scholarly journals DOP37 Large differences in IBD care and education across Europe, first results of the pan-European VIPER survey

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S075-S076
Author(s):  
J Král ◽  
R Nakov ◽  
V Lanska ◽  
B Barberio ◽  
N Benech ◽  
...  
Keyword(s):  
Online Survey ◽  
Clinical Care ◽  
Treat To Target ◽  
Faecal Calprotectin ◽  
Multidisciplinary Meetings ◽  
Routine Monitoring ◽  
District Hospitals ◽  
Bowel Diseases ◽  
First Results ◽  
Almost All

Abstract Background More than 2.5 million people in Europe suffer from inflammatory bowel diseases (IBD). IBD affects the quality of life, but also has important consequences for health systems. As IBD care and education might differ and might be linked to Gross Domestic Product (GDP), we conducted this European Variation In ibd PracticE suRvey (VIPER) to study potential differences. Methods This trainee-initiated survey, run through SurveyMonkey®, consisted of 47 questions inquiring basic demographics, IBD training and clinical care. The survey was distributed through social media and national GI societies from December 2020 - January 2021. Results were compared according to GDP per capita, for which countries were divided into 2 groups (low/high income, according to the World Bank). Differences between groups were calculated using the chi2 statistic. Results The online survey was completed by 1268 participants from 39 European countries (Figure 1). Most of the participants are specialists (65.3 %), followed by fellows in training (>/< 3 years, 19.1%, 15.6 %). Majority of the responders are working in academic institutions (50.4 %), others in public/district hospitals (33.3 %) or private practices (16.3 %). Despite significant differences in access to IBD-specific training between high (56.4%) and low (38.5%) GDP countries (p<0.001), majority of clinicians feels comfortable in treating IBD (77.2% vs 72.0%, p=0.04). Interestingly, a difference in availability of dedicated IBD units could be observed (58.5% vs 39.7%, p<0.001), as well as an inequality in multidisciplinary meetings (72.6% vs 40.2%, p<0.001), which often take place on a weekly basis (53.0%) (Figure 2). In high GDP countries, IBD nurses are more common (86.2%) than in low GDP countries (36.0%, p<0.001), which is mirrored by differences in nurse-led IBD clinics (40.6% vs 13.8%, p<0.001). IBD dieticians (32.4% vs 16.6%) and psychologists (16.7% vs 7.5%) are mainly present in high GDP countries (p<0.001). In the current COVID era, telemedicine is available in 58.4% vs 21.4% of the high/low GDP countries respectively (p<0.001), as well as urgent flare clinics (58.6% vs 38.7%, p<0.001) and endoscopy within 24 hours if needed (83.0% vs 86.7% p=0.1). Treat-to-target approaches are implemented everywhere (85.0%), though access to biologicals and small molecules differs significantly (Figure 3). Almost all (94.7%) use faecal calprotectin for routine monitoring, whereas half also use intestinal ultrasound (47.9%). Conclusion A lot of variability in IBD practice exists across Europe, with marked differences between high vs low GDP countries. Further work is required to help address some of these inequalities, aiming to improve and standardise IBD care across Europe.

scholarly journals Multidisciplinary collaboration among young specialists: results of an international survey by the emerging EULAR network and other young organisations

RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001398 ◽  
Author(s):  
Aurélie Najm ◽  
Marie Kostine ◽  
John D Pauling ◽  
Ana Carina Ferreira ◽  
Kate Stevens ◽  
...  
Keyword(s):  
Clinical Research ◽  
Online Survey ◽  
Research Collaboration ◽  
Clinical Care ◽  
Basic Research ◽  
Multidisciplinary Collaboration ◽  
Collective Work ◽  
Research Collaborations ◽  
Complex Patients ◽  
Multidisciplinary Meetings

BackgroundMultidisciplinary collaboration is defined as a collective work involving multiple disciplines and is common in clinical care and research. Our aim was to describe current clinical and research collaboration among young specialists and to identify unmet needs in this area.MethodsAn online survey was disseminated by email and social media to members of the EMerging EUlar NETwork, the Young Nephrologists’ Platform, the Paediatric Rheumatology European Society Emerging Rheumatologists and Researchers and the European Academy of Allergy and Clinical Immunology Junior Members.ResultsOf 303 respondents from 36 countries, 61% were female, 21% were aged below 30 years and 67% were aged 31–40 years. Young rheumatologists were the most represented (39%), followed by young nephrologists (24%), young paediatricians (20%), young allergologists (11%) then young internists (3%) and 3% other specialities. Collaborations were reported frequently by phone and email, also by various combined clinics while common local multidisciplinary meetings were uncommon. 96% would like to develop clinical research collaborations and 69% basic research collaborations. The majority of young specialists would be interested in online (84%) and/or 1–2 days (85%) common courses including case discussion (81%) and training workshops (85%), as well as webinars recorded with several specialists on a specific disease (96%).ConclusionsThis collaborative initiative highlighted wishes from young specialists for developing (1) regular local multidisciplinary meetings to discuss complex patients, (2) clinical research collaboration with combined grants and (3) multidisciplinary online projects such as common courses, webinars and apps.

scholarly journals COVID-19 in Gastroenterology Departments: The Impact of the First Wave

2021 ◽  
pp. 1-7
Author(s):  
Tiago Leal ◽  
Margarida Gonçalves ◽  
Irina Mocanu ◽  
Rita Carvalho ◽  
Luísa Glória ◽  
...  
Keyword(s):  
Online Survey ◽  
Screening Program ◽  
Health Care Systems ◽  
Recovery Period ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
District Hospitals ◽  
Care Systems ◽  
Almost All ◽  
The Impact

<b><i>Introduction:</i></b> Coronavirus disease 2019 (COVID-19) is a global pandemic that has severely affected health care systems around the world. During the emergency state declared in Portugal in the months of March and April 2020, there was a severe reduction in medical activity in order to reduce the pressure on health systems. This study aimed to assess the impact of COVID-19 in gastroenterology departments across Portugal and the strategies developed to overcome this challenge. <b><i>Methods:</i></b> This was a cross-sectional study based on an online survey. A detailed questionnaire concerning different aspects of gastroenterology department activity was sent via e-mail to the heads of gastroenterology departments of Portuguese District Hospitals (Núcleo de Gastroenterologia dos Hospitais Distritais). Two periods were assessed, i.e., the emergency state and the recovery period between May and September. The responses were collected between September and October 2020. <b><i>Results:</i></b> A total of 21 hospitals were enrolled (80.8% response rate). Twenty-eight percent of the responders reported healthcare professionals from their unit infected with COVID-19. At least 1 member (mostly fellows) of the department was deployed to another workplace in 66.7% of the hospitals. During the emergency state, 47.6% of the hospitals only performed urgent/emergent endoscopic procedures. In 38.5% of the hospitals the need to ration personal protective equipment led to the suspension of endoscopic training. Regarding the recovery period, nonurgent procedures were restarted in almost all of the centers. The same was reported for the colorectal cancer screening program. Remarkably, 81% of the responders confirmed that they had postponed procedures at patients’ request for “fear of getting infected.” Remote consultation was maintained in 81% of the hospitals. Globally, the fellows had resumed their training. <b><i>Discussion/Conclusion:</i></b> This study provides a snapshot of the impact and consequences of the first wave of the COVID-19 pandemic across Portuguese hospitals. It is important to understand how the gastroenterology world dealt with the first impact of COVID-19 and what strategies were implemented in order to better prepare for what might follow.

scholarly journals Disease monitoring of biologic treatment in IBD: early impact and future implications of COVID-19 pandemic

2020 ◽  
pp. flgastro-2020-101563
Author(s):  
Stephanie Shields ◽  
Allan Dunlop ◽  
John Paul Seenan ◽  
Jonathan Macdonald
Keyword(s):  
Clinical Care ◽  
Chronic Illnesses ◽  
Therapeutic Drug ◽  
Disease Monitoring ◽  
Biologic Treatment ◽  
Faecal Calprotectin ◽  
Routine Clinical Care ◽  
Risk Of Disease ◽  
Inflammatory Bowel ◽  
The Impact

COVID-19 has dominated life in 2020 with, at the time of writing, over 4.9M global cases and >320 000 deaths. The impact has been most intensely felt in acute and critical care environments. However, with most UK elective work postponed, laboratory testing of faecal calprotectin halted due to potential risk of viral transmission and non-emergency endoscopies and surgeries cancelled, the secondary impact on chronic illnesses such as inflammatory bowel disease (IBD) is becoming apparent. Data from the Scottish Biologic Therapeutic Drug Monitoring (TDM) service shows a dramatic drop in TDM testing since the pandemic onset. April 2020 saw a 75.6% reduction in adalimumab testing and a 36.2% reduction in infliximab testing when compared with February 2020 data, a reduction coinciding with the widespread cancellation of outpatient and elective activity. It is feared that disruption to normal patterns of care and disease monitoring of biologic patients could increase the risk of disease flare and adverse clinical outcomes. Urgent changes in clinical practice have been instigated to mitigate the effects of the pandemic on routine clinical care. Further transformations are needed to maintain safe, effective, patient-centred IBD care in the future.

scholarly journals Investigating competencies needed by European-trained doctors in rural South African hospitals

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
James R. Barnacle ◽  
Oliver Johnson ◽  
Ian Couper
Keyword(s):  
South Africa ◽  
South African ◽  
Online Survey ◽  
Rural District ◽  
Eastern Cape ◽  
Rural Medicine ◽  
Rural South ◽  
District Hospitals ◽  
Kwazulu Natal ◽  
Postgraduate Diploma

Background: Many European-trained doctors (ETDs) recruited to work in rural district hospitals in South Africa have insufficient generalist competencies for the range of practice required. Africa Health Placements recruits ETDs to work in rural hospitals in Africa. Many of these doctors feel inadequately prepared. The Stellenbosch University Ukwanda Centre for Rural Health is launching a Postgraduate Diploma in Rural Medicine to help prepare doctors for such work.Aim: To determine the competencies gap for ETDs working in rural district hospitals in South Africa to inform the curriculum of the PG Dip (Rural Medicine).Setting: Rural district hospitals in South Africa.Methods: Nine hospitals in the Eastern Cape, KwaZulu-Natal and Mpumalanga were purposefully selected by Africa Health Placements as receiving ETDs. An online survey was developed asking about the most important competencies and weaknesses for ETDs when working rurally. The clinical manager and any ETDs currently working in each hospital were invited to complete the survey.Results: Surveys were completed by 19 ETDs and five clinical managers. The top clinical competencies in relation to 10 specific domains were identified. The results also indicate broader competencies required, specific skills gaps, the strengths that ETDs bring to South Africa and how ETDs prepare themselves for working in this context.Conclusion: This study identifies the important competency gaps among ETDs and provides useful direction for the diploma and other future training initiatives. The diploma faculty must reflect on these findings and ensure the curriculum is aligned with these gaps.

scholarly journals Serum biomarkers confirming stable remission in inflammatory bowel disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christoph Kessel ◽  
Miha Lavric ◽  
Toni Weinhage ◽  
Markus Brueckner ◽  
Sytze de Roock ◽  
...  
Keyword(s):  
Disease Control ◽  
Serum Biomarkers ◽  
Treat To Target ◽  
Optimal Management ◽  
Tight Control ◽  
Follow Up Study ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel

AbstractCrohn's disease (CD) and ulcerative colitis (UC) have a chronic-remittent course. Optimal management of inflammatory bowel diseases (IBD) relies on early intervention, treat-to-target strategies and a tight disease control. However, it is challenging to assess the risk of relapses in individual patients. We investigated blood-based biomarkers for the confirmation of disease remission in patients with IBD. We retrospectively analyzed samples of 40 IBD patients (30 UC, 10 CD) enrolled in a tight-control follow-up study. Half of the patients had a flare during follow up. Serum was analyzed for S100A12 as well as S100A8/A9 and for 50 further biomarkers in a bead-based multiplex assay. The concentrations of 9 cytokines/chemokines and S100A8/A9 significantly differed in IBD patients with unstable remission (before flares) when compared to IBD patients with stable remission. Although the number of patients was small, ROC curve analyses revealed a number of biomarkers (IL-1β, IL-1RA, IL-8, IL13, IL-15, IL-21, IL-25, IFN-β, CXCL9, CXCL10, CXCL11, Galectin-1, G-CSF and S100A8/A9) that were elevated in patients with later occurring relapses. While earlier studies on peripheral biomarkers in IBD are limited to only few analytes, our study using a broad screening approach identified serum biomarkers with the potential to indicate unstable disease control in IBD, which may help to steer individual therapies to maintain remission.

scholarly journals Abortion attempts without clinical supervision among transgender, nonbinary and gender-expansive people in the United States

2021 ◽  
pp. bmjsrh-2020-200966
Author(s):  
Heidi Moseson ◽  
Laura Fix ◽  
Caitlin Gerdts ◽  
Sachiko Ragosta ◽  
Jen Hastings ◽  
...  
Keyword(s):  
United States ◽  
Clinical Supervision ◽  
Online Survey ◽  
Clinical Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Physical Trauma ◽  
Abortion Care ◽  
And Gender

BackgroundTransgender, nonbinary and gender-expansive (TGE) people face barriers to abortion care and may consider abortion without clinical supervision.MethodsIn 2019, we recruited participants for an online survey about sexual and reproductive health. Eligible participants were TGE people assigned female or intersex at birth, 18 years and older, from across the United States, and recruited through The PRIDE Study or via online and in-person postings.ResultsOf 1694 TGE participants, 76 people (36% of those ever pregnant) reported considering trying to end a pregnancy on their own without clinical supervision, and a subset of these (n=40; 19% of those ever pregnant) reported attempting to do so. Methods fell into four broad categories: herbs (n=15, 38%), physical trauma (n=10, 25%), vitamin C (n=8, 20%) and substance use (n=7, 18%). Reasons given for abortion without clinical supervision ranged from perceived efficiency and desire for privacy, to structural issues including a lack of health insurance coverage, legal restrictions, denials of or mistreatment within clinical care, and cost.ConclusionsThese data highlight a high proportion of sampled TGE people who have attempted abortion without clinical supervision. This could reflect formidable barriers to facility-based abortion care as well as a strong desire for privacy and autonomy in the abortion process. Efforts are needed to connect TGE people with information on safe and effective methods of self-managed abortion and to dismantle barriers to clinical abortion care so that TGE people may freely choose a safe, effective abortion in either setting.

scholarly journals Optimizing the Virtual Otolaryngology Residency Information Sessions: A Survey of Applicants

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2110014
Author(s):  
Jordan Grauer ◽  
Amir Aaron Hakimi ◽  
Sonya Malekzadeh
Keyword(s):  
Online Survey ◽  
Recruitment Strategies ◽  
Information Session ◽  
Travel Restrictions ◽  
Residency Application ◽  
Almost All

The 2020-2021 otolaryngology residency application cycle has been immensely distorted by travel restrictions mandated in response to coronavirus disease 2019, limiting opportunities for applicants to meet and rotate with programs of interest. The purpose of this study was to evaluate otolaryngology applicants’ preferences toward the content and format of virtual residency information sessions. An anonymous online survey was developed to gauge applicants’ virtual exposure to otolaryngology programs and investigate their preferences during virtual sessions. Almost all respondents attended at least 1 virtual information session (89%). Respondents felt that the most important aspects of these sessions were meeting residents, learning about operative volume, and meeting faculty. The majority (85%) preferred these sessions last no longer than 2 hours. Participants preferred virtual sessions to include breakout sessions with participant video/microphone on. These findings have implications for future virtual resident recruitment strategies.

Demonstration of the relationship between MSD and online learning during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kochu Therisa Karingada ◽  
Michael Sony
Keyword(s):  
Online Learning ◽  
Undergraduate Students ◽  
Online Survey ◽  
Cross Sectional Study ◽  
The Body ◽  
Body Parts ◽  
Cross Sectional ◽  
Content Type ◽  
The Right ◽  
Almost All

PurposeThe COVID-19 pandemic lockdown has caught many educational institutions by surprise and warranted an abrupt migration from offline to online learning. This has resulted in an education change, without any time for due consideration, as regards its impact on musculoskeletal disorders (MSD) on students. The purpose of this study is to investigate MSD related to online learning during the COVID-19 pandemic lockdown.Design/methodology/approachA cross-sectional study was conducted on undergraduate students in India. In total, 261 students participated in this online survey.FindingsThe study finds that around 80% of students have reported some symptom in the head, neck and eyes since they started online learning. In total, 58% have reported MSD symptom in the right shoulder and 56% in the right hand fingers. Besides, more than 40 % of students experienced some MSD symptoms, in almost all the body parts studied, due to online learning. Correlation analysis is conducted between time spent on online learning per day and MSD symptoms.Originality/valueThis is the first study conducted on MSD and online learning during COVID-19 pandemic.

scholarly journals CONTEMPORARY TECHNOLOGY SUPPORT FOR EDUCATION

2017 ◽  
Vol 5 ◽  
pp. 802-806 ◽  
Author(s):  
Teodor Savov ◽  
Valentina Terzieva ◽  
Katia Todorova ◽  
Petia Kademova-Katzarova
Keyword(s):  
Information And Communication Technologies ◽  
Technology Implementation ◽  
Online Survey ◽  
Human Life ◽  
Instructional Process ◽  
Innovative Learning ◽  
Information And Communication ◽  
Teaching Learning ◽  
Almost All ◽  
And Control

The information and communication technologies (ICT) have penetrated into almost all areas of human life. They have a dual impact on education – increase learning efficiency and train students actively to use innovations. We assess this impact by examining teachers’ experience with innovative tools in Bulgarian schools. In an anonymous online survey, we investigate their opinions on the issues related to technology integration in contemporary classrooms. The research shows that educators appreciate the benefits of technology implementation in the teaching-learning process, but they need a single structured system encompassing all technological resources and tools. This work proposes a conception for a smart classroom – an innovative learning environment that can establish and control suitable conditions for education as well as to impact the instructional process directly.

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