Precarity and progression during a pandemic. Preliminary findings from a study of early career academics' information behaviour during COVID-19

Introduction. COVID-19 has increased research, teaching and administrative pressures for all academics and, by doing so, exacerbated inequalities experienced by early-career academics, who were already dealing with several sources of uncertainty in trying to establish their careers. This study sought to understand the experiences of the academics during the pandemic. Method. We conducted semi-structured remote interviews with 18 early-career academics (PhDs awarded in past 6 years), from a variety of countries;Canada, US, Australia, UK, New Zealand, and South Africa. Analysis. Interviews were analysed using a reflexive inductive Thematic Analysis approach. Results. Preliminary findings demonstrate that the pandemic has disrupted information acquisition and sharing among early-career academics. The increasing amount of incorrect and irrelevant information disseminated by universities, alongside the de-prioritisation of information that is particularly valued by these academics (e.g., information related to professional development and career development) has led some to avoid information Conclusions. The COVID-19 pandemic has further exacerbated the precarious situations faced. Universities need to acknowledge uncertainty, reduce information overload by providing relevant and useful information and provide useful information on and support for career progression.

Reading between the lies: A classification scheme of types of reply to misinformation in public discussion threads

Online misinformation is a fiendish problem. Demonstrably false information propagates faster and more widely than truth and this has heralded a technological arms race. One possible mechanism for addressing misinformation is social: there is evidence seeing misinformation being challenged can ginoculate' a reader against it. To date, no research has examined how discussions sparked by misinformation play out;What are the different ways in which people reply to posts containing misinformation? How does the discussion flow in each case? Are there differences between platforms? We address these questions through an inductive qualitative analysis of discussion threads on three public discussion platforms (Twitter, YouTube and two news sites) and on three topics (COVID, Brexit and climate change). We present a classification scheme of types of replies to misinformation, and show that replies show different patterns between platforms. Knowing how people reply to posts that contain misinformation enriches our knowledge of ghuman misinformation interaction,' and provides an understanding of how socio-technical factors in platform design can reduce the risk of misinformation spreading. © 2022 ACM.

Emergency presentations of colorectal cancer during the COVID 19 Era

Aims: COVID19 has reduced the ability to provide red flag investigations for colorectal patients. The aim of this study is to assess the number of emergency presentations of new colorectal malignancies during the COVID19 era and if there is an increase in palliative cases. Methods: A retrospective review of all patients presenting to unscheduled care with a new diagnosis of colorectal malignancy from 31st March 2020-25th January 2021 in a single UK Trust. An institutional data base and electronic care records were used to review patient demographics, management and curative intent. Data points for the same period in 2019-2020 were recorded for comparison. Results: 45 patients were diagnosed with new colorectal malignancy during an unscheduled admission to hospital within the study timeframe. 22% (10/45) presented in January 2021. 29 diagnosed during the same time interval 2019-2020. Median age at presentation was 77.5 and 79 respectively. 40% (18/45) of patients in 2020-2021 proceeded to emergency surgery, compared to 58% (17/29) in 2019-2020 (P = 0.12). 10.3% (3/29) of 2019-2020 patients were managed with colonic stenting. This increased in 2020-2021 to 17.8% (8/45) (P = 0.38). 77.8% (35/45) patients in 2020/2021 presented at a palliative stage of disease compared to 62.1% (18/29) in 2019-2020 (P = 0.15). Conclusions: Overall the data has not shown a statistically significant difference in patients presenting as an emergency with new colorectal malignancy. However, there was a rise in admissions noted in January 2021;should this trend continue, alongside the persistent pressures of COVID19, ongoing research is needed to assess the true impact.

Colonic stenting in colorectal malignancy-a single centre 3 year review

Aim/Background: Colonic stent insertion is a minimally invasive management option for patients requiring colonic decompression in colorectal malignancy (CRC). Acute colonic obstruction is a common presentation in patients with CRC, and approximately 20% present with distant metastases. Emergency primary resection carries increased morbidity and mortality and decreases likelihood of primary anastomosis. Our objective was to review the use of colorectal stents, examine survival in the palliative setting and determine interval time to surgery. Methods: A retrospective institutional review of all patients undergoing colonic stenting in a single centre between January 2018 and January 2021 was carried out. Data was retrieved from an institutional database search and patient follow up obtained from up to date regional care records. Results: A total of 58 patients were identified, 50 of which underwent attempted stenting for a colonic malignancy, with a 92% success rate. Median age 81.5years (54-95), 60.8% male and median follow up time 545 ± 353 days. Thirty three (64.8%) were performed in the emergency setting. Thirteen patients underwent stenting as a bridge to surgery, with median time interval 20 days (2018/2019) and 30.5 days (2020/2021). Thirty-three patients underwent stenting with palliative intent, with a median survival time of 96 days. There were no major stent related complications or mortality. Conclusion: Colonic stents offer an alternative management pathway in obstructed colorectal malignancies, in both the palliative and curative setting. Our study has illustrated high success rates, with no major complications seen. COVID-19 has expectedly impacted the length of time to surgery following stent insertion.

Adapting an emergency general surgery service in response to the COVID-19 pandemic.

INTRODUCTION: In response to the COVID-19 pandemic, our emergency general surgery (EGS) service underwent significant restructuring, including establishing an enhanced ambulatory service and undertaking nonoperative management of selected pathologies. The aim of this study was to compare the activity of our EGS service before and after these changes. METHODS: Patients referred by the emergency department were identified prospectively over a 4-week period beginning from the date our EGS service was reconfigured (COVID) and compared with patients identified retrospectively from the same period the previous year (Pre-COVID), and followed up for 30 days. Data were extracted from handover documents and electronic care records. The primary outcomes were the rate of admission, ambulation and discharge. RESULTS: There were 281 and 283 patients during the Pre-COVID and COVID periods respectively. Admission rate decreased from 78.7% to 41.7%, while there were increased rates of ambulation from 7.1% to 17.3% and discharge from 6% to 22.6% (all p<0.001). For inpatients, mean duration of admission decreased (6.9 to 4.8 days), and there were fewer operative or endoscopic interventions (78 to 40). There were increased ambulatory investigations (11 to 39) and telephone reviews (0 to 39), while early computed tomography scan was increasingly used to facilitate discharge (5% vs 34.7%). There were no differences in 30-day readmission or mortality. CONCLUSIONS: Restructuring of our EGS service in response to COVID-19 facilitated an increased use of ambulatory services and imaging, achieving a decrease of 952 inpatient bed days in this critical period, while maintaining patient safety.