Inequalities in health have existed for many decades and have led to unjust consequences in morbidity and mortality. These have become even more apparent during the COVID-19 pandemic with individuals from black and minority ethnic groups, poorer socioeconomic backgrounds, urban and rurally deprived locations, and vulnerable groups of society suffering the full force of its effects. This review is highlighting the current disparities that exist within different societies, that subsequently demonstrate COVID-19, does in fact, discriminate against disadvantaged individuals. Also explored in detail are the measures that can and should be taken to improve equality and provide equitable distribution of healthcare resources amongst underprivileged communities.
Background A year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection. Objectives This systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity. Methods We searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019–30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country. Results 115 studies were included spanning 17 European countries, that estimated the seroprevalence of SARS-CoV-2 from samples obtained between November 2019 –August 2020. A total of 54/115 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence between different age groups and the majority of studies reported there was no significant difference by gender. Conclusion This review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.
Objectives: The UK postgraduate training program in cardiothoracic surgery is challenging and competitive, with trainees choosing the field for different reasons. This study aims to identify factors that influence medical students in pursuing a career within cardiothoracic surgery.Methods: A cross-sectional study was carried out in which a questionnaire was anonymously filled out by medical students across 17 medical schools in the United Kingdom. An online survey platform was used for survey distribution and analysis. A mixed-methods approach was employed to gather quantitative and qualitative data. Data collection consisted of a series of closed questions and 1 open-ended question. The questions focused on the attitudes toward, knowledge of, and exposure to cardiothoracic surgery. Results:The survey yielded 265 responses. Interest in cardiothoracic surgery was seen in 45.3% of participants, with the leading factor for pursuing this career being lifestyle factors (50%), closely followed by the career opportunities (42.9%) and the aid of mentors (31%). Some discouraging factors were: Difficulty of learning material (37.7%), length of the training program (27.4%), competition in the field (26%), stress (24.3%), and lifestyle factors (22.1%). PERSPECTIVEAttracting enthusiastic individuals to the specialty is essential to the sustainability of cardiothoracic surgery. In this study, we aimed to understand the influences behind the perceptions of cardiothoracic surgery amongst UK medical students and identify strategies that could ameliorate specialty numbers, through the distribution of a multiuniversity survey targeting medical students of all years.
The coronavirus disease 2019 (COVID‐19) pandemic has increased the burden on hospital staff world‐wide. Through the redistribution of scarce resources to these high‐priority cases, the cardiac sector has fallen behind. In efforts to reduce transmission, reduction in direct patient–physician contact has led to a backlog of cardiac cases. However, this accumulation of postponed or cancelled nonurgent cardiac care seems to be resolvable with the assistance of technology. From telemedicine to artificial intelligence (AI), technology has transformed healthcare systems nationwide. Telemedicine enables patient monitoring from a distance, while AI unveils a whole new realm of possibilities in clinical practice, examples include: traditional systems replacement with more efficient and accurate processing machines; automation of clerical process; and triage assistance through risk predictions. These possibilities are driven by deep and machine learning. The two subsets of AI are explored and limitations regarding “big data” are discussed. The aims of this review are to explore AI: the advancements in methodology; current integration in cardiac surgery or other clinical scenarios; and potential future roles, which are innately nearing as the COVID‐19 era urges alternative approaches for care.
Congenital anomalies of the aortic valve frequently necessitate intervention in childhood. The most common aortic valve pathologies present in childhood are aortic stenosis and insufficiency. Presentation of aortic valve disease depends on severity and presence of concomitant syndromes and valvular disorders. Treatment options are largely categorised as medical, percutaneous repair or surgical repair and replacement. Surgical techniques have been refined over the last few years making this the mainstay of treatment in paediatric cases. Whilst repair is considered in most instances before replacement, there are substantial limitations which are reflected in the frequency of reintervention and restenosis rate. Replacements are typically undertaken with tissue or mechanical prosthesis. The current gold-standard aortic valve replacement surgery is called the Ross procedure—where replacement is undertaken with a competent pulmonic valve and a simultaneous pulmonary homograft.Conclusion: In this review, we aim to outline the various surgical options and discuss efficacy and complications of various interventions. What is Known: • Congenital aortic valve defects repair options medically and surgically What is New: • Comparisons between surgical options for aortic valve repair including efficacy, risks and long-term outcomes.
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