scholarly journals P-BN44 The impact of the COVID-19 pandemic on waiting lists for laparoscopic cholecystectomy and its effect on patient care and outcomes

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Geraint Herbert ◽  
Charlotte Thomas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Patient Care ◽  
Positive Impact ◽  
Elective Surgery ◽  
Emergency Operation ◽  
Waiting Lists ◽  
Waiting List ◽  
Subtotal Cholecystectomy ◽  
Significant Difference ◽  
The Impact

Abstract Background It has been widely reported that the COVID-19 pandemic has had a detrimental impact on waiting lists for elective surgery in the NHS. Delays in laparoscopic cholecystectomy (LC) are likely to prolong suffering for symptomatic patients and risk increasing complications for patients which may then require emergency care and intervention. In this study we aim to quantify the impact of the COVID-19 pandemic on elective waiting lists and to assess what implications this might have on patient care and outcomes.  Methods Electronic health records were retrospectively interrogated for patients undergoing LC in both March 2019 (prior to the COVID-19 pandemic) and March 2021. The following data was captured: age, gender, elective vs emergency operation, laparoscopic vs open, total vs subtotal cholecystectomy, use of drains, length of stay/daycase rates, the number of emergency presentations prior to operation and the number of days between being listed for surgery and their operation. The results were analysed using SPSS Statistics (IBM, New York).  Results 111 patients were included in the study (25 male and 86 female). Of these, 60 had their LC in 2019, and 51 in 2021. The age and gender distribution of the patients in both time periods were similar. The median number of days on the waiting list was significantly higher (P < 0.001) for patients in 2021 at 379.5 days, compared with 153 days in 2019. There was a significant increase in the number of emergency presentations prior to LC in 2021 (P = 0.025) with an average of 0.7 presentations per patient compared with 0.45 in 2019. Additionally, there was a significant increase in the number of emergency LC performed in 2021 (P = 0.002), with 15 performed compared with 4 in 2019, representing 29.4% and 6.7% of all LC respectively. There was no significant change in rates of conversion to open, drains or subtotal cholecystectomy. There was no significant difference in daycase rates for elective patients in either period (55% vs 58%). Conclusions Whilst there has been no change in the operative outcomes for patients undergoing LC, there has been a stark increase in the length of time patients are on a waiting list prior to undergoing elective LC. This has resulted in a significant increase in the number of emergency presentations and the number of emergency LC performed. This study demonstrates the wider impact of increasing waiting list times beyond the prolonged suffering of symptomatic patients. A significant reduction in waiting list times would be beneficial to both patients and healthcare providers, with the aim of reducing the number of emergency presentations. A reduction in these would have a positive impact on acute services and on the associated cost implications.  

The Right to Housing: Challenges Associated with the ‘Waiting List System’ Ekurhuleni Metropolitan Municipality V Various Occupiers, Eden Park Extension 5 2014 3 SA 23 (SCA)

2017 ◽  
Vol 30 (1) ◽  
pp. 112-121
Author(s):  
Shamier Ebrahim
Keyword(s):  
Supreme Court ◽  
Waiting Lists ◽  
The State ◽  
Waiting List ◽  
Allocation Process ◽  
The Supreme Court ◽  
The Right ◽  
The Impact ◽  
Court Of Appeal

The right to adequate housing is a constitutional imperative which is contained in section 26 of the Constitution. The state is tasked with the progressive realisation of this right. The allocation of housing has been plagued with challenges which impact negatively on the allocation process. This note analyses Ekurhuleni Metropolitan Municipality v Various Occupiers, Eden Park Extension 51 which dealt with a situation where one of the main reasons provided by the Supreme Court of Appeal for refusing the eviction order was because the appellants subjected the unlawful occupiers to defective waiting lists and failed to engage with the community regarding the compilation of the lists and the criteria used to identify beneficiaries. This case brings to the fore the importance of a coherent (reasonable) waiting list in eviction proceedings. This note further analyses the impact of the waiting list system in eviction proceedings and makes recommendations regarding what would constitute a coherent (reasonable) waiting list for the purpose of section 26(2) of the Constitution.

scholarly journals Absence of Association between Preoperative Estimated Glomerular Filtration Rates and Postoperative Outcomes following Elective Gastrointestinal Surgeries: A Prospective Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Sivesh K. Kamarajah ◽  
Behrad Barmayehvar ◽  
Mustafa Sowida ◽  
Amirul Adlan ◽  
Christina Reihill ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Glomerular Filtration ◽  
Elective Surgery ◽  
Gastrointestinal Surgery ◽  
Major Complication ◽  
Postoperative Outcomes ◽  
Queen Elizabeth Hospital ◽  
Complication Rates ◽  
Significant Difference ◽  
The Impact

Background. Preoperative risk stratification and optimising care of patients undergoing elective surgery are important to reduce the risk of postoperative outcomes. Renal dysfunction is becoming increasingly prevalent, but its impact on patients undergoing elective gastrointestinal surgery is unknown although much evidence is available for cardiac surgery. This study aimed to investigate the impact of preoperative estimated glomerular filtration rate (eGFR) and postoperative outcomes in patients undergoing elective gastrointestinal surgeries. Methods. This prospective study included consecutive adult patients undergoing elective gastrointestinal surgeries attending preassessment screening (PAS) clinics at the Queen Elizabeth Hospital Birmingham (QEHB) between July and August 2016. Primary outcome measure was 30-day overall complication rates and secondary outcomes were grade of complications, 30-day readmission rates, and postoperative care setting. Results. This study included 370 patients, of which 11% (41/370) had eGFR of <60 ml/min/1.73 m2. Patients with eGFR < 60 ml/min/1.73 m2 were more likely to have ASA grade 3/4 (p<0.001) and >2 comorbidities (p<0.001). Overall complication rates were 15% (54/370), with no significant difference in overall (p=0.644) and major complication rates (p=0.831) between both groups. In adjusted models, only surgery grade was predictive of overall complications. Preoperative eGFR did not impact on overall complications (HR: 0.89, 95% CI: 0.45–1.54; p=0.2). Conclusions. Preoperative eGFR does not appear to impact on postoperative complications in patients undergoing elective gastrointestinal surgeries, even when stratified by surgery grade. These findings will help preassessment clinics in risk stratification and optimisation of perioperative care of patients.

scholarly journals Differences between the profiles of institutionalized elderly people and those on waiting lists and who do not want to be institutionalized

2016 ◽  
Vol 19 (1) ◽  
pp. 105-118 ◽  
Author(s):  
Andrea Mendes Araújo ◽  
Temístocles Bezerra de Sousa Neto ◽  
Ângelo José Gonçalves Bós
Keyword(s):  
The Elderly ◽  
Waiting Lists ◽  
Waiting List ◽  
Elderly Persons ◽  
Cross Sectional ◽  
Term Care ◽  
Number Of Children ◽  
Elderly Resident ◽  
Significant Difference ◽  
Resident Group

Objective To identify the demographic, environmental, economic, functional, and health characteristics and the lifestyle habits of elderly persons considering their degree of institutionalization. Method A cross-sectional observational study was carried out of individuals in long-term care institutions for the elderly (resident group) in João Pessoa in the state of Paraíba, those on the waiting list (waiting list group) for such institutions, and those who did not demonstrate interest in being institutionalized (non-waiting list group). Fifty elderly persons per group were interviewed, paired by sex, age and education level. Results The non-waiting list group had a higher proportion of married individuals (p<0.0001), mean number of children (p=0.0068), number of homeowners (p=0.0060) and less difficulty going out, with a higher frequency of activities. The waiting list group presented a higher proportion of individuals living alone (p=0.0089), and a lower frequency and more difficulty going out. There was no significant difference in the functional capacity of the three groups (p=0.2019). Conclusion There were differences among the three groups; however, the waiting list group had much more similar characteristics to the resident group than the non-waiting list group. Elderly persons on waiting lists to be institutionalized represent a neglected social group both in terms of research and public policies.

scholarly journals Establishing safety huddles on a general adult acute psychiatric ward: staff's views and relation with restrictive practice

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S178-S179
Author(s):  
Sidra Chaudhry ◽  
Nicoletta Lekka
Keyword(s):  
Patient Care ◽  
Positive Impact ◽  
Team Building ◽  
High Risk Patient ◽  
Psychiatric Ward ◽  
Clinical Activity ◽  
Restrictive Practice ◽  
Feedback Questionnaire ◽  
Multidisciplinary Staff ◽  
The Impact

AimsTo establish Safety Huddles (SH) on an acute general adult psychiatric ward, exploring links to restrictive practice. Additionally, to obtain multidisciplinary staff feedback on SH's impact on their workload/wellbeing and on patient care, and to identify barriers in implementation.Background: A SH is a multidisciplinary daily briefing focused on patients most at risk, held at a fixed time and place, lasting max 5-10 minutes. Effective SH involve agreed actions, are informed by multidisciplinary staff feedback of data and provide the opportunity to appreciate and celebrate success in reducing harm. SH are a valuable team building activity, promoting situational awareness and helping with prioritising daily tasks.MethodSH were introduced on September 2020. Templates were developed to prompt staff how to facilitate. Staff were encouraged to identify key goals and reflect on issues in the last and next 24 hours. Each participant was allocated a role, e.g. record keeping or dissemination of information. In December 2020, records of incidence of restrictive practice (numbers of restraints, seclusions and rapid tranquilisations) were obtained for the periods June-August 2020 and September-November 2020. Additionally, staff feedback was obtained through a short anonymous Survey Monkey questionnaire. It explored whether SH had an effect on patient care and staff's workload/wellbeing, and possible barriers to implementation.ResultComparing the two 3-month periods before and after SH implementation, restraint episodes were reduced from 47 to 21, seclusion episodes from 19 to 2, and rapid tranquilisation episodes from 10 to 3. Nine staff members responded to the feedback questionnaire. All believed SH had a positive impact on patient care, or had the potential to do so. Staff reported SH gave them insight into incidents, made them feel safer and prepared for the day, played a part in reducing restrictive practice, and empowered staff from all professional backgrounds by giving them a voice. Low or late participation, cancellation of SH because of clinical activity, and vague questions in the meeting template were identified as barriers in implementation.ConclusionAcute psychiatric wards regularly face challenges of high clinical activity, low staffing levels, bed pressures, and high-risk patient cohorts. SH contributed to reducing restrictive practice and creating a safer and more positive work environment. It is important to ensure SH are taking place daily, using an appropriate template to guide staff who may be new to facilitating. Accordingly, the impact on restrictive practice, patient care and staff wellbeing can be sustained long-term.

scholarly journals Technology Integrated in Interactive Entrepreneurship Activity to Enhance Students Mastery in Mathematics Concept for Active Mathematics Teaching

2020 ◽  
Vol 8 (6) ◽  
pp. 250-255
Keyword(s):  
Learning Strategies ◽  
Learning Strategy ◽  
Positive Impact ◽  
Mathematics Learning ◽  
Treatment Session ◽  
Learning Activity ◽  
Control Group ◽  
Significant Difference ◽  
Technological Developments ◽  
The Impact

This study aims to examine the effectiveness of interactive entrepreneurship activity in mathematics learning towards students’ mastery in mathematics concepts. The objective is to look at the impact of implementing an active learning strategy combined with technology on mastery of mathematics concepts after engaging in a learning activity. The combination of technology in interactive learning and games kits in the form of interactive entrepreneurship activity has resulted in the innovation of learning strategies to enhance the learning interest, enjoyment and to influence the mastery of students' mathematics concepts. The effectiveness study of the strategy was conducted using an experimental study design that involved 109 students from 2 secondary schools who had participated in a 4-week mathematics learning treatment session. The experiment group was exposed to interactive entrepreneurship activity through the use of a learning kit while the control group followed conventional learning for a selected mathematics topic. Post-test were conducted to see differences in understanding and achievement of mathematics concepts for both groups of students. The results show that there is a significant difference between the mastery of mathematics concept of the experiment group students and the control group students. This shows that the integration of technology in learning activities has a positive impact on student learning. The implications of the study indicate that teachers need to constantly improve pedagogical knowledge based on current technological developments and improve teaching strategies in order to improve student competencies. The parties also need to provide the latest technology to improve the quality of education in line with global developments.

Contribution of the co.LAB Framework to the Collaborative Design of Serious Games: Mixed-Methods Validation Study (Preprint)

2021 ◽  
Author(s):  
Dominique Jaccard ◽  
Laurent Suppan ◽  
Félicia Bielser
Keyword(s):  
Mixed Methods ◽  
Game Design ◽  
Serious Games ◽  
Positive Impact ◽  
Serious Game ◽  
Multidisciplinary Design ◽  
Design Teams ◽  
Design And Development ◽  
Significant Difference ◽  
The Impact

BACKGROUND Multidisciplinary collaboration is essential to the successful development of serious games, albeit difficult to achieve. The co.LAB serious game design framework was created to support collaboration within serious game multidisciplinary design teams. Its use has not yet been validated in a naturalistic context. OBJECTIVE The objective of this study was to perform a first assessment of the impact of the co.LAB framework on collaboration within multidisciplinary teams during serious game design and development. METHODS This was a mixed-methods study based on two serious game design projects in which the co.LAB framework was used. The first phase was qualitative and carried out using a general inductive approach. To this end, all members of the first serious game project team who used the co.LAB framework were invited to take part in a focus group session (N=6). Results inferred from qualitative data were then used to define a quantitative instrument (questionnaire) which was designed according to the Checklist for Reporting Results of Internet E-Surveys. Members of both project teams (N=11) were then asked to answer the questionnaire. Quantitative results were reported as median [Q1;Q3] and appropriate non-parametric tests used to assess for between group differences. Finally, results gathered through the qualitative and quantitative phases were integrated. RESULTS In both phases, the participation rate was 100%. Verbatim transcripts were classified into 4 high level themes: influence on collaborative dimensions; impact on project course, monitoring and efficiency; qualitative perceptions of the framework; and influence of team composition on the use of the framework. Accordingly, the web-based questionnaire was then developed according to Burhardt's seven dimensions of collaboration. In both projects, the co.LAB framework had a positive impact on most dimensions of collaboration during the multidisciplinary design and development of serious games. When all collaborative dimensions were aggregated, the overall impact of the framework was rated on a scale from "-42" to "+42" (very negative to very positive). The overall score was 23 [20;27], with no significant difference between groups (P=.58). Most respondents also believed that all serious game design teams should include a member possessing a significant expertise in serious game design frameworks to guide the development process. CONCLUSIONS The co.LAB framework has a positive impact on collaboration within serious game development teams. However, expert guidance seems necessary to maximize development efficiency. Whether such guidance can be provided by means of a collaborative web platform remains to be determined.

scholarly journals Evaluating the Mediating Effect of Work-Life Balance between Emotional Intelligence and Job Satisfaction in Corporate Sector

2020 ◽  
Vol 5 (6) ◽  
Author(s):  
Mushk Qasim Memon ◽  
Mahvish Khaskhely ◽  
Adnan Pitafi
Keyword(s):  
Job Satisfaction ◽  
Emotional Intelligence ◽  
Positive Impact ◽  
Work Life ◽  
Mediating Effect ◽  
Work Life Balance ◽  
Corporate Sector ◽  
Life Balance ◽  
Significant Difference ◽  
The Impact

Work Life Balance (WLB) is the current biggest problem being faced by the corporate employees. This research aims to evaluate the challenges of WLB that an employee has to face in his daily life, meanwhile what role does Emotional Intelligence (EI) play and to see how organizations can initiate to support them to improve their WLB and make them satisfied of their job. It aims to find out the impact of EI employee Job Satisfaction (JS) in the presence of WLB of corporate employees in Karachi, Hyderabad and Thatta. To fulfill this purpose, quantitative methodology was adopted, 300 questionnaires were distributed, and SPSS version 22 was used to analyse data. The results indicate that EI has significant and positive impact on employee JS whether in the presence or absence of WLB. Finally, the results of ANOVA test between male and female employees are statistically different for WLB and EI but no significant difference between the genders was statistically found for JS. There is also no significance difference observed between marital status for EI, WLB and JS. From the findings of the research, some solutions are recommended to improve employees WLB for their job satisfaction in corporate sector.

scholarly journals A Study on Effectiveness of Community De-Addiction Camp at Chamarajanagar

2019 ◽  
Vol 8 (1) ◽  
pp. 132-137
Author(s):  
Suman K. Murthy
Keyword(s):  
Addiction Treatment ◽  
Positive Impact ◽  
Participant Observation ◽  
Total Duration ◽  
T Test ◽  
Alcohol Addiction ◽  
Community Level ◽  
Negative Consequences ◽  
Significant Difference ◽  
The Impact

Alcohol addiction is a serious health hazard which has negative consequences for the affected individual as well as his family and community. Inpatient based de addiction treatment is commonly seen to tackle the problem of addiction. Of late, Community de addiction camps are providing de addiction treatment at community level in India. The current study looks into the impact of exposure to community de addiction camp organized by SKDRDP, Chamarajanagar, Karnataka State, India. Qualitative experimental research design is adopted to study the impact of exposure to the community de addiction camp. The total duration of the residential community de addiction camp was eight days. The universe for the study comprised of 103 participants attending the community de addiction camp. 40 participants formed the sample. Tools used for gathering the data were WHO-AUDIT, Interview schedule and participant observation. The data were analysed using paired t- test using SPSS version version 22.0 and participant observation recordings. The community de addiction camp has met all the thirteen expectations of the participants with regard to the camp; The result of t-test found that there is statistically significant difference in the mean scores on all parameters between before and after de addiction camp; there exists significant positive relationship between Clint behavior and client participation before the community de addiction camp. The participants had a positive impact from the exposure to the camp, which was evident to the researchers who were participant observers of the whole process. The community de addiction camp has been successful in bringing about a positive impact on the participants during the conduct of the camp and abstinence was 100% at 1 month post camp follow up. In view of these findings, the current study concludes that community de addiction camps have a positive impact on the participants. Community de addiction camps are an effective and economical way to combat alcohol addiction at the community level.

scholarly journals Does Growing Economy And Better Governance Impede Banking Efficiency? A DEA Analysis

2015 ◽  
Vol 31 (6) ◽  
pp. 2213
Author(s):  
Ramiz Ur Rehman ◽  
Junrui Zhang ◽  
Rizwan Ali ◽  
Abdul Qadeer
Keyword(s):  
Corporate Governance ◽  
Interest Rates ◽  
Banking Sector ◽  
Negative Impact ◽  
Positive Impact ◽  
Foreign Banks ◽  
Significant Difference ◽  
Governance Practices ◽  
Growing Economy ◽  
The Impact

The paper estimates the efficiencies of Pakistani banking sector from 1998-2009. The analysis is further extended and regressed estimated banking efficiencies by using Data Envelopment Analysis (DEA), with macro-economic indicators and corporate governance variables of the banking sector. The purpose of this analysis is to determine the impact of overall economic conditions of a country and corporate governance practices on banking efficiencies. The results suggest that the corporate governance practices, like, board size, board independence have positive impact on overall banking sector efficiencies of Pakistan. Also, the GPD growth and interest rates have positive and negative impact on banking efficiencies respectively. The study has not found any significant difference in banking efficiencies of state-owned, private and foreign banks of Pakistan. 

scholarly journals THE IMPACT OF SUBLINGUAL ALLERGEN IMMUNOTHERAPY ON ASTHMA CONTROL AND THE QUALITY OF LIFE LEVEL IN PATIENTS WITH ALLERGIC ASTHMA AND SENSITIZATION TO TREES POLLEN

2014 ◽  
Vol 11 (4) ◽  
pp. 50-54
Author(s):  
D A NAGATKIN ◽  
A V ZHESTKOV
Keyword(s):  
Quality Of Life ◽  
Allergic Asthma ◽  
Inhaled Corticosteroids ◽  
Positive Impact ◽  
Forced Expiratory Volume ◽  
Average Dose ◽  
Allergen Specific Immunotherapy ◽  
Significant Difference ◽  
The Impact

Background. To Evaluate the effects of trees pollen sublingual products on the control and quality of life in patients with allergic asthma and proven sensitization to pollens of trees. Methods. We enrolled 56 patients in open prospective study and divided into 2 groups to assess the effectiveness of therapy with sublingual allergen. Groups were matched on estimated parameters of quality of life, level of control and forced expiratory volume in the first second. Results. Statistically significant improvement of quality of life parameters and the level of control within the group receiving sublingual immunotherapy was obtained. Significant difference in the average dose of received inhaled corticosteroids was established in the treatment group comparing to control. Conclusion. Sublingual allergen specific immunotherapy has a positive impact on quality of life and level of control in patients with allergic asthma and proven sensitization to pollens of trees, and decreasing the dose of inhaled corticosteroids.

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