Willingness and preparedness to work during the first wave of the COVID-19 pandemic: A cross-sectional survey among registered nurses in a Danish university hospital

Nurses are imperative for healthcare systems' ability to effectively function during pandemics, yet multiple factors may affect their willingness and preparedness to work. The aim of the present cross-sectional survey was to identify factors associated with registered nurses' (RN) willingness and preparedness to work during the novel coronavirus disease (COVID-19) pandemic. The study was reported following the STROBE guidelines. A total of 358 nurses completed a self-administered online questionnaire. The participants were a part of a COVID-19 task force at a Danish university hospital during spring 2020. The results showed that the majority of RNs felt a professional obligation to engage in clinical work during the pandemic;however, their willingness and preparedness to work were affected by multiple factors, such as being relocated voluntarily, being prepared for the task and feeling safe. This study highlights that these factors are essential for the hospital management and nurse leaders to take responsibility for. © The Author(s) 2023.

Patients experiences of their relationships with relatives and their collaboration with nurses during contact in non-COVID-19 hospital wards – A qualitative study

COVID-19 restrictions prevented relatives from visiting and accompanying patients to hospital and required that nurses wore personal protective equipment. These changes affected patients’ relationships with relatives and challenged their ability to connect with nurses. Individual, semi-structured interviews with 15 patients were carried out to explore patients’ experiences of their relationships with relatives and their collaboration with nurses during in- and outpatient contacts in non-COVID-19 hospital wards. The analysis of data was guided by phenomenological hermeneutic frame of reference and the study was reported according to the COREQ checklist. The findings illustrated that patients felt lonely and insecure when separated from relatives, caught between relatives and professionals during information exchange, and experienced the absence of relatives as both beneficial and burdening. Visitor restrictions provided patients with time to heal but prevented provision of informal care. Patients had to take responsibility for maintaining contact with relatives independent of their health condition. COVID-19 restrictions created distance with nurses, which potentially led to insufficient physical and psychosocial care. © The Author(s) 2022.

Importance of information systems in the recovery of the tourism industry after the COVID-19 pandemic

The COVID-19 pandemic made big cracks in the tourism industry, being responsible for the almost imminent decrease in tourism activities around the world simultaneously, reducing international visits by 75%, causing a loss of world GDP of 2.4 trillion dollars. The tourism industry has always been supported by technology, being the information systems and different mobile applications, its main allies in the promotion and dissemination of information and tourism activities worldwide. The following article seeks to highlight the importance of information systems as a strategy for the recovery of tourism after the COVID-19 pandemic.

Importance of information systems in the recovery of the tourism industry after the COVID-19 pandemic

The COVID-19 pandemic made big cracks in the tourism industry, being responsible for the almost imminent decrease in tourism activities around the world simultaneously, reducing international visits by 75%, causing a loss of world GDP of 2.4 trillion dollars. The tourism industry has always been supported by technology, being the information systems and different mobile applications, its main allies in the promotion and dissemination of information and tourism activities worldwide. The following article seeks to highlight the importance of information systems as a strategy for the recovery of tourism after the COVID-19 pandemic. © 2022 IEEE Computer Society. All rights reserved.

Danish Breast Cancer Group Skagen Trial 1: A report on annual trial participation

Purpose or Objective Clinical trials are essential to improve cancer treatment. Trials rely on wide-ranging patient (pt) participation to gain adequate sample sizes and externally applicable results. The Danish Breast Cancer Group (DBCG) develops national guidelines for breast cancer therapy, and this is preferably through clinical trials. During 2015-2021 moderately hypofractionated adjuvant loco-regional breast cancer (BC) radiation therapy (RT) was tested in an international trial, the DBCG SKAGEN Trial 1, testing 50Gy/25 fr (standard) versus 40Gy/15fr (experimental). The trial inclusion criteria were broad, thus any pt with indication for loco-regional RT (LR-RT) for unilateral early high-risk BC with no prior cancer and willing/able to participate in the 10-year follow up was a candidate.Recently, the inclusion of pts in trials may have been particularly challenged due to difficulties imposed by the COVID 19 pandemic. Hitherto, the DBCG has had no evidencebased knowledge about trial participation rates (TPR). These are important for evaluating the applicability of the trial results and planning of future RT trials. We present annual trial participation rates during the inclusion period. Materials and Methods The international DBCG SKAGEN Trial 1 randomized patients from 2015 to July 1st 2021, and the 17 participating institutions from 7 countries accrued 2,963 patients. Eight of these institutions accruing 2,184 pts in all delivered data on the total number of pts treated with LR-RT during the inclusion period. We calculated annual TPRs per institution and overall as TPR (number pts enrolled per year/ number pts treated with LR-RT per year). Results From 6,929 pts receiving LR-RT, 2,184 pts were enrolled, corresponding to an overall TPR of 31.5% (figure 1). In all eight institutions, accrual was running from 2016 (figure 2). From 2016, the average single institution TPR per year ranged from 14.4% to 50.4%. Annual TPRs varied with time: most institutions experienced a modest decline in TPR during 2019-2020, while in 2021 TPR seemed to stabilize. In one institution, accrual was terminated during 2020 due to COVID 19 related restrictions.(Figure Presented)(Figure Presented)Conclusion TPRs displayed considerable variation across institutions and time and were vulnerable to COVID 19 related restrictions. Even with a straight-forward trial design and the prospect of a shortened LR-RT course, only one institution succeeded in accruing more than half of the patients likely to be trial candidates. The results indicate, that a TPR around 50% was feasible for the best performing department, thus implying a large potential for better trial accrual in most centres. In future trials, systematic monitoring of TPRs and reasons for not participating should be undertaken to optimize trial designs and accrual procedures

A Hybrid System For Pandemic Evolution Prediction

The areas of data science and data engineering have experienced strong advances in recent years. This has had a particular impact on areas such as healthcare, where, as a result of the pandemic caused by the COVID-19 virus, technological development has accelerated. This has led to a need to produce solutions that enable the collection, integration and efficient use of information for decision making scenarios. This is evidenced by the proliferation of monitoring, data collection, analysis, and prediction systems aimed at controlling the pandemic. To go beyond current epidemic prediction possibilities, this article proposes a hybrid model that combines the dynamics of epidemiological processes with the predictive capabilities of artificial neural networks. In addition, the system allows for the introduction of additional information through an expert system, thus allowing the incorporation of additional hypotheses on the adoption of containment measures.

Artificial intelligence models and techniques applied to COVID-19: A review

The rapid spread of SARS-CoV-2 and the consequent global COVID-19 pandemic has prompted the public administrations of different countries to establish health procedures and protocols based on information generated through predictive techniques and models, which, in turn, are based on technology such as artificial intelligence (AI) and machine learning (ML). This article presents some AI tools and computational models used to collaborate in the control and detection of COVID-19 cases. In addition, the main features of the Epidempredict project regarding COVID-19 in Panama are presented. This initiative consists of the planning and design of a digital platform, with cloud-based technology, to manage the ingestion, analysis, visualization and exportation of data regarding the evolution of COVID-19 in Panama. The methodology for the design of predictive algorithms is based on a hybrid model that combines the dynamics associated with population data of an SIR model of differential equations and extrapolation with recurrent neural networks. The technological solution developed suggests that adjustments can be made to the rules implemented in the expert processes that are considered. Furthermore, the resulting information is displayed and explored through user-friendly dashboards, contributing to more meaningful decision-making processes. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Reshaping the diagnostic pathways for investigation of haematuria during and after the COVID-19 pandemic: Diagnostic accuracy of strategies for the detection of bladder cancer from the IDENTIFY cohort study

Background: Haematuria often requires investigation with an imaging test and flexible cystoscopy to rule out urinary tract cancers. With a reduction in diagnostic services due to the COVID-19 pandemic there is a risk of compromise in the care of patients referred with haematuria. We aimed to provide a pragmatic strategy that optimises the use of scarce resources by reducing patient visits to hospital and allocating the appropriate diagnostic tests according to risk of bladder cancer. Methods: The IDENTIFY study was an international, prospective, multicentre cohort study of over 11,000 patients referred to secondary care for investigation of newly suspected urinary tract cancer. Patients underwent cystoscopy, imaging tests, urine cytology and transurethral resection of bladder tumour (TURBT), where indicated. We developed strategies using combinations of imaging and cytology as triage tests to flexible cystoscopy. These strategies aimed to maximise cancer detection within a pragmatic pathway in a resource-limited environment. Findings: 8112 patients (74 4%) received an ultrasound or a CT urogram, with or without cytology. 5737 (70 7%) patients had visible haematuria (VH) and 2375 (29 3%) had non-visible haematuria (NVH). Amongst all patients, 1474 (18 2%) had bladder cancer;1333 (23 2%) in VH group and 141 (5 94%) in NVH group. Diagnostic test performance was used to determine optimal age cut-offs for each proposed strategy. We recommended proceeding directly to TURBT for patients of any age with positive triage tests for cancer. Patients with negative triage tests under 35-years-old with VH, or under 50-years-old with NVH can safely be discharged without undergoing flexible cystoscopy. The remaining patients may undergo flexible cystoscopy, with a greater priority for older patients (threshold of 60-years-old with VH, or 70-years-old with NVH) to capture high risk bladder cancer. Interpretation: We suggest diagnostic strategies in patients with haematuria, which focus on detection of bladder cancer, whilst reducing the burden to healthcare services in a resource-limited setting.

Knowledge management applying disruptive technologies as a response to the COVID-19 crisis in public administration

The accelerated propagation of Sars-Cov2 and the consequent Covid-19 disease in the world has led the public administrations of different countries to use the advantages provided by disruptive technologies to effectively and efficiently manage the large volume of data generated. This communication presents the main characteristics and advances that distinguish the development of the initiative called Epidempredict for Covid19 in Panama. The project involves the implementation of a cloud platform that facilitates data analysis in a distributed, collaborative and secure form. This platform will enable efficient data ingestion, administration, analysis, visualization and export. The development will be a solution oriented to VUCA (Volatile, Uncertain, Complex and Ambiguous) environments. The implementation integrates tools and resources supported by technologies such as Artificial Intelligence (AI) and Machine Learning (ML) integrating models, predictive algorithms and dashboards that enable decision making based on real and meaningful data. The project proposes the use of a neuro-hybrid model, based on a SIR model with artificial intelligence, combining several algorithms. This initiative aims to support the health authorities of the Panamanian public administration by facilitating decision making and the adoption and implementation of precise strategic actions in the field of health and public welfare. © 2021 AISTI.

Reshaping the diagnostic pathways for investigation of haematuria during and after the covid-19 pandemic: Diagnostic accuracy of strategies for detection of bladder cancer from the identify cohort study

Introduction: Diagnostic haematuria services have been reduced due to the COVID-19 pandemic, compromising patient care, and necessitating a more pragmatic pathway. Method: The IDENTIFY study was an international, prospective, multicentre cohort study of over 11,000 patients referred to secondary care for investigation of haematuria. Using this data, we developed strategies using combinations of imaging and cytology as triage tests to maximise cancer detection within a pragmatic pathway. Results: 8112 patients (74 4%) received an ultrasound or a CT urogram, with or without cytology. 5737 (70 7%) patients had visible haematuria (VH) and 2375 (29 3%) had non-visible haematuria (NVH). Diagnostic test performance was used to determine optimal age cut-offs for four proposed strategies. We recommended proceeding directly to transurethral resection of bladder tumour for patients of any age with positive triage tests for cancer. Patients with negative triage tests under 35-years-old with VH, or under 50-years-old with NVH can safely be discharged without undergoing flexible cystoscopy. The remaining patients may undergo flexible cystoscopy, with a greater priority for older patients to capture high risk bladder cancer. Conclusions: We suggest diagnostic strategies in patients with haematuria, which focus on detection of bladder cancer, whilst reducing the burden to healthcare services in a resource-limited setting.

Policing a Pandemic: Understanding the State and Political Instrumentalization of the Coercive Apparatus in Duterte’s Philippines

As the world was mired in distress, some leaders saw opportunities to exploit the pandemic and further consolidate their grip on power. It is, thus, the objective of this article to discuss how, when, and why the state?s coercive apparatus has been instrumentalized by its leader amid a crisis. It will also explain how such apparatus has shaped both the aura of invincibility of the state and social order within the polity. The deployment of the Philippine National Police by President Rodrigo Duterte will be analyzed and discussed. The main argument of the article is that while the police has been given extensive powers to amplify the state?s power and assist in administrating a crisis-stricken society, they have also been instrumentalized to bolster an illiberal regime. In particular, the police were bestowed positions of authority within the state?s pandemic response apparatus, provided a broader leeway to wield violence through a contentious anti-terrorism law, and mobilized to unfairly enforce government-imposed measures. Thus, amid the COVID-19 pandemic in Duterte?s Philippines, civil liberties were violated, cultures of violence and impunity worsened, and the executive powers were consolidated.