bluuebunny/crossref_metadata_2025_split huggingface dataset:
P114 STING. Steroid Injections DurinG Covid-19. A cross speciality call
Authors: Hardman Lotte , Elamin Salma , Giddins Grey , Gardiner Matthew , Reay Emma 
Published: April 2021

Abstract

Introduction
An important clinical question during the Covid -19 pandemic is the safety of steroid use. Guidelines published by rheumatology, physiotherapy, orthopaedic and pain medicine societies have advised on the restricted use of corticosteroids for musculoskeletal and rheumatic conditions. For clinicians across the specialities there is a challenge to safely conducting best practice, yet ensuring patients have access to the significant functional benefits of steroid injections.

Methods
The STING prospective service evaluation will collect data on steroid injections undertaken during this part of the pandemic. Clinicians will be able to input information on patient demographics, background Covid risk and steroid injection specifics. At follow up at 4-6 weeks complications and Covid specific outcomes will be recorded, as well as patient perceived symptom improvement.
Each unit collecting data will have assigned collaborator(s), with a senior consultant validating the data.
Data will be collected and managed using Research Electronic Data Capture (REDCap). Data collection and management will adhere to Caldicott II principles and GDPR.

Results
Results will be analysed through RedCap and compared to national Covid incidence. Local complication and patient reported outcomes will be compared between specialities, environments and steroid specifics (volume, location etc.).

Conclusion
A pan-speciality look at steroid injection use during the pandemic will be useful primarily to contribute to understanding the safety of steroid use. Secondarily to look at cross speciality differences in administration, PROMs and to appreciate patient groups who may be excluded from steroid treatment.
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P116 SURGE: Survey of Undergraduate Respondents on Global surgery Education
Authors:   InciSioN UK Collaborative
Published: April 2021

Abstract

Introduction
It is estimated that over 10% of the global burden of disease can be treated with surgery, most of which is located in low and middle-income countries (LMICs), underpinning the importance of the topic of global surgery (GS). The multidisciplinary principles of GS are increasingly recognised as being key to modern practice and as such, must be fostered at early stages of medical training. However, it is unclear whether medical students are being exposed to GS. This study aimed to assess the importance of GS and its presence in medical curricula.

Methods
A novel, 22-item online questionnaire was developed and disseminated to medical students and faculty members using social media. Data collection was conducted by a collaboration of medical students, who acted as regional leads at their institutions.

Results
795 medical students and 141 faculty members representing 38/42 of UK medical schools (90.4%) completed the questionnaire. Only 84 students (10.6%) were previously exposed to GS. Most students (66.3%) and faculty (60.6%) agreed that GS should be an integral part of the curriculum. Only 20 students (2.5%) were or familiar with what a career in GS means.

Conclusion
Approximately 2/3 of students and faculty agree that global surgery should be an integral part of the mandatory curriculum. Findings of this study should underpin further incorporation of GS into curricula, as high-income countries can decisively contribute to achieving the global surgery 2030 targets, by training a new generation of clinicians who are ready for the challenges of the 21st century.
P122 The Diagnosis and Management of Appendicitis During the COVID-19 Pandemic: The Pennine Acute Trust Experience
Authors: Idama Daniel , Aldersley George , Connolly Meghan , O'Connor Alexander 
Published: April 2021

Abstract

Introduction
Appendicitis management has evolved recently with more reliance on Computed Topography (CT) and laparoscopic surgery being commonplace. In this project we looked at how the Coronavirus pandemic (COVID-19) had impacted the diagnosis, management and outcomes of patients with appendicitis in our unit.

Method
A retrospective review of patients diagnosed with appendicitis from 1st March – 30th April in 2019 and 2020. Data was collected on diagnosis, management and outcomes.

Results
In 2020, 91 patients were identified (mean 33, range 6-85, F:M 1:1.4). In 2019, 107 patients were identified (mean 32, range 7-69, M:F 1:1.1). There was no significant difference in patients’ symptom duration (p = 0.21), White Cell Count (p = 0.20) or C-Reactive Protein (p = 0.10). More CTs were performed in 2020 (56/91, 61.5%) than in 2019 (40/107, 37.4%). Less patients underwent appendicectomy in 2020 (75/91, 82.4%) than in 2019 (104/107, 97.2%). Open appendicectomies were performed in 64% (48/75) of those operated in 2020 compared with 12.2% (13/104) in 2019. There was no difference in hospital length of stay or re-admissions rates.

Conclusion
The diagnosis and management of appendicitis changed considerably at our trust during COVID-19 with more reliance on CT diagnosis and less use of laparoscopy. Despite this, outcomes remained unchanged.
P125 The effect of wellbeing mobile-applications on the Mental and Physical Health of Healthcare workers: A Systematic Review
Authors: Alford Natasha , Okocha Michael , Jones Conor 
Published: April 2021

Abstract

Introduction
The growing pressure on Healthcare workers (HCWs) can lead to worsening physical and mental wellbeing. Use of traditional support systems is limited and whilst there are a significant number of mental health platforms, few are targeted towards HCWs.

Objective
This review aimed to assess the available literature and platforms focused on supporting HCWs mental health and wellbeing.

Methods
A systematic search, following PRISMA guidelines was conducted. Abstracts were included if they targeted HCWs and used smartphone apps to support wellbeing. A further comprehensive application search of IOS and Android stores was performed to identify HCW wellbeing applications.

Results
In total 725 abstracts were identified. 10 publications, with a total of 683 participants, relating to wellbeing applications in HCWs met the inclusion criteria. 87% of the HCWs included in the studies were female. The majority (9/10) of the studies reported improved wellbeing of HCWs following the use of app-based interventions. A total of 1656 mobile applications were identified and met the inclusion criteria if they focused on HCWs wellbeing. The majority of the studies and apps focused on increasing mindfulness practices and yielded statistically significant results compared to traditional interventions.

Conclusion
Wellbeing programmes delivered through an app provide convenience and can improve the mental and physical wellbeing HCW’s. This is particularly key during challenging times. Given the limited number of published studies on smartphone apps and the limited number of apps for HCWs, it is clear that there is a deficit that requires urgent addressing despite two promising candidates.
P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses
Authors: Khajuria Apoorva , Rahim Tuba , Baig Mariam , Leong Kai 
Published: April 2021

Abstract

Introduction
Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures.

Methods
A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken.

Results
Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually.

Conclusion
Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.
P132 TRAVERSING: Transfer of thoracic Aortic Vascular Emergencies to Regional Specialist Institutes Group
Authors: Qureshi M I , Lee K S , Bevis P , Twine C P , Brooks M J , Hinchliffe R J 
Published: April 2021

Abstract

Introduction
The incidence of Acute Aortic Syndrome (AAS) is rising. The Department of Health is considering a supra regional tier of centralisation for complex aortic care. No standardised pathway exists to guide the transfer of patients with AAS, despite increasing evidence from coroners and the Healthcare Safety Investigation Board of delayed transfers and miscommunication costing lives. This study aims to deliver a pathway for the safe transfer of patients with suspected AAS to a specialist aortic centre through multidisciplinary Delphi consensus.

Methods
The researchers will create an interdisciplinary Steering Group to oversee the study, which will identify appropriate stakeholders for inclusion in the Delphi process. A systematic review will be performed to summarise existing evidence and highlight gaps in knowledge where consensus is required. The Steering Group will create, circulate and interpret the Delphi questionnaire. The outcomes will also enable determination of criteria for audit that should become the standard for ensuring a safe and efficient process for patient transfer to a complex aortic centre.

Results
Results will provide inter-disciplinary guidance to healthcare professionals for early management and transfer of patients with suspected AAS, and prevent unnecessary transfer, thereby improving outcomes, ensuring equity of access to specialist aortic care for patients. Results will also provide audit standards through which future improvements can be realised.

Conclusion
This study is reliant upon collaboration between multidisciplinary healthcare providers, qualitative researchers and patients. Its success will streamline emergency pathways in the management of AAS, saving lives and resources, with inbuilt mechanisms for continuous review and improvement.
P133 Types and timing Of venous thromboembolism Prophylaxis for Traumatic Brain Injury (TOP TBI) Study
Authors: Bandyopadhyay Soham , Borchert Robin , Kolias Angelos G , Chari Aswin , Fountain Daniel M , Layard Hugo H , Lawrence Tim P , Hutchinson Peter J 
Published: April 2021

Abstract

Background
Patients with traumatic brain injury are at significant risk for both developing venous thromboembolisms and haemorrhagic progression. Pharmacological thromboprophylaxis and mechanical thromboprophylaxis may be able to minimise the incidence of venous thromboembolisms. Problematically, pharmacological thromboprophylaxis also has the potential to augment clinically significant intracranial haemorrhage expansion. Compounding this issue is that the evidence for mechanical thromboprophylaxis is not based on neurotrauma populations, and there is insufficient evidence to guide clinicians on the optimum agent, dose, and timing of pharmacological thromboprophylaxis. Based on the need for high quality evidence, we propose the Types and timing Of venous thromboembolism Prophylaxis for Traumatic Brain Injury (TOP TBI) Study.

Aim
To collect high quality and relevant data regarding thromboprophylaxis practice and associated outcomes - including rates of venous thromboembolisms, intracranial haemorrhage expansion and mortality – for TBI patients in the UK and Ireland in order to optimise management for these patients.

Methods
We will adopt a multicentre, prospective, observational cohort design. All neurosurgical units: in the UK and Ireland will be eligible to participate. Patient eligibility will be determined according to pre-specified criteria. Eligible cases will be prospectively recruited over two months and followed-up in 6 months. Based on epidemiological investigations and data from the Trauma Audit and Research Network, we expect to recruit between 1000 to 2000 patients. Anonymised data will be collected locally and submitted to a secure web-based central database.

Outcome measures
These include all-cause mortality, venous thromboembolism events, haemorrhagic progression, re-admission, surgical intervention, length of stay in admitting unit, neurological status, and Extended Glasgow Outcome Scale during follow-up.

Conclusion
TOP TBI is an important step in the ongoing efforts to optimise the outcomes of patients who have suffered a traumatic brain injury. It is hoped that the results will give insight into contemporary practice in the UK and Ireland and inform future studies.
O1 Admission avoidance in tonsillitis and peritonsillar abscess: a prospective national audit during the initial peak of the COVID-19 pandemic
Authors:   Integrate UK ENT Trainee Research Network, Rocke John 
Published: April 2021

Abstract

Introduction
During the COVID-19 outbreak, the collaborative network for ENT trainees in the UK (INTEGRATE), conducted a multi-centre prospective audit on the management of Tonsillitis and Quinsy. This was in response to the implementation of new COVID-19 specific guidelines released by ENT UK and to explore factors relating to unscheduled re-presentations discharges direct from the Emergency Department (ED).

Methods
Consecutive patients with suspected tonsillitis or quinsy, aged 18 or over, and referred to ENT in secondary care were eligible for inclusion. Data was collected, using a standardised electronic case report form, relating to patient demographics, COVID-19 status, clinicians’ grade, assessment and interventions. Each case was followed-up for 10 days to assess predictors of unscheduled re-presentation after discharge direct from the ED.

Results
83 centres submitted 765 tonsillitis and 416 quinsy cases. 54.4% of tonsillitis cases and 45.3% of quinsy were discharged directly from the ED. 9.6% of tonsillitis and 10.3% of quinsy discharges re-presented within 10 days, compared to 9.7% and 10.6% for those initially admitted.
IV steroids were given to 67.0% of tonsillitis patients and 73.6% of quinsy.
77.2% of quinsy patients underwent drainage during their initial presentation, but there was no significant difference in re-presentation rate in those drained vs not-drained (p = 0.85).
Univariable logistic regression showed no significant predictors of re-presentation within 10 days.

Conclusion
Management of tonsillitis and quinsy was affected during the initial peak of the pandemic, with a shift towards outpatient care. Some patients who may previously have been admitted to hospital may be safely discharged from the ED.
V3 Is re-introducing major open and minimally invasive surgery during COVID-19 safe for patients and healthcare workers? An international, multi-centre cohort study in the field of oesophago-gastric surgery
Authors: Alasmar Mohamed , Kausar Afsana , Borgstein Alexander , Moons Johnny , Doran Sophie , de Pascale Stefano , Restrepo Rafael , Verrengia Apollonia , Alloggio Mariella , Delgado Ana Moro , del Val Ismael Díez , Kumar Sacheen , Giocapuzzi Simone , Baiocchi Gian Luca , de Vega Irañeta Marta , Salcedo Gabriel , Vorwald Peter , Romario Uberto Fumagalli , Nafteux Philippe , Gisbertz Suzanne , Chaudry Asif , Alkhaffaf Bilal 
Published: April 2021

Abstract

Introduction
The Covid-19 pandemic has resulted in unprecedented and challenging changes to surgical practice, especially with the suspension of cancer surgery. There have been concerns regarding Covid-19 risk and infection to patients and healthcare workers, during major complex open surgical intervention, especially with minimally invasive surgery. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (OG) surgery.

Methods
This was an international, multi-centre, cohort study of open and minimally invasive oesophagectomy and gastrectomy procedures in specialist Upper GI centres, over a consecutive period of two months. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 infections. 30-day operative morbidity and mortality data was collected for patients. All staff involved in the operative care of patients, were invited to complete a health-related survey.

Results
A total of 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy), of which 87 patients (57%) underwent minimally invasive surgery (59 esophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion of which 313 (78%) completed the health survey. Non- standardised precautions to minimise against the risks of COVID for patients and staff were implemented at the centres. There were no cases of Covid-19 among patients in the post-operative period, however, two healthcare workers developed self-limiting COVID infection.

Conclusion
Precautions to minimise COVID-19 infection risk to healthcare staff and patients, have allowed the safe and successful reintroduction of major open and minimally invasive OG surgery.
V9 Risk of death following pulmonary complications after surgery with and without SARS-CoV-2 infection: a pooled analysis of individual patient data from pre-pandemic and pandemic international cohort studies
Authors:   COVIDSurg Collaborative,   STARSurg Collaborative, Gujjuri Rohan 
Published: April 2021

Abstract

Introduction
Whilst the severe consequences of COVID-19 around the time of surgery are well described, no comparison has been made to pulmonary complications in the absence of infection. This study aimed to compare postoperative death in patients with and without SARS-CoV-2 infection.

Methods
A patient-level comparative analysis of two international prospective cohort studies; one conducted before (January to October 2019) and one during the SARS-CoV-2 pandemic (from local emergence of COVID-19 to April 2020). Patients undergoing elective resection of an intra-abdominal cancer with curative intent were included in a multilevel logistic regression. The primary outcome was 30-day postoperative mortality.

Results
Of 7402 patients included, 3031 underwent surgery before and 4371 during the pandemic. Overall, 6.5% (n = 484) patients suffered a pulmonary complication, 5.1% had a SARS-CoV-2 infection diagnosed, and 1.4% patients (n = 107) died. Compared to patients without pulmonary complications, those with SARS-CoV-2 pulmonary complications had a higher adjusted odds of death (OR: 54.14, 95%CI: 23.46 to 124.91, p &lt; 0.001) than those with non-SARS-CoV-2 pulmonary complications (OR: 7.20, 95%CI: 3.85 to 13.45, p &lt; 0.001).

Conclusion
Postoperative pulmonary complications were associated with increased 30-day mortality. SARS-CoV-2 associated pulmonary complications were associated with a far higher mortality than a non-SAR-CoV-2 pulmonary complication.
Social Work and Policy Practice: Understanding the Role of Social Workers
Authors: Saxena Ankur , Chandrapal Sneha 
Published: April 2021

Abstract
The social work profession is a practice-based profession that promotes social justice and advocacy for marginalised individuals. In spite of the fact that the policy practice is considered as crucial component of social work practice, the real participation of social workers in policy practice seems very less. It has a potentially significant influence on social work profession, both as a field of study and an area of practice. History is filled with an evidence showing that the policy practice paved the way for the development of social work profession as people used different social work skills to campaign for the formalisation of the social work profession. Social workers have been held up as exercising substantial power to influence policy being policy implementers (Schorr, A. L. (1985) ‘Professional practice as policy’, Social Service Review, 59(2), pp. 178–96; Scott, W. R. and Davis, G. F. (2007) Organisations and Organising: Rational, Natural, and Open System Perspectives, Upper Saddle River, Pearson Prentice Hall). Social workers having practice experience make them excellent advocates because they understand clearly the challenges confronted by their clients, including clients’ presenting problems, holistic environmental factors, and client strengths that can be drawn on so as to assist them. This article throws light on linkages between social work and social policy, policy practice in social work and role of social worker as a change agent in policy practice.
Supportive Social Work Supervision as an Act of Care: A Conceptual Model
Authors: Newcomb Michelle 
Published: April 2021

Abstract
Supportive supervision is an important but often over-looked practice in contemporary social work, often assisting in maintaining practitioner well-being. The following research explores how eleven social workers in Australia experience supportive supervision and its impact on their well-being and job satisfaction. The research used interpretative phenomenological analysis to reveal the complex and important role supportive supervision has for social workers, working within risk-adverse, managerialist settings. Participants revealed how supportive supervision allowed them to feel cared for and valued within their work environment. This was contrasted with their experience of the tokenistic supervision they received in many agencies leading to feelings of emotional unsafety in the workplace. Whilst social work is inherently an emotionally driven profession, this study revealed how supervisory practices that focus on risk and surveillance place supportive supervision as an afterthought. This research highlights the importance of supportive supervision in ‘caring for the carers’ in front line social work positions.
Measurement of Immature Reticulocytes in Dried Blood Spots by Mass Spectrometry
Authors: Cox Holly D , Miller Geoffrey D , Manandhar Abhilasha , Husk Jacob D , Jia Xuan , Marvin James , Ward Diane M , Phillips John , Eichner Daniel 
Published: April 2021

Abstract

Background
Immature reticulocytes (IRC) are the first cells to respond to changes in erythropoiesis. For antidoping applications, measurement of IRC may improve detection of blood doping practices. Unfortunately, this small cell population has limited stability in liquid blood samples and is difficult to measure with optimal precision. We developed a method to measure 3 IRC membrane proteins in dried blood spots (DBS) to monitor changes in erythropoiesis.

Methods
DBS spots were washed with buffers to remove soluble proteins, membrane proteins remaining in the spot were digested with trypsin, and one peptide for each protein was measured by LC-MS/MS. IRC protein concentration was determined using a DBS single point calibrator.

Results
Intraassay precision for IRC proteins was between 5%–15%. IRC proteins were stable in DBS for 29 days at room temperature. In a longitudinal study of 25 volunteers, the mean intraindividual variation for 3 IRC proteins was 17%, 20%, and 24% from capillary blood DBS. In comparison, the mean longitudinal variation for IRC counts measured on an automated hematology analyzer was 38%. IRC protein concentration from capillary blood DBS correlated well with venous blood DBS protein concentrations.

Conclusions
Measurement of IRC proteins in DBS samples provides a method to measure changes in erythropoiesis with improved analytical sensitivity, stability, and precision. When combined with the inherent advantages of capillary blood collection in the field, this method may substantially improve the detection of blood doping practices.