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It became clear at the onset of the pandemic that radiography could play an important role in diagnosing and staging COVID-19. The key modality would be mobile chest radiography. However, at the onset of the pandemic, no literature existed to indicate whether or not chest X-ray imaging could be used effectively to diagnose or exclude COVID-19. This article explains how a website was created, at speed, during the initial phase of the COVID-19 pandemic. Containing holistic information, the website helped enable rapid redeployment of radiographers onto the frontline where chest X-ray imaging was needed. It aimed to help train radiographers take (and interpret) chest radiographs in high-risk areas that contained large numbers of COVID-19 patients. Within one year, the website had been used in 157 countries. This article documents the approach taken to create the website and suggestions are made about how, in the future, a rapid approach could be achieved to create other websites - should an international crisis occur again. This paper also outlines how stakeholders and content authors from across the world were brought together and supported to create the website. It goes on to explain the leadership style that was adopted to create the website and why that style was selected. An explanation is offered about the project management approach and how its ingredients relate to a published model. Aside from simply providing a historical account of how the website was created, we hope the narrative offers food for thought on how to respond rapidly during an international crisis to formulate and implement a unified international-level solution which addresses an urgent need.
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COVID-19 , Pandemics , COVID-19/epidemiology , HumansABSTRACT
Background: The health and work productivity burden informal cHL patient (pt) caregivers face is unknown. As part of the US-based CONNECT study, we evaluated caregivers' burden and role in treatment (tx) decisions by relation to the pt: spouse/partner (SP) vs other (parent, child, friend, other relative). Methods: The CONNECT caregiver survey was an IRB-approved online survey administered from Dec 2020-Mar 2021 to self-identified current or former adult cHL pt caregivers. Health-related quality of life (HRQoL, PROMIS-Global), work impact (WPAI), decision-making, tx selection, and physician communication were assessed. Statistical significance was at the 95% confidence level. Results: 209 caregivers (58% women;median age 47 yrs;54% employed;53% SP) completed the survey. At completion, 69% cared for pts diagnosed in the past 1-2 yrs;48% of pts cared for had stage III/IV cHL and 58% were in remission/not receiving active tx. While caregiver HRQoL was similar to that of the general population on the PROMIS-Global, employed caregivers had work impairment (29%) from caregiving activities (Table) which was higher when the pt was on vs off tx. Caregiving began at pt symptom onset for more SP vs other caregivers (61 vs 27%), and after the pt's first tx for more other vs SP caregivers (34 vs 5%). 88% of caregivers discussed tx options with the pt. Cure, caregivers' top tx goal (49%), was rated higher by SP vs other caregivers (56 vs 42%). Tx decisions with the pt (54 vs 23%) and tx option discussions with the doctor (52 vs 28%) were more common for SP vs other caregivers. More SP vs other caregivers had extensive tx option discussions with the pt (88 vs 68%), said it was important the doctor discussed managing side effects (94 vs 84%), felt the doctor provided adequate information about side effects (91 vs 71%), and felt aligned with the pt's tx goals (93 vs 79%). Caregivers noted COVID-19 impacts like limiting daily activities to reduce COVID-19 risks (72%). Conclusions: Although cHL pt caregivers reported good HRQoL, caregiving impacted their work productivity regardless of relation to the pt. Cure was caregivers' top tx goal. SP vs other caregivers were more involved and earlier, reporting alignment with pt tx goals and decision-making.
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Taking an interdisciplinary approach to information-led exhibitions focused on performance can be considered practice-as-research historiography if curation is engaged with as praxis. Approaching exhibition curation as research praxis is a knowledge-making process, reconfiguring exhibitions as far more than a ‘pathway to impact’ designed at securing a grant. In the curation of two linked exhibitions on nineteenth-century popular entertainments at the Bill Douglas Cinema Museum and University of Bristol Theatre Collection, which were stunted due to COVID-19, I developed an argument for the shared ground of exhibitions and performance. If archival objects can perform, the exhibition space itself is a stage through which they communicate embodied meanings to audiences. I explore how exhibition curation generates different epistemologies to written research by putting museum studies, performance history, audience studies and performance practice-as-research in conversation. I demonstrate how museum studies could benefit from performance in developing epistemological arguments, and how performance studies can more significantly privilege the audience in the knowledge production process. I conclude my findings by discussing how planned activities and lessons learnt from these exhibitions could provide a blueprint for practitioners interested in using the exhibition form and format to conduct historically relational practice-research inquiries in conversation with audiences. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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This concluding chapter seeks to situate the future of volunteering relative to wider debates and general socio-economic, demographic and technological trends affecting the world of work. Cognisant that this chapter is written very much in the COVID era, an initial debate about whether COVID-19 represents a seismic change or a blip on the graph for event, sport and tourism (EST) volunteering, and volunteering in general, is discussed. With its prominent focus in the EST volunteering literature (see Lis and Tomanek’s chapter of this Handbook), and its inherent travel requirement, the future of volunteer tourism is also discussed. This chapter references other chapters from the Handbook, linking key debates and topics where possible. It draws on generic and sector specific themes to support discussion about where volunteering lies in relation to paid work and unpaid work and briefly touches on its boundaries with leisure. The chapter concludes that the EST sectors will continue post-COVID as essential to the physical and mental well-being of communities. The role of volunteers with respect to this significant transition is discussed and an associated research agenda is highlighted. © 2022 selection and editorial matter, Kirsten Holmes, Leonie Lockstone-Binney, Karen A. Smith and Richard Shipway.
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The lockdown measures put in place in March 2020 in England to counter the spread of the coronavirus have had significant implications for the lives and well-being of young carers and young adult carers. In such unprecedented times, little was known about the potential impact on this group and their specific experience of the Covid-19 lockdown restrictions. A rapid review was conducted, 28 young carers responded to a survey and an additional 20 participants were interviewed in January 2021;the survey was repeated with a further 149 responses. Findings show that the level of care that young carers are required to provide had increased as external agency support for their families had been withdrawn while their own coping strategies had been challenged, in particular through school closures. These restrictions had a significant impact on every aspect of their lives, from their ability to meet their own mental health needs to managing the requirements of home schooling. The needs of young carers should be acknowledged within the political agenda, especially at times of crisis. It is crucial that health and social care services increase their capacity to identify and support young carers and that work is done within educational settings to provide a flexible response to individual needs.
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Background Current NCCN guidelines recommend 1 of 3 first-line (1L) regimens for stage III or IV classical Hodgkin lymphoma (cHL): ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), A+AVD (brentuximab vedotin, doxorubicin, vinblastine, dacarbazine), or escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone);preferred regimens vary by region (e.g., North America vs Europe). The NCCN recommends positron emission tomography/computerized tomography (PET/CT) imaging after cycle 2 (interim PET2) to guide ABVD escalation or de-escalation. We surveyed physicians on their cHL treatment decision-making process and how PET/CT scan access, reimbursement, and comprehension influence their choices as part of CONNECT, the first real-world survey of physicians, patients, and caregivers in cHL. Methods Medical oncologists, hematologist/oncologists, or hematologists who treat cHL were invited to participate in an Institutional Review Board-approved, 30-minute online anonymous survey. Eligible participants had ≥2 years of practice experience in the United States (US) and treated ≥1 adult (aged ≥18 years) with stage III or IV cHL and ≥1 adult with cHL in the 1L setting within the prior 12 months. Surveys were completed from October 19, 2020-November 16, 2020. Results Of 301 participating physicians, 80% were hematologist/oncologists with a median practice duration of 15 years;62% practiced in community and 38% in academic settings. Participants were located in the US (South, 34%;Northeast, 26%;West, 21%;Midwest, 20%) and spent 90% of their professional time in direct patient care. In the preceding 12 months, participants treated a median (interquartile range) of 16 (7-40) patients with active cHL (stage III [median], 4;stage IV, 5) and 15 (8-40) cHL survivors. When treating cHL, 88% of participants reported giving NCCN guidelines somewhat/significant consideration. Overall, 94% of participants (n=284) reported using a PET/CT combined scan to diagnose/stage cHL, in line with current guideline recommendations. Of these participants, 97% reported typically getting an interim PET/CT scan for stage III or IV cHL with 65% typically getting the scan after cycle 2 (Figure A). Participants reported both escalating and de-escalating treatment based on interim PET/CT results (Figure B) with 61% making decisions after cycle 2. Of participants using a PET/CT scan, 42% reported receiving both a Deauville score and a standardized uptake value (SUV;Figure C) with 62% of participants noting that the Deauville score was the primary system used for reviewing PET/CT results (Figure D). However, 19% of participants reported challenges interpreting PET/CT results. Among participants using a Deauville score (n=209), consensus was limited on what defined a positive scan (≥3, 44%;≥4, 37%). Challenges obtaining PET/CT scans were reported by 16% of participants using PET/CT scans. However, despite not reporting challenges 55% of participants on average were unable to obtain a PET/CT scan 20% of the time. Of participants using PET/CT scans, 86% reported typically receiving results within 2 business days and 14% within 3-5 business days. Twenty-one percent of participants reported that delays in PET/CT results affected their ability to use a PET-adaptive approach. Forty-nine percent of those using PET/CT scans reported increased difficulty in PET/CT access for stage III or IV cHL due to lack of insurance coverage. In absence of a PET/CT scan, 36% of participants reported using an interim biopsy and 63% an interim CT scan to inform treatment choices. Among all participants, 36% reported increased difficulty in getting patients with cHL access to PET/CT scans due to COVID-19. Conclusions Although participants consider NCCN guidelines when treating cHL, interim PET scans are not universally obtained after cycle 2 for stage III or IV cHL, with 65% of participants who use PET/CT scans obtaining an interim PET scan after cycle 2 for stage III or IV cHL. When PET/CT scans are obtained, Deau ille scores are commonly provided;however, there is variability in what is termed a positive or negative Deauville score. Challenges in obtaining PET/CT scans, with increased difficulty during COVID-19, were reported. Also, there are other barriers, such as lack of insurance, that may prohibit the optimal adherence to guidelines on interim PET/CT utilization. [Formula presented] Disclosures: Parsons: SeaGen: Consultancy. Yu: Seagen, Inc: Current Employment, Current equity holder in publicly-traded company. Liu: Seagen, Inc: Current Employment, Current equity holder in publicly-traded company. Kumar: Seagen, Inc: Consultancy. Fanale: Seagen, Inc: Current Employment, Current equity holder in publicly-traded company. Flora: Seagen, Inc: Research Funding.