PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions

Spirituality and wellbeing in the workplace

The final publication is available at Springer via http://dx.doi.org/10.1007/978-3-319-95681-7_92The late 20th century and the early 21st centuries have seen a growing interest in spirituality in general and its role in the workplace (Petchsawanga and Duchon, 2012; Bell and Burack, 2001; Sedikides, 2010; Wagner-Marsh and Conley, 1999). However, despite this growing interest in spirituality and its place within the organisation, the concept remains undertheorized, and there is no generally accepted definition. The literature is primarily dominated by speculative discussion, fragmentation, dearth and incomprehensibility and a marked lack of empirical data, especially quantitative research (Khaled et al. 2012). Corner (2008: 377) goes on to note that, much of this work is in fact useful and thought-provoking but “…needs to be extended with experience or empirical data to prevent theories being remote from the phenomenon they intend to describe.” Often, the words spirituality, ethics and religion tend to overlap, so there is a need to clarify the concepts (Giacalone and Jurkiewicz, 2010). In a broad sense, ethics normally differentiates between right and wrong, religion is concerned with beliefs, prayers, and related formalised practices, whilst spirituality tends to refer to an individual’s determination to experience a deeper meaning to life through the way in which they live and work. (Snyder and Lopez, 2008)