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Li C, Gong X, Wei Z, Gao L, Graham Y, Yang W. Novice Chinese Bariatric Nurses' Perceptions of Their Role as Bariatric Case Managers: A Qualitative Study. Obes Surg 2024; 34:1464-1470. [PMID: 38504064 DOI: 10.1007/s11695-024-07177-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Bariatric case managers (BCM) are integral healthcare team members for patients undergoing bariatric surgery in China. As the demand for bariatric surgery increases in China, the number of BCMs has also risen. However, more is needed to know about the perceptions of novice bariatric nurses toward their role as case managers. This study aims to investigate the perceptions of novice Chinese bariatric nurses toward their roles during the early stages of their careers. METHODS This qualitative study employed semi-structured individual interviews with 15 novice bariatric nurses who received training as BCMs. The interviews were audio-recorded, transcribed line-by-line, and analyzed thematically. The study was conducted in a bariatric surgery center of a public tertiary hospital in Southern China. RESULTS Three themes emerged from the data related to the perceptions of being a BCM: "negotiating the ambiguity of the BCM role," "establishing a core set of behaviors for the BCM role," and "identifying areas of competence to develop a BCM role framework." The novice bariatric nurses expressed both positive and negative feelings toward their role. They highlighted the need for further training to improve their qualifications and the importance of support from colleagues, and hospital management. CONCLUSIONS The findings illuminate the role of the BCM in China. Future research should investigate effective and acceptable job descriptions and cooperation modes between BCMs, colleagues and hospital management. We recommend using these findings to develop training programs for novice BCMs and improve their capacity to provide quality care to patients undergoing bariatric surgery.
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Affiliation(s)
- Chunqun Li
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Xue Gong
- School of Medical Technology and Nursing, Shenzhen Polytechnic University, Xili Lake, Nanshan District, Shenzhen, Guangdong Province, China
| | - Zhuoqi Wei
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Lilian Gao
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Yitka Graham
- Helen McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland, SR1 3SD, UK.
- Bariatric Surgical Unit, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, SR4 7TP, UK.
- Faculty of Psychology, University of Anahuac, Mexico City, Mexico.
- Department of Biomedical Sciences, University Hospital Austral, Buenos Aires, Argentina.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong Province, China.
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Bandlamudi N, Holt G, Graham Y, O'Kane M, Singhal R, Parmar C, Sakran N, Mahawar K, Pouwels S, Potluri S, Madhok B. Malnutrition Following One-Anastomosis Gastric Bypass: a Systematic Review. Obes Surg 2023; 33:4137-4146. [PMID: 37917389 DOI: 10.1007/s11695-023-06907-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
Severe malnutrition following one-anastomosis gastric bypass (OAGB) remains a concern. Fifty studies involving 49,991 patients were included in this review. In-hospital treatment for severe malnutrition was needed for 0.9% (n = 446) of patients. Biliopancreatic limb (BPL) length was 150 cm in five (1.1%) patients, > 150 cm in 151 (33.9%), and not reported in 290 (65%) patients. OAGB was revised to normal anatomy in 126 (28.2%), sleeve gastrectomy in 46 (10.3%), Roux-en-Y gastric bypass in 41 (9.2%), and shortening of BPL length in 17 (3.8%) patients. One hundred fifty-one (33.8%) patients responded to treatment; ten (2.2%) did not respond and was not reported in 285 (63.9%) patients. Eight (0.02%) deaths were reported. Standardisation of the OAGB technique along with robust prospective data collection is required to understand this serious problem.
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Affiliation(s)
- Nanda Bandlamudi
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK.
| | - Guy Holt
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK
| | - Yitka Graham
- Bariatric Surgical Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK
- Faculty of Psychology, University of Anahuac, Huixquilucan Municipality, 01840, Anahuac, Mexico
- Department of Biomedical Sciences, Austral University, 1629, Buenos Aires, Argentina
| | - Mary O'Kane
- Dietetic Department, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - Rishi Singhal
- Bariatric and Upper GI Unit, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, B9 5SS, UK
| | - Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, N19 5NF, UK
| | - Nasser Sakran
- Department of Surgery, Holy Family Hospital, Nazareth, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Kamal Mahawar
- Bariatric Surgical Unit, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
- Department of General, Abdominal and Minimally Invasive Surgery, Helios Klinikum Krefeld, Krefeld, NRW, Germany
| | - Sudha Potluri
- Queens Hospital Burton, University Hospital of Derby and Burton NHS Foundation Trust, Burton, DE13 0RB, UK
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK
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Johnston L, Jackson K, Hilton C, Graham Y. The forgotten patient: A psychological perspective on the implementation of bariatric surgery guidelines. Obes Sci Pract 2023; 9:538-547. [PMID: 37810523 PMCID: PMC10551119 DOI: 10.1002/osp4.670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/04/2023] [Accepted: 03/17/2023] [Indexed: 10/10/2023] Open
Abstract
There is strong evidence demonstrating the impact of bariatric surgery on weight-loss and comorbidity improvement. In the UK, there is specific guidance to facilitate the assessment of a person's suitability for bariatric surgery. This paper highlights the clinical reality of routinely implementing this guidance, supported by literature and the perspectives of practicing psychologists. The consequences of the implementation of clinical guidelines within the context of the typical biopsychosocial profile of those referred for bariatric surgery are discussed. The ramifications of a screening approach rather than a clinical formulation-based approach to assessment, impact of a possible unconscious bias in commissioning and an overemphasis on a biomedical model approach to treatment are also presented. These contextual factors are argued to contribute to a population of "forgotten patients" that is, patients who have been assessed as not suitable for bariatric surgery, and thus "stuck" in their journey toward better health. For these individuals the only option left are energy balance only approaches, which are the very same approaches to weight-loss and comorbidity improvement that have been attempted, often for many years. Not only have these approaches not resulted in weight-loss and health improvement, they also fail to address the underlying psychological causes of obesity. Consequently, this lack of support means that patients continue to suffer from poor quality of life, with no clear pathway to improved health and wellbeing. This paper illuminates the clear gaps in weight management service provision, the implementation of guidelines in practice, and offers practical suggestions to reduce the unintended consequences of clinical guidelines for bariatric surgery.
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Affiliation(s)
- Lynne Johnston
- Halley Johnston Associated LtdWhitley BayUK
- Golden Jubilee University National HospitalScotlandUK
- Helen McArdle Nursing and Care Research InstituteFaculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
- South Tyneside and Sunderland NHS Foundation TrustSunderlandUK
| | | | - Charlotte Hilton
- South Tyneside and Sunderland NHS Foundation TrustSunderlandUK
- Hilton Health ConsultancyDerbyshireUK
- University of FloridaGainesvilleFloridaUSA
- University of DerbyDerbyUK
| | - Yitka Graham
- Helen McArdle Nursing and Care Research InstituteFaculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
- South Tyneside and Sunderland NHS Foundation TrustSunderlandUK
- Faculty of PsychologyUniversity of Anahuac MexicoMexico CityMexico
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Martinino A, Puri O, Pereira JPS, Owen E, Chatterjee S, Abouelazayem M, Yang W, Mulita F, Graham Y, Parmar C, Ramnarain D, Isik A, Yadav S, Budihal BR, Kashyap S, Aloulou M, Kundu M, Ibrahimli A, Rajesh E, Silva RGD, Bhatt G, Malhotra K, Magnani R, Smeenk FWJM, Pouwels S. The ASGLOS Study: A global survey on how predatory journals affect scientific practice. Dev World Bioeth 2023. [PMID: 37584521 DOI: 10.1111/dewb.12421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 08/17/2023]
Abstract
Predatory journals and conferences are an emerging problem in scientific literature as they have financial motives, without guaranteeing scientific quality and exposure. The main objective of the ASGLOS project is to investigate the predatory e-email characteristics, management, and possible consequences and to analyse the extent of the current problem at each academic level. To collect the personal experiences of physicians' mailboxes on predatory publishing, a Google Form® survey was designed and disseminated from September 2021 to April 2022. A total of 978 responses were analysed from 58 countries around the world. A total of 64.8% of participants indicated the need for 3 or fewer emails to acquire a criticality view in distinguishing a real invitation from a spam, while 11.5% still have doubt regardless of how many emails they get. The AGLOS Study clearly highlights the problem of academic e-mail spam by predatory journals and conferences. Our findings signify the importance of providing academic career-oriented advice and organising training sessions to increase awareness of predatory publishing for those conducting scientific research.
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Cox J, Graham Y, Hayes C. Patient-reported outcome measures (PROMs) in radiology: embracing the metrics of change. Clin Radiol 2023; 78:565-567. [PMID: 37087314 DOI: 10.1016/j.crad.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 04/24/2023]
Affiliation(s)
- J Cox
- Department of Radiology, County Durham and Darlington NHS FT, UHND, North Rd, Durham DH1 5TW, UK; Faculty of Health Sciences and Wellbeing, University of Sunderland, Chester Road, Sunderland SR1 3SD, UK.
| | - Y Graham
- Department of Radiology, County Durham and Darlington NHS FT, UHND, North Rd, Durham DH1 5TW, UK; Faculty of Health Sciences and Wellbeing, University of Sunderland, Chester Road, Sunderland SR1 3SD, UK
| | - C Hayes
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Chester Road, Sunderland SR1 3SD, UK
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Graham Y, Fox A, Mahawar K, Parrott J, Khalil F, Hayes C. Developing a long-term follow up service for bariatric surgical patients in the community: Patient and professional perspectives. Obes Sci Pract 2023; 9:346-354. [PMID: 37546285 PMCID: PMC10399522 DOI: 10.1002/osp4.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/25/2022] [Accepted: 12/18/2022] [Indexed: 08/08/2023] Open
Abstract
Background In the UK, bariatric surgical patients are followed up for 2 years post-operatively in hospital settings, before being discharged into General Practice for long-term follow-up. Presently, there is ambiguous guidance as to what should be included in a community-based bariatric surgical follow-up service. The aim of the study was to understand, from both patient and professional perspectives, what is needed to support the long-term management of bariatric surgical patients in community-based settings. Methods Post-surgical bariatric patients and General Practice staff were recruited from an area in the UK which has an National Health Service (NHS) hospital providing a high-volume and established bariatric surgical service. Data was collected through semi-structured interviews. A thematic analytic framework was used to construct eight themes which illuminated the participants' experiences. The study took place between March and December 2021. Findings Thirty participants (14 patients and 16 healthcare professionals) were recruited to the study. The study revealed the lack of a framework for delivery of a long-term follow up service was frustrating to both patients and professionals. Patient participants reported needing more support, especially dietetic and psychological input, and professionals stated they had little knowledge about bariatric surgical care, and what was needed to provide optimal care, but wanted to provide quality patient care. Conclusion Long-term follow up of bariatric surgical patients is an important issue which needs addressing. This study illuminates both the patient and professional perspectives on developing a pragmatic, community-based service which meets the needs of patients and considers the need to incorporate such a service into existing infrastructures without adding additional demands on General Practice.
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Affiliation(s)
- Yitka Graham
- Faculty of Health Sciences and WellbeingHelen McArdle Nursing and Care Research InstituteUniversity of SunderlandSunderlandUK
- Sunderland Clinical Commissioning GroupSunderlandUK
- Faculty of PsychologyUniversity of Anahuac MexicoMexico CityMexico
| | - Ann Fox
- Faculty of Health Sciences and WellbeingHelen McArdle Nursing and Care Research InstituteUniversity of SunderlandSunderlandUK
- Sunderland Clinical Commissioning GroupSunderlandUK
| | - Kamal Mahawar
- Faculty of Health Sciences and WellbeingHelen McArdle Nursing and Care Research InstituteUniversity of SunderlandSunderlandUK
- Bariatric Surgical UnitSunderland Royal HospitalSunderlandUK
| | - Julie Parrott
- Faculty of Health Sciences and WellbeingHelen McArdle Nursing and Care Research InstituteUniversity of SunderlandSunderlandUK
- Department of Clinical and Preventive Nutrition SciencesRutgers UniversityNew BrunswickNew JerseyUSA
| | - Fadi Khalil
- Sunderland Clinical Commissioning GroupSunderlandUK
- Broadway Medical PracticeSpringwell Health CentreSunderlandUK
| | - Catherine Hayes
- Faculty of Health Sciences and WellbeingHelen McArdle Nursing and Care Research InstituteUniversity of SunderlandSunderlandUK
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Massey L, Siddiqui MR, Shirazi S, Hayes C, Graham Y, Vig S. Perceived impact of equality and equity in medical education by junior doctors in the UK. Postgrad Med J 2023; 99:904-912. [PMID: 37117045 DOI: 10.1136/pmj-2022-141893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/22/2022] [Indexed: 11/03/2022]
Abstract
This exploratory study was undertaken to provide an insight into issues of equality and equity that UK junior doctors perceive in relation to being able to achieve a work-life balance within educational and clinical practice. A survey with 443 junior doctors was conducted between May 2018 and September 2019. Thematic analysis of open question responses alongside correlative analyses were used to highlight issues in equity and equality faced by junior doctors. The survey revealed 77% were junior doctors in Health Education England (HEE) posts. 59% were noti n personal relationships, 60% had no children, 38% perceived the national recruitment process as helpful and 70% perceived HEE did not impact on their training. 72% had no personal barriers and 77% felt the role eas not a barrier. 1% identified no barriers. The research raised important implications for redress of equality and equity issues for all within inclusive postgraduate training in the UK. KEY MESSAGES
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Affiliation(s)
- Lisa Massey
- Department of Colorectal Surgery, Royal Devon and Exeter Hospital, Exeter, UK
- University of Exeter, Exeter, UK
| | | | - Shalini Shirazi
- Department of General Surgery, Croydon University Hospital, Croydon, UK
| | - Catherine Hayes
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Stella Vig
- Department of General Surgery, Croydon University Hospital, Croydon, UK
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8
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Hayes C, Fox A, Scott-Thomas J, Graham Y. Pressure ulcer prevention in practice. Br J Community Nurs 2023; 28:S14-S21. [PMID: 37262096 DOI: 10.12968/bjcn.2023.28.sup6.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pressure ulcer avoidance in the context of care has the potential to improve the quality and longevity of lives for those living in residential and non-residential care home settings. This paper reports on an educational intervention in the North East of England, which focused on the initial benchmarking of self-reported knowledge levels of healthcare workers, who regularly work with people living within this context. Using a longitudinal study design, a series of three questionnaires were used to collate data from research participants. The study revealed a disparity between what healthcare workers perceived their knowledge to be versus what it was, in terms of application to practice at the front line of patient care. The study reveals that confidence levels in dealing with pressure ulceration had been significantly altered by the training session that was being implemented. It also raised concerns on the methodological approaches being used in the education and training of care staff, which should ideally lead them to be proactive with patients in their care. The study provides an insight into the need for a strategic and targeted approach to pressure ulceration avoidance education, which is tailored to individual learning needs through supervision and mentorship as part of clinical education.
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Affiliation(s)
- Catherine Hayes
- Professor of Health Professions Pedagogy and Scholarship, University of Sunderland, Faculty of Health Sciences and Wellbeing
| | - Ann Fox
- Executive Director of Nursing, NHS Sunderland CCG
| | - Jeanette Scott-Thomas
- Executive Director of Nursing, Quality and Patient Safety at South Tyneside Clinical Commissioning Group
| | - Yitka Graham
- Associate Professor of Health Services Research and Head of the Helen McCardle Nursing and Research Care Institute
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Jerome E, Giet L, Wiggins T, Graham Y, Pouwels S, Rajeev Y, Madhok B, Bhandari M, Ahmed S, Ludwig C, Hanif W, Mahawar K, Singhal R. Global trends in BMS research using publication as a surrogate marker: A 30 year review. Obes Res Clin Pract 2023:S1871-403X(23)00041-8. [PMID: 37188620 DOI: 10.1016/j.orcp.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Abstract
Obesity is a global pandemic with increasing prevalence and long-term negative health outcomes. Bariatric metabolic surgery (BMS) is the most effective treatment option for achieving long-term weight loss. A systematic search was performed from 1990 to 2020 of BMS procedures using standardised groups. Data were collected on operation type reported, country and continent of publication. North America and Europe were the leading contributors to global publications in BMS, producing 41.3 % (n = 4931) and 37.1 % (n = 4436) of publications respectively, with increasing publications from Asia. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) were the most studied procedure types with number of publications continuing to increase over time. A plateau and downward trend was seen for Laparoscopic Adjustable Gastric Band (LAGB) publication from 2015 to 2019. An increase in emerging/experimental techniques over the past decade is observed.
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Affiliation(s)
- Ellen Jerome
- Upper GI Unit, Worcestershire Royal Hospital, Worcestershire Acute Hospitals NHS Trust, Charles Hastings Way, Worcester, UK; Department of Hepatopancreatobiliary Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Leeying Giet
- Department of Hepatopancreatobiliary Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Tom Wiggins
- Department of Bariatric Surgery, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Yitka Graham
- Department of Health Services Research, University of Sunderland, Sunderland, UK
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Yashasvi Rajeev
- Paediatric Department, Hillingdon Hospital, Hillingdon Hospital NHS Foundation Trust, London, UK
| | - Brijesh Madhok
- Department of Upper Gastrointestinal Surgery, University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Mohit Bhandari
- Department of Bariatric Surgery, Bhandari Hospital and Research Centre, Indore, India
| | - Saleem Ahmed
- Department of General Surgery, Tan Tock Seng Hospital, National Healthcare Group, Singapore
| | - Christian Ludwig
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Wasim Hanif
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK; Diabetes Department, University Hospital Birmingham and Birmingham City University, UK
| | - Kamal Mahawar
- Department of Surgery, South Tyneside and Sunderland NHS Trust, Sunderland, UK; University of Sunderland, Sunderland, UK
| | - Rishi Singhal
- Department of Bariatric Surgery, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; Healthier Weight, UK.
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Sherf-Dagan S, Biton R, Ribeiro R, Kessler Y, Ben-Porat T, Raziel A, Rossoni C, Kais H, Bragança R, Santos Z, Goitein D, Viveiros O, Graham Y, Mahawar K, Sakran N. Gastrointestinal reported outcomes following One Anastomosis Gastric Bypass based on a multicenter study. Expert Rev Gastroenterol Hepatol 2023:1-9. [PMID: 37165861 DOI: 10.1080/17474124.2023.2211766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To describe gastrointestinal-related side-effects reported following One Anastomosis Gastric Bypass (OAGB). METHODS A multicenter study among OAGB patients across Israel (n=277) and Portugal (n=111) who were recruited to the study based on time elapsed since surgery was performed. An online survey with information on demographics, anthropometrics, medical conditions, and gastrointestinal outcomes was administered in both countries simultaneously. RESULTS Respondents from Israel (pre-surgery age of 41.6±11.0 years, 75.8% females) and Portugal (pre-surgery age of 45.6±12.3 years, 79.3% females) presented mean excess weight loss of 51.0±19.9 and 62.4±26.5%, 89.0±22.0 and 86.2±21.4%, and 89.9±23.6 and 98.2±20.9% (P<0.001 for both countries), at 1-6 months, 6-12 months, and 1-5 years post-surgery, respectively. Median Gastrointestinal Symptom Rating Scale score was similar between time elapsed since surgery groups among respondents from Israel and Portugal (≤1.97 and ≤2.12). A notable proportion of respondents from Israel and Portugal at all time points reported 1-3 bowel movements per day (≤62.8 and ≤87.6%), Bristol stool scale categories which represent diarrhea-like stools (≤51.9 and ≤56.3%), having discomfort due to flatulence (≤79.4 and ≤90.2%), and mild to severe dyspepsia symptoms (≤50.5 and ≤73.0%). CONCLUSIONS A notable proportion of OAGB patients might experience certain gastrointestinal symptoms postoperatively, including flatulence, dyspepsia, and diarrhea-like stools.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Nutrition, Assuta Medical Center, Tel Aviv, Israel
| | - Reut Biton
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rui Ribeiro
- Multidisciplinary Center for Obesity Treatment - Hospital Lusíadas Amadora, Amadora, Portugal
- General Surgery Department Coordinator - Hospital Lusíadas Amadora, Amadora, Portugal
| | - Yafit Kessler
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
| | - Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, Canada
- Montreal Behavioural Medicine Centre (MBMC), Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, Canada
| | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
| | - Carina Rossoni
- Multidisciplinary Center for Obesity Treatment - Hospital Lusíadas Amadora, Amadora, Portugal
- Institute of Environmental Health, Faculty Medicine, University of Lisbon, Lisbon, Portugal
| | - Hasan Kais
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of surgery, Shamir Medical Center, Zerifin, Israel
| | - Rossela Bragança
- Multidisciplinary Center for Obesity Treatment - Hospital Lusíadas Amadora, Amadora, Portugal
| | - Zélia Santos
- Multidisciplinary Center for Obesity Treatment - Hospital Lusíadas Amadora, Amadora, Portugal
- H&TRC-Health & Technology Research Center (ESTeSL)-Escola Superior de Tecnologia da Saúde de Lisboa, Lisbon, Portugal
| | - David Goitein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
- Department of Surgery C, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Octávio Viveiros
- Multidisciplinary Center for Obesity Treatment - Hospital Lusíadas Amadora, Amadora, Portugal
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland, UK
| | - Nasser Sakran
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
- Department of Surgery, Holy Family Hospital, Nazareth, Israel
- The Azrieli Faculty of Medicine Safed, Bar-Ilan University, Ramat Gan, Israel
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11
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Sherf-Dagan S, Biton R, Ribeiro R, Kessler Y, Raziel A, Rossoni C, Kais H, Bragança R, Santos Z, Goitein D, Viveiros O, Graham Y, Mahawar K, Sakran N, Ben-Porat T. Nutritional and Lifestyle Behaviors Reported Following One Anastomosis Gastric Bypass Based on a Multicenter Study. Nutrients 2023; 15:nu15061515. [PMID: 36986245 PMCID: PMC10053792 DOI: 10.3390/nu15061515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
This study aimed to describe nutritional and lifestyle parameters following one-anastomosis gastric bypass (OAGB). A multicenter study among OAGB patients across Israel (n = 277) and Portugal (n = 111) was performed. Patients were approached according to the time elapsed since surgery. An online survey with information regarding demographics, anthropometrics, and nutritional and lifestyle aspects was administered in both countries simultaneously. Respondents from Israel (pre-surgery age of 41.6 ± 11.0 years, 75.8% females) and Portugal (pre-surgery age of 45.6 ± 12.3 years, 79.3% females) reported changes in their appetite (≤94.0% and ≤94.6%), changes in their taste (≤51.0 and ≤51.4%), and intolerance to specific foods (i.e., red meat, pasta, bread, and rice). Bariatric surgery-related eating recommendations were generally followed well, but a trend toward lower adherence was evident in groups with longer time elapsed since surgery in both countries. Most respondents from Israel and Portugal reported participation in follow-up meetings with a surgeon (≤94.0% and 100%) and a dietitian (≤92.6% and ≤100%), while far fewer reported participation in any follow-up meeting with a psychologist/social worker (≤37.9% and ≤56.1%). Patients following OAGB might experience changes in appetite, taste, and intolerance to specific foods. Adherence to bariatric surgery-related eating recommendations is not always satisfying, especially in the longer term post-surgery.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Department of Nutrition, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Reut Biton
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
| | - Rui Ribeiro
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- General Surgery Department Coordinator, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Yafit Kessler
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Carina Rossoni
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- Institute of Environmental Health, Faculty Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Hasan Kais
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Division of Surgery, Shamir Medical Center, Zerifin 70300, Israel
| | - Rossela Bragança
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Zélia Santos
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- H&TRC-Health & Technology Research Center, (ESTeSL) Escola Superior de Tecnologia da Saúde de Lisboa, 1990-096 Lisbon, Portugal
| | - David Goitein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
- Department of Surgery C, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel
| | - Octávio Viveiros
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Nasser Sakran
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
- Department of Surgery, Holy Family Hospital, Nazareth 1600100, Israel
- The Azrieli Faculty of Medicine Safed, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QC H4B 1R6, Canada
- Montreal Behavioural Medicine Centre (MBMC), Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
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12
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Graham Y, Hayes C, Mahawar K, Tahrani A, López Landiribar JM, Martinez P. Social Aspects of Bariatric Surgery. Obesity, Bariatric and Metabolic Surgery 2023:1299-1310. [DOI: 10.1007/978-3-030-60596-4_116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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13
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Graham Y. Commentary: Navigating data governance approvals to use routine health and social care data to evidence the hidden population with severe obesity: a case study from a clinical academic's perspective. J Res Nurs 2022; 27:637-638. [PMID: 36405807 PMCID: PMC9669931 DOI: 10.1177/17449871221123858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- Yitka Graham
- Professor of Health Services Research and Head, Helen
McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland,
UK
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14
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Singhal R, Wiggins T, Pouwels S, Rajeev Y, Madhok B, Hanif W, Tahrani AA, Graham Y, Ludwig C, Mahawar K. Handling of the Covid-19 Pandemic and Its Effects on Bariatric Surgical Practice: Analysis of GENEVA Study Database. Obes Surg 2022; 32:3908-3921. [PMID: 36282429 PMCID: PMC9592878 DOI: 10.1007/s11695-022-06267-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic led to a worldwide suspension of bariatric and metabolic surgery (BMS) services. The current study analyses data on patterns of service delivery, recovery of practices, and protective measures taken during the COVID-19 pandemic by bariatric teams. MATERIALS AND METHODS The current study is a subset analysis of the GENEVA study which was an international cohort study between 01/05/2020 and 31/10/2020. Data were specifically analysed regarding the timing of BMS suspension, patterns of service recovery, and precautionary measures deployed. RESULTS A total of 527 surgeons from 439 hospitals in 64 countries submitted data regarding their practices and handling of the pandemic. Smaller hospitals (with less than 200 beds) were able to restart BMS programmes more rapidly (time to BMS restart 60.8 ± 38.9 days) than larger institutions (over 2000 beds) (81.3 ± 30.5 days) (p = 0.032). There was a significant difference in the time interval between cessation/reduction and restart of bariatric services between government-funded practices (97.1 ± 76.2 days), combination practices (84.4 ± 47.9 days), and private practices (58.5 ± 38.3 days) (p < 0.001). Precautionary measures adopted included patient segregation, utilisation of personal protective equipment, and preoperative testing. Following service recovery, 40% of the surgeons operated with a reduced capacity. Twenty-two percent gave priority to long waiters, 15.4% gave priority to uncontrolled diabetics, and 7.6% prioritised patients requiring organ transplantation. CONCLUSION This study provides global, real-world data regarding the recovery of BMS services following the COVID-19 pandemic.
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Affiliation(s)
- Rishi Singhal
- Upper GI Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B9 5SS, UK.
| | - Tom Wiggins
- Upper GI Unit, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B9 5SS, UK
| | - Sjaak Pouwels
- Department of Surgery, Agaplesion Bethanien Krankenhaus, Frankfurt am Main , Hessen, Germany
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Yashasvi Rajeev
- Pediatric Accidents and Emergencies Department, Northwick Park Hospital, London Northwest University Healthcare NHS Trust, London, UK
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Wasim Hanif
- Diabetes Department, University Hospital Birmingham UK and Birmingham City University, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
| | - Abd A Tahrani
- Diabetes Department, University Hospital Birmingham UK and Birmingham City University, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
- Clinical Drug Development, Novo Nordisk, Søborg, Denmark
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Facultad de Psycologia, Universidad Anahuac Mexico, Mexico City, Mexico
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | - Christian Ludwig
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
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15
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Carpenter S, Graham Y, Kulkarni T, Lyburn I, Vinnicombe S, Sharma S, Sharma N, Lowes S. A national survey investigating the impact of the COVID-19 pandemic on core and higher breast radiology training in the UK. Clin Radiol 2022; 77:749-758. [PMID: 35981922 PMCID: PMC9377933 DOI: 10.1016/j.crad.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022]
Abstract
AIM To investigate the impact of the COVID-19 pandemic on core and higher breast radiology training in the UK from the perspective of trainees and new consultants. MATERIALS AND METHODS A survey comprising 25 questions was distributed to UK radiology trainees via the regional Junior Radiologists Forum representatives under the auspices of the British Society of Breast Radiology (BSBR). RESULTS Sixty-nine eligible responses were received representing all UK training regions. Fifty-five per cent of respondents completing either a core or higher breast rotation felt that the pandemic had a negative effect on their breast training. There was an overall reduction in exposure to the key breast imaging methods when rotations took place during the pandemic. Completing a core breast rotation during the pandemic was less likely to attract trainees to higher breast training. Three out of four breast radiology consultants in their first year after receiving their Certificate of Completion of Training (CCT) felt the pandemic reduced their preparedness for becoming consultants. Positive outcomes included the increased use of online educational resources and remote multidisciplinary meetings. CONCLUSIONS As well as having a negative impact on breast radiology training overall, the pandemic has had a detrimental effect on attracting trainees to breast radiology as a future career. It is of key importance that trainees have a positive core breast rotation as this experience appears central to many trainees' decisions to pursue higher breast training. Increased use of online learning resources has also been positively received and is a valuable approach to learning that can be maintained in the longer term.
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Affiliation(s)
- S Carpenter
- Breast Screening and Assessment Unit, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK
| | - Y Graham
- Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, SR1 3SD, UK
| | - T Kulkarni
- Nightingale Centre & Genesis Prevention Centre, University Hospital of South Manchester, M23 9LT, UK
| | - I Lyburn
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AN, UK; Cobalt Medical Charity, Linton House, Thirlestaine Rd, Cheltenham, GL53 7AS, UK; Cranfield University, College Rd, Cranfield, Wharley End, Bedford, MK43 0AL, UK
| | - S Vinnicombe
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AN, UK
| | - S Sharma
- Liverpool University Hospitals NHS Foundation Trust, Prescot St, Liverpool, L7 8XP, UK
| | - N Sharma
- Breast Unit, St James's University Hospital, Leeds, LS9 7TF, UK
| | - S Lowes
- Breast Screening and Assessment Unit, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
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16
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Singhal R, Omar I, Madhok B, Rajeev Y, Graham Y, Mahawar K. SP2.1.1 Safety of Bariatric Surgery in The Older Patients During the COVID-19 Pandemic. Br J Surg 2022. [PMCID: PMC9384814 DOI: 10.1093/bjs/znac247.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The progressive growth of the older patients with obesity represents a challenge to the weight management teams. Although initially, old age was a relative contraindication to the surgical option, current advances in laparoscopic techniques and perioperative optimization protocols have changed the old notion. However, the performance of bariatric procedures in the older patients during the ongoing COVID-19 pandemic carries a potential risk. This study aimed to assess the safety of bariatric surgery (BS) in older patients during the pandemic. Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - older patients ≥65-year-old (Group I) and young < 65-year-old (Group II). Two groups were compared for 30-day morbidity and mortality. Results We included 7084 patients, the mean age was 40.35±11.9 years, and 5197 (73.4%) were females. The mean preoperative weight and BMI were 119.49±24.4 Kgs and 43.03±6.9 Kg/m2, respectively. The overall comorbidities were significantly higher in Group I, p= <0.001. In Group II, 14.8% were current smokers, compared to 7.4% of Group I. The complications in Group I were significantly higher (11.4%) compared to Group II (6.6%), p= 0.022. However, the mortality rate and COVID-19 infection within 30 days were not significantly different between the two groups. Conclusions Bariatric surgery during the COVID-19 pandemic in the older patients (≥65 years old) is associated with a higher complication rate than the younger age group. However, the mortality and postoperative COVID-19 infection rates are comparable to the younger age group.
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Affiliation(s)
- Rishi Singhal
- Upper GI unit, University Hospital Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Islam Omar
- General Surgery Department, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, North West, UK
| | - Brijesh Madhok
- Upper GI unit, University Hospital of Derby and Burton NHS Foundation Trust, Derby, East Midlands, UK
| | - Yashasvi Rajeev
- Pediatric Accidents and Emergencies Department, London Northwest University Healthcare NHS Trust, London, UK
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, North East, UK,Faculdad de Pyscologia, Universidad Anahuac, Anahuac, Mexico
| | - Kamal Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, North East, UK,University of Sunderland, Sunderland, UK
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17
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Omar I, Miller K, Madhok B, Amr B, Singhal R, Graham Y, Pouwels S, Abu Hilal M, Aggarwal S, Ahmed I, Aminian A, Ammori BJ, Arulampalam T, Awan A, Balibrea JM, Bhangu A, Brady RR, Brown W, Chand M, Darzi A, Gill TS, Goel R, Gopinath BR, Henegouwen MVB, Himpens JM, Kerrigan DD, Luyer M, Macutkiewicz C, Mayol J, Purkayastha S, Rosenthal RJ, Shikora SA, Small PK, Smart NJ, Taylor MA, Udwadia TE, Underwood T, Viswanath YK, Welch NT, Wexner SD, Wilson MSJ, Winter DC, Mahawar KK. The first international Delphi consensus statement on Laparoscopic Gastrointestinal surgery. Int J Surg 2022; 104:106766. [PMID: 35842089 DOI: 10.1016/j.ijsu.2022.106766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/16/2022] [Accepted: 06/28/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Laparoscopic surgery has almost replaced open surgery in many areas of Gastro-Intestinal (GI) surgery. There is currently no published expert consensus statement on the principles of laparoscopic GI surgery. This may have affected the training of new surgeons. This exercise aimed to achieve an expert consensus on important principles of laparoscopic GI surgery. METHODS A committee of 38 international experts in laparoscopic GI surgery proposed and voted on 149 statements in two rounds following a strict modified Delphi protocol. RESULTS A consensus was achieved on 133 statements after two rounds of voting. All experts agreed on tailoring the first port site to the patient, whereas 84.2% advised avoiding the umbilical area for pneumoperitoneum in patients who had a prior midline laparotomy. Moreover, 86.8% agreed on closing all 15 mm ports irrespective of the patient's body mass index. There was a 100% consensus on using cartridges of appropriate height for stapling, checking the doughnuts after using circular staplers, and keeping the vibrating blade of the ultrasonic energy device in view and away from vascular structures. An 84.2% advised avoiding drain insertion through a ≥10 mm port site as it increases the risk of port-site hernia. There was 94.7% consensus on adding laparoscopic retrieval bags to the operating count and ensuring any surgical specimen left inside for later removal is added to the operating count. CONCLUSION Thirty-eight experts achieved a consensus on 133 statements concerning various aspects of laparoscopic GI Surgery. Increased awareness of these could facilitate training and improve patient outcomes.
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Affiliation(s)
- Islam Omar
- Wirral University Teaching Hospital NHS Foundation Trust, UK.
| | - Karl Miller
- King's College Hospital London, Dubai, United Arab Emirates
| | - Brijesh Madhok
- University Hospitals of Derby & Burton NHS Foundation Trust, UK
| | - Bassem Amr
- Taunton & Somerset NHS Foundation Trust, UK
| | - Rishi Singhal
- University Hospital Birmingham NHS Foundation Trust, UK
| | - Yitka Graham
- University of Sunderland, Sunderland, UK; Universidad Anahuac, Anahuac, Mexico
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Mohammad Abu Hilal
- Department of Surgery, Poliambulanza Hospital Brescia, Italy; Southampton University Hospitals NHS Trust, UK
| | - Sandeep Aggarwal
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | - Ali Aminian
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Altaf Awan
- University Hospitals of Derby & Burton NHS Foundation Trust, UK
| | - José María Balibrea
- Department of Gastrointestinal Surgery, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | | | - Wendy Brown
- Monash University Department of Surgery, Alfred Health, Australia
| | | | | | | | | | | | - Mark van Berge Henegouwen
- Department of Surgery, Amsterdam UMC, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | | | | | - Julio Mayol
- Hospital Clinico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Des C Winter
- St Vincent's University Hospital, Dublin, Ireland
| | - Kamal K Mahawar
- University of Sunderland, Sunderland, UK; Bariatric Unit, South Tyneside and Sunderland Foundation Trust, UK
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18
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Singhal R, Omar I, Madhok B, Rajeev Y, Graham Y, Tahrani AA, Ludwig C, Wiggins T, Mahawar K. Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic. Obes Surg 2022; 32:1-13. [PMID: 35513762 PMCID: PMC9071248 DOI: 10.1007/s11695-022-06067-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
Background Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort. Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups — patients ≥ 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality. Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 ± 2.5 years, 119.5 ± 24.5 kg, and 43 ± 7 in Group I and 39.8 ± 11.3 years, 117.7±20.4 kg, and 43.7 ± 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I (11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups. Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those ≥ 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups. Graphical abstract ![]()
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Affiliation(s)
- Rishi Singhal
- Upper GI unit, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Bordesley Green East, Birmingham, West Midlands, B9 5SS, UK.
- Healthier Weight, Birmingham, UK.
| | - Islam Omar
- General Surgery Department, Wirral University Teaching Hospital NHS Foundation Trust, North West, Wirral, UK
| | - Brijesh Madhok
- Upper GI unit, University Hospital of Derby and Burton NHS Foundation Trust, East Midlands, Derby, UK
| | - Yashasvi Rajeev
- Pediatric Accidents and Emergencies Department, London Northwest University Healthcare NHS Trust, London, UK
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, North East, Sunderland, UK
- Faculdad de Pyscologia, Universidad Anahuac, Anahuac, Naucalpan de Juárez, Mexico
| | - Abd A Tahrani
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes, and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Christian Ludwig
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands, UK
| | - Tom Wiggins
- Upper GI unit, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Bordesley Green East, Birmingham, West Midlands, B9 5SS, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, North East, Sunderland, UK
- Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, North East, Sunderland, UK
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19
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Sharma M, Nayar R, Graham Y, Parretti HM, Abbott S, Tahrani A, Miras AD, Madhok B, Singhal R, Mahawar K. Risk of Harm from Use of Sodium-Glucose Co-Transporter-2 (SGLT-2) Inhibitors in Patients Pre or Post Bariatric Surgery. Obes Surg 2022; 32:2469-2470. [PMID: 35482224 DOI: 10.1007/s11695-022-06044-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Mitesh Sharma
- Department of Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK. .,Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
| | - Rahul Nayar
- Department of Medicine, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Yitka Graham
- Department of Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.,Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | | | - Sally Abbott
- Department of Dietetics, University Hospital Coventry and Warwickshire NHS Trust, Warwickshire, UK
| | - Abd Tahrani
- Clinical Drug Development, Novo Nordisk, Søborg, Denmark & Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Alexander D Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | | | - Kamal Mahawar
- Department of Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.,Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
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20
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Graham Y, Hayes C, Cox J, Mahawar K, Fox A, Yemm H. A systematic review of obesity as a barrier to accessing cancer screening services. Obes Sci Pract 2022; 8:715-727. [DOI: 10.1002/osp4.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Yitka Graham
- Faculty of Health Sciences and Wellbeing School of Nursing and Health Sciences Helen McArdle Nursing and Care Research Institute Sunderland UK
- Department of General Surgery South Tyneside and Sunderland NHS Foundation Trust Sunderland UK
- Sunderland Clinical Commissioning Group Sunderland UK
- Faculty of Psychology University of Anahuac Mexico City Mexico
| | - Catherine Hayes
- Faculty of Health Sciences and Wellbeing School of Nursing and Health Sciences Helen McArdle Nursing and Care Research Institute Sunderland UK
| | - Julie Cox
- Faculty of Health Sciences and Wellbeing School of Nursing and Health Sciences Helen McArdle Nursing and Care Research Institute Sunderland UK
- Department of Radiology South Tyneside and Sunderland NHS Foundation Trust Sunderland UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing School of Nursing and Health Sciences Helen McArdle Nursing and Care Research Institute Sunderland UK
- Department of General Surgery South Tyneside and Sunderland NHS Foundation Trust Sunderland UK
| | - Ann Fox
- Faculty of Health Sciences and Wellbeing School of Nursing and Health Sciences Helen McArdle Nursing and Care Research Institute Sunderland UK
- Sunderland Clinical Commissioning Group Sunderland UK
| | - Heather Yemm
- Faculty of Health Sciences and Wellbeing School of Nursing and Health Sciences Helen McArdle Nursing and Care Research Institute Sunderland UK
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21
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Scarano Pereira JP, Owen E, Martinino A, Akmal K, Abouelazayem M, Graham Y, Weiner S, Sakran N, Dekker LR, Parmar C, Pouwels S. Epicardial adipose tissue, obesity and the occurrence of atrial fibrillation: an overview of pathophysiology and treatment methods. Expert Rev Cardiovasc Ther 2022; 20:307-322. [PMID: 35443854 DOI: 10.1080/14779072.2022.2067144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Obesity is a chronic disease, which has significant health consequences and is a staggering burden to health care systems. Obesity can have harmful effects on the cardiovascular system, including heart failure, hypertension, coronary heart disease, and atrial fibrillation (AF). One of the possible substrates might be epicardial adipose tissue (EAT), which can be the link between AF and obesity. EAT is a fat deposit located between the myocardium and the visceral pericardium. Numerous studies have demonstrated that EAT plays a pivotal role in this relationship regarding atrial fibrillation. AREAS COVERED This review will focus on the role of obesity and the occurrence of atrial fibrillation (AF) and examine the connection between these and epicardial adipose tissue (EAT). The first part of this review will explain the pathophysiology of EAT and its association with the occurrence of AF. Secondly, we will review bariatric and metabolic surgery and its effects on EAT and AF. EXPERT COMMENTARY In this review, the epidemiology, pathophysiology, and treatments methods of AF are explained. Secondly the effects on EAT were elucidated. Due to the complex pathophysiological link between EAT, AF, and obesity, it is still uncertain which treatment strategy is superior.
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Affiliation(s)
| | - Eloise Owen
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | | | - Kiran Akmal
- Faculty of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Mohamed Abouelazayem
- Department of Surgery, Royal Free London Hospitals NHS Foundation, London, United Kingdom
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, United Kingdom.,Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Sylvia Weiner
- Department of Bariatric and Metabolic Surgery, Krankenhaus Nordwest, Frankfurt am Main, Germany
| | - Nasser Sakran
- Department of Surgery, Holy Family Hospital, Nazareth, Israel.,Azrieli, Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Lukas R Dekker
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, United Kingdom
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
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22
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Pouwels S, Sakran N, Graham Y, Leal A, Pintar T, Yang W, Kassir R, Singhal R, Mahawar K, Ramnarain D. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord 2022; 22:63. [PMID: 35287643 PMCID: PMC8919523 DOI: 10.1186/s12902-022-00980-1] [Citation(s) in RCA: 176] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/02/2022] [Indexed: 02/21/2023] Open
Abstract
Given the increasing prevalence of diabetes and obesity worldwide, the deleterious effects of non-alcoholic fatty liver disease (NAFLD) are becoming a growing challenge for public health. NAFLD is the most common chronic liver disease in the Western world. NAFLD is closely associated with metabolic disorders, including central obesity, dyslipidaemia, hypertension, hyperglycaemia and persistent abnormalities of liver function tests.In general NAFLD is a common denominer for a broad spectrum of damage to the liver, which can be due to hepatocyte injury, inflammatory processes and fibrosis. This is normally seen on liver biopsy and can range from milder forms (steatosis) to the more severe forms (non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis and liver failure). In these patients, advanced fibrosis is the major predictor of morbidity and liver-related mortality, and an accurate diagnosis of NASH and NAFLD is mandatory. Histologic evaluation with liver biopsy remains the gold standard to diagnose NAFLD. Diagnosis of NAFLD is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Weight loss, dietary modification, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established. Dietary recommendations and lifestyle interventions, weight loss, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established with promising results but are difficult to maintain. Pioglitazone and vitamin E are recommended by guidelines in selected patients. This review gives an overview of NAFLD and its treatment options.
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Affiliation(s)
- Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
| | - Nasser Sakran
- Department of Surgery, Holy Family Hospital, Nazareth, Israel, and the Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Facultad de Psycologia, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Angela Leal
- Department of Bariatric Surgery, Christus Muguerza Conchita Hospital, Monterrey, Mexico
| | - Tadeja Pintar
- Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloška cesta, Ljubljana, Slovenia
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Radwan Kassir
- CHU Félix Guyon, Allée des Topazes, Saint-Denis, France
| | - Rishi Singhal
- Bariatric and Upper GI Unit, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Dharmanand Ramnarain
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands
- Department of Intensive Care Medicine, Saxenburg Medical Centre, Hardenberg, The Netherlands
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23
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Sakran N, Graham Y, Pintar T, Yang W, Kassir R, Willigendael EM, Singhal R, Kooreman ZE, Ramnarain D, Mahawar K, Parmar C, Madhok B, Pouwels S. The many faces of diabetes. Is there a need for re-classification? A narrative review. BMC Endocr Disord 2022; 22:9. [PMID: 34991585 PMCID: PMC8740476 DOI: 10.1186/s12902-021-00927-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/22/2021] [Indexed: 12/13/2022] Open
Abstract
The alarming rise in the worldwide prevalence of obesity and associated type 2 diabetes mellitus (T2DM) have reached epidemic portions. Diabetes in its many forms and T2DM have different physiological backgrounds and are difficult to classify. Bariatric surgery (BS) is considered the most effective treatment for obesity in terms of weight loss and comorbidity resolution, improves diabetes, and has been proven superior to medical management for the treatment of diabetes. The term metabolic surgery (MS) describes bariatric surgical procedures used primarily to treat T2DM and related metabolic conditions. MS is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Originally, BS was used as an alternative weight-loss therapy for patients with severe obesity, but clinical data revealed its metabolic benefits in patients with T2DM. MS is more effective than lifestyle or medical management in achieving glycaemic control, sustained weight loss, and reducing diabetes comorbidities. New guidelines for T2DM expand the use of MS to patients with a lower body mass index.Evidence has shown that endocrine changes resulting from BS translate into metabolic benefits that improve the comorbid conditions associated with obesity, such as hypertension, dyslipidemia, and T2DM. Other changes include bacterial flora rearrangement, bile acids secretion, and adipose tissue effect.This review aims to examine the physiological mechanisms in diabetes, risks for complications, the effects of bariatric and metabolic surgery and will shed light on whether diabetes should be reclassified.
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Affiliation(s)
- Nasser Sakran
- Department of Surgery, Holy Family Hospital, Nazareth, Israel
- the Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Facultad de Psycologia, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Tadeja Pintar
- Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloška cesta, Ljubljana, Slovenia
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, 613 Huangpu Avenue West, Guangzhou, Guangdong Province, China
| | - Radwan Kassir
- CHU Félix Guyon, Allée des Topazes, Saint-Denis, France
| | - Edith M Willigendael
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Rishi Singhal
- Bariatric and Upper GI Unit, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Zoë E Kooreman
- Department of Dermatology, Amphia Hospital, Breda, The Netherlands
| | - Dharmanand Ramnarain
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, UK
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Burton, UK
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
- Department of Intensive Care Medicine, ETZ Elisabeth, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
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24
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Omar I, Graham Y, Singhal R, Wilson M, Madhok B, Mahawar K. EP.TH.26Identification of Common Themes from Never Events Data Published by NHS England. Br J Surg 2021. [DOI: 10.1093/bjs/znab309.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Never events (NEs) are serious clinical incidents that cause potentially avoidable harm and impose a significant financial burden on healthcare systems. The purpose of this study was to identify common never events.
Methods
We analysed the NHS England NE data from 2012 to 2020 to identify common never events category and themes.
Results
We identified 51 common NE themes in 4 main categories out of a total of 3247 NE reported during this period. Wrong-site surgery was the most common category (n = 1307;40.25%)) followed by retained foreign objects (n = 901;27.75%); wrong implant or prosthesis (n = 425;13.09%); and non-surgical/infrequent ones (n = 614;18.9%).
Wrong-side and wrong tooth removal were the most common wrong-site NE accounting for 300 (22.95%) and 263 (20.12%) incidents, respectively. There were 197 (15%) wrong-site blocks, 125 (9.56%) wrong procedures, and 96 (7.3%) wrong skin lesions excised. Vaginal swabs were the most commonly retained items (276;30.63%) followed by surgical swabs (164;18.20%) and guidewires (152;16.87%). There were 67 (7.44%) incidents of retained parts of instruments and 48 (5.33%) retained instruments. Wrong intraocular lenses (165;38.82%) were the most common wrong implants followed by wrong hip prostheses (n = 94;22.11%) and wrong knees (n = 91;21.41%).
Non-surgical events accounted for 18.9% (n = 614) of the total incidents. Misplaced naso-or oro-gastric tubes (n = 178;29%) and wrong-route administration of medications were the most common events in this category (n = 111;18%), followed by unintentional connection of a patient requiring oxygen to an air flow-meter (n = 93;15%).
Conclusion
This paper identifies common NE categories and themes. Awareness of these might help reduce their incidence.
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Affiliation(s)
- Islam Omar
- Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Trust, Sunderland, United Kingdom
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, United Kingdom
| | - Rishi Singhal
- Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, UK
| | | | - Brijesh Madhok
- Royal Derby Hospital, University Hospitals of Derby & Burton NHS Foundation Trust, UK
| | - Kamal Mahawar
- Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Trust, Sunderland, United Kingdom
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25
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Graham Y, Mahawar K, Riera M, Omar I, Bhasker A, Wilson M. EP.FRI.32 Emotional Resilience and Bariatric Surgical Teams: a Priorityin the Pandemic. Br J Surg 2021. [PMCID: PMC8574403 DOI: 10.1093/bjs/znab312.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The infection control measures implemented as a result of COVID-19 led to a postponement of bariatric surgical procedures across many countries worldwide. Many bariatric surgical teams were in essence left without a profession, with many redeployed to other areas of clinical care and were not able to provide the levels of patient support given before COVID-19. As the pandemic continues, some restrictions have been lifted, with staff adjusting to new ways of working, incorporating challenging working conditions and dealing with continuing levels of stress. This article explores the concept of emotional labour, defined as ‘inducing or suppressing feelings in order to perform one’s work’, and its application to multidisciplinary teams working within bariatric surgery, to offer insight into the mental health issues that may be affecting healthcare professionals working in this discipline.
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Affiliation(s)
- Yitka Graham
- Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, UK
- Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Kamal Mahawar
- Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, UK
| | - Manel Riera
- Department of General Surgery, Royal Shrewsbury Hospital, The Shrewsbury and Telford Hospitals NHS Trust, Mytton Oak Road, Shrewsbury, UK
| | - Islam Omar
- Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, UK
| | | | - Michael Wilson
- Department of General Surgery, Forth Valley Royal Hospital, NHS Forth Valley, Stirling Road, Larbert, UK
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26
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Singhal R, Tahrani AA, Sakran N, Herrera M, Menon V, Khaitan M, Foschi D, Super J, Sandvik J, Angrisani L, Kawahara N, Teixeira J, Campos GM, Kothari S, Graham Y, Ludwig C, Mahawar K. Effect of COVID-19 pandemic on global Bariatric surgery PRActiceS - The COBRAS study. Obes Res Clin Pract 2021; 15:395-401. [PMID: 33994148 PMCID: PMC8062442 DOI: 10.1016/j.orcp.2021.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022]
Abstract
Introduction There is a paucity of data in scientific literature on the impact of Coronavirus Disease 2019 (COVID-19) pandemic on bariatric surgery. The aim of this study was to evaluate the impact of COVID-19 pandemic on Bariatric Surgery globally. Methods We conducted a global online survey of bariatric surgeons between 16/04/20 – 15/05/20. The survey was endorsed by five national bariatric surgery societies and circulated amongst their memberships. Authors also shared the link through their personal networks, email groups, and social media. Results 703 respondents from 77 countries completed the survey. Respondents reported a drop in elective bariatric activity from a median (IQR) of 130 (60–250) procedures in 2019 to a median of 0 (0–2) between16/03/2020 and 15/04/2020 during the pandemic. The corresponding figures for emergency activity were 5 (2–10) and 0 (0–1) respectively. 441 (63%) respondents did not perform any bariatric procedures during this time period. Surgeons reported outcomes of 61 elective bariatric surgical procedures during the pandemic with 13 (21%) needing ventilation and 2 (3.3%) deaths. Of the 13 emergency bariatric procedures reported, 5 (38%) needed ventilation and 4 (31%) died. 90 (13%) surgeons reported having had to perform a bariatric surgical or endoscopic procedure without adequate Personal Protective Equipment. Conclusions COVID-19 pandemic led to a remarkable decline in global elective and emergency bariatric surgery activity at its beginning. Both elective and emergency procedures performed at this stage of the pandemic had considerable morbidity and mortality.
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Affiliation(s)
- Rishi Singhal
- Department of Bariatric Surgery, Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; Healthier Weight, UK.
| | - Abd A Tahrani
- Metabolic Endocrinology and Obesity Medicine, Institute of Metabolism and Systems Research, University of Birmingham, UK; Diabetes and Weight Management, University Hospitals Birmingham NHS Foundation Trust, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Nasser Sakran
- Department of Surgery, Emek Medical Center, Afula, Israel; The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Miguel Herrera
- Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico
| | - Vinod Menon
- Department of Surgery, University Hospitals Coventry & Warwickshire NHS Trust, UK
| | - Manish Khaitan
- Department of Bariatric Surgery, K D Hospital, Ahmedabad, India
| | - Diego Foschi
- Department of Surgery, Ospedale San Giuseppe, University of Milan, Milan, Italy
| | - Jonathan Super
- Department of Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Jorunn Sandvik
- Department of Surgery, Møre and Romsdal Hospital Trust, Aalesund, Norway; Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Luigi Angrisani
- Department of Public Health, "Federico II" University of Naples, Naples, Italy
| | - Nilton Kawahara
- Department of General Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Guilherme M Campos
- Division of Bariatric and Gastrointestinal Surgery, Department of Surgery, Virginia Commonwealth University, USA
| | | | - Yitka Graham
- Specialty Lead in Health Services Research, Faculty of Health Sciences and Wellbeing, Sunderland, UK; Department of Surgery, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | - Christian Ludwig
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Kamal Mahawar
- Department of Surgery, South Tyneside and Sunderland NHS Trust, Sunderland, UK; University of Sunderland, Sunderland, UK
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27
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Sakran N, Zakeri R, Madhok B, Graham Y, Parmar C, Mahawar K, Arhi C, Shah K, Pouwels S. Splenic Abscess Following Sleeve Gastrectomy: A Systematic Review of Clinical Presentation and Management Methods. Obes Surg 2021; 31:2753-2761. [PMID: 33791929 DOI: 10.1007/s11695-021-05396-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Splenic abscess is a rare complication following sleeve gastrectomy. METHODS We performed a systematic review to clarify its clinical significance, presentation, and management. PubMed, Embase, MEDLINE, Google Scholar, and the Cochrane Library were searched up to the 19th of July 2020. A total of 18 patients were included, of which 11 were female and 7 were male. The mean age was 34.1 ± 12.3 years, and the mean body mass index was 45.8 ± 7.6 kg/m2. Type 2 diabetes mellitus was reported in 11.1% of patients and hypertension in 22.2%. Fever was the most common presenting symptom seen in 17 (94.4%) patients, followed by abdominal pain in 10 (55.6%). The mean duration from surgery to presentation was 98.6 ± 132.7 days (range 10-547 days). Computed tomography was used for investigations in 17/18 (94.4%) patients. Seven patients had reported leak, three reported bleeding, and 2 reported pleural effusion. Thirteen patients had unilocular abscess. All patients were treated with antibiotics. Four patients needed total parenteral nutrition, and three were given proton pump inhibitor. In total, 11 patients needed percutaneous drainage as a part of treatment and 11 patients needed total splenectomy and 1 needed partial splenectomy. CONCLUSION Splenic abscess following sleeve gastrectomy is a rare identity. The etiology of formation of splenic abscess needs further studies. A computed tomography of the abdomen with contrast is the preferred diagnostic tool. There is no gold standard treatment for splenic abscess.
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Affiliation(s)
- Nasser Sakran
- Department of Surgery, Emek Medical Center, 21 Izhak Rabin Blvd, 1834111, Afula, Israel.
- Technion - Israel Institute of Technology, Haifa, Israel.
| | - Roxanna Zakeri
- Department of Surgery, Whittington Health NHS Trust, London, UK
| | - Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico
| | - Chetan Parmar
- Department of Surgery, Whittington Health NHS Trust, London, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | - Chanpreet Arhi
- Department of Surgery, University Hospital Lewisham, London, UK
| | - Kamran Shah
- Bariatric and Upper GI Department, GB Obesitas Skaane, Malmö, Sweden
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
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28
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Ahmed S, Pouwels S, Parmar C, Kassir R, de Luca M, Graham Y, Mahawar K. Outcomes of Bariatric Surgery in Patients with Liver Cirrhosis: a Systematic Review. Obes Surg 2021; 31:2255-2267. [PMID: 33595790 DOI: 10.1007/s11695-021-05289-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Obesity is commonly associated with non-alcoholic fatty liver disease and is a significant cause of chronic liver disease and cirrhosis. Some patients undergoing bariatric surgery suffer from cirrhosis of the liver. Currently, there is a lack of consensus on the management of these patients and the safety and efficacy of bariatric surgery in this group. This review aims to update our previously published systematic review on the same topic. A total of 21 studies reporting experience on patients with cirrhosis undergoing bariatric surgery were included. Sleeve gastrectomy was the most common surgery performed, followed by Roux-en-Y gastric bypass. The results show that bariatric surgery may be feasible in carefully selected patients with obesity and cirrhosis although they have slightly higher morbidity and mortality rates.
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Affiliation(s)
- Saleem Ahmed
- Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Chetan Parmar
- Department of Surgery, University College London Hospital NHS Foundation Trust, London, UK.,Department of Surgery, Whittington Hospital NHS Trust, London, UK
| | - Radwan Kassir
- CHU Félix Guyon, Allée des Topazes, Saint-Denis, France
| | - Maurizio de Luca
- Department of Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Bariatric Unit, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
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Mahawar KK, Omar I, Singhal R, Aggarwal S, Allouch MI, Alsabah SK, Angrisani L, Badiuddin FM, Balibrea JM, Bashir A, Behrens E, Bhatia K, Biertho L, Biter LU, Dargent J, De Luca M, DeMaria E, Elfawal MH, Fried M, Gawdat KA, Graham Y, Herrera MF, Himpens JM, Hussain FA, Kasama K, Kerrigan D, Kow L, Kristinsson J, Kurian M, Liem R, Lutfi RE, Menon V, Miller K, Noel P, Ospanov O, Ozmen MM, Peterli R, Ponce J, Prager G, Prasad A, Raj PP, Rodriguez NR, Rosenthal R, Sakran N, Santos JN, Shabbir A, Shikora SA, Small PK, Taylor CJ, Wang C, Weiner RA, Wylezol M, Yang W, Aminian A. The first modified Delphi consensus statement on sleeve gastrectomy. Surg Endosc 2021; 35:7027-7033. [PMID: 33433676 DOI: 10.1007/s00464-020-08216-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG. METHODS We established a committee of 54 globally recognized opinion makers in this field. The committee agreed to vote on several statements concerning SG. An agreement or disagreement amongst ≥ 70.0% experts was construed as a consensus. RESULTS The committee achieved a consensus of agreement (n = 71) or disagreement (n = 7) for 78 out of 97 proposed statements after two rounds of voting. The committee agreed with 96.3% consensus that the characterization of SG as a purely restrictive procedure was inaccurate and there was 88.7% consensus that SG was not a suitable standalone, primary, surgical weight loss option for patients with Barrett's esophagus (BE) without dysplasia. There was an overwhelming consensus of 92.5% that the sleeve should be fashioned over an orogastric tube of 36-40 Fr and a 90.7% consensus that surgeons should stay at least 1 cm away from the angle of His. Remarkably, the committee agreed with 81.1% consensus that SG patients should undergo a screening endoscopy every 5 years after surgery to screen for BE. CONCLUSION A multinational team of experts achieved consensus on several aspects of SG. The findings of this exercise should help improve the outcomes of SG, the commonest bariatric procedure worldwide, and guide future research on this topic.
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Affiliation(s)
- Kamal K Mahawar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK.
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.
| | - Islam Omar
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | - Rishi Singhal
- Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Sandeep Aggarwal
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | | | | | | | | | | | | | | | - Laurent Biertho
- Quebec Heart and Lung Institute-Laval University, Quebec, Canada
| | - L Ulas Biter
- Franciscus Gasthuis Rotterdam, Rotterdam, Netherlands
| | | | | | | | | | - Martin Fried
- OB Klinika-Center for Treatment of Obesity and Metabolic Disorders, Prague, Czech Republic
| | | | - Yitka Graham
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Miguel F Herrera
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
| | | | | | | | | | - Lilian Kow
- Flinders University, Adelaide, South Australia, Australia
| | | | - Marina Kurian
- New York University School of Medicine, New York, USA
| | - Ronald Liem
- Dutch Obesity Clinic (NOK), The Hague, Netherlands
| | | | - Vinod Menon
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Karl Miller
- Diakonissen & Wehrle Private Hospital, Salzburg, Austria
| | - Patrick Noel
- Bouchard Private Hospital, Elsan, Marseille, France
- Mediclinic Parkview, Dubayy, United Arab Emirates
| | - Oral Ospanov
- KF "University Medical Center", Nur-Sultan, Kazakhstan
| | | | | | | | | | | | | | | | | | | | | | - Asim Shabbir
- National University Hospital, Singapore, Singapore
| | - Scott A Shikora
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Peter K Small
- Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Craig J Taylor
- Concord Repatriation General Hospital, Sydney, Australia
| | - Cunchuan Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | | | - Wah Yang
- The First Affiliated Hospital of Jinan University, Guangzhou, China
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Graham Y, Hayes C, Mahawar K, Tahrani A, López Landiribar JM, Martinez P. Social Aspects of Bariatric Surgery. Obesity, Bariatric and Metabolic Surgery 2021:1-12. [DOI: 10.1007/978-3-030-54064-7_116-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/15/2021] [Indexed: 09/01/2023]
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Graham Y, Mahawar K, Riera M, Islam O, Bhasker AG, Wilson M, Tahrani A, Moize V, Leal A, Hayes C. Emotional Resilience and Bariatric Surgical Teams: a Priority in the Pandemic. Obes Surg 2020; 31:1887-1890. [PMID: 33136263 PMCID: PMC7604646 DOI: 10.1007/s11695-020-05083-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 01/23/2023]
Abstract
The infection control measures implemented as a result of COVID-19 led to a postponement of bariatric surgical procedures across many countries worldwide. Many bariatric surgical teams were in essence left without a profession, with many redeployed to other areas of clinical care and were not able to provide the levels of patient support given before COVID-19. As the pandemic continues, some restrictions have been lifted, with staff adjusting to new ways of working, incorporating challenging working conditions and dealing with continuing levels of stress. This article explores the concept of emotional labour, defined as ‘inducing or suppressing feelings in order to perform one’s work’, and its application to multidisciplinary teams working within bariatric surgery, to offer insight into the mental health issues that may be affecting healthcare professionals working in this discipline.
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Affiliation(s)
- Yitka Graham
- Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK. .,Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, UK. .,Faculdad de Psicologia, Universidad de Anahuac, Mexico City, Mexico.
| | - Kamal Mahawar
- Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, UK
| | - Manel Riera
- Department of General Surgery, Royal Shrewsbury Hospital, The Shrewsbury and Telford Hospitals NHS Trust, Mytton Oak Road, Shrewsbury, UK
| | - Omar Islam
- Department of General Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Kayll Road, Sunderland, UK
| | | | - Michael Wilson
- Department of General Surgery, Forth Valley Royal Hospital, NHS Forth Valley, Stirling Road, Larbert, UK
| | - Abd Tahrani
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK.,Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Centre of Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
| | - Violeta Moize
- Obesity Unit, Institut d'Investigacions Biomediques August Pi Sunyer (DIPABS), Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Hospital Clinic Barcelona, Barcelona, Spain
| | - Angela Leal
- Department of Bariatric Surgery, Christus Muguerza Conchita Hospital, Monterrey, Mexico
| | - Catherine Hayes
- Helen McArdle Nursing and Care Research Institute, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
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Sakran N, Zakeri R, Madhok B, Graham Y, Parmar C, Mahawar K, Pouwels S. Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options. Obes Surg 2020; 31:357-369. [PMID: 33123868 DOI: 10.1007/s11695-020-05078-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022]
Abstract
This study aimed to establish the optimal diagnostic and treatment algorithm for the management of gastric fistula in the chest (GFIC) after sleeve gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed, which produced 1182 results, of which 26 studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever, and/or dyspnea. Computed tomography (CT) scan in combination with either upper gastrointestinal (UGI) series or an esophagogastroduodenoscopy (EGD) was used to adequately diagnose the fistulas. Initial treatment was either with clips and/or clips and stents that were placed endoscopically. When unsuccessful in the majority of the cases, the surgical treatment consisted of total gastrectomy and Roux-en-Y esophagojejunostomy in a laparoscopic or open fashion.
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Affiliation(s)
- Nasser Sakran
- Department of Surgery, Emek Medical Center, 21 Izhak Rabin Blvd, 1834111, Afula, Israel. .,The Technion - Israel Institute of Technology, Haifa, Israel.
| | - Roxanna Zakeri
- Department of Surgery, University College London Hospital NHS Foundation Trust, London, UK
| | - Brijesh Madhok
- University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico.,Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | | | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
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Cox J, Bhatti A, Graham Y, Lee D. Update on breast cancer diagnosis and management: new topics for primary care. Br J Gen Pract 2020; 70:515-516. [PMID: 33004378 PMCID: PMC7518917 DOI: 10.3399/bjgp20x712985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/29/2020] [Indexed: 10/31/2022] Open
Affiliation(s)
- Julie Cox
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland Royal Hospital; University of Sunderland, Faculty of Health Sciences and Wellbeing, Sunderland
| | - Amir Bhatti
- County Durham and Darlington NHS Foundation Trust, Department of Surgery, Durham
| | - Yitka Graham
- University of Sunderland, Faculty of Health Sciences and Wellbeing, Sunderland
| | - Daniela Lee
- Northern Centre for Cancer Care, Newcastle Hospitals Foundation Trust, Freeman Hospital, Newcastle upon Tyne
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Bosun-Arije FS, Ling J, Graham Y, Hayes C. Organisational factors influencing non-pharmacological management of type 2 diabetes mellitus (T2DM) in public hospitals across Lagos, Nigeria: A qualitative study of nurses' perspectives. Diabetes Res Clin Pract 2020; 166:108288. [PMID: 32615277 DOI: 10.1016/j.diabres.2020.108288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/24/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prevalence and incidence of Type 2 Diabetes mellitus (T2DM) are significantly increasing in Nigeria. Effective management of the condition, in clinical settings, can be achieved with a minimal financial cost, but this is often overlooked. It is crucial to understand organisational factors influencing non-pharmacological management of T2DM in Nigerian public hospitals for effective management of patients diagnosed with the condition. AIM To examine healthcare delivery services influencing patient management and seek approaches to heighten optimisation of patient health outcomes. METHODS Adopting a qualitative case study design, we used the Constant Comparative Method and semi-structured questions to interview17 nurses in public hospitals across Lagos. Using the five stages of the Framework Analysis process, the transcribed interviews were thematically analysed. RESULTS Nurses suggested that a complex, multifaceted system constituted organisational factors influencing T2DM management in public hospitals across Lagos, Nigeria. Specific factors identified were levels of available information and knowledge, relationship, policy and decision-making management. These factors were, in turn, linked to political, infrastructural, health professional and the environments within which patients were given health services. CONCLUSIONS The study revealed a significant gap in the organisation of care for individuals diagnosed with T2DM in public hospitals across Lagos. Timely and affordable strategies have been highlighted to secure effective care delivery to patients.
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MESH Headings
- Adult
- Attitude of Health Personnel
- Decision Making, Organizational
- Delivery of Health Care/organization & administration
- Delivery of Health Care/standards
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/nursing
- Diabetes Mellitus, Type 2/therapy
- Female
- Health Knowledge, Attitudes, Practice
- Health Services/standards
- Hospitals, Public/organization & administration
- Hospitals, Public/standards
- Hospitals, Public/statistics & numerical data
- Humans
- Male
- Middle Aged
- Nigeria/epidemiology
- Nurses/organization & administration
- Nurses/psychology
- Nurses/standards
- Nurses/statistics & numerical data
- Perception
- Practice Patterns, Nurses'/organization & administration
- Practice Patterns, Nurses'/standards
- Practice Patterns, Nurses'/statistics & numerical data
- Qualitative Research
- Socioeconomic Factors
- Surveys and Questionnaires
- Treatment Outcome
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Affiliation(s)
- Foluke Stella Bosun-Arije
- Manchester Metropolitan University, Faculty of Health, Psychology and Social Care, Department of Nursing, United Kingdom.
| | - Jonathan Ling
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
| | - Yitka Graham
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
| | - Catherine Hayes
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
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Mahawar KK, Clare K, O'Kane M, Graham Y, Callejas-Diaz L, Carr WRJ. Patient Perspectives on Adherence with Micronutrient Supplementation After Bariatric Surgery. Obes Surg 2020; 29:1551-1556. [PMID: 30652245 DOI: 10.1007/s11695-019-03711-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Adherence to post-bariatric surgery nutritional supplements can be poor and is associated with higher micronutrient deficiency rates. There is currently no available study specifically seeking patients' perspectives on the reasons behind poor adherence and how to address it. METHODS Bariatric surgery patients living in the UK were invited to take part in an anonymous survey on SurveyMonkey®. RESULTS A total of 529 patients (92.61% females, mean age 47.7 years) took part. Most of these patients had undergone either a Roux-en-Y gastric bypass (63.0%) or sleeve gastrectomy (24.0%). Most of the patients were in full-time (49.0%, n = 260/529) or part-time (15.7%, n = 83/529) employment. Approximately 54.0% (n = 287/529) of the respondents reported having trouble taking all their supplements. Males were significantly more likely to report complete compliance. The most important reported reason for poor compliance was difficulty in remembering (45.6%), followed by too many tablets (16.4%), side effects (14.3%), cost (11.5%), non-prescribing by GP (10.8%), bad taste (10.1%), and not feeling the need to take (9.4%). Patients suggested reducing the number of tablets (41.8%), patient education (25.7%), GP education (24.0%), reducing the cost (18.5%), and more information from a healthcare provider (12.5%) or a pharmacist (5.2%) to improve the compliance. CONCLUSIONS This study is the first attempt to understand patient perspectives on poor adherence to post-bariatric surgery nutritional recommendation. Patients offered a number of explanations and also provided with suggestions on how to improve it.
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Affiliation(s)
- Kamal K Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. .,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK.
| | - Ken Clare
- WLS Info and Obesity Empowerment Network, Liverpool, UK
| | - Mary O'Kane
- Obesity Centre, Leeds Teaching Hospitals NHS Trust, London, UK
| | - Yitka Graham
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, UK
| | | | - William R J Carr
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
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Mahawar K, Sharples AJ, Graham Y. A systematic review of the effect of gastric pouch and/or gastrojejunostomy (stoma) size on weight loss outcomes with Roux-en-Y gastric bypass. Surg Endosc 2019; 34:1048-1060. [DOI: 10.1007/s00464-019-07277-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/12/2019] [Indexed: 01/13/2023]
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Bellini MI, Adair A, Fotopoulou C, Graham Y, Hutson A, McNally S, Mohan H, Vig S, Parks R, Papalois V. Changing the norm towards gender equity in surgery: the women in surgery working group of the Association of Surgeons of Great Britain and Ireland's perspective. J R Soc Med 2019; 112:325-329. [PMID: 31414936 DOI: 10.1177/0141076819854194] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Maria Irene Bellini
- 1 Renal and Transplant Directorate, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W120HS, UK
| | - Anya Adair
- 2 Department of Clinical Surgery, University of Edinburgh, Edinburgh EH8 9YL, UK
| | - Christina Fotopoulou
- 3 Gynaecologic Oncology, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK.,4 Charité University Hospital of Berlin, Berlin 10117, Germany
| | - Yitka Graham
- 5 Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK.,6 Directorate of General Surgery, Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Alexis Hutson
- 7 Faculty of Medical Leadership and Management, London WC1R 4SG, UK.,8 Academy of Medical Sciences, London W1B 1QH, UK.,9 Royal College of Radiologists, London WC2A 3JW, UK.,10 Nottingham University Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Scarlett McNally
- 11 Eastbourne District General Hospital, Eastbourne BN21 2UD, UK
| | - Helen Mohan
- 12 Association of Surgeons in Training, London WC2A3PE, UK
| | - Stella Vig
- 13 Department of Vascular and General Surgery, Croydon University Hospital, Croydon, Surrey CR7 7YE, UK
| | - Rowan Parks
- 2 Department of Clinical Surgery, University of Edinburgh, Edinburgh EH8 9YL, UK
| | - Vassilios Papalois
- 1 Renal and Transplant Directorate, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W120HS, UK.,14 Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
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Cox J, Graham Y. Radiology and patient communication: if not now, then when? Eur Radiol 2019; 30:501-503. [PMID: 31359123 DOI: 10.1007/s00330-019-06349-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/10/2019] [Accepted: 06/28/2019] [Indexed: 11/24/2022]
Abstract
KEY POINTS • Communication with patients in radiology is, in general, indirect using the referrer as a conduit. • Direct patient communication may be beneficial for radiology departments and radiologists to improve patient awareness about the nature of our role and also to provide correct and measured information about the nature and frequency of discrepancies in radiology.
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Affiliation(s)
- Julie Cox
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK. .,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK.
| | - Yitka Graham
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK.,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK
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Mahawar KK, Parmar C, Graham Y. One anastomosis gastric bypass: key technical features, and prevention and management of procedure-specific complications. MINERVA CHIR 2019; 74:126-136. [DOI: 10.23736/s0026-4733.18.07844-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Bellini MI, Graham Y, Hayes C, Zakeri R, Parks R, Papalois V. A woman's place is in theatre: women's perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group. BMJ Open 2019; 9:e024349. [PMID: 30617103 PMCID: PMC6326292 DOI: 10.1136/bmjopen-2018-024349] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Surgery remains an inherently male-dominated profession. The aim of this study was to survey women working within the discipline, to understand their current perceptions, providing insight into their practical day-to-day lives, supporting an action-oriented change. DESIGN AND SETTING The link to a confidential, online survey was distributed through the Association of Surgeons of Great Britain and Ireland (ASGBI) social media platforms on Facebook and Twitter over a 2-week period in October 2017. PARTICIPANTS Women working in surgical specialties and actively responding to the link shared through the ASGBI social media platforms. No patients were involved in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Data were analysed through a mixed-methods approach. The quantitative data were analysed through descriptive statistics and qualitative analysis was undertaken using a constant comparative analysis of the participants' comments, to identify salient patterns (themes). RESULTS A total of 81 female participants replied (42% response rate based on the Facebook group members), with 88% (n=71) perceiving surgery as a male-dominated field. Over half had experienced discrimination (59%, n=47), while 22% (n=18) perceived a 'glass ceiling' in surgical training. Orthopaedics was reported as the most sexist surgical specialty by 53% (n=43). Accounts of gendered language in the workplace were reported by 59% (n=47), with 32% (n=25) of surveys participants having used it. Overall, a lack of formal mentorship, inflexibility towards part-time careers, gender stereotypes and poor work-life balance were the main perceived barriers for women in surgical careers. CONCLUSION These findings highlight the implicit nature of the perceived discrimination that women report in their surgical careers. The ASGBI acknowledges these perceptual issues and relative implications as the first of many steps to create an action-oriented change by allowing all staff, regardless of gender, to reflect on their own behaviour, perceptions and the culture in which they work.
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Affiliation(s)
- Maria Irene Bellini
- Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, UK
| | - Yitka Graham
- Science Complex, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, Sunderland, UK
- Directorate of General Surgery, Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland, Sunderland, UK
| | - Catherine Hayes
- Science Complex, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, Sunderland, UK
| | - Roxanna Zakeri
- Department of General Surgery, University College London Hospital NHS Foundation Trust, London, UK
| | - Rowan Parks
- Directorate of General Surgery, Hepatobiliary-Pancreatic Surgical Services Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Vassilios Papalois
- Renal Transplant Directorate, Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
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Bosun-Arije FS, Ling J, Graham Y, Hayes C. A systematic review of factors influencing Type 2 Diabetes Mellitus management in Nigerian public hospitals. International Journal of Africa Nursing Sciences 2019. [DOI: 10.1016/j.ijans.2019.100151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Graham Y, Hayes C, Mehrotra P, Spratt J, Siddle K, Cox J. Clinicians' perceptions of the quality of outsourced radiology and actions taken around perceived imaging errors in practice. Eur Radiol 2018; 29:1649-1654. [PMID: 30542751 DOI: 10.1007/s00330-018-5873-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/14/2018] [Accepted: 11/06/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Outsourcing of radiological reporting services has fundamentally altered communication between radiologists and clinicians in clinical decision making, which relies heavily on diagnostic imaging. The aim of this study was to understand clinicians' perspectives and experiences of interpretation of outsourced reports in clinical practice, if the author of imaging reports matters to clinicians, and actions taken to deal with perceived errors. METHODS A printed survey was distributed to a purposive sample of 50 of the 250 senior medical and surgical staff of a large National Health Service hospital in the UK who regularly engaged with the Radiology Department between May and October 2017, representing 20% of this hospital workforce. The survey consisted of ten questions examining clinicians' opinions on radiology reporting, with comment options to encourage respondents to give further detail. Participants were requested to return the survey to the study investigators. RESULTS The survey elicited a 100% response rate (n = 50). A constant comparative framework was used to guide analysis, revealing themes relevant to the ongoing inter-professional relationship between clinicians and radiologists. The disparity between in-house and externally sourced radiology reports and underlying issues of trust surrounding outsourced reports were the most significant themes identified. CONCLUSIONS This study found outsourcing of radiology reporting needs multi-disciplinary team availability regarding the interpretation and discussions around capacity for effective communication. It raises important issues around often under-acknowledged additional workloads imposed on in-house radiologists. There are financial and pragmatic clinical aspects in pathways of radiology practice which require further research and examination. KEY POINTS • Utilisation of outsourcing is increasing in practice in response to imaging demands. • Outsourcing increases departmental primary reporting capacity but may increase the workload of the local radiologist. • The development of strategies for outsourcing examinations may lessen demands on the in-house workforce.
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Affiliation(s)
- Yitka Graham
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK. .,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK.
| | - Catherine Hayes
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK
| | - Pallavi Mehrotra
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK
| | - Jonathan Spratt
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK
| | - Kathryn Siddle
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK
| | - Julie Cox
- Department of Radiology, City Hospitals Sunderland NHS Foundation Trust, Kayll Road, Sunderland, Tyne and Wear, SR4 7TP, UK.,Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, Tyne and Wear, SR1 3SD, UK
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45
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Abstract
Up to 50% of patients have zinc deficiency before bariatric surgery. Roux-en-Y gastric bypass (RYGB) is the commonest bariatric procedure worldwide. It can further exacerbate zinc deficiency by reducing intake as well as absorption. The British Obesity and Metabolic Surgery Society, therefore, recommends that zinc level should be monitored routinely following gastric bypass. However, the American guidance does not recommend such monitoring for all RYGB patients and reserves it for patients with 'specific findings'. This review concludes that clinically relevant Zn deficiency is rare after RYGB. Routine monitoring of zinc levels is hence unnecessary for asymptomatic patients after RYGB and should be reserved for patients with skin lesions, hair loss, pica, dysgeusia, hypogonadism or erectile dysfunction in male patients, and unexplained iron deficiency anaemia.
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Affiliation(s)
- Kamal K Mahawar
- Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
- Indian Bariatric Research Network, Kolkata, India.
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK.
| | - Aparna Govil Bhasker
- Indian Bariatric Research Network, Kolkata, India
- Centre for Obesity and Digestive Surgery, Mumbai, India and Institute of Minimal Invasive Surgical Sciences and Research Center, Saifee Hospital, Mumbai, India
| | - Vivek Bindal
- Indian Bariatric Research Network, Kolkata, India
- Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS) and Institute of Robotic Surgery (IRS), Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110060, India
| | - Yitka Graham
- Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK
| | - Usha Dudeja
- Super Specialty Paediatric Hospital and Post Graduate Training Institute, Sector 30, Noida, Uttar Pradesh, 201303, India
| | - Muffazal Lakdawala
- Centre for Obesity and Digestive Surgery, Mumbai, India and Institute of Minimal Invasive Surgical Sciences and Research Center, Saifee Hospital, Mumbai, India
| | - Peter K Small
- Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK
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Ojelabi AO, Graham Y, Haighton C, Ling J. A systematic review of the application of Wilson and Cleary health-related quality of life model in chronic diseases. Health Qual Life Outcomes 2017; 15:241. [PMID: 29228977 PMCID: PMC5725920 DOI: 10.1186/s12955-017-0818-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/30/2017] [Indexed: 02/08/2023] Open
Abstract
Background A conceptual model approach to clarify the elements of health-related quality of life (HRQL), their determinants and causal pathways is needed to aid researchers, health practitioners and policy makers in their bid to improve HRQL outcomes in patients. The aim of this systematic review was to appraise empirical evidence on the performance of the Wilson and Cleary Model of HRQL. Methods We conducted a search of MEDLINE, Science Direct, PsyARTICLES and CINAHL databases to identify articles that used Wilson and Cleary model to examine HRQL in chronic diseases. A narrative synthesis was employed in the review of the articles. Results Evidence supports linkages between adjacent concepts and between non-adjacent concepts of the Wilson and Cleary model indicating that in practice there is a need to examine relationships among constructs - or to consider interventions in terms of - both with and without mediators. Symptoms status has the highest magnitude of relative impact on health-related quality of life. Conclusion The Wilson and Cleary model demonstrated good features suitable for evaluating health-related quality of life in chronic diseases.
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Affiliation(s)
- Adedokun Oluwafemi Ojelabi
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK. .,University of Ibadan, Ibadan, Nigeria.
| | - Yitka Graham
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
| | - Catherine Haighton
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Northumbria, UK.,Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Jonathan Ling
- Department of Pharmacy, Health and Wellbeing, University of Sunderland, Sunderland, UK
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Mahawar KK, Parmar C, Graham Y, De Alwis N, Carr WRJ, Jennings N, Small PK. Monitoring of Liver Function Tests after Roux-en-Y Gastric Bypass: An Examination of Evidence Base. Obes Surg 2017; 26:2516-22. [PMID: 27381560 DOI: 10.1007/s11695-016-2280-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
There is no consensus on the monitoring of liver function tests after Roux-en-Y gastric bypass (RYGB). Since the main objective of such monitoring would be to diagnose early those who will eventually develop liver failure after RYGB, we performed a systematic review on this topic. An extensive search of literature revealed only 10 such cases in 6 published articles. It would hence appear that liver failure is a rare problem after RYGB. Routine lifelong monitoring of liver function tests is therefore unnecessary for otherwise asymptomatic individuals. Such monitoring should hence be reserved for high-risk groups, such as patients with liver cirrhosis, those undergoing extended limb/distal RYGB, patients with new illnesses, those abusing alcohol, those on hepatotoxic drugs and those presenting with a surgical complication.
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Affiliation(s)
- Kamal K Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK.
| | - Chetan Parmar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
| | - Yitka Graham
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK
| | | | - William R J Carr
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
| | - Neil Jennings
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
| | - Peter K Small
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK
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Graham Y, Hayes C, Small PK, Mahawar K, Ling J. Patient experiences of adjusting to life in the first 2 years after bariatric surgery: a qualitative study. Clin Obes 2017; 7:323-335. [PMID: 28744976 PMCID: PMC5763321 DOI: 10.1111/cob.12205] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/21/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
Abstract
There is currently little research into the experiences of those who have undergone bariatric surgery, or how surgery affects their lives and social interactions. Adopting a constructivist grounded theory methodological approach with a constant comparative analytical framework, semi-structured interviews were carried out with 18 participants (11 female, 7 male) who had undergone permanent bariatric surgical procedures 5-24 months prior to interview. Findings revealed that participants regarded social encounters after bariatric surgery as underpinned by risk. Their attitudes towards social situations guided their social interaction with others. Three profiles of attitudes towards risk were constructed: Risk Accepters, Risk Contenders and Risk Challengers. Profiles were based on participant-reported narratives of their experiences in the first two years after surgery. The social complexities which occurred as a consequence of bariatric surgery required adjustments to patients' lives. Participants reported that social aspects of bariatric surgery did not appear to be widely understood by those who have not undergone bariatric surgery. The three risk attitude profiles that emerged from our data offer an understanding of how patients adjust to life after surgery and can be used reflexively by healthcare professionals to support both patients pre- and post-operatively.
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Affiliation(s)
- Y. Graham
- Faculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
- Bariatric Surgical UnitDirectorate of General Surgery Sunderland Royal HospitalSunderlandUK
| | - C. Hayes
- Faculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
| | - P. K. Small
- Faculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
- Bariatric Surgical UnitDirectorate of General Surgery Sunderland Royal HospitalSunderlandUK
| | - K. Mahawar
- Faculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
- Bariatric Surgical UnitDirectorate of General Surgery Sunderland Royal HospitalSunderlandUK
| | - J. Ling
- Faculty of Health Sciences and WellbeingUniversity of SunderlandSunderlandUK
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Mahawar KK, Kular KS, Parmar C, Van den Bossche M, Graham Y, Carr WRJ, Madhok B, Magee C, Purkayastha S, Small PK. Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A Survey of 210 Surgeons. Obes Surg 2017; 28:204-211. [DOI: 10.1007/s11695-017-2831-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Ogbonmwan D, Graham Y, Hotonu O, Hussey J. Development of a regional urogenital pain network: Sharing good practice. Eur J Obstet Gynecol Reprod Biol 2017; 211:222-223. [DOI: 10.1016/j.ejogrb.2017.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/11/2017] [Indexed: 11/17/2022]
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