  
S Cheema ◽  
I Adeoye ◽  
S Theivacumar ◽  
T Hussain ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Minimally Invasive ◽  
Elective Surgery ◽  
Radiology Department ◽  
Safety Measures ◽  
The United Kingdom ◽  
Reduce Risk ◽  
Interventional Radiology Department

Abstract Aim Following the initial COVID-19 surge in the United Kingdom, there was a national incentive for elective vascular surgery to be restricted to clean sites in order to reduce perioperative cross infection and subsequent mortality. We assessed the risk of dying from perioperatively acquired COVID-19 during the peak of the London outbreak. Method 43 consecutive patients who had vascular (n = 48) procedures in March and April 2020 at a regional hub serving five London hospitals were analysed. The patients were screened for COVID-19 in the 30-day postoperative period and the main outcome measure was mortality from COVID-19. A comparison was then made with patients who underwent minimally invasive procedures from our integrated interventional radiology department. Median follow-up was 41 days (IQR 8- 58 days). Results Three patients (7%) in the vascular group (median age 61 years, all diabetic, two male) died from COVID-19, all of whom tested positive postoperatively. Two others became positive but recovered. In comparison, two patients (2%) in the interventional radiology group died from COVID-19, however one was positive prior to their procedure. Conclusions Only urgent vascular cases should be performed during a COVID-19 surge, with elective work delayed or continued at clean sites. However, with growing waiting lists for elective surgery currently, further restrictions may not be a viable long-term solution. Resumption of care at hot sites should be considered, if resources allow for it and if safety measures can be implemented. The advantages of minimally invasive surgery may inherently reduce risk as well.

scholarly journals O32 COVID-19 mortality after vascular procedures during the initial UK surge: moving forward with elective vascular work

2021 ◽  
Vol 108 (Supplement_5) ◽  
Author(s):  
P Liu ◽  
S M Cheema ◽  
I Adeoye ◽  
N S Theivacumar ◽  
S T Hussain ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Minimally Invasive ◽  
Elective Surgery ◽  
Radiology Department ◽  
Safety Measures ◽  
The United Kingdom ◽  
Reduce Risk ◽  
Interventional Radiology Department

Abstract Introduction Following the initial COVID-19 surge in the United Kingdom, there was a national incentive for elective vascular surgery to be restricted to clean sites in order to reduce perioperative cross infection and subsequent mortality. We assessed the risk of dying from perioperatively acquired COVID-19 during the peak of the London outbreak. Materials and Methods 43 consecutive patients who had vascular (n = 48) procedures in March and April 2020 at a regional hub serving five London hospitals were analysed. The patients were screened for COVID-19 in the 30-day postoperative period and the main outcome measure was mortality from COVID-19. A comparison was then made with patients who underwent minimally invasive procedures from our integrated interventional radiology department. Median follow-up was 41 days (IQR 8–58 days). Result Three patients (7%) in the vascular group (median age 61 years, all diabetic, two male) died from COVID-19, all of whom tested positive postoperatively. Two others became positive but recovered. In comparison, two patients (2%) in the interventional radiology group died from COVID-19, however one was positive prior to their procedure. Conclusion Only urgent vascular cases should be performed during a COVID-19 surge, with elective work delayed or continued at clean sites. However, with growing waiting lists for elective surgery currently, further restrictions may not be a viable long-term solution. Resumption of care at hot sites should be considered, if resources allow for it and if safety measures can be implemented. The advantages of minimally invasive surgery may inherently reduce risk as well. Take-home Message Only urgent vascular cases should be performed during a peak outbreak of COVID-19, however we cannot continue to postpone elective procedures indefinitely or restrict all cases to solely clean sites. The resumption of care at hot sites encompasses a fine balance of risks versus benefits.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

Efektivitas Layanan Darurat Jakarta Siaga 112 dalam Penanganan Kebakaran oleh UPT. Pusat Data & Informasi Kebencanaan BPBD Provinsi DKI Jakarta

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Musa Musa
Keyword(s):  
Emergency Service ◽  
Fire Management ◽  
Emergency Services ◽  
The Public ◽  
Information Center ◽  
Disaster Data ◽  
In Fire ◽  
Document Review

This research was conducted to determine the Effectiveness of Jakarta Siaga 112 Emergency Services in Fire Management by UPT. Disaster Data & Information Center of BPBD DKI Jakarta Province by paying attention to aspects contained in the Effectiveness of the Jakarta Siaga Emergency Service Program 112. The research method was carried out with a case study method with data collection techniques using interview methods and document review. Interviews were conducted on 10 (ten) key informants, document review focused on documents related to the Jakarta Emergency Alert Service 112 Effectiveness research in Fire Management. The results showed that the Effectiveness of Jakarta Siaga 112 Emergency Services in Fire Management by UPT. The Center for Disaster Data & Information BPBD DKI Jakarta Province Its effectiveness is still low, due to the Implementation of Emergency Services Jakarta Standby 112 in Fire Management implemented by UPT. Disaster Data & Information Center of BPBD DKI Jakarta Province in terms of the Target Group Understanding of the Program, the Achievement of the Program Objectives aspects, and the Program Follow-up aspects. It is recommended to continue to disseminate this Emergency Service to the public, it is necessary to increase the firm commitment of the Head of 8 SKPD related to fire management so that all units play a role in accordance with the Standard Operating Procedures (SOPs) for Fire Management and the evaluation and follow-up of program services that are held periodically 3 once a month.Keywords: Effectiveness, Emergency Services, Fire Handling

İngiltere’den Türkiye’ye ‘Düzensiz’ Göçmen Dövizi Gönderme Davranışının Nedenleri Üzerine Nitel Bir İnceleme

2019 ◽  
Vol 6 (2) ◽  
pp. 173-190
Author(s):  
Fethiye Tilbe
Keyword(s):  
Cultural Values ◽  
Host Country ◽  
Regulatory Framework ◽  
Face To Face ◽  
Migrant Communities ◽  
The United Kingdom ◽  
Main Determinants ◽  
Money Transfers ◽  
The Uk ◽  
Migrant Groups

Bu makale, göçmen dövizi  akımlarında “düzensizlik” olarak ifade ettiğimiz, Türkiye’ye resmi kanallar dışında gönderilen enformel  göçmen dövizlerini, Birleşik Krallık’ta (özellikle Londra’da) yaşayan Türkiye kökenli göçmenler açısından incelemektedir. Her göçmen grubu, gerek ev sahibi ülkedeki düzenleyici çerçeve ve sosyo-ekonomik koşullar, gerek göçmen topluluğunun sosyo-kültürel değerleri tarafından belirlenen biçimde, farklı göçmen dövizi transfer biçimlerine eğilim sergilemektedir. Dolayısıyla farklı ülkelerdeki aynı kökenden göçmen toplulukları, ev sahibi ülkedeki dinamikler nedeniyle göçmen dövizlerinin formel ya da enformel (düzenli ya da düzensiz) gönderiminde farklılaşabilirken, aynı ülkedeki farklı ülke kökenli göçmen grupları da pek çok örüntünün etkisiyle farklı eğilim gösterebilmektedir. Nitel araştırma tasarımı kapsamında 27 göçmen ve 7 anahtar statüdeki katılımcıyla gerçekleştirilen yüz yüze görüşmelere dayalı olan bu çalışma, Birleşik Krallık’tan Türkiye’ye göçmen dövizi gönderimindeki düzensizlik olgusunu, her iki ülkenin sosyal, ekonomik ve kültürel dinamikleriyle ilişkilendirerek incelemeyi ve nedenlerini ortaya çıkarmayı amaç edinmektedir. Elde edilen sonuçlar, göçmenlik statüsü, gönderilen para miktar ve sıklığı ile geleneksel ilişki ağlarına olan güvenin yanında, Birleşik Krallık’taki sosyal yardım ve çalışma biçimine ilişkinin düzenleyici çerçevenin ve göçmenlerin sosyo-ekonomik durumlarının Türkiye’ye enformel göçmen dövizi gönderiminde temel belirleyici olduğunu ortaya koymaktadır.ABSTRACT IN ENGLISHA Qualitative Examination of Determinants of Remittances Sending Behaviour Among Immigrants from Turkey in the UKThis article examines the causes of irregularity in remittances flows from the United Kingdom (UK) to Turkey, from the perspective of migrants from Turkey living in the UK. Each group of migrants prefers different types of remittance sending methods, as determined by the regulatory framework and socio-economic conditions in the host country and the socio-cultural values of the migrant community. Therefore, migrant communities of the same origin in different countries may differ in using formal or informal sending methods of remittances due to the dynamics in the host country. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. This study aims to examine the phenomenon of irregularities in sending remittances by associating with the social, economic and cultural dynamics of both countries. For this purpose, face-to-face in-depth interviews were conducted with 27 immigrants and 7 key status participants by using qualitative research method. The obtained results reveal that the regulatory framework relating to social assistance and labour market in the UK, immigration status, the frequency and the amount of money sent and confidence in traditional relationship networks is the main determinants of informal money transfers to Turkey.

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