ABSTRACT
This paper proposes four principles for managers and higher education educators who are designing units and programmes so as to be dual mode ready. `Dual mode’ design and delivery enables students to equitably complete their studies fully online, while also offering on-campus experiences where possible. The four principles are: (1) All learning outcomes can be met irrespective of participation mode;(2) Teaching-learning activities are equitable across participation modes;(3) All students have equivalent opportunity to demonstrate achievement of learning outcomes;and (4) ‘Online ready’ design. Being dual mode ready will likely remain important as on-campus delivery may not be possible for all students. Further, universities may need to pivot rapidly to fully online delivery for a range of reasons, including pandemic-related circumstances. The four principles provide guidance on how best to ensure equity and fairness for students and teachers in a dual mode context. © 2022 Informa UK Limited, trading as Taylor & Francis Group.
ABSTRACT
Recent decades have seen much greater attention paid to risk management at an organizational level, as evidenced by the proliferation of legislation, regulation, international standards and good practice guidance. The recent experience of Covid-19 has only served to heighten this attention. Growing interest in the discipline has been accompanied by significant growth in the risk management profession;but practitioners are not well served with suitable books to guide them in their work or challenge them in their professional development. This book attempts to place the practice of risk management within organizations into a broader context, looking as much at why we try to manage risk as how we try to manage risk. In doing so, it challenges two significant trends in the practice of risk management: The treatment of risk management primarily as a compliance issue within an overall corporate governance narrative;and The very widespread use of qualitative risk assessment tools ("heat maps" etc.) which have absolutely no proven effectiveness. Taken together, these trends have resulted in much attention being devoted to developing formalized systems for identifying and analyzing risks;but there is little evidence that this is driving practical, cost-effective efforts to actually manage risk. There appears to be a preoccupation with the risks themselves, rather than a focus on the positive actions that can (and should) be taken to benefit stakeholders. This book outlines a simple, quantitative approach to risk management which refocuses attention on treating risks;and presents choices about risk treatment as normal business decisions. © 2022 Patrick Roberts.
ABSTRACT
Objective: To evaluate the effect of the COVID-19 pandemic on prostatectomies, mastectomies, colectomies, and hysterectomies done at the University Hospital of the West Indies (UHWI). Design and Methods: Data was extracted from the records for the main operating theatre of the UHWI, for all cases done between January 1st, 2016, and September 30th, 2021. Patients who underwent any of these surgeries with a diagnosis of an associated cancer were included. The covid pandemic in Jamaica was considered to start March 1st, 2020, based on the detection of the first case in the island. Result(s): 921 cases were identified, 145 colectomies, 280 mastectomies, 114 prostatectomies and 382 hysterectomies. Comparisons were made of the mean number of cases done monthly pre and post pandemic. The rates pre and post were, 4.12 and 4.11 for mastectomies (p = 0.976), 2.20 and 2.0 for colectomies (p = 0.713), 5.65 and 5.74 for hysterectomies (p = 0.881) and 1.88 and 1.16 for prostatectomies (p = 0.012). The proportion of males in the population decreased from 20% to 15% (p = 0.155). The mean age for patients pre and post were, 55.8 and 56.1 for mastectomies (p = 0.842), 63.2 and 63.7 for colectomies (p = 0.82), 58.5 and 58.4 for hysterectomies (p = 0.91) and 63.7 and 61.2 for prostatectomies (p = 0.176). Conclusion(s): Except for prostatectomies, the pandemic has had little impact on the number of common oncological surgeries done at the UHWI. Investigation of the causes of the decreased number of prostatectomies is needed.
ABSTRACT
Dementia is a far-reaching disease and it is estimated that approximately 850,000 people are living with dementia in the UK;this is estimated to increase to over 1 million by the year 2025 (Prince, Knapp, Guerchet, et al., 2014). Caring for people with dementia is demanding and this care is often provided by unpaid carers in the home (National Institute for Health Research, 2016). So often people are uncertain about what the future could hold following diagnosis and how to support a person with dementia. Due to this in 2017, St Giles Hospice in collaboration with Green Square Accord launched a four-week carers' course which was designed to support unpaid carers in the community who support people living with dementia. The course covers a range of topics, including looking after yourself and activities for people with dementia, eating and drinking and infections in dementia, dementia related behaviours and planning for the future including end-of-life. Prior to 2020 this four-week course was face-to-face and was group based. When the COVID-19 pandemic hit the service had to act quickly to ensure the much-needed support for these carers did not disappear. The carers' course was adapted to provide support via a one-to-one basis either via video consultation or through a telephone call. This ensured that carers were not isolated and had access to specialist support and signposting to other services. Data captured showed that 100% of participants found that the topics covered were relevant to their situations, 92% of participants found that sessions fulfilled their expectations and that 100% were given opportunity to ask questions. Over 80 carers have been supported through the adaptation of the service so far.
ABSTRACT
The objective of this study was to describe the response by state boards of pharmacy pertaining to personal protective equipment shortages during the early phase of the COVID-19 pandemic. All webpages of state boards of pharmacy were independently reviewed for written guidance pertaining to personal protective equipment conservation strategies in sterile compounding and deviations from United States Pharmacopeia General Chapter <797> standards;each guidance was then reviewed for referenced sources. Of 52 state pharmacy regulatory bodies, 38 (73.08%) provided guidance to modifying personal protective equipment use during sterile compounding activities to mitigate supply shortages. The references for each guidance varied, however, most referenced CriticalPoint, LLC or the United States Pharmacopeia. A few of the guidance documents from boards also permitted other deviations from United States Pharmacopeia Chapter <797> standards. Early in the pandemic, pharmacists within sterile compounding practices had to conserve personal protective equipment while mitigating contamination risk. Pharmacists looked to state boards of pharmacy for guidance. This report shows a high level of state response to the personal protective equipment shortage induced by the pandemic.
ABSTRACT
Objective: To evaluate patterns of patient management in an academic Radiation Oncology department between3/17/20 and 5/8/20 during the COVID-19 pandemic. Background: As a response to the worldwide COVID-19 pandemic, our Radiation Oncology department instituted anumber of measures to limit spread of the disease to our patients and staff. This included prospectively evaluatingall new referrals for radiation treatment and determining an appropriate course of action, which if appropriateincluded delaying the start of radiation, hypofractionation, or using other modalities of treatment prior to start ofradiation. Methods: We analyzed data for 82 patients between 3/17/20-5/8/20 to evaluate patterns of management. The chi-squared test was used to evaluate the descriptive characteristics of the study population, with P values ≤ 0.05considered statistically significant. One sample t-test was used to compare the statistical mean difference betweensample variables. Data were analyzed using SPSS 24.0 software (IBM, Armonk, NY, USA). Results: The data set comprised 38% Caucasians and 59% African Americans. An age breakdown revealed 12.3%below age 30, 42% between ages 30-60, and 45.7% over age of 60. When the data were analyzed by gender, wenoted a significant difference by site of treatment (p=0.005) and whether immediate treatment was required or not(p=0.029). This likely reflects gender-driven differences in cancer site with patients diagnosed with prostate cancergetting LHRH agonist therapy prior to start of radiation. Hypofractionated radiation schedules were used in 2patients with cord compression early during the study period compared to 3 patients who received standardfractionation later, and one person elected to go straight to hospice care (p=0.002). Of patients for heterotopicossification prophylaxis, 3/14 declined radiation and one was over the weight limit of the radiation table (p=0.000).41% of patients were inpatients. No patients developed COVID-19 during our study period. Conclusion: A prospective evaluation of new patient referrals may have helped mitigate the spread of COVID-19 atour Radiation Oncology facility. This is one of several prospective measures that our department took to protectpatients and staff.
ABSTRACT
BACKGROUND: COVID-19 is caused by the coronavirus SARS-CoV-2, which uses angiotensin-converting enzyme 2 (ACE-2) as a receptor for cellular entry. It is theorized that ACE inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) may increase vulnerability to SARS-CoV-2 by upregulating ACE-2 expression, but ACE-I/ARB discontinuation is associated with clinical deterioration. OBJECTIVE: To determine whether ACE-I and ARB use is associated with acute kidney injury (AKI), macrovascular thrombosis and in-hospital mortality. METHODS: A retrospective, single-centre study of 558 hospital inpatients with confirmed COVID-19 admitted from 1 March to 30 April 2020, followed up until 24 May 2020. AKI and macrovascular thrombosis were primary end-points, and in-hospital mortality was a secondary end-point. RESULTS: AKI occurred in 126 (23.1%) patients, 34 (6.1%) developed macrovascular thrombi, and 200 (35.9%) died. Overlap propensity score-weighted analysis showed no significant effect of ACE-I/ARB use on the risk of occurrence of the specified end-points. On exploratory analysis, severe chronic kidney disease (CKD) increases odds of macrovascular thrombi (OR: 8.237, 95% CI: 1.689-40.181, P = 0.009). The risk of AKI increased with advancing age (OR: 1.028, 95% CI: 1.011-1.044, P = 0.001) and diabetes (OR: 1.675, 95% CI: 1.065-2.633, P = 0.025). Immunosuppression was associated with lower risk of AKI (OR: 0.160, 95% CI: 0.029-0.886, P = 0.036). Advancing age, dependence on care, male gender and eGFR < 60 mL min-1 /1.73 m2 increased odds of in-hospital mortality. CONCLUSION: We did not identify an association between ACE-I/ARB use and AKI, macrovascular thrombi or mortality. This supports the recommendations of the European and American Societies of Cardiology that ACE-Is and ARBs should not be discontinued during the COVID-19 pandemic.