RESUMO
Background: The COVID-19 pandemic has had a significant effect on healthcare services, particularly affecting patients who suffer from chronic conditions. However, the pandemic's effect on endometriosis surgery is not yet known. Objectives: To determine the impact of the COVID-19 pandemic on surgery for severe endometriosis in the UK at a national, regional and centre-level. Materials and Methods: The British Society for Gynaecological Endoscopy (BSGE) collects data nationally on all operations for severe endometriosis which involve dissection of the pararectal space. Annual audits of this database were obtained from the BSGE. Publicly available data on COVID-19 cases and population were obtained from the UK Office for National Statistics. Main outcome measures: Numbers of annual BSGE-registered endometriosis operations. Results: A total of 8204 operations were performed. The number of operations decreased by 49.4% between 2019 and 2020 and then increased in 2021, but remained 10.5% below average pre-pandemic levels, indicating at least 980 missed operations between 2019-2020. Median operations per centre decreased by 51.0% in 2020 (IQR 29.4% - 75.0%) and increased in 2021 but remained 33% below pre-pandemic levels. There was no change in the type of surgery performed. All 11 administrative regions of Great Britain had reduced numbers of operations in 2020 compared with the average for 2017-2019, with a median 44.2% decrease (range 13.3% - 67.5%). Regional reduction in operations was correlated with COVID-19 infection rates (r=0.54, 95% CI of r 0.022 - 1.00, p=0.043). Conclusion: The number of operations performed annually in the UK for severe endometriosis fell dramatically during the COVID-19 pandemic and is yet to normalise. What's new?: This study shows the dramatic effect that the COVID-19 pandemic has had on UK services for endometriosis surgery, which may continue to affect patients and clinicians for a considerable time to come.
RESUMO
Background: AYA with cancer commonly experience sexuality concerns during and post treatment. Evaluation andmanagement of these critical aspects are often neglected by health professionals due to factors such as poor knowledge, confidence and communication, lack of comfort, time and prioritisation of sexuality concerns. It is not known what policy and practice tools are available to bridge this evidence gap. Aim(s): To scope, analyse and map the literature on policy and practice tools, specific to AYA oncosexology education and training programs, for health professionals. Method(s): A scoping review was conducted using the Joanna Briggs Institute methodology. A search strategy was developed using key words initially tested in OVID MEDLINE. The formal search was conducted in July 2022 in Medline, EMCARE, EMBASE and PsychINFO (all on OVID platform) for articles: published after 2012;in English;qualitative, quantitative, mixed method studies, case studies, review articles or grey literature;in patients aged 15-39 years. Articles were excluded if they did not meet these criteria, only examined potential education/training programs or health professionals' knowledge, attitudes or practices, or only focused on patients' perspectives. Retrieved articles were extracted into Covidence and two screening roundswere independently performed by two authors each for the final analysis and evidence synthesis. Result(s): After removing 1140 duplicate records, 1825 records were screened of which 1523 were excluded and 302 full texts assessed for eligibility. The final number of studies included along with other quantitative findings will be reported against the PRISMA-ScR reporting checklist. Results from the basic content analysis to organise qualitative findings into higher level categories will also be presented. Conclusion(s): Evidence gaps, limitations and implications for research will be discussed. We will seek stakeholders' views on whether our findings are locally relevant and how they can inform improvements in health professional oncosexology policy and practice tools.
RESUMO
Aim: Healthier You (HY) is an NHS England commissioned diabetes prevention programme meeting criteria for structured education programmes (SEPs). It is evidence-based, informed by theory, underpinned with a philosophy and usually delivered as sixteen 90 minute face-to- face group sessions for participants at risk of type 2 diabetes. We decided to adapt HY for virtual delivery to enable this SEP to continue during covid-19. We aimed to examine the uptake and impact of this new delivery mode. Method: A multidisciplinary group of stakeholders reviewed and modified the programme to support virtual delivery, while retaining credibility as SEP. HY facilitators were trained in the new mode of delivery. Delivery of virtual HY began April 2020. Data was collated over 2 time periods;face-to- face delivery (2019) and virtual delivery (1/4/2020-1/ 12/2020) and compared for acceptability and accessibility. Results: Uptake to face-to- face HY was 66%, increasing to 69.5% for virtual delivery during covid-19. An increase in attendance of people <35 years of age (12% vs. 5%), from non-White groups (30% vs. 23%) and from the most deprived quintile of deprivation (28% vs. 17%) was seen for virtual HY compared to face-to- face. Average weight loss improved with virtual delivery compared to face-to- face (3.6 kg vs. 2.4 kg). Conclusions: Since covid-19, there has been increased uptake to virtual HY by those who are younger, employed, from BAME background and/or socially deprived areas. Fewer older, retired people attended. Post-covid- 19, a hybrid approach to HY delivery may support accessibility and equity while improving weight loss.