Occupational differences in COVID-19 incidence, severity, and mortality in the United Kingdom: Available data and framework for analyses

There are important differences in the risk of SARS-CoV-2 infection and death depending on occupation. Infections in healthcare workers have received the most attention, and there are clearly increased risks for intensive care unit workers who are caring for COVID-19 patients. However, a number of other occupations may also be at an increased risk, particularly those which involve social care or contact with the public. A large number of data sets are available with the potential to assess occupational risks of COVID-19 incidence, severity, or mortality. We are reviewing these data sets as part of the Partnership for Research in Occupational, Transport, Environmental COVID Transmission (PROTECT) initiative, which is part of the National COVID-19 Core Studies. In this report, we review the data sets available (including the key variables on occupation and potential confounders) for examining occupational differences in SARS-CoV-2 infection and COVID-19 incidence, severity and mortality. We also discuss the possible types of analyses of these data sets and the definitions of (occupational) exposure and outcomes. We conclude that none of these data sets are ideal, and all have various strengths and weaknesses. For example, mortality data suffer from problems of coding of COVID-19 deaths, and the deaths (in England and Wales) that have been referred to the coroner are unavailable. On the other hand, testing data is heavily biased in some periods (particularly the first wave) because some occupations (e.g. healthcare workers) were tested more often than the general population. Random population surveys are, in principle, ideal for estimating population prevalence and incidence, but are also affected by non-response. Thus, any analysis of the risks in a particular occupation or sector (e.g. transport), will require a careful analysis and triangulation of findings across the various available data sets. Copyright: .. 2023 Pearce N et al.

Responsive, adaptive, and future-centred leadership in response to crisis: findings from Australia, Fiji, and New Zealand

The COVID-19 pandemic has caused major disruption to education and highlighted the importance of effective leadership during times of crisis. This paper considers the impact of the pandemic on school leaders in Australia, Fiji, and New Zealand. A secondary analysis of data from five interpretivist, qualitative studies was conducted. The aim of the study was to investigate the similarities and differences between the leaders' experiences across school settings, states/provinces, and countries. Our findings place renewed importance on understanding the role of schools within the community and the vital role school leaders play in helping schools respond to volatile and dynamic circumstances. The findings show how leaders' roles and responsibilities adapted to respond quickly and effectively to the urgency of the crisis, regardless of the context. Furthermore, common practices such as attending to wellbeing and providing clear and timely communication were revealed. The analysis also revealed some interesting nuances in the leaders' responses because of the duration of the crisis, the particular needs of the community, and government requirements. Papers like this provide insights into what leaders do and how schools and systems might prepare and support leaders to lead during times of crisis. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

How has the management of acute Biliary pathology changed as a result of the SARS COV2 pandemic?

Aims: Gallbladder pathology is a common cause of Emergency admission under General surgery-however management had to be drastically changed given The unexpected pressures of The SARS-CoV-2 pandemic. This study aimed to compare management strategies in patients presenting with Biliary pathology pre and intra-SARS-CoV-2 pandemic in one NHS truSt. Method(s): A database of patients admitted to The acute surgical admissions ward in The months of November 2019 and 2021 was accessed, patients with Biliary presentations were isolated and information about these admissions analysed. Result(s): In 2019 4 of 57 (8.7%) of patients admitted with Biliary pathology had a laparoscopic cholecystectomy during that acute admission, compared to 8 of 65 (12.3%) in 2021. For all interventions (including ERCp and cholecystostomy) these values were 14 of 57 (25%) in 2019 and 24 of 65 (37%) in 2021. of 54 patients in 2019 who did not have laparoscopic cholecystectomy on index admission, 9 were readmitted (16.7%). The median duration of admission for all Biliary patients on index admission was 4 days in 2019 compared to 5.9 days in 2021. Conclusion(s): SARS COV2 has precipitated a change in management of acute Biliary patients. There is now an increased rate of intervention during The index admission and subsequent increase in admission duration. This is seen as an improvement in The pathway for patients in The long term, reducing The burden on The elective waiting list and reducing re-admission which will of fset The modest increase in length of stay on The index admission.

From the EHEA to the EEA: Renewed State-Making Ambitions in the Regional Governance of Education in Europe

The launch of the Bologna Process in 1999 supported by the European University Association was widely seen as an ambitious intergovernmental project to reshape national higher education institutions across Europe. Over time, however, the Bologna Process framework has not only been taken up in other parts of the world, but the European Commission has incorporated it into its European Higher Education Area, and most recently the creation of a European Education Area by 2025. In our chapter we explore the framing of this expanded agenda for the European Commission for education more generally in the face of rising national populisms across European, the new challenges posed by COVID-19 and institutional lockdowns, and the geo-strategic challenges to the East with the rise of China and its Belt and Road Initiative. We note the continuing dependence in techniques of governing such as mobility and ask about the ongoing challenges facing this state-making project. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Increasing access to cognitive–behavioural therapy for patients with psychosis by evaluating the feasibility of a randomised controlled trial of brief, targeted cognitive–behavioural therapy for distressing voices delivered by assistant psychologists: the GiVE2 trial

Background Cognitive-behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therapists. This study explored a combination of these responses by investigating a brief, CBT-informed intervention targeted at distressing voices (the GiVE intervention) administered by a briefly trained workforce of assistant psychologists. Aims To explore the feasibility of conducting a randomised controlled trial to evaluate the clinical and cost-effectiveness of the GiVE intervention when delivered by assistant psychologists to patients with psychosis. Method This was a three-arm, feasibility, randomised controlled trial comparing the GiVE intervention, a supportive counselling intervention and treatment as usual, recruiting across two sites, with 1:1:1 allocation and blind post-treatment and follow-up assessments. Results Feasibility outcomes were favourable with regard to the recruitment and retention of participants and the adherence of assistant psychologists to therapy and supervision protocols. For the candidate primary outcomes, estimated effects were in favour of GiVE compared with supportive counselling and treatment as usual at post-treatment. At follow-up, estimated effects were in favour of supportive counselling compared with GiVE and treatment as usual, and GiVE compared with treatment as usual. Conclusions A definitive trial of the GiVE intervention, delivered by assistant psychologists, is feasible. Adaptations to the GiVE intervention and the design of any future trials may be necessary.

COVID Check-In: Optimizing Cleft & Craniofacial Team Care during COVID-19 using an on-line social pediatrics screening instrument

Background/Purpose: The public health mandates associated with COVID-19 to decrease transmission in children and youth added unprecedented stress on families, providers and health care systems, including ambulatory multidisciplinary cleft/craniofacial team care. In order to provide responsive, multidisciplinary team (MDT) cleft and craniofacial care, it was essential to identify direct and indirect impacts of COVID-19 on our patients and families, whilst planning ahead for ongoing coordinated surgical, pediatric, and psychosocial interventions. The purpose of this Platform presentation is to discuss how incorporating a short on-line psychosocial screening questionnaire prior to a MDT clinic, using a 'What Matters to You' quality improvement (QI) format, can facilitate care coordination and responsiveness, triage for in-person and virtual care settings, and respond to family centred care priorities in the midst of evolving COVID-19 landscapes. Methods/Description: Description - During this platform paper, the interdisciplinary team coordinator and/or pediatrician from a large North American multidisciplinary Cleft Craniofacial Program will present the key findings from a quality improvement project conducted during the concurrent COVID-19 pandemic. The use of a smart phone accessible data system to record QI data will also be discussed. Main Objectives of Presentation - At the end of this presentation, the learner will list 5 key psychosocial screening questions to triage patients in need of addition supports exacerbated by the COVID-19 pandemic. Care coordinators will discuss key findings and the application of similar approaches in other team settings to address direct and indirect care needs exacerbated by COVID-19 and its aftermath. Key Findings and Insights - Out of 110 sequential MDT visits, families reported that COVID impacted timely access to health services (20%);employment (32%);basic needs like food and shelter (13%);and social capital. Almost half (47%) reported less than 5 people to turn to for extra support. The most common concerns caregivers reported about their children were development, learning, and/or school progress (38%);mental health (36%) and social emotional well-being (31%).

Implementing smoking cessation interventions in a preoperative clinic

Cigarette smoking has negative health implications for surgical patients. Smoking cessation before surgery reduces complications;however, information on the risks of smoking and benefits of quitting on surgical outcomes are not regularly provided to patients. It is especially important for smokers to quit now because they are at increased risk of serious complications of coronavirus disease 2019 (COVID-19). The purpose of this project was to develop and implement a program for smoking cessation in a preanesthesia clinic associated with a southwestern medical center to increase motivation to quit smoking. The evidence-based program involved development of a provider toolkit, a referral process, provider education, and program evaluation. After provider education, the program commenced. Of the 134 current smokers encountered over a 16-week period, most were ready to quit within 30 days (n = 92, 68.66%). Of the smokers who were ready to quit, 50 (37.31%) accepted referral for smoking cessation counseling, treatment, or both. Only 13 (9.70%) of the 134 smokers were already receiving treatment. This program enabled providers to feel more comfortable discussing the implications of smoking, advising smokers to quit, providing education materials, and offering referral services at the appropriate stage of readiness for behavior change.