A multicentre national study of the effectiveness of virtual fracture clinic management of orthopaedic trauma during the COVID-19 pandemic (MAVCOV): a cross-sectional study protocol

Aims Virtual fracture clinics (VFCs) are advocated by recent British Orthopaedic Association Standards for Trauma and Orthopaedics (BOASTs) to efficiently manage injuries during the COVID-19 pandemic. The primary aim of this national study is to assess the impact of these standards on patient satisfaction and clinical outcome amid the pandemic. The secondary aims are to determine the impact of the pandemic on the demographic details of injuries presenting to the VFC, and to compare outcomes and satisfaction when the BOAST guidelines were first introduced with a subsequent period when local practice would be familiar with these guidelines. Methods This is a national cross-sectional cohort study comprising centres with VFC services across the UK. All consecutive adult patients assessed in VFC in a two-week period pre-lockdown (6 May 2019 to 19 May 2019) and in the same two-week period at the peak of the first lockdown (4 May 2020 to 17 May 2020), and a randomly selected sample during the ‘second wave’ (October 2020) will be eligible for the study. Data comprising local VFC practice, patient and injury characteristics, unplanned re-attendances, and complications will be collected by local investigators for all time periods. A telephone questionnaire will be used to determine patient satisfaction and patient-reported outcomes for patients who were discharged following VFC assessment without face-to-face consultation. Ethics and dissemination The study results will identify changes in case-mix and numbers of patients managed through VFCs and whether this is safe and associated with patient satisfaction. These data will provide key information for future expert-led consensus on management of trauma injuries through the VFC. The protocol will be disseminated through conferences and peer-reviewed publication. This protocol has been reviewed by the South East Scotland Research Ethics Service and is classified as a multicentre audit. Cite this article: Bone Jt Open 2021;2(3):211–215.

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663 A Multi-centre National Study of the Effectiveness of Virtual Fracture Clinic Management of Orthopaedic Trauma during the COVID-19 Pandemic (MAVCOV): A Cross-sectional Study Protocol

British Journal of Surgery ◽

10.1093/bjs/znab259.406 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

Z H Ng ◽

S Downie ◽

N Makaram ◽

S Kolhe ◽

S Mackenzie ◽

...

Keyword(s):

Patient Satisfaction ◽

Cross Sectional Study ◽

Study Data ◽

National Study ◽

Cross Sectional ◽

Clinic Management ◽

Future Clinical Practice ◽

Study Results ◽

Patient Reported ◽

The Impact

Abstract Aim Virtual fracture clinics (VFCs) are advocated by recent British Orthopaedic Association Standards for Trauma and Orthopaedics (BOASTs) to efficiently manage injuries during the COVID-19 pandemic. The primary aim of this national study is to assess the impact of these standards on patient satisfaction and clinical outcome amid the pandemic. The secondary aims are to determine the impact of the pandemic on demographics of injuries presenting to the VFC and to compare outcomes and satisfaction when the BOAST guidelines were first introduced with a subsequent period when local practice would be familiar with these guidelines. Method This is a national cross-sectional cohort study comprising centres with VFC services across the United Kingdom. All consecutive adult patients assessed at VFC pre-lockdown (6 May 2019 to 19 May 2019) and at the peak of the first lockdown (4 May 2020 to 17 May 2020), and a randomly selected sample during the second wave (October 2020) will be eligible for the study. Data comprising local VFC practice, patient and injury characteristics, unplanned re-attendances, and complications will be collected. A telephone questionnaire will be used to determine patient satisfaction and patient-reported outcomes for patients who were discharged following VFC assessment without face-to-face consultation. Results As of 31 October 2020, 51 hospitals with VFC services have been recruited to participate in this study. Conclusions The study results will identify changes in case-mix and numbers of patients managed through VFCs, due to urgent necessity, and whether this is safe and is associated with patient satisfaction to inform future clinical practice.

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Variation in Performance on Common Content Items at UK Medical Schools

10.21203/rs.3.rs-153247/v1 ◽

2021 ◽

Author(s):

David Hope ◽

David Kluth ◽

Matthew Homer ◽

Avril Dewar ◽

Richard Fuller ◽

...

Keyword(s):

Medical School ◽

Standard Setting ◽

Medical Schools ◽

Cross Sectional Study ◽

Pass Rates ◽

Cross Sectional ◽

Study Results ◽

The Uk ◽

Common Content ◽

The Impact

Abstract Background Due to the diverse approaches to medical school assessment, making meaningful cross-school comparisons on knowledge is difficult. Ahead of the introduction of national licensing assessment in the UK, we evaluate schools on “common content” to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants for a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5% of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40%, whereas a passing standard that would see 5% of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standard setting approaches that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional gaps in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.

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Loneliness and Its Associated Factors Nine Months after the COVID-19 Outbreak: A Cross-National Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062841 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2841

Author(s):

Tore Bonsaksen ◽

Mariyana Schoultz ◽

Hilde Thygesen ◽

Mary Ruffolo ◽

Daicia Price ◽

...

Keyword(s):

Social Media ◽

Cross Sectional Study ◽

National Study ◽

Cross Sectional ◽

Daily Lives ◽

Emotional Loneliness ◽

The Usa ◽

The Uk ◽

Cross National Study ◽

The Impact

COVID-19 has been a global healthcare concern impacting multiple aspects of individual and community wellness. As one moves forward with different methods to reduce the infection and mortality rates, it is critical to continue to study the impact that national and local “social distancing” policies have on the daily lives of individuals. The aim of this study was to examine loneliness in relation to risk assessment, measures taken against risks, concerns, and social media use, while adjusting for sociodemographic variables. The cross-sectional study collected data from 3474 individuals from the USA, the UK, Norway, and Australia. Loneliness was measured with the de Jong Gierveld Loneliness Scale. Multiple linear regression was used in the analysis of associations between variables. The results showed that concerns about finances were more strongly associated with social loneliness, while concerns about the future was more strongly associated with emotional loneliness. Longer daily time spent on social media was associated with higher emotional loneliness. In conclusion, pandemic-related concerns seem to affect perceptions of loneliness. While social media can be used productively to maintain relationships, and thereby prevent loneliness, excessive use may be counterproductive.

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A Cross-National Study of Dementia Stigma Among the General Public in Israel and Australia

Journal of Alzheimer s Disease ◽

10.3233/jad-210277 ◽

2021 ◽

pp. 1-8

Author(s):

Perla Werner ◽

Sarang Kim

Keyword(s):

General Public ◽

Cultural Context ◽

Online Survey ◽

Cross Sectional Study ◽

National Study ◽

Cross Sectional ◽

Subjective Knowledge ◽

Cultural Aspects ◽

The Impact ◽

Cross National

Background: Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects. Objective: The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia. Methods: A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia. Results: Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample. Conclusion: Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.

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PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

Journal of Primary Care & Community Health ◽

10.1177/21501327211030413 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110304

Author(s):

Ravindra Ganesh ◽

Aditya K. Ghosh ◽

Mark A. Nyman ◽

Ivana T. Croghan ◽

Stephanie L. Grach ◽

...

Keyword(s):

Health Status ◽

Social Roles ◽

Disease Process ◽

Cross Sectional Study ◽

Large Sample Size ◽

Sectional Study ◽

Cross Sectional ◽

Data Set ◽

Patient Reported ◽

The Impact

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

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Variation in performance on common content items at UK medical schools

BMC Medical Education ◽

10.1186/s12909-021-02761-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

David Hope ◽

David Kluth ◽

Matthew Homer ◽

Avril Dewar ◽

Richard Fuller ◽

...

Keyword(s):

Undergraduate Students ◽

Standard Setting ◽

Medical Schools ◽

Cross Sectional Study ◽

Pass Rates ◽

Cross Sectional ◽

Study Results ◽

Institutional Differences ◽

Common Content ◽

The Impact

Abstract Background Due to differing assessment systems across UK medical schools, making meaningful cross-school comparisons on undergraduate students’ performance in knowledge tests is difficult. Ahead of the introduction of a national licensing assessment in the UK, we evaluate schools’ performances on a shared pool of “common content” knowledge test items to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice ‘common content’ items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants, creating a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5 % of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40 %, whereas a passing standard that would see 5 % of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standards that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional differences in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.

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Political views of doctors in the UK: a cross-sectional study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-210801 ◽

2018 ◽

Vol 72 (10) ◽

pp. 880-887 ◽

Cited By ~ 3

Author(s):

Kate L Mandeville ◽

Rose-Marie Satherley ◽

Jennifer A Hall ◽

Shailen Sutaria ◽

Chris Willott ◽

...

Keyword(s):

Online Survey ◽

Cross Sectional Study ◽

Urgent Care ◽

The European Union ◽

Left Wing ◽

Sectional Study ◽

Cross Sectional ◽

Political Views ◽

The Uk ◽

The Impact

BackgroundLittle is known about the political views of doctors in the UK despite doctors' importance in the functioning of the National Health Service (NHS).MethodsThis is a survey-based, cross-sectional study in which we asked questions about voting behaviour in 2015 and 2017 UK general elections and 2016 referendum on leaving the European Union (EU) (Brexit), and questions relating to recent health policies.Results1172 doctors (45.1% women) from 1295 responded to an online survey. 60.5% described their political views as ‘left-wing’ and 62.2% described themselves as ‘liberal’. 79.4% of respondents voted to remain in the EU in the 2016 referendum compared with 48.1% of voters as a whole (χ2=819.8, p<0.001). 98.6% of respondents agreed that EU nationals working in the NHS should be able to remain in the UK after Brexit. The median score for the impact of Brexit on the NHS on a scale of 0 (worst impact) to 10 (best impact) was 2 (IQR=1–4). Most respondents agreed with the introduction of minimum alcohol pricing in the UK (73.9%), charging patients who are not eligible for NHS treatment for non-urgent care (70.6%) and protecting a portion of national spending for the NHS (87.1%). 65.8% thought there was too much use of NHS-funded private sector provision in their medical practice. Specialty, income and grade were associated with divergent opinions.ConclusionsUK doctors are left-leaning and liberal in general, which is reflected in their opinions on topical health policy issues. Doctors in the UK voted differently from the general electorate in recent polls.

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Influence of COVID-19 on the Mental Health of Nurses dealing with COVID-19 Patients (A Study on Nurses within Karachi)

10.53350/pjmhs211551200 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1200-1204

Author(s):

U. Amen ◽

Z. Rajwani ◽

U. Sumayya ◽

R. Haroon ◽

N. Mushtaq ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Preventive Intervention ◽

Cross Sectional Study ◽

Depression Anxiety Stress Scale ◽

Cross Sectional ◽

Moderate Depression ◽

Study Results ◽

The Impact ◽

Severe Anxiety

Background: Globally Corona virus (COVID-19) has become a huge challenge for all of the population. In South Asia, country Pakistan city Karachi the 1st case of this breakdown was identified on 26th February 2020 (Waris et al., 2020). This disease has developed psychological distress among all the population. COVID virus is one of the leading threats to all the healthcare organizations and due to increase rate of patients day by day, it has given enormous burden to all healthcare workers especially nurses the front line fighters who are always ready to give care towards the patient whom they encountered so it’s very crucial part to assess the impact of COVID -19 on the mental health of the nurses. Objective: The objective of the study is to identify the frequency level of stress, anxiety and depression among nurses while dealing with those patients who were admitted in various hospitals in Karachi for treatment of COVID-19. Method: A cross-sectional study was conducted from 20th November to 31st December 2020 from different hospitals in Karachi, Pakistan. Those Registered nurses who were assigned in isolation ward of Covid-19 were the part of the study. For data collection survey form was designed based on Depression Anxiety Stress scale (DASS-21) scale (Lovibond & Lovibond 1995). Results: The total mean score of depression among nurses was 50 (68%), Anxiety was 32 (43%) and stress was 34 (46%). 50 nurses suffered from moderate depression, 24 nurses reported from extremely severe anxiety and 50 nurses suffered from moderate stress level. From 74 participants 41(55.4%) were females and 33 (44.6%) were males. Furthermore, it shows that 25 (76%) males and 25 (61%) females suffered from moderate depression, 32 nurses 14 (42%) male and 18(43.90%) females reported from extremely severe anxiety. Conclusion: This pandemic is highly complex, contagious and vulnerable. The study results portrait that nurses working with COVID-19 patients have affected a lot of various psychological distress such as anxiety, stress, and depression. It is very vital for higher management to take major steps and take preventive intervention which would be beneficial towards their mental health in decreasing negative psychological outcomes, because they all are working under pressure environment. Key Words: Stress, Anxiety, Depression, Pandemic, Registered Nurse

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Characteristics of water containers influencing the presence of Aedes immatures in an ecotourism area of Bang Kachao Riverbend, Thailand

Journal of Health Research ◽

10.1108/jhr-09-2018-0096 ◽

2019 ◽

Vol 33 (5) ◽

pp. 398-407

Author(s):

Pathavee Waewwab ◽

Sungsit Sungvornyothin ◽

Kamolnetr Okanurak ◽

Ngamphol Soonthornworasiri ◽

Rutcharin Potiwat ◽

...

Keyword(s):

Vector Control ◽

Chemical Properties ◽

Control Program ◽

Cross Sectional Study ◽

Study Data ◽

Tourist Attraction ◽

Binary Logistic Regression Model ◽

Cross Sectional ◽

Content Type ◽

Study Results

Purpose The purpose of this paper is to investigate the influence of breeding containers on the production of Aedes mosquitoes after a vector-control program in households that might support dengue transmission in tourist attraction areas of Bang Kachao Riverbend, Thailand. Design/methodology/approach A cross-sectional study was conducted in an ecotourism area of Bang Kachao Riverbend, Thailand, during the period October 2016 to September 2017. A total of 832 households from five villages participated in the study. Data collection employed an interview questionnaire, larval mosquito survey and measurements of the chemical properties of the water in each container. A binary logistic regression model was used to investigate the characteristics of water containers influencing the presence or absence of Aedes immatures. Findings The study found that water containers located inside households had a highly presence of Aedes immatures (2.22 times) compared with outdoor containers. Water containers without lids and water containers with ineffective had a high presence of Aedes immatures (3.69 and 2.54 times, respectively). In addition, the chemical properties of the water inside the containers, such as pH, influenced the presence of Aedes immatures (1.76 times) (OR=1.76, 95% CI=1.59–1.96). Originality/value The study results emphasized the characteristics of water containers in households located in a tourist attraction area. The findings may inform public health vector-control messages for households located in the tourist attraction area.

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Association of the combination of weight gain after 20 years of age and current obesity with chronic kidney disease in Japan: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027752 ◽

2019 ◽

Vol 9 (6) ◽

pp. e027752

Author(s):

Hirotaka Ochiai ◽

Takako Shirasawa ◽

Takahiko Yoshimoto ◽

Satsue Nagahama ◽

Mariko Kobayashi ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Weight Gain ◽

Kidney Disease ◽

Cross Sectional Study ◽

Primary Outcome Measure ◽

Sectional Study ◽

Cross Sectional ◽

Study Results ◽

Obese Subjects ◽

The Impact

ObjectivesWeight gain after 20 years of age is associated with chronic kidney disease (CKD). However, the impact of weight gain on CKD might differ by current obesity status. We investigated the association of the combination of weight gain after 20 years of age and current obesity with CKD among adults in Japan.DesignA cross-sectional study.Setting and participantsWe analysed data from 94 822 adults aged 40–64 years who had an annual health check-up in Japan from April 2013 to March 2014.Primary outcome measureCKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2and/or proteinuria.ResultsBoth weight gain ≥10 kg after 20 years of age plus obesity (OR 2.21, 95% CI 2.07 to 2.36) and weight gain of ≥10 kg plus non-obesity (OR 1.31, 95% CI 1.21 to 1.42) significantly increased the OR for CKD when compared with weight gain <10 kg plus non-obesity in men. In women, weight gain ≥10 kg plus obesity (OR 2.04, 95% CI 1.84 to 2.25) and weight gain ≥10 kg plus non-obesity (OR 1.53, 95% CI 1.36 to 1.72) significantly increased the OR for CKD compared with weight gain <10 kg plus non-obesity. These results persisted even after adjustment for age, lifestyle factors, hypertension, dyslipidaemia and diabetes.ConclusionsWeight gain ≥10 kg after 20 years of age was significantly associated with CKD in both obese and non-obese subjects. Moreover, the influence of weight gain ≥10 kg plus obesity on CKD was greater than that of weight gain ≥10 kg plus non-obesity on CKD. The present study results suggest that it is important to consider weight gain after maturity in both obese and non-obese subjects to prevent CKD among Japanese middle-aged adults.

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