scholarly journals An analysis of virtual fracture clinics in orthopaedic trauma in the UK during the coronavirus crisis

2020 ◽  
Vol 5 (7) ◽  
pp. 442-448
Author(s):  
John-Henry Rhind ◽  
Eamon Ramhamadany ◽  
Ruaraidh Collins ◽  
Siddharth Govilkar ◽  
Debashis Dass ◽  
...  
Keyword(s):  
Negative Impact ◽  
Working Hours ◽  
Educational Opportunities ◽  
Decision Makers ◽  
Traditional Model ◽  
Face To Face ◽  
The United Kingdom ◽  
The Uk ◽  
Virtual Fracture Clinic ◽  
British Orthopaedic Association

Virtual fracture clinics (VFC) are advocated by new orthopaedic (British Orthopaedic Association) and National Health Service (NHS) guidelines in the United Kingdom. We discuss benefits and limitations, reviewing the literature, as well as recommendations on introducing a VFC service during the coronavirus pandemic and into the future. A narrative review identifying current literature on virtual fracture clinic outcomes when compared to traditional model fracture clinics in the UK. We identify nine relevant publications related to VFC. The Glasgow model, initiated in 2011, has become the benchmark. Clinical efficiency can be improved, reducing the number of emergency department (ED) referrals seen in VFC by 15–28% and face-to-face consultations by 65%. After review in the VFC, 33–60% of patients may be discharged. Some studies have shown no negative impact on the ED; the time to discharge was not increased. Patient satisfaction ranges from 91–97% using a VFC service, and there may be cost-saving benefits annually of £67,385 to £212,705. Non-attendance may be reduced by 75% and there are educational opportunities for trainees. However, evidence is limited; 28% of patients prefer face-to-face consultations and not all have access to internet or email (72%). We propose a pathway integrating the VFC model, whilst having senior orthopaedic decision makers available in the ED, during normal working hours, to cope with the pandemic. Beyond the pandemic, evidence suggests the Glasgow model is viable for day-to-day practice. Cite this article: EFORT Open Rev 2020;5:442-448. DOI: 10.1302/2058-5241.5.200041

scholarly journals 42 An Analysis of Virtual Fracture Clinics in Orthopaedic Trauma in the UK During the Coronavirus Crisis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J H Rhind ◽  
E Ramhamadany ◽  
R Collins ◽  
S Govilkar ◽  
D Dass ◽  
...  
Keyword(s):  
Negative Impact ◽  
Working Hours ◽  
Educational Opportunities ◽  
Decision Makers ◽  
Face To Face ◽  
Patients Satisfaction ◽  
The United Kingdom ◽  
The Uk ◽  
Virtual Fracture Clinic ◽  
British Orthopaedic Association

Abstract Aim Virtual Fracture Clinics (VFC) are advocated by new Orthopaedic (British Orthopaedic Association) and National Health Service (NHS) guidelines in the United Kingdom. We discuss benefits and limitations, reviewing the literature. As well as recommendations on introducing a VFC service during the Coronavirus pandemic and into the future. Method A narrative review identifying current literature on virtual fracture clinic outcomes when compared to traditional model fracture clinics in the UK. We identify 9 relevant publications related to VFC. Results The Glasgow Model initiated in 2011 has become the benchmark. Clinical efficiency can be improved, reducing the number of ED referrals seen in VFC by 15%-28% and face to face consultations by 65%. 33-60% of patients may be discharged after review in the VFC. Some studies have shown no negative impact on the Emergency Department (ED), the time to discharge was not increased. Patients satisfaction ranges from 91%-97% using a VFC service, and there may be cost saving benefits annually from £67,385-£212,705. Non-attendance may be reduced by 75% and there are educational opportunities for trainees. However, evidence is limited, 28% of patients prefer face-to-face consultations and not all have access to internet or email (72%). Conclusions We propose a pathway integrating the VFC model, whilst having Senior Orthopaedic decision makers available in ED, during normal working hours, to cope with the pandemic. Beyond the pandemic, evidence suggests the Glasgow model is viable for day-to-day practice.

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.

Private Dentistry after COVID-19 – A Clinician’s Personal Experience

2020 ◽  
Author(s):  
Reginald O’Neill
Keyword(s):  
Dental Care ◽  
Private Practice ◽  
Personal Experience ◽  
Dental Practice ◽  
Health Practice ◽  
Dental Services ◽  
Face To Face ◽  
The United Kingdom ◽  
The Government ◽  
The Uk

Face to face dental care in the UK was largely suspended from March until June and beyond is very limited still in many cases. Both NHS and Private dental services in the four nations of the United Kingdom aligned with the government in lockdown and dental emergencies could be accessed face to face in specific urgent centres only (UDC’s). Return to dental practice has been challenging for the profession with a lack of clarity from regulators and a gulf between financial support of private practice (almost none) and National Health practice (at 100% of their contact value pre-COVID). Dramatic changes to the provision of dental care are likely to persist and the COVID crisis may precipitate significant change to both private and NHS dental services.

scholarly journals Mental Health During COVID-19: A Qualitative Study with Ethnically Diverse Healthcare Workers in the United Kingdom

2021 ◽  
Author(s):  
Irtiza Qureshi ◽  
Mayuri Gogoi ◽  
Amani Al-Oraibi ◽  
Fatimah Wobi ◽  
Jonathan Chaloner ◽  
...  
Keyword(s):  
Mental Health ◽  
United Kingdom ◽  
Ethnic Minority ◽  
Healthcare Workers ◽  
Negative Impact ◽  
Ethnically Diverse ◽  
Working Hours ◽  
Severe Illness ◽  
List Type ◽  
The United Kingdom

ABSTRACTIntroductionHealthcare workers are experiencing deterioration in their mental health due to COVID-19. Ethnic minority populations in the United Kingdom are disproportionately affected by COVID-19, with a higher death rate and poorer physical and mental health outcomes. It is important that healthcare organisations consider the specific context and mental, as well as physical, health needs of an ethnically diverse healthcare workforce in order to better support them during, and after, the COVID-19 pandemic.MethodsWe undertook a qualitative work package as part of the United Kingdom Research study into Ethnicity and COVID-19 outcomes among healthcare workers (UK-REACH). As part of the qualitative research, we conducted focus group discussions with healthcare workers between December 2020 and July 2021, and covered topics such as their experiences, fears and concerns, and perceptions about safety and protection, while working during the pandemic. The purposive sample included ancillary health workers, doctors, nurses, midwives and allied health professionals from diverse ethnic backgrounds. We conducted discussions using Microsoft Teams. Recordings were transcribed and thematically analysed.FindingsWe carried out 16 focus groups with a total of 61 participants. Several factors were identified which contributed to, and potentially exacerbated, the poor mental health of ethnic minority healthcare workers during this period including anxiety (due to inconsistent protocols and policy); fear (of infection); trauma (due to increased exposure to severe illness and death); guilt (of potentially infecting loved ones); and stress (due to longer working hours and increased workload).ConclusionCOVID-19 has affected the mental health of healthcare workers. We identified a number of factors which may be contributing to a deterioration in mental health across diverse ethnic groups. Healthcare organisations should consider developing strategies to counter the negative impact of these factors. This paper will help employers of healthcare workers and other relevant policy makers better understand the wider implications and potential risks of COVID-19 and assist in developing strategies to safeguard the mental health of these healthcare workers going forward, and reduce ethnic disparities.Key messagesWhat is already known about this subjectHealthcare Workers (HCWs) are experiencing deterioration of their mental health due to COVID-19Ethnic minority populations and HCWs are disproportionately affected by COVID-19More research is needed on the specific factors influencing the mental health of ethnically diverse healthcare workforcesWhat are the new findingsProminent factors influencing the mental health and emotional wellbeing of this population include:anxiety (due to inconsistent protocols and policy)fear (of infection)trauma (due to increased exposure to severe illness and death)guilt (of potentially infecting loved ones)stress (due to longer working hours and increased workload)How might this impact on policy or clinical practice in the foreseeable futureHealthcare organisations should consider the specific circumstances of these staff and develop strategies to counter the negative impact of these factors and help safeguard the mental health of their staff

scholarly journals Papers please: Predictive factors for the uptake of national and international COVID-19 immunity and vaccination passports

2021 ◽  
Author(s):  
Paul Michael Garrett ◽  
Joshua Paul White ◽  
Simon Dennis ◽  
Stephan Lewandowsky ◽  
Cheng-Ta ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Policy Decision ◽  
Decision Makers ◽  
Policy Makers ◽  
The Public ◽  
The United Kingdom ◽  
Effective Policy ◽  
Generalized Linear Mixed Effects ◽  
The Uk ◽  
Representative Samples

In response to the COVID-19 pandemic, countries are introducing digital passports that allow citizens to return to normal activities if they were previously infected with (immunity passport) or vaccinated against (vaccination passport) SARS-CoV-2. To be effective, policy decision makers must know whether immunity and vaccination passports will be widely accepted by the public, and under what conditions? We collected representative samples across six countries – Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom – during the 2020 COVID-19 pandemic to assess attitudes towards the introduction of immunity passports. Immunity passport support was moderate-to-low, ranging from 51% in the UK and Germany, down to 22% in Japan. Bayesian generalized linear mixed effects modelling controlling for each country showed neoliberal world views, personal concern and perceived virus severity, the fairness of immunity passports, and willingness to become infected to gain an immunity passport, were all predictive factors of immunity passport support. By contrast, gender (woman), immunity passport concern, and risk of harm to society predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries. These findings will help policy makers introduce effective immunity passport policies in these six countries and around the world.

scholarly journals Japanese knotweed (Fallopia japonica): An analysis of capacity to cause structural damage (compared to other plants) and typical rhizome extension

2018 ◽  
Author(s):  
Mark Fennell ◽  
Max Wade ◽  
Karen L Bacon
Keyword(s):  
Structural Damage ◽  
Structural Integrity ◽  
Negative Impact ◽  
Significant Risk ◽  
Japanese Knotweed ◽  
Socioeconomic Impacts ◽  
Fallopia Japonica ◽  
The United Kingdom ◽  
Invasive Species Control ◽  
The Uk

Fallopia japonica (Japanese knotweed) is a well-known invasive alien species in the United Kingdom and elsewhere in Europe and North America. The plant is known to have a negative impact on local biodiversity, flood risk, and ecosystem services; but in the UK it is also considered to pose a significant risk to the structural integrity of buildings that are within 7 m of the above ground portions of the plant. This has led to the presence of the plant regularly being used to refuse mortgage applications. Despite the significant socioeconomic impacts of such automatic mortgage option restriction, little research has been conducted to investigate this issue. The ‘7 m rule’ is derived from widely adopted government guidance in the UK. This study considered if there is evidence to support this phenomenon in the literature, reports the findings of a survey of invasive species control contractors and property surveyors to determine if field observations support these assertions, and reports a case study of 68 properties, located on three streets in northern England where F. japonicawas recorded. Additionally, given the importance of proximity, the 7 m rule is also tested based on data collected during the excavation based removal of F. japonicafrom 81 sites. No support was found to suggest that F. japonicacauses significant damage to built structures, even when it is growing in close proximity to them and certainly no more damage than other plant species that are not subject to such stringent lending policies. It was found that the 7 m rule is not a statistically robust tool for estimating likely rhizome extension. F. japonica rhizome rarely extends more than 4 m from above ground plants and is typically found within 2 m for small stands and 2.5 m for large stands. Based on these findings, the practice of automatically restricting mortgage options for home buyers when F. japonicais present, is not commensurate with the risk.

scholarly journals A Missed Opportunity for Men? Partnered and Employed Individuals’ Involvement with Housework during the COVID-19 Lockdown in the UK

2021 ◽  
Vol 10 (4) ◽  
pp. 135
Author(s):  
İbrahim Sönmez
Keyword(s):  
United Kingdom ◽  
Interaction Analysis ◽  
Working Hours ◽  
Policy Implications ◽  
Market Work ◽  
The United Kingdom ◽  
The Uk ◽  
Missed Opportunity ◽  
Daily Time ◽  
Key Worker

Given the outbreak of the coronavirus, SARS-CoV-2 (COVID-19), pandemic during March 2020, lockdown measures taken by governments have forced many families, especially those who have children, to re-arrange domestic and market work division. In this study, I investigate the factors associated with partnered and employed individuals’ involvement with housework during the COVID-19 lockdown in the United Kingdom. Drawing evidence from the first wave of the Covid-19 Survey from the Five National Longitudinal Studies dataset with using OLS regressions, this study found that daily working hours, socioeconomic status, and partner’s key worker status are important indicators of daily time spent on housework. Furthermore, interaction analysis showed that women living with a key worker partner not only did more housework than women whose partner was working in a regular job, but they also did more housework than men living with a key worker partner during the lockdown. Policy implications of regulating maximum daily working hours and key worker status are discussed in the context of re-arranging paid and unpaid work between couples during the first lockdown in the United Kingdom.

scholarly journals Impact of COVID-19 Pandemic on a Regional Stroke Thrombectomy Service in the United Kingdom

2020 ◽  
pp. 1-7
Author(s):  
Joseph Kwan ◽  
Madison Brown ◽  
Paul Bentley ◽  
Zoe Brown ◽  
Lucio D’Anna ◽  
...  
Keyword(s):  
Negative Impact ◽  
Service Evaluation ◽  
Outcome Data ◽  
Term Outcome ◽  
Neurological Outcomes ◽  
Neurological Improvement ◽  
Patient Demographics ◽  
The United Kingdom ◽  
The Uk ◽  
The Impact

<b><i>Introduction:</i></b> We examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on our regional stroke thrombectomy service in the UK. <b><i>Methods:</i></b> This was a single-center health service evaluation. We began testing for COVID-19 on 3 March and introduced a modified “COVID Stroke Thrombectomy Pathway” on 18 March. We analyzed the clinical, procedural and outcome data for 61 consecutive stroke thrombectomy patients between 1 January and 30 April. We compared the data for January and February (“pre-COVID,” <i>n</i> = 33) versus March and April (“during COVID,” <i>n</i> = 28). <b><i>Results:</i></b> Patient demographics were similar between the 2 groups (mean age 71 ± 12.8 years, 39% female). During the COVID-19 pandemic, (a) total stroke admissions fell by 17% but the thrombectomy rate was maintained at 20% of ischemic strokes; (b) successful recanalization rate was maintained at 81%; (c) early neurological outcomes (neurological improvement following thrombectomy and inpatient mortality) were not significantly different; (d) use of general anesthesia fell significantly from 85 to 32% as intended; and (e) time intervals from onset to arrival, groin puncture, and recanalization were not significantly different, whereas internal delays for external referrals significantly improved for door-to-groin puncture (48 [interquartile range (IQR) 39–57] vs. 33 [IQR 27–44] minutes, <i>p</i> = 0.013) and door-to-recanalization (82.5 [IQR 61–110] vs. 60 [IQR 55–70] minutes, <i>p</i> = 0.018). <b><i>Conclusion:</i></b> The COVID-19 pandemic has had a negative impact on the stroke admission numbers but not stroke thrombectomy rate, successful recanalization rate, or early neurological outcome. Internal delays actually improved during the COVID-19 pandemic. Further studies should examine the effects of the COVID-19 pandemic on longer term outcome.

scholarly journals Postgraduate Surgical Training in the UK: the Trainees’ Perspective

2021 ◽  
Author(s):  
Anna Rose ◽  
Noel Aruparayil
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
Surgical Trainee ◽  
The United Kingdom ◽  
Flexible Working Hours ◽  
Flexible Working ◽  
The Uk ◽  
Training Opportunities ◽  
Postgraduate Surgical Training

AbstractOver the last 20 years, surgical training in the United Kingdom (UK) has changed dramatically. There have been considerable efforts towards creating a programme that delivers the highest standard of training while maintaining patient safety. However, the journey to improve the quality of training has faced several hurdles and challenges. Recruitment processes, junior doctor contracts, flexible working hours and equality and diversity have all been under the spotlight in recent times. These issues, alongside the extended surgical team and the increasingly recognised importance of trainee wellbeing, mean that postgraduate surgical training is extremely topical. Alongside this, as technology has evolved, this has been incorporated into all aspects of training, from recruitment to simulated training opportunities and postgraduate examinations. The coronavirus (COVID-19) pandemic has brought technology and simulation to the forefront in an attempt to compensate for reduced operative exposure and experience, and has transformed the way that we learn and work. In this article, we reflect on the UK surgical trainee experience and discuss areas of success as well as highlighting potential areas for improvement going forward.

scholarly journals COVID-19 and fertility services in the United Kingdom; a biphasic qualitative study.

2021 ◽  
Author(s):  
Babu Karavadra ◽  
Andrea Stockl ◽  
Adam H Balen ◽  
Edward Patrick Morris
Keyword(s):  
United Kingdom ◽  
Service Providers ◽  
Negative Impact ◽  
Fertility Treatment ◽  
Online Questionnaire ◽  
Telephone Interviews ◽  
The United Kingdom ◽  
The Uk ◽  
Cultural Pressures ◽  
The Impact

Recently, fertility services have started the process of resumption since COVID 19 was declared a pandemic, but there remains significant uncertainty in the way this care will be delivered in the United Kingdom (UK). The objective of our study was to explore the impact of COVID-19 on individuals using fertility services in the UK. The study was conducted in two phases between May 2020 to July 2020: an online questionnaire involving 1212 participants and subsequent individual semi-structured telephone interviews with 15 participants. Through thematic analysis, we learned from the questionnaire findings that 74% of individuals identified as White British, 21% as Black And Minority Ethnic (BAME) and 2.6% as male. 96% of individuals from the questionnaire explained that COVID-19 had a ‘negative impact’ on their fertility treatment, namely ‘delay in care’. 82% of participants discussed concerns about the 'uncertainty' they felt about fertility services; these included the ‘unknown impact of COVID-19 on pregnancy outcomes’, the ‘unknown impact on general gynaecology services’ and the ‘unknown impact of COVID-19 on fertility success'. Through semi-structured telephone interviews with fifteen participants, we learned about the ‘cultural pressures’ individuals from BAME backgrounds faced in relation to care. Participants were mindful about the ‘pressures on the service’ when re-opening, and therefore ‘advancing maternal age’, ‘socio-economic background’ and ‘previous unsuccessful fertility treatment’ were the main factors individuals considered important when ‘prioritising’ fertility care. Our findings can be used by fertility service providers to appreciate the patient perspective when considering the re-opening of fertility services nationally and internationally.

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