scholarly journals Evaluating the utility of an international webinar as a platform to educate students and doctors on the UK Core Surgical Training Portfolio

2021 ◽  
Author(s):  
Siddarth Raj ◽  
Harroop Bola ◽  
Amar Rai ◽  
Sarika Grover ◽  
Anisha Bandyopadhyay ◽  
...  
Keyword(s):  
Surgical Training ◽  
Statistical Significance ◽  
Demographic Data ◽  
Self Report ◽  
Equal Opportunities ◽  
Long Term Outcomes ◽  
Surgical Career ◽  
Postgraduate Training Program ◽  
The Uk

Abstract Background Core Surgical Training (CST) is a competitive two-year postgraduate training program in the UK that is scored based on three equally weighted stations: management, clinical and portfolio. Preparing a surgical portfolio can start in medical school, however, there is limited guidance on what forms a competitive portfolio with the majority of advice coming from surgical societies and mentors, which are variable throughout the country. Our aim was to assess the utility of a webinar to educate students and doctors on the CST portfolio to address this disparity. Methods Pre- and post-event questionnaires that included demographic data, 10-point Likert scales to self-report confidence on understanding of the CST portfolio and its domains, and questions on utilising webinars were distributed to attendees. Pre- and post-event responses were paired, and scores were assessed for normality via the Shapiro-Wilk test; the Mann-Whitney U test was used to assess statistical significance. Cohen's d effect sizes were calculated to report standardised differences between pre- and post-event scores. Results A total of 177 participants from over 24 countries attended and responded to both questionnaires. A statistically significant improvement in awareness of how to score maximum points was demonstrated across all nine CST domains (p < 0.0001). Almost half of the participants stated a preference for a webinar over an in-person format and only less than a third felt that webinars limited their ability to network and socialise at such events. Interestingly, most attendees did not feel that their university had provided them with adequate information on preparing for a surgical career with over half of the attendees stating that they had to attend events by external organisations to obtain such information. Conclusions This study has demonstrated that a webinar can be effectively utilised to educate students and doctors on the various domains of the CST portfolio and how to maximise points in each section. Such events could address the variability of societies and mentors across the country and provide equal opportunities for students. Further studies that directly compare webinars with in-person events and investigate long-term outcomes, such as success in CST applications, are required.

scholarly journals P663 Long-term follow up in IBD: 10-year observational study of a UK IBD cohort

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S588-S588
Author(s):  
S T Radhakrishnan ◽  
A Vasireddy ◽  
K I Gallagher ◽  
L C Hicks ◽  
S T Powles ◽  
...  
Keyword(s):  
Observational Study ◽  
Statistical Significance ◽  
Z Score ◽  
Long Term Outcomes ◽  
Phenotypic Data ◽  
Long Term Follow Up ◽  
Inflammatory Bowel ◽  
The Uk

Abstract Background Crohn’s Disease (CD) and ulcerative colitis (UC) are the two main sub-types of Inflammatory Bowel disease (IBD), which affect 300–500 per 100,000 people within Europe, with an increasing incidence. Long-term outcomes have been reported cohorts of Korean and Scandinavian populations, but long-term UK data are limited. Methods Data were prospectively collected from an IBD cohort over a 10-year period. 90 patients were included (47 CD, 36 UC, 7 IBD-unclassified). Phenotypic data (Montreal classification), medication and management decisions were documented. Statistical significance was determined by the Z-score for 2 population proportions. Results Over 10 years, the number of operations for CD significantly increased from 8 to 19 patients (p=0.03) but not significantly in UC from 1 to 4 (p=0.09). Perianal involvement in CD also increased from 15.5% to 27.7% at 10 years, but this change was non-significant (p=0.14). Within the UC cohort, a trend for aminosalicylate use was seen, increasing from 53% to 64% (p=0.34), whilst thiopurine use decreased from 44% to 28% (p=0.12). 6/36 patients with UC and 10/47 patients with CD failed thiopurine use due to intolerance or severe side-effects. Biologic use in both UC and CD significantly increased from 10 to 22 patients (p=0.013) over 10 years. Conclusion This is the first long-term observational study in IBD patients within the UK. The data show that even with an increase in biologic availability and prescribing, the overall lifetime risk of surgical management in CD does increase with time, mirroring recent publications. Studies with an increased number of IBD patients under long-term follow up are ongoing.

Stability in Waking-Sleep States in Neonates as a Predictor of Long-Term Neurologic Outcome

PEDIATRICS ◽  
1985 ◽  
Vol 76 (1) ◽  
pp. 52-63
Author(s):  
Cesare T. Lombroso ◽  
Yoichi Matsumiya
Keyword(s):  
Statistical Significance ◽  
Observation Time ◽  
Long Term Outcomes ◽  
Newborn Period ◽  
Waking And Sleep ◽  
Total Observation Time ◽  
Total Observation ◽  
The Individual

Thirty-three full-term neonates were ranked blindly on a scale ranging from the least to the highest "risk" for future neurologic complications on the basis of available perinatal biographies, tests, and examinations performed during the newborn period. Four prolonged polygraphic-behavioral recordings were obtained one week apart beginning at ten days after birth. Five waking and sleep states were scored in each session as percentages of total observation time, giving a total of 20 scores for each baby to be subjected to analysis of variance. These measures also provided individual profile consistency or variability in maintaining waking-sleep states over the selected period of postnatal time. The whole cohort, except three infants who could not be followed adequately, was then reexamined periodically over a period ranging from 3 to 4 years (±6 months) for neurologic and developmental assessments. Except for two scores that produced a low level of statistical significance (P &lt; .05), the other 18 scores were found to be not associated with long-term outcomes. Even the first two scores were not satisfactory discriminators for the outcome of the individual babies. However, when coefficients of concordance (W) were computed from each individual baby profile, significant statistics (P &lt; .001) emerged to indicate good correlations between high or low W values in the newborn period and long-term outcomes. All 17 newborns who had W scores greater than 0.9 were found to be normal at follow-up regardless of the poor ranking given several of them during the newborn period. Among the 13 newborns who had W scores less than 0.9, 11 had a poor clinical outcome at follow-up, though several had been ranked initially as falling within the least "risk" group.

Modelled evaluation of multi-component meningococcal vaccine (Bexsero®) for the prevention of invasive meningococcal disease in infants and adolescents in the UK

2013 ◽  
Vol 142 (9) ◽  
pp. 2000-2012 ◽  
Author(s):  
J. HUELS ◽  
K. M. CLEMENTS ◽  
L. J. McGARRY ◽  
G. J. HILL ◽  
J. WASSIL ◽  
...  
Keyword(s):  
Meningococcal Disease ◽  
Standard Care ◽  
Demographic Data ◽  
Time Frame ◽  
Transmission Dynamics ◽  
Transmission Model ◽  
Meningococcal Vaccine ◽  
Catch Up ◽  
The Uk

SUMMARYNeisseria meningitidis is the main cause of bacterial meningitis and sepsis in the UK, and can potentially be lethal or cause long-term sequelae. Bexsero® (4CMenB) is a new multi-component vaccine approved by the European Commission for use in individuals aged ⩾2 months. A theoretical transmission model was constructed to assess the long-term effectiveness of Bexsero compared to standard care. The model was populated with UK-specific demographic data and calibrated to ensure that the transmission dynamics of meningococcal disease in the UK were adequately simulated. The model showed the best strategy to be a routine vaccination programme at ages 2, 3, 4, 12 months and 14 years combined with a 5-year catch-up programme in toddlers aged 12–24 months and adolescents aged 15–18 years. This would lead to a 94% reduction in meningococcal cases or 150 000 cases and 15 000 deaths over a 100-year time-frame.

scholarly journals Radiofrequency ablation versus traditional liver resection and chemotherapy for liver metastases from gastric cancer

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052094050
Author(s):  
Kezhong Tang ◽  
Bo Zhang ◽  
Linping Dong ◽  
Lantian Wang ◽  
Zhe Tang
Keyword(s):  
Gastric Cancer ◽  
Radiofrequency Ablation ◽  
Liver Resection ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Statistical Significance ◽  
Local Treatment ◽  
Long Term Outcomes ◽  
Short And Long Term

Objective To compare the short- and long-term outcomes of radiofrequency ablation (RFA) versus liver resection and chemotherapy for liver metastases from gastric cancer. Methods We retrospectively evaluated 50 patients who underwent curative gastrectomy and local treatments for liver metastases (RFA, n = 20; liver resection, n = 20; and chemotherapy, n = 10) from 2008 to 2018. Results The short- and long-term outcomes of each local treatment were evaluated. The median overall survival (OS) after RFA was similar to that after liver resection (20 vs. 20 months, respectively) and longer than that after chemotherapy (20 vs. 10 months, respectively). The 3-year OS and progression-free survival (PFS) rates after RFA were 20% and 10%, respectively, while those in the liver resection group were 23.5% and 23.5%, respectively. The 3-year OS rate after chemotherapy was 10%. The size and number of metastases were prognostic factors for patients with gastric cancer with liver metastasis without statistical significance. Conclusions Among patients with liver metastasis from gastric cancer, OS and PFS were satisfactory and comparable between RFA and liver resection but better than those of chemotherapy. RFA is an appropriate option for patients with gastric cancer who have a solitary liver metastasis measuring ≤3.0 cm.

Maximizing opportunities at medical school to support a career in surgery

2019 ◽  
Vol 80 (11) ◽  
pp. 670-673
Author(s):  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Surgical Training ◽  
Nominal Group ◽  
Annual Conference ◽  
School Students ◽  
The Core ◽  
Surgical Career ◽  
Competency Based ◽  
The Uk

Introduction: During medical school, students have numerous opportunities to develop their portfolios for a career in surgery, such as undertaking additional surgical placements and participating in surgical research. However, at present, there is little guidance available for medical students on how to build a strong portfolio for the UK core surgical training application. This article outlines work undertaken to provide concise guidance to support future surgeons, via application of the competency-based CanMEDS framework to the current UK core surgical training specification. Materials and methods: A pre-conference meeting was arranged for medical students at the Society of Academic and Research Surgeons annual conference in January 2018. Self-selected research enthusiasts from different university years discussed practical approaches to pair the CanMEDS model with the core surgical training specification, with support from the STARSurg Collaborative committee to facilitate discussion. A nominal group-based method was adopted in order to reach areas of consensus. Results: Practical tips and recommendations for each respective CanMEDS domain (communicator, collaborator, leader, health advocate, scholar, professional) were made in relation to the core surgical training specification. These included key action points and named opportunities that are currently available to UK medical students. Conclusions: A consensus approach was taken to address key areas of competence across each CanMEDS domain. This informed the development of a guidance framework to support students to develop a strong portfolio for a core surgical training application. This framework can be followed by medical students, equipping them with the skills necessary to succeed in their future surgical career.

scholarly journals Oncoplastic and reconstructive breast surgery in Canada: breaking new ground in general surgical training

2018 ◽  
pp. 294-299
Author(s):  
Lashan Peiris ◽  
David Olson ◽  
Kelly Dabbs
Keyword(s):  
Breast Cancer ◽  
Surgical Training ◽  
Breast Surgery ◽  
Fellowship Training ◽  
Immediate Breast Reconstruction ◽  
Oncoplastic Breast Surgery ◽  
The Uk

Oncoplastic breast surgery combines certain plastic surgery procedures with a breast cancer resection to minimize the cosmetic penalty. We compared current practices in breast surgery in Canada and the UK, looking at the classification of oncoplastic breast surgery, management of larger tumours that would otherwise mandate a mastectomy, and the breast surgeon’s role in immediate breast reconstruction. Reconstructive breast surgery has always fallen within the domain of the plastic surgeon, but surgical subspecialization and more focused fellowship training have meant that breast surgeons with the appropriate skillset can offer these procedures. This evolution of the breast surgeon has led to the birth of a new field of breast surgery known as oncoplastic and reconstructive breast surgery. Those tasked with developing surgical training programs in Canada must now decide whether to train breast surgeons in these techniques to improve long-term quality of life among Canadian patients with breast cancer.

Balloon Eustachian tuboplasty for Eustachian tube dysfunction: report of long-term outcomes in a UK population

2020 ◽  
Vol 134 (1) ◽  
pp. 34-40
Author(s):  
A E L McMurran ◽  
G E Hogg ◽  
S Gordon ◽  
P M Spielmann ◽  
S E Jones
Keyword(s):  
Eustachian Tube ◽  
Practical Experience ◽  
Eustachian Tube Dysfunction ◽  
Long Term Outcomes ◽  
Presenting Symptoms ◽  
Tube Dysfunction ◽  
One Year ◽  
The Uk ◽  
Balloon Eustachian Tuboplasty

AbstractBackgroundBalloon Eustachian tuboplasty is a surgical management option for Eustachian tube dysfunction; it has shown promising results in studies worldwide, but has had limited uptake in the UK. This study reports long-term outcomes for patients offered balloon Eustachian tuboplasty for chronic dilatory and baro-challenge-induced Eustachian tube dysfunction, and describes practical experience gained from its implementation.MethodsBalloon Eustachian tuboplasty was conducted in 25 patients (36 ears) with Eustachian tube dysfunction over three years. Information on presenting symptoms and signs, audiometric findings, tympanometry, and Eustachian Tube Dysfunction Questionnaire-7 scores were recorded pre- and post-operatively with a minimum follow up of one year.ResultsSixteen (64 per cent) of the 25 patients demonstrated symptom resolution after balloon Eustachian tuboplasty according to the Eustachian Tube Dysfunction Questionnaire-7. Fourteen (64 per cent) of the 22 patients with a type B or C tympanogram pre-operatively, had a type A trace post-operatively. Fifteen (75 per cent) of 20 patients with pre-operative conductive hearing loss showed improvement post-operatively, and 11 (50 per cent) of 22 patients with pre-operative middle-ear effusion or tympanic membrane retraction showed resolution.ConclusionBalloon Eustachian tuboplasty can improve subjective and objective measures of Eustachian tube dysfunction, and provide longer-term resolution.

Long-term visual, anterior and posterior corneal changes after crosslinking for progressive keratoconus

2021 ◽  
pp. 112067212110528
Author(s):  
Abdelrahman Salman ◽  
Ali Ali ◽  
Shaaban Rafea ◽  
Rana Omran ◽  
Buraa Kubaisi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Significance ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Long Term Outcomes ◽  
Corrected Distance Visual Acuity ◽  
Hyperopic Shift ◽  
The Mean

Aim To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus. Method In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min “epi-off” corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking. Results Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (−2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR −0.08 ± 0.30) and (LogMAR −0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (−0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from −1.31 ± 0.97 D to −1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (−35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry. Conclusion This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.

scholarly journals A survey of bolus tube feeding prevalence and practice in adult patients requiring home enteral tube feeding

2019 ◽  
Vol 122 (11) ◽  
pp. 1271-1278 ◽  
Author(s):  
Gary P. Hubbard ◽  
Sophie Andrews ◽  
Sean White ◽  
Gary Simpson ◽  
Sarah Topen ◽  
...  
Keyword(s):  
Demographic Data ◽  
Tube Feeding ◽  
Feeding Tube ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Feeding Method ◽  
Oral Nutritional Supplements ◽  
The Uk ◽  
At Home

AbstractAnecdotal evidence suggests the use of bolus tube feeding is increasing in the long-term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from ten centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding (n 604, 60 % male, age 58 years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37 %). Patients were long-term tube fed (4·1 years tube feeding, 3·5 years bolus tube feeding), living at home (71 %) and sedentary (70 %). The majority were head and neck cancer patients (22 %) who were significantly more active (79 %) and lived at home (97 %), while those with cerebral palsy (12 %) were typically younger (age 31 years) but sedentary (94 %). Most patients used bolus feeding as their sole feeding method (46 %), because it was quick and easy to use, as a top-up to oral diet or to mimic mealtimes. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85 % of patients, with 51 % of these being compact-style ONS (2·4 kcal (10·0 kJ)/ml, 125 ml). This survey shows that bolus tube feeding is common among UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.

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