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2.
J Clin Transl Sci ; 5(1): e142, 2021.
Article in English | MEDLINE | ID: covidwho-1351901

ABSTRACT

INTRODUCTION: In response to a call issued by the National Research Council to investigate the knowledge, skills, and attitudes of effective science teams, we designed a team training program for conducting science in collaborative contexts. METHODS: We reviewed the literature to develop an evidence-based competency model for effective science teams along with exemplary behaviors that can be used for founding team training and evaluation. We discuss the progress of teamwork and team development research that serves as a foundation for this work, as well as previous research involving team-based competencies. RESULTS: Three overarching competencies emerged from the literature as key for science team effectiveness: psychological safety, awareness and exchange, and self-correction and adaptation. These competencies are fully described, including their evidence base. CONCLUSIONS: We developed a competency model and implementation plan for a team training program specific to science teams - TeamMAPPS (Team Methods to Advance Processes and Performance in Science). This paper details steps in the implementation process, including plans for consortia dissemination, evaluation, and future development.

4.
Lancet Respir Med ; 9(3): 275-284, 2021 03.
Article in English | MEDLINE | ID: covidwho-1117266

ABSTRACT

BACKGROUND: Biological considerations suggest that renin-angiotensin system inhibitors might influence the severity of COVID-19. We aimed to evaluate whether continuing versus discontinuing renin-angiotensin system inhibitors (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) affects outcomes in patients admitted to hospital with COVID-19. METHODS: The REPLACE COVID trial was a prospective, randomised, open-label trial done at 20 large referral hospitals in seven countries worldwide. Eligible participants were aged 18 years and older who were admitted to hospital with COVID-19 and were receiving a renin-angiotensin system inhibitor before admission. Individuals with contraindications to continuation or discontinuation of renin-angiotensin system inhibitor therapy were excluded. Participants were randomly assigned (1:1) to continuation or discontinuation of their renin-angiotensin system inhibitor using permuted block randomisation, with allocation concealed using a secure web-based randomisation system. The primary outcome was a global rank score in which participants were ranked across four hierarchical tiers incorporating time to death, duration of mechanical ventilation, time on renal replacement or vasopressor therapy, and multiorgan dysfunction during the hospitalisation. Primary analyses were done in the intention-to-treat population. The REPLACE COVID trial is registered with ClinicalTrials.gov, NCT04338009. FINDINGS: Between March 31 and Aug 20, 2020, 152 participants were enrolled and randomly assigned to either continue or discontinue renin-angiotensin system inhibitor therapy (continuation group n=75; discontinuation group n=77). Mean age of participants was 62 years (SD 12), 68 (45%) were female, mean body-mass index was 33 kg/m2 (SD 8), and 79 (52%) had diabetes. Compared with discontinuation of renin-angiotensin system inhibitors, continuation had no effect on the global rank score (median rank 73 [IQR 40-110] for continuation vs 81 [38-117] for discontinuation; ß-coefficient 8 [95% CI -13 to 29]). There were 16 (21%) of 75 participants in the continuation arm versus 14 (18%) of 77 in the discontinuation arm who required intensive care unit admission or invasive mechanical ventilation, and 11 (15%) of 75 participants in the continuation group versus ten (13%) of 77 in the discontinuation group died. 29 (39%) participants in the continuation group and 28 (36%) participants in the discontinuation group had at least one adverse event (χ2 test of adverse events between treatment groups p=0·77). There was no difference in blood pressure, serum potassium, or creatinine during follow-up across the two groups. INTERPRETATION: Consistent with international society recommendations, renin-angiotensin system inhibitors can be safely continued in patients admitted to hospital with COVID-19. FUNDING: REPLACE COVID Investigators, REPLACE COVID Trial Social Fundraising Campaign, and FastGrants.


Subject(s)
Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , COVID-19/therapy , Cardiovascular Diseases/drug therapy , Withholding Treatment/statistics & numerical data , Aged , COVID-19/complications , COVID-19/mortality , Cardiovascular Diseases/mortality , Cardiovascular Diseases/virology , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Prospective Studies , Respiration, Artificial/statistics & numerical data , SARS-CoV-2 , Treatment Outcome
5.
Hum Factors ; 64(8): 1429-1440, 2022 12.
Article in English | MEDLINE | ID: covidwho-1093904

ABSTRACT

OBJECTIVE: To provide insights for organizations that must rapidly deploy teams to remote work. BACKGROUND: Modern situations, such as the COVID-19 pandemic, are rapidly accelerating the need for organizations to move employee teams to virtual environments, sometimes with little to no opportunities to prepare for the transition. It is likely that organizations will continually have to adapt to evolving conditions in the future. METHOD: This review synthesizes the literature from several sources on best practices, lessons learned, and strategies for virtual teams. Information from each article deemed relevant was then extracted and de-identified. Over 64 best practices were independently and blindly coded for relevancy for the swift deployment of virtual teams. RESULTS: As a result of this review, tips for virtual teams undergoing rapid transition to remote work were developed. These tips are organized at the organization, team, and individual levels. They are further categorized under six overarching themes: norm setting, performance monitoring, leadership, supportive mechanisms, communication, and flexibility. CONCLUSION: There is a significant deficit in the literature for best practices for virtual teams for the purposes of rapid deployment, leaving it to organizations to subjectively determine what advice to adhere to. This manuscript synthesizes relevant practices and provides insights into effective virtual team rapid deployment.


Subject(s)
COVID-19 , Humans , Interdisciplinary Research , Pandemics , Leadership , Problem Solving
7.
Am Psychol ; 76(1): 1-13, 2021 01.
Article in English | MEDLINE | ID: covidwho-894373

ABSTRACT

As the COVID-19 pandemic has ravaged the United States, health care teams are on the frontlines of this global crisis, often navigating harrowing conditions at work, such as a lack of personal protective equipment and staffing shortages, and distractions at home, including worries about elderly relatives or making childcare arrangements. While the nature and severity of stressors impacting health care teams are in many ways unprecedented, decades of psychological research exploring teamwork in extreme contexts can provide insights to understand and improve outcomes for teams in a crisis. This review highlights the psychological principles that apply to teams in a crisis and illustrates how psychologists can use this knowledge to improve teamwork for medical teams in the midst of the COVID-19 pandemic., The review also provides a glimpse toward the future, noting both how psychologists can help health care teams recover and rebound, as well as how additional research can improve psychologists' understanding of teamwork in times of crisis. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
COVID-19 , Group Processes , Occupational Stress/prevention & control , Patient Care Team , Personnel, Hospital/psychology , Humans
8.
J Clin Hypertens (Greenwich) ; 22(10): 1780-1788, 2020 10.
Article in English | MEDLINE | ID: covidwho-767484

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin-converting enzyme 2 (ACE2), which facilitates SARS-CoV-2 host cell entry, may be impacted by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two commonly used antihypertensive classes. In a multicenter, international randomized controlled trial that began enrollment on March 31, 2020, participants are randomized to continuation vs withdrawal of their long-term outpatient ACEI or ARB upon hospitalization with COVID-19. The primary outcome is a hierarchical global rank score incorporating time to death, duration of mechanical ventilation, duration of renal replacement or vasopressor therapy, and multiorgan dysfunction severity. Approval for the study has been obtained from the Institutional Review Board of each participating institution, and all participants will provide informed consent. A data safety monitoring board has been assembled to provide independent oversight of the project.


Subject(s)
Angiotensin Receptor Antagonists/pharmacology , Angiotensin-Converting Enzyme Inhibitors/pharmacology , COVID-19/complications , Multiple Organ Failure/epidemiology , SARS-CoV-2/drug effects , Adult , Angiotensin Receptor Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , COVID-19/epidemiology , COVID-19/virology , Case-Control Studies , Female , Hospitalization/statistics & numerical data , Humans , Incidence , Male , Multiple Organ Failure/mortality , Prospective Studies , Renal Replacement Therapy/statistics & numerical data , Respiration, Artificial/statistics & numerical data , SARS-CoV-2/genetics , Severity of Illness Index , Vasoconstrictor Agents/therapeutic use , Withholding Treatment/statistics & numerical data
9.
Organ Dyn ; : 100777, 2020 Jun 24.
Article in English | MEDLINE | ID: covidwho-611166
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