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  1. Article ; Online: Collaboration is key: the role of social media in advancing surgical research.

    Bisset, Carly N / Moug, Susan J

    Surgery

    2023  Volume 174, Issue 2, Page(s) 392–394

    Abstract: Social media has revolutionized how we design, deliver, and disseminate surgical research for the better. The rise of collaborative research groups has been a major contributor to and beneficiary of social media, leading to increased involvement from ... ...

    Abstract Social media has revolutionized how we design, deliver, and disseminate surgical research for the better. The rise of collaborative research groups has been a major contributor to and beneficiary of social media, leading to increased involvement from clinicians, medical students, healthcare professionals, patients, and industry. Everyone benefits from collaborative research by widening access and participation and delivering more impactful research with increasing validity of results applicable to global populations. Now more than ever, the international surgical community is engaged in the process of surgical research, including the role of interdisciplinary collaboration. Patient groups are also central to the process of collaboration. By delivering increasingly relevant research, and by asking pertinent research questions that patients value, higher-impact research is more likely to directly lead to clinical change. From an academic perspective, hierarchies have flattened, facilitating the inclusion of anyone who is interested in contributing to surgical research to be able to do so. Social media has led to a paradigm shift in how surgical research may be conducted. Diversity of thought in research is improving, and engagement in surgical research is at an all-time high. Collaboration of all stakeholders is key to #SoMe4Surgery success and is the new 'gold standard' of surgical research.
    MeSH term(s) Humans ; Social Media ; Health Personnel ; Students, Medical
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2023.04.053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Influencing factors in surgical decision-making: a qualitative analysis of colorectal surgeons' experiences of postoperative complications.

    Bisset, Carly N / Moug, Susan J / Oliphant, Raymond / Dames, Nicola / Parson, Simon / Cleland, Jennifer

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2024  

    Abstract: Aim: When making anastomotic decisions in rectal cancer surgery, surgeons must consider the risk of anastomotic leakage, which bears implications for the patient's quality of life, cancer recurrence and, potentially, death. The aim of this study was to ... ...

    Abstract Aim: When making anastomotic decisions in rectal cancer surgery, surgeons must consider the risk of anastomotic leakage, which bears implications for the patient's quality of life, cancer recurrence and, potentially, death. The aim of this study was to investigate the views of colorectal surgeons on how their individual attributes (e.g. experience, personality traits) may influence their decision-making and experience of complications.
    Method: This qualitative study used individual interviews for data collection. Purposive sampling was used to invite certified UK-based colorectal surgeons to participate. Participants were recruited until ongoing data review indicated no new codes were generated, suggesting data sufficiency. Data were analysed thematically following Braun and Clarke's six-step framework.
    Results: Seventeen colorectal surgeons (eight female, nine male) participated. Two key themes with relevant subthemes were identified: (1) personal attributes influencing variation in decision-making (e.g. demographics, personality) and (2) the influence of complications on decision-making. Surgeons described variation in the management of complications based upon their personal attributes, which included factors such as gender, experience and subspeciality interests. Surgeons described the detrimental impact of anastomotic leakage on their mental and physical health. Experience of anastomotic leakage influences future decision-making and is associated with changes in practice even when a technical error is not identified.
    Conclusion: Colorectal surgeons consider anastomotic leaks to be personal 'failures', which has a negative impact on surgeon welfare. Better understanding of how surgeons make difficult decisions, and how surgeons respond to and learn from complications, is necessary to identify 'personalized' methods of supporting surgeons at all career stages, which may improve patient outcomes.
    Language English
    Publishing date 2024-03-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16943
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Investigation of frailty markers including a novel biomarker panel in emergency laparotomy: protocol of a prospective cohort study.

    Ng, Hwei Jene / Quasim, Tara / Rattray, Nicholas J W / Moug, Susan

    BMC surgery

    2023  Volume 23, Issue 1, Page(s) 190

    Abstract: Background: Emergency laparotomy (EmLAP) is one of the commonest emergency operations performed in the United Kingdom (approximately 30, 000 laparotomies annually). These potentially high-risk procedures can be life changing with frail patients and/ or ... ...

    Abstract Background: Emergency laparotomy (EmLAP) is one of the commonest emergency operations performed in the United Kingdom (approximately 30, 000 laparotomies annually). These potentially high-risk procedures can be life changing with frail patients and/ or older adults (≥ 65 years) having the poorest outcomes, including mortality. There is no gold standard of frailty assessment and no clinical chemical biomarkers existing in practice. Early detection of subclinical changes or deficits at the molecular level are essential in improving our understanding of the biology of frailty and ultimately improving patient outcomes. This study aims primarily to compare preoperative frailty markers, including a blood-based biomarker panel, in their ability to predict 30 and 90-day mortality post-EmLAP. The secondary aim is to analyse the influence of perioperative frailty on morbidity and quality of life post-EmLAP.
    Methods: A prospective single centred observational study will be conducted on 150 patients ≥ 40 years of age that undergo EmLAP. Patients will be included according to the established NELA (National Emergency Laparotomy Audit) criteria. The variables collected include demographics, co-morbidities, polypharmacy, place of residence, indication and type of surgery (as per NELA criteria) and prognostic NELA score. Frailty will be assessed using: a blood sample for ultra-high performance liquid chromatography mass spectrometry analysis; preoperative CT abdomen pelvis (sarcopenia) and Rockwood Clinical Frailty Scale (CFS). Patients will be followed up for 90 days. Variables collected include blood samples (at post operative day 1, 7, 30 and 90), place of residence on discharge, morbidity, mortality and quality of life (EQ-5D-5 L). The frailty markers will be compared between groups of frail (CFS ≥ 4) and non-frail using statistical methods such as regression model and adjusted for appropriate confounding factors.
    Discussion: This study hypothesises that frailty level changes following EmLAP in frail and non- frail patients, irrespective of age. We propose that non- frail patients will have better survival rates and report better quality of life compared to the frail. By studying the changes in metabolites/ biomarkers in these patients and correlate them to frailty status pre-surgery, this highly novel approach will develop new knowledge of frailty and define a new area of clinical biomolecular research.
    Trial registration: ClinicalTrials.gov: NCT05416047. Registered on 13/06/2022 (retrospectively registered).
    MeSH term(s) Humans ; Aged ; Frailty/diagnosis ; Frail Elderly ; Prospective Studies ; Laparotomy ; Quality of Life ; Biomarkers ; Observational Studies as Topic
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-07-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050442-1
    ISSN 1471-2482 ; 1471-2482
    ISSN (online) 1471-2482
    ISSN 1471-2482
    DOI 10.1186/s12893-023-02093-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The virtual uncertainty of futility in emergency surgery.

    Javanmard-Emamghissi, Hannah / Moug, Susan J

    The British journal of surgery

    2022  Volume 109, Issue 12, Page(s) 1184–1185

    MeSH term(s) Humans ; Medical Futility ; Uncertainty ; Withholding Treatment ; Ethics, Medical
    Language English
    Publishing date 2022-09-06
    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/znac313
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: An evaluation of the feasibility of implementing the BeWEL lifestyle intervention programme for people at increased risk of colorectal cancer – from research to real life

    Anderson, Annie S. / Donaghy, Claire / Lamb, Ross / Steele, R. J. C. / Moug, Susan

    Journal of Human Nutrition and Dietetics. 2023 Apr., v. 36, no. 2 p.540-553

    2023  

    Abstract: BACKGROUND: The BeWEL randomised controlled trial (RCT) of weight loss in people with colorectal adenomas demonstrated that a significant proportion of people are interested in lifestyle interventions (49%) and clinically relevant changes in body weight ... ...

    Abstract BACKGROUND: The BeWEL randomised controlled trial (RCT) of weight loss in people with colorectal adenomas demonstrated that a significant proportion of people are interested in lifestyle interventions (49%) and clinically relevant changes in body weight were achieved at 12‐month follow‐up. The current work aimed to assess the feasibility of the BeWEL programme invitation and delivery in a nonresearch setting to assess whether the original results could be replicated. METHODS: The original BeWel programme was modified through the provision of verbal introductions (vs. letter), requirement for people to contact BeWEL team (vs. BeWEL team contacting them), community delivery (vs. home), duration (12 weeks vs. 12 months) and two intervention visits (vs. 3) and inclusion of people with predisposition to colorectal cancer. Eligible people were informed about the BeWel programme from National Health Service (NHS) staff after colonoscopy procedures and invited to contact a dedicated Bowel Cancer UK lifestyle team. RESULTS: Findings demonstrated that programme uptake (10.6% vs. 33%) and retention (71% vs. 93%) was significantly lower than that obtained from the BeWEL RCT. For people who participated in the 3‐month programme (n = 21), self‐reported weight loss (mean: −7% body weight) was successful, and the programme was well received. CONCLUSIONS: The current approach to engaging clients with the BeWEL programme is unsustainable. Reliance on busy NHS staff to deliver invitations and the need for people to contact the delivery team (due to data protection) may have impacted on uptake. Alternative approaches to supporting weight management in this population should be explored further.
    Keywords body weight ; colonoscopy ; colorectal neoplasms ; dietetics ; health services ; lifestyle ; people ; risk ; weight control ; weight loss
    Language English
    Dates of publication 2023-04
    Size p. 540-553.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note JOURNAL ARTICLE
    ZDB-ID 645183-4
    ISSN 1365-277X ; 0952-3871 ; 1465-8178
    ISSN (online) 1365-277X
    ISSN 0952-3871 ; 1465-8178
    DOI 10.1111/jhn.13117
    Database NAL-Catalogue (AGRICOLA)

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  6. Article ; Online: Postoperative outcomes and identification of risk factors for complications after emergency intestinal stoma surgery - a multicentre retrospective study.

    MacDonald, Scott / Wong, Li-Siang / Ng, Hwei Jene / Hastings, Claire / Ross, Immogen / Quasim, Tara / Moug, Susan

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2024  

    Abstract: Aim: Approximately 4000 patients in the UK have an emergency intestinal stoma formed each year. Stoma-related complications (SRCs) are heterogeneous but have previously been subcategorized into early or late SRCs, with early SRCs generally occurring ... ...

    Abstract Aim: Approximately 4000 patients in the UK have an emergency intestinal stoma formed each year. Stoma-related complications (SRCs) are heterogeneous but have previously been subcategorized into early or late SRCs, with early SRCs generally occurring within 30 days postoperatively. Early SRCs include skin excoriation, stoma necrosis and high output, while late SRCs include parastomal hernia, retraction and prolapse. There is a paucity of research on specific risk factors within the emergency cohort for development of SRCs. This paper aims to describe the incidence of SRCs after emergency intestinal surgery and to identify potential risk factors for SRCs within this cohort.
    Method: Consecutive patients undergoing emergency formation of an intestinal stoma (colostomy, ileostomy or jejunostomy) were identified prospectively from across three acute hospital sites over a 3-year period from the ELLSA (Emergency Laparotomy and Laparoscopic Scottish Audit) database. All patients were followed up for a minimum of 1 year. A multivariate logistic regression model was used to identify risk factors for early and late SRCs.
    Results: A total of 455 patients were included (median follow-up 19 months, median age 64 years, male:female 0.52, 56.7% ileostomies). Early SRCs were experienced by 54.1% of patients, while 51% experienced late SRCs. A total of 219 patients (48.1%) had their stoma sited preoperatively. Risk factors for early SRCs included end ileostomy formation [OR 3.51 (2.24-5.49), p < 0.001], while preoperative stoma siting was found to be protective [OR 0.53 (0.35-0.83), p = 0.005]. Patient obesity [OR 3.11 (1.92-5.03), p < 0.001] and reoperation for complications following elective surgery [OR 4.18 (2.01-8.69), p < 0.001] were risk factors for late SRCs.
    Conclusion: Stoma-related complications after emergency surgery are common. Preoperative stoma siting is the only truly modifiable risk factor to reduce SRCs, and further research should be aimed at methods of improving the frequency and accuracy of this in the emergency setting.
    Language English
    Publishing date 2024-03-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16947
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Prehabilitation vs Postoperative Rehabilitation for Frail Patients.

    Keller, Deborah S / Carter, Ben / Moug, Susan J

    JAMA surgery

    2020  Volume 155, Issue 9, Page(s) 896

    MeSH term(s) Aged ; Colonic Neoplasms ; Colorectal Neoplasms ; Frail Elderly ; Humans ; Postoperative Complications/prevention & control ; Preoperative Exercise
    Language English
    Publishing date 2020-06-25
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2020.1798
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Comment on: Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables.

    Bradley, Alison / Knight, Stephen / Chin, Mei Ying / Moug, Susan

    The British journal of surgery

    2021  Volume 109, Issue 2, Page(s) e39

    MeSH term(s) Humans ; Rectal Neoplasms/surgery ; Surgical Stomas
    Language English
    Publishing date 2021-11-06
    Publishing country England
    Document type Journal Article ; Comment
    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/znab387
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: An evaluation of the feasibility of implementing the BeWEL lifestyle intervention programme for people at increased risk of colorectal cancer - from research to real life.

    Anderson, Annie S / Donaghy, Claire / Lamb, Ross / Steele, Robert J C / Moug, Susan

    Journal of human nutrition and dietetics : the official journal of the British Dietetic Association

    2022  Volume 36, Issue 2, Page(s) 540–553

    Abstract: Background: The BeWEL randomised controlled trial (RCT) of weight loss in people with colorectal adenomas demonstrated that a significant proportion of people are interested in lifestyle interventions (49%) and clinically relevant changes in body weight ...

    Abstract Background: The BeWEL randomised controlled trial (RCT) of weight loss in people with colorectal adenomas demonstrated that a significant proportion of people are interested in lifestyle interventions (49%) and clinically relevant changes in body weight were achieved at 12-month follow-up. The current work aimed to assess the feasibility of the BeWEL programme invitation and delivery in a nonresearch setting to assess whether the original results could be replicated.
    Methods: The original BeWel programme was modified through the provision of verbal introductions (vs. letter), requirement for people to contact BeWEL team (vs. BeWEL team contacting them), community delivery (vs. home), duration (12 weeks vs. 12 months) and two intervention visits (vs. 3) and inclusion of people with predisposition to colorectal cancer. Eligible people were informed about the BeWel programme from National Health Service (NHS) staff after colonoscopy procedures and invited to contact a dedicated Bowel Cancer UK lifestyle team.
    Results: Findings demonstrated that programme uptake (10.6% vs. 33%) and retention (71% vs. 93%) was significantly lower than that obtained from the BeWEL RCT. For people who participated in the 3-month programme (n = 21), self-reported weight loss (mean: -7% body weight) was successful, and the programme was well received.
    Conclusions: The current approach to engaging clients with the BeWEL programme is unsustainable. Reliance on busy NHS staff to deliver invitations and the need for people to contact the delivery team (due to data protection) may have impacted on uptake. Alternative approaches to supporting weight management in this population should be explored further.
    MeSH term(s) Humans ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/prevention & control ; Life Style ; Feasibility Studies ; Weight Loss ; Body Weight ; Behavior Therapy ; Male ; Female ; Middle Aged ; Aged ; United Kingdom/epidemiology ; Adenoma/epidemiology ; Adenoma/prevention & control
    Language English
    Publishing date 2022-12-08
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 645183-4
    ISSN 1365-277X ; 0952-3871 ; 1465-8178
    ISSN (online) 1365-277X
    ISSN 0952-3871 ; 1465-8178
    DOI 10.1111/jhn.13117
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Comparison of the clinical frailty score (CFS) to the National Emergency Laparotomy Audit (NELA) risk calculator in all patients undergoing emergency laparotomy.

    Palaniappan, Subbra / Soiza, Roy L / Duffy, Siobhan / Moug, Susan J / Myint, Phyo Kyaw

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2022  Volume 24, Issue 6, Page(s) 782–789

    Abstract: Aim: There is evolving evidence that preoperative frailty predicts outcomes of older adults undergoing emergency laparotomy (EmLap). We assessed frailty scoring in an emergency surgical population that included patients of all ages and then compared ... ...

    Abstract Aim: There is evolving evidence that preoperative frailty predicts outcomes of older adults undergoing emergency laparotomy (EmLap). We assessed frailty scoring in an emergency surgical population that included patients of all ages and then compared this to an established perioperative prognostic score.
    Method: Data from the prospective Emergency Laparoscopic and Laparotomy Scottish Audit (ELLSA; November 2017-October 2018) was used. All adults over 18 were included. Frailty was measured using 7-point clinical frailty score (CFS).
    Outcome measures: 30-day mortality, hospital length of stay (LOS), 30-day readmission. Areas under the receiver-operating characteristic (ROC) curves were calculated for CFS (1-7) and compared to the National Emergency Laparotomy Audit (NELA) score with Forest plots used to compare 30-day mortality across CFS and NELA categories.
    Results: A total of 2246 patients (median age 65 years [IQR 51-75]; female 51%) underwent EmLap (60% for colorectal pathology). A total of 10.6% were frail preoperatively (≥CFS 5). As CFS increased so did 30-day mortality (2.1% CFS1 to 25.3% CFS6 and 7; ꭓ
    Conclusion: This study supports the prognostic role of frailty in the emergency surgical setting, finding increasing frailty to be associated with increased mortality and longer LOS in adults of all ages. Although NELA performed better, CFS remained predictive and has the advantage of being calculated preoperatively to aid decision-making and treatment planning.
    MeSH term(s) Aged ; Female ; Frail Elderly ; Frailty/complications ; Frailty/epidemiology ; Humans ; Laparotomy ; Length of Stay ; Prospective Studies ; Retrospective Studies
    Language English
    Publishing date 2022-03-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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