Etiology of Pancreatitis in Patients at a Tertiary Care Center

Objective: To compare etiological frequencies in patients of acute pancreatitis presenting to our setup with international data. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Pakistan Emirates Military Hospital & Combined Military Hospital, Rawalpindi Pakistan, from Aug 2020 to Jan 2022. Methodology: Patients over 12 years suffering from pancreatitis were recruited using a convenience sampling technique based upon predefined criteria for diagnosis of pancreatitis on a questionnaire. Relevant basic lab tests, including chemistries and imaging, including Ultrasound abdomen and CECT abdomen, were analyzed to establish aetiology. Data were continuously uploaded into an electronic data sheet. International Consensus Diagnostic Criteria (ICDC) algorithms were applied to diagnose autoimmune pancreatitis. Results: Out of 120 patients, 74(61.7%) were males, and 46(38.3%) were females. Biliary pancreatitis was the most common aetiology 50(41.7%), followed in descending order by idiopathic 36(30%), drug-induced pancreatitis (DIP) 9(7.5%), Post ERCP Pancreatitis (PEP) 8(6.7%), tumours 5(4%), Autoimmune pancreatitis (AIP), Hypertriglyceridemia and alcohol-induced pancreatitis each 2(1.7%). Conclusion: Biliary pancreatitis has the highest frequency, followed by idiopathic and drug-induced pancreatitis. © 2023, Army Medical College. All rights reserved.

How Has the COVID-19 Crisis Transformed Entrepreneurs into Sustainable Leaders?

EntREsilience, a five-country longitudinal qualitative study, was launched in 2020 in China, Malaysia, the Philippines, Thailand and the UK to understand how entrepreneurs manifested resilience in response to the COVID-19 pandemic crisis events from March 2020 to February 2022. EntREsilience proposed a resilience-manifestation process model describing how entrepreneurs responded to the COVID-19 disruption, aided by external and internal enablers, adjusting their businesses to stabilise and even hunting for opportunities to grow their businesses. The present research adds to the findings of EntREsilience by analysing the strategies applied by entrepreneurs in their response to the crisis. This exploratory study focused on the entrepreneurs' community interactions and studied the effects of these interactions on the response measures adopted by the entrepreneurs. The results describe how the awareness of their stakeholder challenges shaped the entrepreneurial response. Realising the importance of stakeholder well-being to the sustainability of their enterprise motivated the entrepreneurs to develop sustainability competencies towards their stakeholder challenges, innovating solutions for their mutual well-being. By extending the resilience-manifestation process model, this paper proposes a transformation model depicting the process of entrepreneurs transforming into sustainable leaders triggered by stakeholder challenge awareness and moderated by contextual factors.

Automatic Boot Spray Machine: A Preventive Measure Against Corona Virus

Corona Virus (COVID-19) has already done havoc in the world. More than six hundred million people suffered from this virus and six million people are dead amongst them in the world. In Bangladesh, two million people have tested positive and approximately 30 thousand people are dead. SARS-CoV-2 virus causes this infectious corona disease. When an infected individual sneezes, coughs, speaks, or breathes, the virus is disseminated from their mouth or nose. One can also be infected by touching contaminated surface and spreads more in indoor environment. So, it has taught us the necessity of washing and sanitizing in our daily affairs. Automatic boot spray machine is a very practical and useful instrument to fight against the corona virus. This contact free spray machine helps to sanitize the boot without getting in contact with the surface and ultimately helps to prevent the spread of corona virus. The purpose of this essay is to create a boot sprayer that automatically releases soapy water. At a distance of meters, an obstruction sensor is employed to identify the heat and presence of the boot. A p-n-p transistor is used to operate the machine. This machine works perfectly at a distance of 2-30cm. It also provides good sensitivity percentage. This setup is user convenient and it saves money and power. © 2023 IEEE.

The prevalence of telework under Covid-19 in Canada

Purpose: This study investigates the determinants of teleworking before and during COVID-19 in Canada. It explores the extent of telework adoption across industrial sectors, as well as the long-term impacts of large-scale adoption of teleworking on urban travel demand and the dwindling demand for commercial real estate in downtowns. Design/methodology/approach: Using data from a survey of business establishments, this study employs data visualization techniques to illustrate how telework adoption evolved during the early stages of the COVID-19 lockdown. The study also estimates Logit models to explore the determinants of telework before and during the pandemic using a subsample from the Canadian labor force survey. Findings: The study found that telework adoption reached a peak in March and April of 2020 when almost 40% of the workers in Canada were teleworking. Only 12% of employees reported teleworking before the pandemic. The adoption of teleworking was far more pronounced amongst firms that use information and communication technologies (ICTs) extensively. Teleworking appears to be far more frequent among university-educated (knowledge economy) workers. Practical implications: Knowledge economy and highly educated workers, who switched to teleworking during the pandemic at higher rates than workers with less education, are more frequently employed in offices located in the urban core or downtowns. The drastic decline in commuting to the urban core via public transit and record low occupancy levels in downtown office towers suggests that, even if telework prevailed at levels much lower than those observed during March and April of 2020, landlords holding large portfolios of commercial real estate must prepare to cope with the lower demand for commercial real estate. This is especially significant when commercial leases come up for renewal in the next few years. In addition, governments struggling to address traffic congestion by spending hundreds of billions of dollars on transport and transit infrastructure might want to promote teleworking as a means of reducing travel demands and costly infrastructure expenditures. Social implications: Teleworking has partially eroded the boundaries between work and home by enabling millions to continue being productive while working from home. However, teleworking would require new norms and rules to maintain a work-life balance. This change requires workers and employers to cooperate. Originality/value: To the best of the authors' knowledge, this is the first study that explores the extent of telework adoption during COVID-19 in Canada and the determinants of telework adoption, presenting both employee and firm-level perspectives using Canada-wide representative data. © 2021, Emerald Publishing Limited.

Health Communication Barriers Faced by Rohingya Refugees During COVID-19

For many years, Rohingya refugees in Bangladesh have been the target of extreme racism and violence, leaving them displacedand without resources. Rohingya refugees, as well as others such as Syrian and South Sudanese refugees, tend to show poor health conditions and lack health literacy needed to protect themselves from the threat of COVID-19. Social isolation, usage of face masks, and constant hand sanitation are vital in preventing the contraction of the virus, however, for refugee populations, these health guidelines are nearly impossible to follow. While impoverished conditions at camps significantly enable the spread of the COVID-19 virus, the lack of risk communication targeting the comprehension needs of refugees has further added to the threat. Communication challenges place refugee populations at a greater risk of contracting and spreading the virus. In order to protect these vulnerable communities, host country governments must address these obstacles by increasing access to risk communication targeting the needs of refugee populations. © 2022 selection and editorial matter, Do Kyun David Kim and Gary L. Kreps;individual chapters, the contributors.

Impact of COVID-19 pandemic on glycemic control of children and adolescents with type 1 diabetes mellitus, two point observational study from a tertiary care center of low middle income country

Introduction: COVID-19 impacted lives of people globally, especially with chronic conditions like Type 1 Diabetes mellitus (T1DM). Since its emergence and increase, pandemic restrictions were imposed in Pakistan too to counter infection and prevent spread. This situation posed challenges for T1DM children causing significant lifestyle changes, psychosocial distress, difficult medication access, monitoring, and physician follow-up. This study was planned to see how restrictions and adjustments in health care affected T1DM children by comparing glycemic control prior to and following pandemic. Objective(s): To evaluate impact of COVID-19 on glycemic control of children and adolescents with type 1 diabetes. Method(s): A 2 point observational cross sectional study was done in 139 T1DM children 10-18 years enrolled in pediatric endocrine clinic of Aga Khan University with disease duration >6 months. Demographics, clinic visits (pre and during pandemic) last HbA1c value before and last value during pandemic were recorded in structured questionnaire at 2 time points (Post pandemic face to face interview between Feb and April 2022 at follow up visit, pre pandemic data from hospital medical records between Sep 2019 and Feb 2020). Paired t-test was used to compare HbA1c values and number of clinic visits before and after. Result(s): Out of 139 patients, 45% were male, 55% females. Mean age was 13.7 years. Mean HbA1c value increased from 8.7% during 6 months preceding pandemic restrictions to 9.5% during pandemic and difference was statistically significant (p-value 0.002) using paired T test. Mean clinic visits reduced from 3 visits/year pre-COVID to 1 visit/year during pandemic. This difference was also statistically significant (p value 0.000). Conclusion(s): This study demonstrates significantly negative impact of pandemic on glycemic control of children with T1DM, a chronic condition requiring regular monitoring and follow-up. Barriers in continuity of healthcare due to restrictions reflected by less clinic visits during pandemic highlights importance of telemedicine services as well.

REMDESIVIR-ASSOCIATED ASYMPTOMATIC BRADYCARDIA IN AN ICU PATIENT ON DEXAMETHASONE FOR COVID-19

SESSION TITLE: Cardiovascular Complications in Patients with COVID-19 SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: Even though COVID-19 is the largest pandemic of the twenty-first century, little is known about the disease or its management. Remdesivir has demonstrated some activity against severe ARDS associated with COVID-19. There is a dearth of data on the adverse effects of Remdesivir. We report a case of a COVID-19 patient who developed bradycardia following the administration of Remdesivir. CASE PRESENTATION: A 64-year-old man, who tested positive for COVID-19, presented with shortness of breath (SOB) for a week. SOB was accompanied by a cough with tan-colored sputum. Past medical history included hypertension and benign prostatic hyperplasia. Physical examination showed regular rate and rhythm of the heart and diffusely decreased breath sounds. His blood pressure was 104/60 mmHg and his heart rate was 80 bpm. Oxygen saturation was 58% at room air. Significant lab results showed elevated CRP: 17.13 mg/dl, D-Dimer: 10.16 ug/mL FEU, Lactic acid: 2.5 mg/dl, Creatinine: 1.8 mg/dl, BUN: 60 mg/dl, and AST: 46 U/L. Chest x-ray showed bilateral patchy interstitial airspace opacities. Calculated Well's score of 3 indicated a moderate risk for pulmonary embolism. CT scan showed moderate bilateral diffuse areas of ground-glass lung consolidation concerning diffuse atypical infection. The patient was admitted to the ICU and started on CPAP with PEEP of 12 and FiO2 of 100%. The management included dexamethasone 6 mg oral for 10 days, Remdesivir for 5 days, and Tocilizumab given elevated CRP level. The patient was found to develop asymptomatic bradycardia with a heart rate as low as 40 bpm. An EKG obtained demonstrated sinus bradycardia without any heart block. Echocardiography showed mildly dilated right ventricle & mild aortic regurgitation. Bradycardia resolved after the last dose of Remdesivir. DISCUSSION: Remdesivir is frequently used in severe COVID-19 infections. The commonly reported adverse events affect the gastrointestinal and renal systems. The reported cardiovascular adverse events include hypotension, atrial fibrillation, and cardiac arrest. However, bradycardia is becoming increasingly encountered. Although corticosteroids are known to cause bradycardia, the patient we managed developed bradycardia following remdesivir therapy. The baseline EKG was normal and the history was non-contributory. Given the asymptomatic nature of the finding, cardiac monitoring alone sufficed. The heart rate picked up following the last dose of remdesivir further suggesting its causative role. CONCLUSIONS: Bradycardia is becoming more common with Remdesivir use. If the patient is not exhibiting any symptoms, cardiac monitoring alone should suffice;bradycardia is expected to resolve when the drug is stopped. Reference #1: Elsawah HK, Elsokary MA, Abdallah MS, ElShafie AH. Efficacy and safety of remdesivir in hospitalized Covid-19 patients: Systematic review and meta-analysis including network meta-analysis. Rev Med Virol. 2021;31(4):e2187. Reference #2: Taqi M, Gillani SFUHS, Tariq M, Raza ZA, Haider MZ. Current updates on clinical management of COVID-19 infectees: a narrative review. Rev Assoc Med Bras (1992). 2021 Aug;67(8):1198-1203. doi: 10.1590/1806-9282.20210582. PMID: 34669870. DISCLOSURES: No relevant relationships by AISHA ADIGUN No relevant relationships by Mobeen Haider No relevant relationships by Yousra Khalid No relevant relationships by Muhammad Hasib Khalil No relevant relationships by Aleena Naeem No relevant relationships by Zarlakhta Zamani

Exploring enablers and barriers toward COVID-19 vaccine acceptance among Arabs: A qualitative study.

Background: With the emergence of the coronavirus disease 2019 (COVID-19) and rapid vaccine development, research interest in vaccine hesitancy (VH) has increased. Research usually focuses on quantitative estimates which largely neglected the qualitative underpinnings of this phenomenon. This study aimed to explore the beliefs and views towards COVID-19 vaccination among Arabs in different countries. Furthermore, we explored the effect of confidence in the healthcare system, misinformation, and scientific approaches adopted to mitigate COVID-19 on how individuals are following the recommended preventative actions including vaccination. Methods: This study was based on the Strategic Advisory Group of Experts (SAGE)-VH Model: A qualitative design that utilized in-depth, online interviews. The study was conducted in seven Arab countries (Egypt, Qatar, Kingdom of Saudi Arabia, Libya, Sudan, United Arab Emirates and Jordan) from June 2020 to December 2021. Transcripts were analyzed using NVivo 12 Software. Results: A total of 100 participants, 44 males and 56 females, of different age groups (37.1 ± 11.56 years) were interviewed. Findings revealed six themes as enablers and barriers to COVID-19 vaccination. Many participants indicated trusting the vaccines, the healthcare systems, and the vaccination policies were the main driver to get the vaccine. Participants showed concerns towards potential long-term vaccine effects. A consistent inclination towards collective responsibility, which is the willingness to protect others by own vaccination, was also reported. Conclusion: Enablers and barriers of COVID-19 vaccination acceptance in the Arab region, from sociocultural and political perspectives, are critical to guide policymakers in designing target-oriented interventions that can improve vaccine acceptance.

Assessment of attitude and hesitancy toward vaccine against COVID-19 in a Pakistani population: A mix methods survey Evaluación de la actitud y la renuencia hacia la vacuna frente a la COVID-19 en una población paquistaní: encuesta de método mixto

Objective The objective of this study was to assess the attitude and hesitancy toward vaccine against COVID-19 in a Pakistani Population. Materials and methods A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate. The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15th September to 30th November 2020. Results The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62 ± 10.47 years. The majority of participants were females;60.9% (n = 611). 57.02% (n = 572) of the participants were employed at the time of survey. Overall, 70.68% (n = 709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n = 49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n = 392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P < 0.001). Conclusion This study demonstrated that majority of the participants showed positive attitude toward considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population toward COVID-19 vaccination.

THE PROJECTED IMPACT OF COVID-19 ON GLOBAL HEALTH SERVICES: TAXING AN ALREADY CRITICALLY LIMITED RESOURCE

INTRODUCTION AND OBJECTIVE: Prior to the COVID-19 pandemic, an estimated 4.8 billion individuals lacked access to basic surgical care worldwide, with near absence in many low-income/ middle-income countries (LMICs). Global health programs work to advance universal health coverage. The COVID-19 pandemic eliminated in-person surgical care and local training to LMICs provided by these programs. The objective of this study was to project a calculated impact of interrupted International Volunteers in Urology (IVUmed) global health surgical workshops since the start of the COVID-19 pandemic on patient care and training provided to partner LMIC sites. METHODS: Data from the 5 fiscal years (FY - April to March) prior to the COVID-19 pandemic was reviewed. This included metrics of number patients seen and surgical cases performed, local surgeons trained, countries visited, and estimated value of service provided as part of financial impact reporting. The last IVUmed workshop was March 5-15, 2020 and concludes the FY 2020. No surgical workshops were performed for FY 2021 and FY 2022 (through October 31, 2021). The projected FY loss of productivity for each metric was calculated by averaging the 5 FYs prior to FY 2021. The total loss since the COVID-19 pandemic was then calculated by the sum of the projected FY 2021 (this value) and that of FY 2022 thus far (7/12ths of this value). RESULTS: Averaging IVUmed surgical workshops over FY 2016-2020, 23 trips were taken each year to 13 countries. The average number of patients seen was 812, with an average of 564 surgical cases performed. The average number local surgeons involved in each workshop was 296. The FY average value of service was US$4,204,217.60. Projected losses for FY 2021 through October 31, 2021 (FY 2022 thus far) would be in the form of 36 trips to 21 countries. This has impacted 1,286 patients and meant the loss of 893 surgical cases. 469 local surgeons have been impacted by lost in-person training. The estimated value of service lost is US$6,656,677.86. CONCLUSIONS: COVID-19 has negatively impacted the already critically limited global surgical volume in LMICs. A simple calculation of lost surgical workshops thus far attempts to put a number on the impact this pandemic has had on the IVUmed program. This is the estimate of the impact of COVID-19 on only a single global health program, with the impact likely nearly immeasurable with the universal loss of global health services being provided during the pandemic. Such estimates can try to help global health programs prepare for the potential backlog of care and training that will be faced when workshops resume.

REINTEGRATING A GLOBAL HEALTH PROGRAM TO ON-SITE VISITS DURING THE COVID-19 PANDEMIC

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic limited global surgical missions. As a vaccine has been developed and deployed with low-/middle-income countries (LMICs) adjusting to a post-pandemic landscape, the question remains of how and when to restart surgical missions to these locations. This study reports the experience of International Volunteers in Urology (IVUmed) with identifying metrics of “readiness” for return to global health surgical workshops. METHODS: A survey was created and emailed in September 2021 to LMIC international partners where IVUmed has previously performed or is planning surgical workshops. The survey queried if international sites were ready for the return of surgical workshops, the timing of readiness, type workshop requested first, challenges faced including equipment limitations, and vaccination status. Results were tabulated. RESULTS: Of 30 emails sent, there were 12 responses. This represented 11 unique hospitals in 10 unique cities in 9 countries. The majority of respondents were from the continent of Africa (n=9) while the others were from Asia (n=2) and the Caribbean (n=1). Most respondents lived in countries where vaccines were available (75%) with all respondents stating they were vaccinated and are required to wear masks out in public. Most sites (66.7%) responded being ready for IVUmed workshops, with a start date of February 2022 (55.6%). 83% of respondents stated their hospital infrastructure could support a workshop, with 75% stating good access to personal protective equipment;58%, however, noted difficulty obtaining surgical supplies. Two respondents stating their hospitals continue to only perform emergent surgical cases. The most popular first workshops requested were pediatric urology and laparoscopy/endourology (30% each). Themes of the biggest challenge noted since the start of COVID-19 included 7 comments on performing operations, 4 about lack of supplies, and 2 about lost learning opportunities. CONCLUSIONS: It is unclear how and when to restart global health surgical mission programs since the start of the COVID-19 pandemic, which impacted the already critically limited global surgical volumes in LMICs. While LMIC partners queried report a high vaccination status, the vaccination status of the general population in surveyed countries has not been established. While this is an ongoing research project, important considerations for resumption of surgical missions must include careful assessment of timeliness, surgical and anesthetic capacity, facility resources, and safety. Direct communication with local sites is imperative.

Face Mask Detection from Live-Stream Surveillance Video using Convolutional Neural Network

The coronavirus is a contagious disease and can spread very rapidly if the proper measures are not taken. Though the invention of the vaccines against coronavirus has given a sigh of relief, however, the complete eradication still looks a very long way to go. With the presence of the new variants of the coronavirus, the risk of the spread still remains. Among several guidelines given by the WHO and healthcare practitioners, facemasks have been one of the most effective ways to prevent the spread of the virus. However, some people usually ignore or forget to follow these guidelines especially in public places such as offices, shopping malls, etc. The number of people in such places is usually high and facemask is a factor to consider against the spread of the virus. Therefore, to hinder the spread of the virus, people with no facemask must be identified and notified. This research proposes a convolutional neural network-based deep learning model for detecting the people without facemasks using the frames captured from the livestream surveillance video. The research primarily focuses on the facemask detection module of the proposed system. The data for this study contains almost 1500 images for masked and without mask faces. The proposed model has been implemented using two different optimizers. The RMSprop optimizer-based model outperforms the Adam optimizer-based model. The accuracy achieved by RMSprop based model was 92.27% and the accuracy achieved by Adam optimizer-based model was 85.1%.

Arabic validation and cross-cultural adaptation of the 5C scale for assessment of COVID-19 vaccines psychological antecedents

Background: In the Arab countries, there has not been yet a specific validated Arabic questionnaire that can assess the psychological antecedents of COVID-19 vaccine among the general population. This study, therefore, aimed to translate, culturally adapt, and validate the 5C scale into the Arabic language. Methods: The 5C scale was translated into Arabic by two independent bilingual co-authors, and then translated back into English. After reconciling translation disparities, the final Arabic questionnaire was disseminated into four randomly selected Arabic countries (Egypt, Libya, United Arab Emirates (UAE), and Saudi Arabia). Data from 350 Arabic speaking adults (aged >= 18 years) were included in the final analysis. Internal consistency was assessed by Cronbach's alpha. Construct validity was determined by concurrent, convergent, discriminant, exploratory and confirmatory factor analyses. Results: Age of participants ranged between 18 to 73 years;57.14% were females, 37.43% from Egypt, 36.86%, from UAE, 30% were healthcare workers, and 42.8% had the intention to get COVID-19 vaccines. The 5 sub-scales of the questionnaire met the criterion of internal consistency (Cronbach's alpha >= 0.7). The predictors of intention to get COVID-19 vaccines (concurrent validity) were young age and the 5C sub-scales. Convergent validity was identified by the significant inter-item and item-mean score of the sub-scale correlation (P < 0.001). Discriminant validity was reported as inter-factor correlation matrix (< 0.7). Kaiser- Meyer-Olkin sampling adequacy measure was 0.80 and Bartlett's sphericity test was highly significant (P < 0.001). Exploratory factor analysis indicated that the 15 items of the questionnaire could be summarized into five factors. Confirmatory factor analysis confirmed that the hypothesized five-factor model of the 15-item questionnaire was satisfied with adequate psychometric properties and fit with observed data (RMSEA = 0.060, GFI = 0.924, CFI = 0.957, TLI = 0.937, SRMR = 0.076 & NFI = 906). Conclusion: The Arabic version of the 5C scale is a valid and reliable tool to assess the psychological antecedents of COVID-19 vaccine among Arab population. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The prevalence of telework under Covid-19 in Canada

Purpose: This study investigates the determinants of teleworking before and during COVID-19 in Canada. It explores the extent of telework adoption across industrial sectors, as well as the long-term impacts of large-scale adoption of teleworking on urban travel demand and the dwindling demand for commercial real estate in downtowns. Design/methodology/approach: Using data from a survey of business establishments, this study employs data visualization techniques to illustrate how telework adoption evolved during the early stages of the COVID-19 lockdown. The study also estimates Logit models to explore the determinants of telework before and during the pandemic using a subsample from the Canadian labor force survey. Findings: The study found that telework adoption reached a peak in March and April of 2020 when almost 40% of the workers in Canada were teleworking. Only 12% of employees reported teleworking before the pandemic. The adoption of teleworking was far more pronounced amongst firms that use information and communication technologies (ICTs) extensively. Teleworking appears to be far more frequent among university-educated (knowledge economy) workers. Practical implications: Knowledge economy and highly educated workers, who switched to teleworking during the pandemic at higher rates than workers with less education, are more frequently employed in offices located in the urban core or downtowns. The drastic decline in commuting to the urban core via public transit and record low occupancy levels in downtown office towers suggests that, even if telework prevailed at levels much lower than those observed during March and April of 2020, landlords holding large portfolios of commercial real estate must prepare to cope with the lower demand for commercial real estate. This is especially significant when commercial leases come up for renewal in the next few years. In addition, governments struggling to address traffic congestion by spending hundreds of billions of dollars on transport and transit infrastructure might want to promote teleworking as a means of reducing travel demands and costly infrastructure expenditures. Social implications: Teleworking has partially eroded the boundaries between work and home by enabling millions to continue being productive while working from home. However, teleworking would require new norms and rules to maintain a work-life balance. This change requires workers and employers to cooperate. Originality/value: To the best of the authors’ knowledge, this is the first study that explores the extent of telework adoption during COVID-19 in Canada and the determinants of telework adoption, presenting both employee and firm-level perspectives using Canada-wide representative data. © 2021, Emerald Publishing Limited.

Assessment of attitude and hesitancy toward vaccine against COVID-19 in a Pakistani population: A mix methods survey.

Objective: The objective of this study was to assess the attitude and hesitancy toward vaccine against COVID-19 in a Pakistani Population. Materials and methods: A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate. The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15th September to 30th November 2020. Results: The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62 ± 10.47 years. The majority of participants were females; 60.9% (n = 611). 57.02% (n = 572) of the participants were employed at the time of survey. Overall, 70.68% (n = 709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n = 49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n = 392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P < 0.001). Conclusion: This study demonstrated that majority of the participants showed positive attitude toward considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population toward COVID-19 vaccination.

Objetivo: El objetivo de este estudio fue evaluar la actitud y la renuencia hacia la vacuna frente a la COVID-19 en una población paquistaní. Materiales y métodos: Se realizó un estudio prospectivo de método mixto, invitándose a participar a personas adultas (edad ≥18 años) residentes en Paquistán. Se preparó el cuestionario, que se alojó en Google Forms y se hizo circular a través de plataformas electrónicas, pudiendo realizarse también de manera personal. Los datos se recopilaron desde el 15 de septiembre al 30 de noviembre de 2020. Resultados: La tasa de respuesta fue del 80%. El análisis final incluyó un total de 1.003 participantes, de los cuales el 75% completó el cuestionario-encuesta online, mientras que el 25% respondió en persona. La edad media de los participantes fue de 29,62 ± 10,47 años. La mayoría de los participantes eran mujeres: el 60,9% (n = 611). El 57,02% (n = 572) de los participantes tenía empleo en el momento de la encuesta. En general, el 70,68% (n = 709) de los participantes tenía experiencia previa sobre vacunas tales como la vacuna frente a la gripe. Solo el 4,9% (n = 49) de los participantes pensaba que padecerían la COVID-19 de forma grave en el plazo de seis meses, y el 39% (n = 392) de los participantes estaba seguro de que se contagiaría de dicha enfermedad. El 71,29% de los participantes reportó que consideraría recibir la vacuna una vez que se dispusiera de la misma. Existió una asociación estadística entre el sexo y el ser vacunado (P< 0,001). Conclusión: Este estudio demostró que la mayoría de los participantes mostró una actitud positiva hacia la consideración de la vacuna frente a la COVID-19. Sin embargo, la concienciación sobre el conocimiento informado de la vacuna, los posibles efectos adversos y el coste supondrían un gran valor añadido al incremento de la respuesta real de la población paquistaní hacia la vacuna frente a la COVID-19.

The coronavirus disease 2019 (COVID-19) vaccination psychological antecedent assessment using the Arabic 5c validated tool: An online survey in 13 Arab countries.

BACKGROUND: Following the emergency approval of the coronavirus disease 2019 (COVID-19) vaccines, research into its vaccination hesitancy saw a substantial increase. However, the psychological behaviors associated with this hesitancy are still not completely understood. This study assessed the psychological antecedents associated with COVID-19 vaccination in the Arab population. METHODOLOGY: The validated Arabic version of the 5C questionnaire was distributed online across various social media platforms in Arabic-speaking countries. The questionnaire had three sections, namely, socio-demographics, COVID-19 related infection and vaccination, and the 5C scale of vaccine psychological antecedents of confidence, complacency, constraints, calculation, and collective responsibility. RESULTS: In total, 4,474 participants with a mean age of 32.48 ± 10.76 from 13 Arab countries made up the final sample, 40.8% of whom were male. Around 26.7% of the participants were found to be confident about the COVID-19 vaccination, 10.7% indicated complacency, 96.5% indicated they had no constraints, 48.8% had a preference for calculation and 40.4% indicated they had collective responsibility. The 5C antecedents varied across the studied countries with the confidence and collective responsibility being the highest in the United Arab Emirates (59.0% and 58.0%, respectively), complacency and constraints in Morocco (21.0% and 7.0%, respectively) and calculation in Sudan (60.0%). The regression analyses revealed that sex, age, educational degrees, being a health care professional, history of COVID-19 infection and having a relative infected or died from COVID-19 significantly predicted the 5C psychological antecedents by different degrees. CONCLUSION: There are wide psychological antecedent variations between Arab countries, and different determinants can have a profound effect on the COVID-19 vaccine's psychological antecedents.

Redirecting a global health surgical program to remote support during a pandemic: the IVU virtual visiting professorship program

INTRODUCTION AND OBJECTIVE: Global health surgical programs generally provide support through hands on surgical workshops. The COVID-19 pandemic has significantly impacted domestic and international travel, virtually eliminating the ability of such programs to provide in person care. International Volunteers in Urology (IVU) has developed a virtual visiting professorship (VVP) program out of necessity to redirect in person support to virtual support. METHODS: The VVP program was established in February 2020 when the decision was being made to suspend surgical mission trips. The program consists of hour long lectures provided to established international sites at which IVU has previously held global health surgical workshops on topics requested by those sites after solicitation by IVU. Lecturers are IVU volunteers. We report the experience of the IVU VVP program from February 2020 through January 2021. We evaluated the number and timing of VVPs, as well as topics, locations served, and volunteers engaged. We also report the results of a basic survey from participants evaluating the program. RESULTS: 42 lectures have been given over 12 months. Topics included those in General Urology (n=9), Oncology (n=20), Female Urology (n=2), Reconstruction (n=2), and Pediatrics (n=9). Lectures have been given to sites in 11 countries outside of the US, mainly in Africa, with 10 lectures given to the Pan-African Urological Surgeon's Association. A total of 2,149 persons registered for the VVPs;1,094 (51%) participated. While participation initially was proportionate to the number lectures given, there has been some decrease since September 2020 (Figure 1). The lectures have been given by 31 IVU volunteers, of which for 12 (39%), the VVP was their first experience with IVU. Participants ranked presentations on Likert Scale (0 poor-100 excellent) a median of 98. CONCLUSIONS: The COVID-19 pandemic has required global health surgical programs to significantly rethink their support of others. IVU has created a well-received VVP program that enables remote education during a time when it has been necessary for more selfisolation. Such a program enables maintained connectivity in this altered landscape of global health programs and has increased IVU participation.