ABSTRACT
Background and aims: Covid-19 has disrupted essential stroke prevention and treatment services, stroke rehabilitation and support services and delivery of stroke research. We examine recruitment data for two stroke rehabilitation trials recruiting within a single centre in November 2019 and November 2021, to identify if/how Covid-19 impacted upon recruitment rates and processes. Both studies were managed by the same research team and comprised of comparable protocols and selection criteria. Methods: Recruitment data from the two corresponding time periods, are reported using descriptive statistics. Field notes and direct researcher experiences are used to support observations derived from the data. Results: Patients screened reduced by >40% in November 2021 compared to the same period in 2019, despite an almost 20% increase in admissions, recruitment reduced by 75%. Research staffing issues (sickness) resulted in missed recruitment data and opportunities in November 2021. There were changes in participant identification methods, resulting from restricted researcher screening within clinical areas;more remote screening, less attendance at clinical meetings and increased initiation of referrals from the clinical staff (Table 1). While the centre's clinical trials portfolio expanded between 2019 and 2021 (from 11 to 17), we noted a reduction in research co-enrolment;reasons for this are unclear, however lower recruitment rates more broadly may have contributed to this. Conclusions: Covid-19 has changed how we engage with/in clinical research. Understanding the ways in which Covid-19 has altered the research recruitment landscape will be important in the continued delivery of vital stroke research, driving clinical advancements in the field.
ABSTRACT
BACKGROUND: Reducing COVID-19 transmission relies on controlling droplet and aerosol spread. Fluorescein staining reveals microscopic droplets. AIM: To compare the droplet spread in non-laminar and laminar air flow operating theatres. METHODS: A 'cough-generator' was fixed to a theatre trolley at 45°. Fluorescein-stained 'secretions' were projected on to a series of calibrated targets. These were photographed under UV light and 'source detection' software measured droplet splatter size and distance. FINDINGS: The smallest droplet detected was â¼120 µm and the largest â¼24,000 µm. An average of 25,862 spots was detected in the non-laminar theatre, compared with 11,430 in the laminar theatre (56% reduction). The laminar air flow mainly affected the smaller droplets (<1000 µm). The surface area covered with droplets was: 6% at 50 cm, 1% at 2 m, and 0.5% at 3 m in the non-laminar air flow; and 3%, 0.5%, and 0.2% in the laminar air flow, respectively. CONCLUSION: Accurate mapping of droplet spread in clinical environments is possible using fluorescein staining and image analysis. The laminar air flow affected the smaller droplets but had limited effect on larger droplets in our 'aerosol-generating procedure' cough model. Our results indicate that the laminar air flow theatre requires similar post-surgery cleaning to the non-laminar, and staff should consider full personal protective equipment for medium- and high-risk patients.