Video Interviews and Surgical Applicants' Ability to Assess Fit to Residency Programs.

INTRODUCTION: Due to the COVID-19 pandemic, the recruitment cycle for the 2021 Match was performed virtually. This Association for Surgical Education (ASE)-sponsored survey set out to study applicants' ability to assess the factors contributing to fit through video interviews. METHODS: An IRB-approved, online, anonymous survey was distributed to surgical applicants at a single academic institution and through the ASE clerkship director distribution list between the rank order list certification deadline and Match Day. Applicants used 5-point Likert-type scales to rate factors for importance to fit and their ease of assessment through video interviewing. A variety of recruitment activities were also rated by applicants for their perceived helpfulness in assessment of fit. RESULTS: One hundred and eighty-three applicants responded to the survey. The three most important factors for applicant fit were how much the program cared, how satisfied residents seem with their program, and how well residents get along. Resident rapport, diversity of the patient population, and quality of the facilities were hardest to assess through video interviews. In general, diversity-related factors were more important to female and non-White applicants, but not more difficult to assess. Interview day and resident-only virtual panels were the most helpful recruitment activities, while virtual campus tours, faculty-only panels, and a program's social media were the least helpful. CONCLUSIONS: This study provides valuable insight into the limitations of virtual recruitment for surgical applicants' perception of fit. These findings and the recommendations herein should be taken into consideration by residency program leadership to ensure successful recruitment of diverse residency classes.

#WuhanDiary and #WuhanLockdown: gendered posting patterns and behaviours on Weibo during the COVID-19 pandemic.

Social media can be both a source of information and misinformation during health emergencies. During the COVID-19 pandemic, social media became a ubiquitous tool for people to communicate and represents a rich source of data researchers can use to analyse users' experiences, knowledge and sentiments. Research on social media posts during COVID-19 has identified, to date, the perpetuity of traditional gendered norms and experiences. Yet these studies are mostly based on Western social media platforms. Little is known about gendered experiences of lockdown communicated on non-Western social media platforms. Using data from Weibo, China's leading social media platform, we examine gendered user patterns and sentiment during the first wave of the pandemic between 1 January 2020 and 1 July 2020. We find that Weibo posts by self-identified women and men conformed with some gendered norms identified on other social media platforms during the COVID-19 pandemic (posting patterns and keyword usage) but not all (sentiment). This insight may be important for targeted public health messaging on social media during future health emergencies.

COVID-19, sex, and gender in China: a scoping review.

BACKGROUND: During the course of the COVID-19 pandemic, states were called upon by the World Health Organization to introduce and prioritise the collection of sex-disaggregated data. The collection of sex-disaggregated data on COVID-19 testing, infection rates, hospital admissions, and deaths, when available, has informed our understanding of the biology of the infectious disease. The collection of sex-disaggregated data should also better inform our understanding of the gendered impacts that contribute to risk of exposure to COVID-19. In China, the country with the longest history of fighting the COVID-19 infection, what research was available on the gender-differential impacts of COVID-19 in the first 6 months of the COVID-19 pandemic? METHODS: In this scoping review, we examine the first 6 months (January-June 2020) of peer-reviewed publications (n = 451) on sex and gender experiences related to COVID-19 in China. We conducted an exhaustive search of published Chinese and English language research papers on COVID-19 in mainland China. We used a COVID-19 Gender Matrix informed by the JPHIEGO gender analysis toolkit to examine and illuminate research into the gendered impacts of COVID-19 within China. RESULTS: In China, only a small portion of the COVID-19-related research focused on gender experiences and differences. Near the end of the six-month literature review period, a small number of research items emerged on women healthcare workers, women's mental health, and pregnant women's access to care. There was an absence of research on the gendered impact of COVID-19 amongst populations. There was minimal consideration of the economic, social and security factors, including gender stereotypes and expectations, that affected different populations' experiences of infection, treatment, and lockdown during the period of review. CONCLUSION: At the outset of health emergencies in China, gender research needs to be prioritised during the first stage of an outbreak to assist with evaluation of the most effective public health measures, identifying access to healthcare and social welfare barriers amongst priority communities. Gender stereotypes and gendered differences lead to different patterns of exposure and treatment. The exclusion of this knowledge in real time affects the design of effective prevention and recovery.

Applicants' perception of fit to residency programmes in the video-interview era: A large multidisciplinary survey.

INTRODUCTION: 'Fit' refers to an applicants' perceived compatibility to a residency programme. A variety of structural, identity-related and relational factors contribute to self-assessments of fit. The 2021 residency recruitment cycle in the USA was performed virtually due to the COVID-19 pandemic. Little is known about how video-interviewing may affect residency applicants' ability to gauge fit. METHODS: A multidisciplinary, anonymous survey was distributed to applicants at a large academic institution between rank order list (ROL) certification deadline and Match Day 2021. Using Likert-type scales, applicants rated factors for importance to 'fit' and their ease of assessment through video-interviewing. Applicants also self-assigned fit scores to the top-ranked programme in their ROL using Likert-type scales with pairs of anchoring statements. RESULTS: Four hundred seventy-three applicants responded to the survey (25.7% response rate). The three most important factors to applicants for assessment of fit (how much the programme seemed to care, how satisfied residents seem with their programme and how well the residents get along) were also the factors with the greatest discrepancy between importance and ease of assessment through video-interviewing. Diversity-related factors were more important to female applicants compared with males and to non-White applicants compared with White applicants. Furthermore, White male applicants self-assigned higher fit scores compared with other demographic groups. CONCLUSION: There is a marked discrepancy between the most important factors to applicants for fit and their ability to assess those factors virtually. Minoritised trainees self-assigned lower fit scores to their top-ranked programme, which should raise concern amongst medical educators and highlights the importance of expanding current diversity, equity and inclusion efforts in academic medicine.

Using gender analysis matrixes to integrate a gender lens into infectious diseases outbreaks research.

Evidence shows that infectious disease outbreaks are not gender-neutral, meaning that women, men and gender minorities are differentially affected. This evidence affirms the need to better incorporate a gender lens into infectious disease outbreaks. Despite this evidence, there has been a historic neglect of gender-based analysis in health, including during health crises. Recognizing the lack of available evidence on gender and pandemics in early 2020 the Gender and COVID-19 project set out to use a gender analysis matrix to conduct rapid, real-time analyses while the pandemic was unfolding to examine the gendered effects of the coronavirus disease 2019 pandemic. This paper reports on what a gender analysis matrix is, how it can be used to systematically conduct a gender analysis, how it was implemented within the study, ways in which the findings from the matrix were applied and built upon, and challenges encountered when using the matrix methodology.

Protection levels of N95-level respirator substitutes proposed during the COVID-19 pandemic: safety concerns and quantitative evaluation procedures.

OBJECTIVE: The COVID-19 pandemic has precipitated widespread shortages of filtering facepiece respirators (FFRs) and the creation and sharing of proposed substitutes (novel designs, repurposed materials) with limited testing against regulatory standards. We aimed to categorically test the efficacy and fit of potential N95 respirator substitutes using protocols that can be replicated in university laboratories. SETTING: Academic medical centre with occupational health-supervised fit testing along with laboratory studies. PARTICIPANTS: Seven adult volunteers who passed quantitative fit testing for small-sized (n=2) and regular-sized (n=5) commercial N95 respirators. METHODS: Five open-source potential N95 respirator substitutes were evaluated and compared with commercial National Institute for Occupational Safety and Health (NIOSH)-approved N95 respirators as controls. Fit testing using the 7-minute standardised Occupational Safety and Health Administration fit test was performed. In addition, protocols that can be performed in university laboratories for materials testing (filtration efficiency, air resistance and fluid resistance) were developed to evaluate alternate filtration materials. RESULTS: Among five open-source, improvised substitutes evaluated in this study, only one (which included a commercial elastomeric mask and commercial HEPA filter) passed a standard quantitative fit test. The four alternative materials evaluated for filtration efficiency (67%-89%) failed to meet the 95% threshold at a face velocity (7.6 cm/s) equivalent to that of a NIOSH particle filtration test for the control N95 FFR. In addition, for all but one material, the small surface area of two 3D-printed substitutes resulted in air resistance that was above the maximum in the NIOSH standard. CONCLUSIONS: Testing protocols such as those described here are essential to evaluate proposed improvised respiratory protection substitutes, and our testing platform could be replicated by teams with similar cross-disciplinary research capacity. Healthcare professionals should be cautious of claims associated with improvised respirators when suggested as FFR substitutes.

How Can The Public Be Better Protected Against COVID-19?

The response to the COVID-19 pandemic is a tragic aberration gripping the world. As the disease evolves, uncertainty and fear of harm rise, which can significantly diminish community health and wellbeing. This article stresses the importance of public health preparedness in overcoming social and health risks associated with public panic.Since the COVID-19 outbreak began in late 2019, the numbers of people affected and fatalities continue to mount, causing panic and crippling vital economic and social activities. Authorities have failed to prevent inaccurate and misleading headlines that agitate the public and impinge on public communication. Fake news and rumors about magical products claiming to cure the virus abound. Additionally, people assumed emergency preparation meant stockpiling resources. Amid growing fears, consumers raided supermarkets and pharmacies for supplies, from masks to hygiene products, and people have fought over protective gear as tensions flared among anxious customers.When general panic starts driving political decision-making, public health professionals may be unable to implement strategies based on informed decisions. Researchers argue that government secrecy and non-transparency diminish people?s confidence and trust, creating panic (Wilson et al., 2007). Even naming the disease possibly triggered epidemic-related trauma and the ensuing public mistrust and disbelief of authorities;the panic has also sparked a wave of racial prejudice (Titanji, 2020). Although a series of emerging and re-emerging infectious diseases, from Avian flu to Zika virus, may have created more public awareness, whether leaders can translate this newfound awareness into meaningful policies and action is debatable.Globally, attention is growing on responses from state leaders, as some try to downplay the epidemic?s severity to maintain ?business as usual?. In early March 2020, the Indonesian government was still in a state of denial and was attempting to convince the general public that the country was free from COVID-19 (Lindsey & Mann, 2020) Instead, currently confirmed cases are growing rapidly, suspected cases are far above the testing capacity, and case fatality is at an alarming rate.In contrast, several countries took drastic action by declaring travel restrictions and locking down cities. As an example, New Zealand decided to implement level-4 measures, with strict movement restrictions, not long after they confirmed their first case on 28 February 2020;they have recently begun a gradual exit from coronavirus lockdown (Knight, 2020).The public expects leaders to curb the spread of COVID-19 responsibly, appropriately, effectively, and proactively. Meanwhile, leaders are urging the public to stay calm and adopt new norms during this rapidly evolving situation. This crisis is not limited to any individual and requires cooperation rather than a unilateral response.�DISCUSSIONHow to do this?A critical approach to pandemics is to ensure the preparedness of both healthcare capacity and public health systems (Jain, Duse, & Bausch, 2018). To respond to emergency needs?to have the capacity to treat rapidly increasing numbers of COVID-19 patients?it is important for each country to have existing policies and action plans for healthcare facilities to temporarily expand service capacity, cancel or postpone elective procedures, and engage in rapid intervention to conserve medical supplies, including personal protective equipment (Gan, Tseng, & Lee, 2020). Measures including recalling recently retired healthcare workers and providing drive-through services for chronic disease medications have been implemented to lessen pressures on hospitals (Wang, Ng, & Brook, 2020).While healthcare capacity is the ability to care for patients with COVID-19, the public health system aims to prevent people from being infected and mitigating the health risks associated with COVID-19. The public health system is important for strengthening community vigilance by promoting effective sanitation, a healthy lifestyle, and food safety, and preventing injuries, inequality, and violence. This involves not only healthcare professionals, but also well-planned strategies that consider various stakeholders? perspectives and concerns (Glik, 2007). Despite the lockdown, we have seen healthcare workers and people in the community providing the basic essentials for those in need?from food, Personal Protective Equipment (PPE), mental health support, and evidence-based research communication, to virtual musical performances and concerts. Organizations in the virtual sphere, including WhatsApp (WhatsApp Inc, 2020) and TikTok, are partnering with health agencies to increase accessibility to health information.The best outbreak response is a collective response (Gille & Brall, 2020), which could effectively contain the disease and the panic caused by the disease. People naturally experience fear when dealing with a catastrophic event. This unprecedented threat triggered panic purchasing or falling for viral hoaxes, which reflects misconceptions about the problem, most likely because people lack trust in the measures taken (Heide, 2004), When designing and implementing public health measures, we must ensure we do not just acknowledge that, but actively engage relevant stakeholders. In an age of uncertainty, community solidarity and collective action are key to maintaining community vigilance against the crisis (Aldrich et al., 2015).

More than a public health crisis: A feminist political economic analysis of COVID-19.

Gender norms, roles and relations differentially affect women, men, and non-binary individuals' vulnerability to disease. Outbreak response measures also have immediate and long-term gendered effects. However, gender-based analysis of outbreaks and responses is limited by lack of data and little integration of feminist analysis within global health scholarship. Recognising these barriers, this paper applies a gender matrix methodology, grounded in feminist political economy approaches, to evaluate the gendered effects of the COVID-19 pandemic and response in four case studies: China, Hong Kong, Canada, and the UK. Through a rapid scoping of documentation of the gendered effects of the outbreak, it applies the matrix framework to analyse findings, identifying common themes across the case studies: financial discrimination, crisis in care, and unequal risks and secondary effects. Results point to transnational structural conditions which put women on the front lines of the pandemic at work and at home while denying them health, economic and personal security - effects that are exacerbated where racism and other forms of discrimination intersect with gender inequities. Given that women and people living at the intersections of multiple inequities are made additionally vulnerable by pandemic responses, intersectional feminist responses should be prioritised at the beginning of any crises.

Quantitative Fit Tested N95 Respirator-Alternatives Generated With CT Imaging and 3D Printing: A Response to Potential Shortages During the COVID-19 Pandemic.

RATIONALE AND OBJECTIVE: Three-dimensional (3D) printing allows innovative solutions for personal protective equipment, particularly in times of crisis. Our goal was to generate an N95-alternative 3D-printed respirator that passed Occupational Safety and Health Administration (OSHA)-certified quantitative fit testing during the COVID-19 pandemic. MATERIALS AND METHODS: 3D printed prototypes for N95 solutions were created based on the design of commercial N95 respirators. Computed tomography imaging was performed on an anthropomorphic head phantom wearing a commercially available N95 respirator and these facial contour data was used in mask prototyping. Prototypes were generated using rigid and flexible polymers. According to OSHA standards, prototypes underwent subsequent quantitative respirator fit testing on volunteers who passed fit tests on commercial N95 respirators. RESULTS: A total of 10 prototypes were 3D printed using both rigid (n = 5 designs) and flexible materials (n = 5 designs), Prototypes generated with rigid printing materials (n = 5 designs) did not pass quantitative respirator fit testing. Three of the five prototypes with flexible materials failed quantitative fit testing. The final two prototypes designs passed OSHA-certified quantitative fit tests with an overall mean fit factor of 138 (passing is over 100). CONCLUSION: Through rapid prototyping, 3D printed N95 alternative masks were designed with topographical facial computed tomography data to create mask facial contour and passed OSHA-certified quantitative respiratory testing when flexible polymer was used. This mask design may provide an alternative to disposable N95 respirators in case of pandemic-related shortages. Furthermore, this approach may allow customization for those that would otherwise fail fit testing on standard commercial respirators.

3D printed mask extenders: supplement to isolation masks to relieve posterior auricular discomfort

Purpose Many commonly used mask designs are secured by elastic straps looping around the posterior auricular region. This constant pressure and friction against the skin may contribute to increased wearer pain, irritation, and discomfort. The purpose of this work is to report a modified 3D printed mask extender to alleviate discomfort and increase mask wearability by relieving posterior auricular pressure from isolation masks.Methods Our institutional review board designated this project as non-human research and exempt. As part of resourcing 3D printing laboratories along with individual 3D printers to provide resources to healthcare workers, mask extenders were printed to relieve posterior auricular pressure from individuals wearing isolation masks. The authors modifed an existing mask extender, increasing its length with accompanying peripheral rungs for isolation mask securement. 3D printing was performed with Ultimaker S5 (Ultimaker B.V.;Geldermalsen, Netherlands) and CR-10 (Creality3D;Shenzhen, China) 3D printers using polylactic acid filaments. The author's modified extended mask extenders were printed and freely delivered to healthcare workers (physicians, nurses, technologists, and other personnel) at the authors' institution.Results The final mask extender design was printed with the two 3D printers with a maximum 7 straps printed simultaneously on each 3D printer. Mean print times ranges from 105 minutes for the Ultimaker S5 printer and 150 minutes for the CR-10. 475 mask extenders were delivered to healthcare workers at the authors' institution, with the demand far exceeding the available supply.Conclusion We offer a modification of a 3D printed mask extender design that decreases discomfort and increases the wearability of isolation mask designs with ear loops thought to relieve posterior auricular skin pressure and ability to control strap tension. The design is simple, produced with inexpensive material (polylactic acid), and have been well-received by healthcare providers at our institution

3D printed mask extenders as a supplement to isolation masks to relieve posterior auricular discomfort: an innovative 3D printing response to the COVID-19 pandemic.

PURPOSE: Many commonly used mask designs are secured by elastic straps looping around the posterior auricular region. This constant pressure and friction against the skin may contribute to increased wearer pain, irritation, and discomfort. The purpose of this work is to report a modified 3D printed mask extender to alleviate discomfort and increase mask wearability by relieving posterior auricular pressure from isolation masks. METHODS: Our institutional review board designated this project as non-human research and exempt. As part of resourcing 3D printing laboratories along with individual 3D printers to provide resources to healthcare workers, mask extenders were printed to relieve posterior auricular pressure from individuals wearing isolation masks. The authors modifed an existing mask extender, increasing its length with accompanying peripheral rungs for isolation mask securement. 3D printing was performed with Ultimaker S5 (Ultimaker B.V.; Geldermalsen, Netherlands) and CR-10 (Creality3D; Shenzhen, China) 3D printers using polylactic acid filaments. The author's modified extended mask extenders were printed and freely delivered to healthcare workers (physicians, nurses, technologists, and other personnel) at the authors' institution. RESULTS: The final mask extender design was printed with the two 3D printers with a maximum 7 straps printed simultaneously on each 3D printer. Mean print times ranges from 105 min for the Ultimaker S5 printer and 150 min for the CR-10. Four hundred seventy-five mask extenders were delivered to healthcare workers at the authors' institution, with the demand far exceeding the available supply. CONCLUSION: We offer a modification of a 3D printed mask extender design that decreases discomfort and increases the wearability of isolation mask designs with ear loops thought to relieve posterior auricular skin pressure and ability to control strap tension. The design is simple, produced with inexpensive material (polylactic acid), and have been well-received by healthcare providers at our institution.