8 research outputs found
Impact of the COVID-19 Pandemic on Acute General Surgical Admissions in a District General Hospital in the United Kingdom: A Retrospective Cohort Study
No full textThe COVID-19 pandemic of 2020 has greatly impacted healthcare systems and society more generally around the world. The management of patients infected with SARS-CoV-2 has primarily impacted emergency departments, medical teams, and intensive care units. However, the impact on health systems as a whole, including surgical specialties, has been wide ranging. We aimed to establish the impact of the COVID-19 pandemic and associated lockdown on the number and characteristics of general surgical patients reviewed and/or admitted by the surgical team within a district general hospital. We performed a retrospective cohort analysis of patients admitted in the 2-week period from start of the lockdown (Monday 23rd March 2020 to 5th April 2020), and the same period 1 year earlier (Monday 25th March 2019 to 7th April 2019). Number of patients reviewed and admitted were compared between the two cohorts. Data including diagnosis, operation/procedural interventions, and length of stay were analysed. The overall number of patients reviewed and admitted by the surgical team was substantially lower during the period of lockdown (61 vs 126). Of the patients seen during lockdown, a smaller proportion were admitted to hospital after initial surgical review (59% vs 77%, p < 0.05). Interventional/operative procedures were performed in a similar proportion of patients in both cohorts (31%). Our data show that there has been a substantial reduction in the number of patients being referred to and admitted by the general surgical team at our centre during the COVID-19 pandemic. Explanations for this include reduced attendance due to risk perception of the patients, the impact of lockdown messages and advice regarding self-isolation, as well as an increased threshold for patient admission during the COVID-19 pandemic. Key learning points include the possible benefits of a reduction in admission to hospital of patients with nonurgent conditions
Mobile Application for Personal Journal/Diary
No full textFor centuries, diary has been seen as a tool of learning and reflection. Many studies have
shown that not only diary is an excellent tool to capture author‟s thoughts and life
experiences but also yield significant health benefits such as coping with stress and
depression. However, in recent years, changes in lifestyle and boom of technology cause the
practice of diary writing to fall out of favour. The fact that people are facing health problems
often associated with work stress and lack of focus as well as organization indicates the need
to preserve the culture of diary writing. Introduction of smartphone to the world opens up the
opportunity to incorporate diary writing in the form of mobile application. In this research,
the author discusses on the importance and value of expressive writing in diary writing that
makes it a valuable learning and reflection tool. The interest of this research is to develop a
suitable diary mobile application that matches the current lifestyle and enhance the
experience of diary writing on the go as people are spending more time on their smartphone
than ever. The scope of the study will be on Android operating system and the development
will undergo incremental and iterative development based on modern mobile application
architecture
"Suvokiamos rizikos įtaka ketinimui pirkti iš užsienio elektroninių parduotuvių posovietinėse šalyse".
No full textThesis supervisor – Prof. Vytautas Dikčius Thesis completed – 2022, Vilnius Paper volume – 62 pages Number of tables – 30 Number of figures – 7 Number of literature references – 181 Every year, the Internet evolves allowing business to develop their services through the marketing environment. Since the Internet's beginning and expansion, consumers do not find it difficult to make purchases as well as saving time searching for information. However, despite the significant development in online shopping e-commerce, negative aspects of this method of shopping are becoming increasingly associated with it. As a result, the issue of perceived risks continues to be a substantial barrier to e-commerce growth, and it is still relevant because many online businesses are affected by perceived risk. As a result, the role of perceived risk may subconsciously influence consumers attitudes towards the particular online store and their further intention to purchase online. Moreover, since each country has different social and cultural origins, it is not particularly clear what attitudes and intentions they have towards a specific country-of-origin image. Since the uncertainty avoidance is also associated with the potential negative consequences of purchasing a certain product or service, and also contributes to the perception of risk. Therefore, the goal of the author is to find out how country-of-origin image of Poland and Turkey online stores, and different types of perceived risk will have an impact on the intention to purchase online, considering the impact of uncertainty avoidance for the respondents from Lithuania and Azerbaijan. In order to achieve the goal of the research, current study is based on the theory of planned behavior (TPB). In order to evaluate hypotheses data was collected by using a survey method, and tested by using 2x2 design for the experiment. The experiment was carried out using a 2x2 factorial design with two components divided into two levels. The attitudes of Azerbaijani and Lithuanian consumers about internet shopping in Poland and Turkey are the manipulated variables. As a result, A and B questionnaires for distinct groups of consumers were developed and distributed. In order to examine the hypotheses, the Multiple Linear Regression analysis and The Independent Samples T-test by using the SPSS process procedure was used. The findings of the survey suggest that overall customer perceptions of risk play a significant impact in determining whether or not they will continue to purchase online. Furthermore, the author has contributed to research by claiming that cultural factors play a significant influence; as a result, the results for perceived risk differed between customers from Azerbaijan and Lithuania. When looking at the impact of a country-of-origin image on consumer trust, however, the findings are inconsistent, which supports the theory that each respondent's country's view of uncertainty avoidance is a determinant in this outcome. Lithuanians, who have a lower level of uncertainty avoidance than Azerbaijanis, are more likely to trust online purchases of mobile devices than Azerbaijani consumers. To summarize, the current research assists both the academic and business communities in terms of marketers and e-commerce retailers. Businesses and developers of consumer-generated content might use clear developed research model and discovered key elements that influence purchase intentions for consumers in Lithuania and Azerbaijan
3D reconstruction and virtual reality is an acceptable and feasible method for addressing body image in bariatric metabolic surgery
No full textBACKGROUND: Patients living with obesity continue to experience body image dissatisfaction following bariatric metabolic surgery. The underlying reasons are poorly understood but may be due to unmet expectations. Negative body image perception following metabolic surgery leads to poorer psychological and clinical outcomes. This study aims to establish the acceptability and feasibility of three-dimensional (3D) reconstruction and virtual reality (VR) as a method of providing psychological support to bariatric patients to improve body image satisfaction and interventional outcomes. METHODS: Seven participants were recruited from the Imperial Weight Centre. 3D photographs were captured and processed to produce two 3D reconstructed images with 15% and 25% total weight loss. Participants were shown their images using VR and participated in peer group workshops. RESULTS: Six participants were retained until the end of the study. Five out of six participants agreed the images provided them with a more accurate representation of their body changes and overall appearance following bariatric metabolic surgery. All participants strongly agreed with the group setting and felt VR facilitated discussions on body image. Overall, all participants felt that the use of VR and 3D reconstruction is beneficial in supporting patients to adjust to changes in their body image after bariatric metabolic surgery. CONCLUSIONS: This is the first study to explore and demonstrate that 3D reconstruction and VR is an acceptable and feasible method providing patients with a realistic expectation of how their body will change following significant weight loss, potentially improving body image satisfaction after surgery, as well as psychological and interventional outcomes
End-user acceptability of a prototype digital stethoscope to diagnose childhood pneumonia:A qualitative exploration from Sylhet, Bangladesh
No full textBackground: Considering the high frequency of respiratory infections among children in low- and middle-income countries (LMICs), the World Health Organization (WHO) developed a pragmatic guideline for managing pneumonia in low-resource settings. The guideline’s low specificity leads to many false-positive pneumonia cases receiving antibiotic treatment. Integrating diagnostic technology to incorporate lung sounds into WHO guidelines could improve childhood pneumonia diagnosis and management. This qualitative study aimed to explore the acceptability of a prototype digital stethoscope device among potential end-users in Bangladesh.Methods: We conducted four focus group discussions (FGDs) with beneficiaries and service providers who used a 2018 digital stethoscope prototype. The data collection was conducted in November 2020. The study was carried out at Zakiganj Upazila (sub-district) of Sylhet district of Bangladesh. A total of 34 respondents, including parents of under-5 children, Community Health Care Providers (CHCPs), and community leaders were enrolled. Two researchers (TJ and a research assistant (not a co-author of this manuscript) conducted the FGDs. Verbatim transcripts were prepared, and translations were completed. Coding was executed in Microsoft Excel, and relevant quotes were extracted to ascertain the emerging themes. To ensure validity, two researchers coded the dataset independently and inconsistencies were resolved through discussion.Findings: Mothers were more aware of the digital stethoscope than fathers. Except for the female community leaders, male leaders were unaware of the stethoscopes. Most CHCPs had positive perceptions of the digital stethoscope. They appreciated stethoscope training as they learned about new technology and diagnostic approaches. The users mentioned several technical shortcomings of the prototype device. A few stakeholders expressed dissatisfaction with the level of community involvement and information sharing from the study. The use of the device plummeted during the COVID-19 pandemic for fear of infection, to counteract which the CHCPs cleaned the device with chlorhexidine after every application as a precaution.Conclusion: Overall, device use was supported by stakeholders despite perceptions that the prototype had some technological limitations, community engagement was suboptimal, and the COVID-19 pandemic caused disruptions. Stronger community engagement, addressing technological issues, and further research on its health systems application would improve the acceptability and effective use of the digital stethoscope.<br/
PD17-08 THE EFFECTS OF MEDICALLY EXPULSIVE THERAPY (MET) ON SPONTANEOUS STONE PASSAGE (SSP) IN PATIENTS PRESENTING WITH ACUTE URETERIC COLIC
No full textPANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK
No full textAbstract
Background
Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment.
Methods
All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals.
Results
A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death.
Conclusion
Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions.
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