COVID-19 and liver cancer: lost patients and larger tumours.

BACKGROUND: Northern England has been experiencing a persistent rise in the number of primary liver cancers, largely driven by an increasing incidence of hepatocellular carcinoma (HCC) secondary to alcohol-related liver disease and non-alcoholic fatty liver disease. Here we review the effect of the COVID-19 pandemic on primary liver cancer services and patients in our region. OBJECTIVE: To assess the impact of the COVID-19 pandemic on patients with newly diagnosed liver cancer in our region. DESIGN: We prospectively audited our service for the first year of the pandemic (March 2020-February 2021), comparing mode of presentation, disease stage, treatments and outcomes to a retrospective observational consecutive cohort immediately prepandemic (March 2019-February 2020). RESULTS: We observed a marked decrease in HCC referrals compared with previous years, falling from 190 confirmed new cases to 120 (37%). Symptomatic became the the most common mode of presentation, with fewer tumours detected by surveillance or incidentally (% surveillance/incidental/symptomatic; 34/42/24 prepandemic vs 27/33/40 in the pandemic, p=0.013). HCC tumour size was larger in the pandemic year (60±4.6 mm vs 48±2.6 mm, p=0.017), with a higher incidence of spontaneous tumour haemorrhage. The number of new cases of intrahepatic cholangiocarcinoma (ICC) fell only slightly, with symptomatic presentation typical. Patients received treatment appropriate for their cancer stage, with waiting times shorter for patients with HCC and unchanged for patients with ICC. Survival was associated with stage both before and during the pandemic. 9% acquired COVID-19 infection. CONCLUSION: The pandemic-associated reduction in referred patients in our region was attributed to the disruption of routine healthcare. For those referred, treatments and survival were appropriate for their stage at presentation. Non-referred or missing patients are expected to present with more advanced disease, with poorer outcomes. While protective measures are necessary during the pandemic, we recommend routine healthcare services continue, with patients encouraged to engage.

Articulated dissent and immediacy: a cross-national analysis of the effects of COVID-19 lockdowns

Purpose>In the midst of the COVID-19 pandemic, this study aims to explore how working remotely might impact the superior–subordinate relationship. Specifically, this study examines how immediacy explains articulated dissent, considers how an individual’s attitudes toward online communication predicts immediacy and articulated dissent and compares these relationships in England, Australia and the USA.Design/methodology/approach>Three nations were examined: Australia, England and the USA (n = 1,776). Surveys included demographic questions and the following measures: organizational dissent scale, perceived immediacy measure, computer-mediated immediate behaviors measure and measure of online communication attitude.Findings>The results reveal supervisors’ computer-mediated immediate behaviors and perceived immediacy both positively predict dissent. Some aspects of online communication attitudes positively predict computer-mediated immediate behaviors and perceived immediacy. In addition, attitudes toward online communication positively predict dissent. National culture influences some of these relationships;in each case the effects were substantively larger for the USA when compared to the other nations.Originality/value>This study is the first to cross-culturally analyze dissent and immediacy. In addition, this study considers the extent to which the COVID-19 pandemic influences the superior–subordinate relationship.

The Link Between Supervisor-Subordinate Computer-Mediated Immediate Behaviors and Organizational Identification in U.S., English, and Australian Organizations

More than 5.89 million people have died from COVID-19. Due to COVID-19, there is a need for organizations to reconsider their structures and systems in response to increased remote working and decreased face-to-face (FTF) interactions. This study analyzes organizational relationships, specifically the supervisor-subordinate relationship. This study examines the link between supervisor-subordinate immediacy and organizational identification in mediated communication. Participants from three nations (n = 1776) were explored to test the assumption that supervisor-subordinate immediacy explains organizational identification. The United States, Australia, and England were chosen as focal nations due to the differing government responses to the COVID-19 outbreak. Results revealed supervisors? perceived computer-mediated immediate behaviors and subordinates? perceived immediacy with their supervisors were positive predictors of organizational identity. U.S. supervisors were perceived to use higher levels of computer-mediated immediacy behaviors and have more perceived immediacy than Australian and English supervisors. Australian supervisors had higher levels of perceived immediacy than English supervisors.

SARS-CoV-2 one year on – the worrying impact on early detection of liver cancers

PWE-43 Figure 1