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Article ; Online: Gender representation in the authorship of general surgery journals.

Arshad, Serish R / Gallivan, Elisha R / Skinner, Helen / Burke, Joshua R / Young, Alastair L

2023 Volume 110, Issue 4, Page(s) 513–514

MeSH term(s)	Humans ; Authorship ; Periodicals as Topic ; Publishing ; Sex Factors
Language	English
Publishing date	2023-03-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znad047
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Article ; Online: Failure to Rescue Deteriorating Patients: A Systematic Review of Root Causes and Improvement Strategies.

Burke, Joshua R / Downey, Candice / Almoudaris, Alex M

Journal of patient safety

2020 Volume 18, Issue 1, Page(s) e140–e155

Abstract: Objectives: "Failure to rescue" (FTR) is the failure to prevent a death resulting from a complication of medical care or from a complication of underlying illness or surgery. There is a growing body of evidence that identifies causes and interventions ... ...

Abstract	Objectives: "Failure to rescue" (FTR) is the failure to prevent a death resulting from a complication of medical care or from a complication of underlying illness or surgery. There is a growing body of evidence that identifies causes and interventions that may improve institutional FTR rates. Why do patients "fail to rescue" after complications in hospital? What clinically relevant interventions have been shown to improve organizational fail to rescue rates? Can successful rescue methods be classified into a simple strategy? Methods: A systematic review was performed and the following electronic databases searched between January 1, 2006, to February 12, 2018: MEDLINE, PsycINFO, Cochrane Library, CINAHL, and BNI databases. All studies that explored an intervention to improve failure to rescue in the adult population were considered. Results: The search returned 1486 articles. Eight hundred forty-two abstracts were reviewed leaving 52 articles for full assessment. Articles were classified into 3 strategic arms (recognize, relay, and react) incorporating 6 areas of intervention with specific recommendations. Conclusions: Complications occur consistently within healthcare organizations. They represent a huge burden on patients, clinicians, and healthcare systems. Organizations vary in their ability to manage such events. Failure to rescue is a measure of institutional competence in this context. We propose "The 3 Rs of Failure to Rescue" of recognize, relay, and react and hope that this serves as a valuable framework for understanding the phases where failure of patient salvage may occur. Future efforts at mitigating the differences in outcome from complication management between units may benefit from incorporating this proposed framework into institutional quality improvement.
MeSH term(s)	Adult ; Humans ; Quality Improvement
Language	English
Publishing date	2020-05-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2394324-5
ISSN	1549-8425 ; 1549-8417
ISSN (online)	1549-8425
ISSN	1549-8417
DOI	10.1097/PTS.0000000000000720
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Article ; Online: The management of retrorectal tumours: tertiary centre retrospective study.

Burke, Joshua R / Shetty, Kunal / Thomas, Owen / Kowal, Mikolaj / Quyn, Aaron / Sagar, Peter

BJS open

2021 Volume 6, Issue 2

Abstract: Aim: Tumours of the retrorectal space are uncommon, pathologically heterogeneous, and difficult to diagnose, with ongoing controversy over their surgical management. The aim of this study was to evaluate the surgical management of a consecutive series ... ...

Abstract	Aim: Tumours of the retrorectal space are uncommon, pathologically heterogeneous, and difficult to diagnose, with ongoing controversy over their surgical management. The aim of this study was to evaluate the surgical management of a consecutive series of patients who had undergone excision of primary retrorectal tumours (PRRTs) at a tertiary referral centre. Method: Patients were identified from a prospectively maintained database between 1 March 2001 and 1 August 2021. Electronic patient records were reviewed for demographics, preoperative imaging, operative details, histology, and follow-up. A chi-squared test was used to assess the statistical significance of findings. Results: A total of 144 patients were included in the study. Of these, 103 patients were female (71.5 per cent), 46 patients (31.9 per cent) presented incidentally, and 99 of the patients had tumours located below S3 (68.7 per cent). Overall, 76 patients underwent a transperineal approach (52.7 per cent) with the most common findings of a benign tailgut cyst occurring in 59 (40.9 per cent) of cases. Preoperative MRI predicted urovascular and pelvic sidewall involvement assessed intraoperatively with a sensitivity of 83.3 and 90 per cent and a specificity of 98.1 and 98 per cent respectively. Risk of malignancy in solid tumours was 31.4 versus 8.8 per cent in cystic tumours (relative risk 3.5, 95 per cent c.i. 1.6 to 7.6, P < 0.001). Major complications (Clavien-Dindo grade III and above) occurred in eight patients (5.6 per cent) and all-cause long-term mortality was 4.8 per cent (seven patients). Discussion: PRRTs can be safely excised with minimal complications in specialized centres by surgical teams with the relevant expertise. This study questions the conservative management of cystic tumours and given the risk of solid tumour malignancy, supports surgical management.
MeSH term(s)	Databases, Factual ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/surgery ; Retrospective Studies
Language	English
Publishing date	2021-08-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac044
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Article: Self-reported surgeon health behaviours: A multicentre, cross-sectional exploration into the modifiable factors that impact surgical performance with the association of surgeons in training.

Whelehan, Dale F / Connelly, Tara M / Burke, Joshua R / Doherty, Eva M / Ridgway, Paul F

Annals of medicine and surgery (2012)

2021 Volume 65, Page(s) 102299

Abstract: Introduction: Surgeons regularly educate patients on health promoting behaviours including diet, sleep and exercise. No study thus far has explored surgeons' personal compliance with these health behaviours and their relationship with surgical ... ...

Abstract	Introduction: Surgeons regularly educate patients on health promoting behaviours including diet, sleep and exercise. No study thus far has explored surgeons' personal compliance with these health behaviours and their relationship with surgical performance. The primary outcomes of this study were self-reported health, health related behaviours, wellbeing, fatigue and surgical performance. Methods: A survey of validated themes on health related behaviours, workplace variables and performance was distributed to surgical trainees and consultants in the UK and Ireland through the Association for Surgeons in Training (ASiT). Non-parametric analysis was used to determine inferential associations. Results: Ninety five surgeons (51.5% female, 39.9% registrars) completed the survey. 94% and 74% reported 'good' or better overall health and mental wellbeing respectively. The majority (54.7%) reported inconsistent sleep patterns. Less than a quarter engage in regular exercise. Sixty two and 64.2% reported being regularly fatigued and bothered by feelings of anxiety and/or depression respectively. Poor self-reported health and wellbeing were associated with poorer reported off-call performance (p < .01). Higher levels of fatigue negatively impacted self-reported surgical and non-surgical task proficiency (p < .01). Discussion and conclusion: Surgeons reported high levels of overall health. However, healthy behaviours around sleep, diet and exercise were not consistently reported. Fewer reported good mental health and emotional well-being. Self-reported health behaviours including sleep and physical activity were associated with surgical performance. Strategies to improve modifiable lifestyle factors which will optimise physical health, mental wellbeing and levels of fatigue may optimise surgical performance.
Language	English
Publishing date	2021-04-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2021.102299
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Article ; Online: Anaesthetic management of subcutaneous abscesses: current status.

Poulton, Theodore / Hogston, Samuel P / Bolton, William S / Burke, Joshua R / Jayne, David G

British journal of anaesthesia

2020 Volume 125, Issue 2, Page(s) e227–e229

MeSH term(s)	Abscess/complications ; Abscess/surgery ; Administration, Topical ; Anesthesia/methods ; Anesthetics, Dissociative/administration & dosage ; Anesthetics, Dissociative/therapeutic use ; Anesthetics, Local/administration & dosage ; Anesthetics, Local/therapeutic use ; Drainage ; Drug Therapy, Combination ; Humans ; Hypnotics and Sedatives/administration & dosage ; Hypnotics and Sedatives/therapeutic use ; Intraoperative Care/methods ; Ketamine/administration & dosage ; Ketamine/therapeutic use ; Midazolam/administration & dosage ; Midazolam/therapeutic use ; Pain/etiology ; Pain/prevention & control
Chemical Substances	Anesthetics, Dissociative ; Anesthetics, Local ; Hypnotics and Sedatives ; Ketamine (690G0D6V8H) ; Midazolam (R60L0SM5BC)
Language	English
Publishing date	2020-05-05
Publishing country	England
Document type	Letter ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.03.018
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Article ; Online: Gender representation in leadership roles in UK surgical societies.

Skinner, Helen / Burke, Joshua R / Young, Alastair L / Adair, Robert A / Smith, Andrew M

International journal of surgery (London, England)

2019 Volume 67, Page(s) 32–36

Abstract: Introduction: Despite making up more than half of new doctors, women are underrepresented in most surgical specialties. Various reasons have been suggested for this including issues with work-life balance, discrimination and a lack of female role models ...

Abstract	Introduction: Despite making up more than half of new doctors, women are underrepresented in most surgical specialties. Various reasons have been suggested for this including issues with work-life balance, discrimination and a lack of female role models in the specialty. We sought to quantify the extent of gender discrimination in leadership roles in surgical societies in the UK. Methods: All major Surgical Specialty Organisations were identified via the Royal College of Surgeons Website. Leadership and committee information was collected via organisation websites on 5th September 2018. All societies were then contacted requesting data including total membership, their stage of training and the gender split. Results: Of the twenty-four organisations contacted, eighteen were able to provide data. Women accounted for 11.8% (2446/20 803) of consultant and 34.3% (5267/15 366) of trainee members. 2/24 presidents; 3/26 of vice presidents; 18.1% (39/215) of executive committees and 13.5% (49/364) of wider committee members were female. Thirty-four committee members were not included as they were not surgeons (23 female; 11 male). Discussion: Despite accounting for 27% of the surgical workforce and indeed 24% of surgical society members, women account for only 2 of 24 Presidents and 18.1% (39/215) of the executive committees of surgical societies in the UK. Action should be taken so women are fairly represented in leadership roles in surgical societies with one of the benefits being more visible role models for prospective female surgeons.
MeSH term(s)	Female ; Gender Identity ; Humans ; Leadership ; Male ; Prospective Studies ; Societies, Medical/organization & administration ; Specialties, Surgical/organization & administration ; Surgeons/supply & distribution ; United Kingdom
Language	English
Publishing date	2019-05-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2019.05.007
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Article ; Online: Can surgical skills be taught using technological advances online? A comparative study of online and face-to-face surgical skills training.

Fehervari, Matyas / Das, Bibek / Soleimani-Nouri, Payam / Ahmad, Manal / Fadel, Michael G / Deputy, Mohammed / Morgan, Catrin / Burke, Joshua R / Mason, John D / Nott, David / Spalding, Duncan

Surgical endoscopy

2022 Volume 36, Issue 6, Page(s) 4631–4637

Abstract: Introduction: Online teaching has rapidly emerged as a viable alternative to traditional face-to-face education. How to teach surgical skills in the online environment, however, has not yet been fully established nor evaluated.: Methods: An ... ...

Abstract	Introduction: Online teaching has rapidly emerged as a viable alternative to traditional face-to-face education. How to teach surgical skills in the online environment, however, has not yet been fully established nor evaluated. Methods: An international 1-day online surgical skills course consisting of lectures, pre-recorded virtual workshops, live demonstrations and along with surgical skills teaching in breakout rooms was organised. Based on existing learning theories, new methods were developed to deliver skills teaching online. Simultaneously, traditional in-person surgical skills teaching was also conducted and used as a benchmark. Skills development was assessed by trained demonstrators and self-reported competency scores were compared between the online and face-to-face event. Results: 553 delegates from 20 different countries attended the online course. Of these, 64 were trained in breakout rooms with a 1:5 demonstrator-to-delegate ratio whilst the remaining 489 delegates participated in didactic skills development sessions. In a separate face-to-face course, 20 delegates were trained with traditional methods. Demonstrators rated the competency of delegates for suturing, tendon repair and vascular anastomosis. There was no significant difference in the competency ratings of delegates receiving online teaching or face-to-face teaching (p = 0.253, p = 0.084, p = 1.00, respectively). The development of the same skills to "articulation" were not different between formats (p = 0.841, p = 0.792, p = 1.00, respectively). Post course self-rated competency scores improved for all technical skills (p < 0.001). Small group sessions, both online and face-to-face, received higher satisfaction ratings compared to large group sessions in terms of clarity of instructions, answers to questions and demonstrator feedback. Overall feedback on teaching quality, however, was equivalent across both groups. Discussion: Online teaching of surgical skills for early training years is an appropriate alternative to face-to-face teaching.
MeSH term(s)	Clinical Competence ; Curriculum ; Feedback ; Humans ; Teaching
Language	English
Publishing date	2022-03-07
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09170-5
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Article: Global academic response to COVID-19: Cross-sectional study.

Helliwell, Jack A / Bolton, William S / Burke, Joshua R / Tiernan, Jim P / Jayne, David G / Chapman, Stephen J

Learned publishing : journal of the Association of Learned and Professional Society Publishers

2020 Volume 33, Issue 4, Page(s) 385–393

Abstract: This study explores the response to COVID-19 from investigators, editors, and publishers and seeks to define challenges during the early stages of the pandemic. A cross-sectional bibliometric review of COVID-19 literature was undertaken between 1 ... ...

Abstract	This study explores the response to COVID-19 from investigators, editors, and publishers and seeks to define challenges during the early stages of the pandemic. A cross-sectional bibliometric review of COVID-19 literature was undertaken between 1 November 2019 and 24 March 2020, along with a comparative review of Middle East respiratory syndrome (MERS) literature. Investigator responsiveness was assessed by measuring the volume and type of research published. Editorial responsiveness was assessed by measuring the submission-to-acceptance time and availability of original data. Publisher-responsiveness was assessed by measuring the acceptance-to-publication time and the provision of open access. Three hundred and ninety-eight of 2,835 COVID-19 and 55 of 1,513 MERS search results were eligible. Most COVID-19 studies were clinical reports ( Key points: COVID-19 publications show rapid response from investigators, specifically aiming to define the disease.Median time between submission and acceptance of COVID-19 articles is 5 days demonstrating rapid decision-making compared with the median of 71.5 days for MERS articles.Median time from acceptance to publication of COVID-19 articles is 5 days, confirming the ability to introduce rapid increases at times of crisis, such as during the SARS outbreak.The majority of both COVID-19 and MERS articles are available open-access.
Keywords	covid19
Language	English
Publishing date	2020-07-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2018596-0
ISSN	1741-4857 ; 0953-1513
ISSN (online)	1741-4857
ISSN	0953-1513
DOI	10.1002/leap.1317
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Article ; Online: The impact of SARS-CoV-2 on the mental health of healthcare workers in a hospital setting-A Systematic Review.

Sanghera, Jaspinder / Pattani, Nikhil / Hashmi, Yousuf / Varley, Kate F / Cheruvu, Manikandar Srinivas / Bradley, Alex / Burke, Joshua R

Journal of occupational health

2020 Volume 62, Issue 1, Page(s) e12175

Abstract: Objectives: The SARS-CoV-2 global pandemic has subjected healthcare workers (HCWs) to high risk of infection through direct workplace exposure, coupled with increased workload and psychological stress. This review aims to determine the impact of SARS- ... ...

Abstract	Objectives: The SARS-CoV-2 global pandemic has subjected healthcare workers (HCWs) to high risk of infection through direct workplace exposure, coupled with increased workload and psychological stress. This review aims to determine the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and formulate recommendations for future action. Methods: A systematic review was performed between 31st December 2019 and 17th June 2020 through Ovid Medline and Embase databases (PROSPERO ID CRD42020181204). Studies were included for review if they investigated the impact of SARS-CoV-2 on mental health outcomes of hospital-based HCWs and used validated psychiatric scoring tools. Prevalence of ICD-10 classified psychiatric disorders was the primary outcome measure. Results: The initial search returned 436 articles. Forty-four studies were included in final analysis, with a total of 69,499 subjects. Prevalence ranges of six mental health outcomes were identified: depression 13.5%-44.7%; anxiety 12.3%-35.6%; acute stress reaction 5.2%-32.9%; post-traumatic stress disorder 7.4%-37.4%; insomnia 33.8%-36.1%; and occupational burnout 3.1%-43.0%. Direct exposure to SARS-CoV-2 patients was the most common risk factor identified for all mental health outcomes except occupational burnout. Nurses, frontline HCWs, and HCWs with low social support and fewer years of working experience reported the worst outcomes. Conclusion: The SARS-CoV-2 pandemic has significantly impacted the mental health of HCWs. Frontline staff demonstrate worse mental health outcomes. Hospitals should be staffed to meet service provision requirements and to mitigate the impact onmental health. This can be improved with access to rapid-response psychiatric teams and should be continually monitored throughout the pandemic and beyond its conclusion.
MeSH term(s)	Anxiety Disorders/diagnosis ; Anxiety Disorders/epidemiology ; Burnout, Professional/epidemiology ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Depression/epidemiology ; Depression/physiopathology ; Female ; Health Personnel/psychology ; Humans ; Male ; Mental Health ; Occupational Health ; Occupational Stress/epidemiology ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Prevalence ; Risk Assessment ; Sleep Initiation and Maintenance Disorders/epidemiology ; United States
Keywords	covid19
Language	English
Publishing date	2020-10-26
Publishing country	Australia
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1340985-2
ISSN	1348-9585 ; 1341-9145
ISSN (online)	1348-9585
ISSN	1341-9145
DOI	10.1002/1348-9585.12175
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Article ; Online: Impact of COVID-19, gender, race, specialty and seniority on mental health during surgical training: an international study.

Kovoor, Joshua G / Layton, Georgia R / Burke, Joshua R / Churchill, James A / Jacobsen, Jonathan Henry W / Reid, Jessica L / Edwards, Suzanne / Issa, Eyad / Garrod, Tamsin J / Archer, Julian / Tivey, David R / Babidge, Wendy J / Dennison, Ashley R / Maddern, Guy J

ANZ journal of surgery

2022 Volume 92, Issue 9, Page(s) 2094–2101

Abstract: Background: Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross-sectional study determining relative impacts of COVID-19, gender, race, specialty and seniority on mental ... ...

Abstract	Background: Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross-sectional study determining relative impacts of COVID-19, gender, race, specialty and seniority on mental health of surgical trainees. Method: Trainees across Australia, New Zealand and UK enrolled in surgical training accredited by the Royal Australasian College of Surgeons or Royal College of Surgeons were included. Outcomes included the short version of the Perceived Stress Scale, Oxford Happiness Questionnaire short scale, Patient Health Questionnaire-2 and the effect on individual stress levels of training experiences affected by COVID-19. Predictors included trainee characteristics and local COVID-19 prevalence. Multivariable linear regression analyses were conducted to assess association between outcomes and predictors. Results: Two hundred and five surgical trainees were included. Increased stress was associated with number of COVID-19 patients treated (P = 0.0127), female gender (P = 0.0293), minority race (P = 0.0012), less seniority (P = 0.001), and greater COVID-19 prevalence (P = 0.0122). Lower happiness was associated with training country (P = 0.0026), minority race (P = 0.0258) and more seniority (P < 0.0001). Greater depression was associated with more seniority (P < 0.0001). Greater COVID-19 prevalence was associated with greater reported loss of training opportunities (P = 0.0038), poor working conditions (P = 0.0079), personal protective equipment availability (P = 0.0008), relocation to areas of little experience (P < 0.0001), difficulties with career progression (P = 0.0172), loss of supervision (P = 0.0211), difficulties with pay (P = 0.0034), and difficulties with leave (P = 0.0002). Conclusion: This is the first study to specifically describe the relative impacts of COVID-19 community prevalence, gender, race, surgical specialty and level of seniority on stress, happiness and depression of surgical trainees on an international scale.
MeSH term(s)	COVID-19/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Mental Health ; Prospective Studies ; Specialties, Surgical/education
Language	English
Publishing date	2022-08-18
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.17980
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