Analysis of Quality Indicators in Molecular Laboratory of a Tertiary Care Hospital in India

Introduction: Quality indicators are important parameters to enhance the quality of the clinical laboratory services. Due to the extensive testing processes, errors cannot be completely avoided in a clinical laboratory. To minimize errors, however, adequate training, QC checks, and regular procedure evaluations are beneficial. Objective(s): The objective of the study was to establish and evaluate quality indicators on an ongoing basis as an effort to increase quality. Method(s): This retrospective study, different quality indicators in a molecular laboratory in northern Gujarat were assessed over the course of a year (September 2020-August 2021). Data of total 8176 samples were summarized. Each Quality indicator was examined at the end of the month after being divided into the pre, analytical, and post-analytical stages, respectively. Result(s): As summarization of total 8176 samples, we found a cumulative error rate for all quality indicators of 346 (4.23%). Preanalytical errors were the most common 180 (2.20%), followed by analytical errors 114 (1.39%), and post analytical errors 52 (0.63%). Conclusion(s): There is no question that by continuously striving to develop the outcome of these quality indicators through the adoption of corrective measures over time, the quality of laboratory services and patient care would be improved.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Rise in Out-of-Hospital Cardiac Arrest Cases in Chicago in 2020

Background: Italy, France and New York City have reported an increase in out-of-hospital cardiac arrest (OHCA) incidence during the COVID-19 pandemic. The purpose of our study was to assess the effect of COVID-19 on OHCA cases in Chicago. Method(s): Cardiac Arrest Registry to Enhance Survival (CARES) database was used. Bivariate analysis was conducted to assess changes in demographic and other characteristics. We excluded the cases that occurred in a healthcare facility or a nursing home. We compared the cases reported in 2020 to 2019 (and prior years). ArcGIS was used to geocode incident addresses and to show the temporal distribution by community areas. Bivariate analysis was done using chi-square tests. Result(s): A total of 3221 OHCA cases were reported in Chicago in 2020, which is 31.5% higher than those reported in 2019 (n=2450 cases). This increase was higher than what has been noticed historically (for instance, the increase from 2018 to 2019 was only 17%). There was an increase in Hispanic OHCA cases (17.3% in 2020 vs. 13.5% in 2019, p<0.01) but a decrease in White cases (20.5% vs. 23.1%). The cases in 2020 were less likely to be reported at public location (22% vs. 26%, p<0.001) or have shockable rhythm (10% vs. 13%, p=0.0002). There was a marked increase in those that were declared dead in the field in 2020 (37% vs. 27%, p<0.001). However, there were no statistically significant differences in age distribution, gender, witnessed arrest (49% vs. 51%, p=0.07) or bystander cardiopulmonary resuscitation (BCPR) (23% vs. 22%, p=0.3). Conclusion(s): A better understanding of the causes of the excess cardiac arrest numbers will be important to help plan and better prepare for future public health interventions. The effect of COVID19 on OHCA survival needs to be examined further in future studies.

Evaluation of Stress, Depression, and Anxiety among Health-Care Workers doing Duty for COVID-19 Patients in Tertiary Health-Care Facilities

Background: The coronavirus pandemic (coronavirus disease 2019 [COVID-19]) has brought the entire world to a standstill, causing an unprecedented impact on people's lives. The most affected population is the frontline health-care workers, including the on-duty doctors and paramedical staff members providing treatment and care to the COVID patients in the wards and intensive care units. Aim: The present study aimed to evaluate, compare, and correlate the prevalent levels of stress, depression, and anxiety among the doctors and the paramedical personnel treating COVID-19 patients. Materials and Methods: Two hundred and eight consecutive medical professionals and 209 consecutive paramedical personnel, fulfilling the inclusion criteria, were evaluated. Sociodemographic and clinical data were gathered using a semi-structured proforma. Assessments were further done using the Depression, Anxiety, and Stress Scale. Chi-square test was used to compare the groups (medical and paramedical staff) and their correlates. Results: Depression was present in significantly higher number of paramedical staff (43.54%) compared to medical personnel (33.17%). Among doctors, the total duty hours had a significant positive correlation (P < 0.05) to the depressive symptoms. In contrast, the anxiety levels were significantly lower (P < 0.05) among those paramedical staff members who performed their COVID duty for more than 2 weeks. Conclusion: The relentless management of COVID patients by the health-care warriors has begotten a high level of psychiatric morbidity among them. Provision of better facilities, adequate information, and appropriate interventions are required in this regard. © 2022 The Author(s).

A randomised controlled trial of early intervention with oral favipiravir in patients hospitalised with COVID-19 (PIONEER Trial)

Background: Oral anti-viral therapies are licensed worldwide in COVID-19 but indications and efficacy rates vary. Aims and Objectives: To evaluate the safety and efficacy of oral favipiravir in patients hospitalised with COVID-19. Method(s): We conducted a multi-centre, open-label, randomised controlled trial of oral favipiravir in patients newly hospitalised with COVID-19, in five centres worldwide. 500 participants were randomised 1:1 to receive oral favipiravir (1800 mg twice daily (BD) for one-day;800 mg BD for nine-days) plus standard care (SC), or SC alone. NCT: 04373733. Result(s): Recruitment was performed between May 2020 and May 2021, with 251 patients randomised to favipiravir and 249 to SC. There was no difference in time to recovery in all patients (HR 1 06;95% CI 0 89-1 27;n=499;p=0.52). A faster rate of recovery was observed in patients receiving favipiravir under the age of 60 years (HR 1 35;95% CI 1 06-1 72;n=247, p=0 01). A 66 % improvement in mechanical ventilation free survival was evident in patients under 60-years of age (HR 0 34;95% CI 0 13-0 85;n=247, p=0 02). A non-significant 26 % reduction in mortality was observed in patients receiving favipiravir (favipiravir: 26;SC: 34;p=0 24). No significant differences were observed in serious adverse events (SAE) between arms (favipiravir: 36 in 27 patients;SC: 33 in 27 patients). Conclusion(s): Orally administered favipiravir has a beneficial effect on recovery, and mechanical ventilation freesurvival in patients under 60-years of age, hospitalised with COVID-19. Wider evaluation of anti-viral medications and their potential treatment combinations is warranted in patients with COVID-19.

fvWillingness to Vaccinate Children against COVID-19 Declined During the Pandemic

Objectives To document the level of vaccine hesitancy in caregivers' of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3). Results Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively). Conclusions COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.

Abnormal FeNO post COVID-19

Background: Airway inflammation post COVID-19 is a possible cause for persistent breathlessness. Aim(s): We sought to evaluate the role of fractional exhaled nitric oxide (FeNO) measurements in this cohort. Methodology: We report FeNO results in patients undergoing lung function testing as part of the PHENOTYPE study (NCT 04459351). Result(s): 83 patients had FeNO performed between January and Nov 2021. Of the patients admitted to hospital (n=78), the median time to testing from discharge was 96 days (IQR 90-115). Median FeNO results for the whole cohort was 20 ppb (16-29). 24/83 (29%) had a FeNO in the intermediate range [median 33 (IQR 28-45)], and 5/83 (6%), FeNO >50 ppb. Chi squared testing revealed no relationship between patient-reported breathlessness (p=0.12) or cough (p=0.45) and FeNO >=25ppb. 52 patients underwent repeat lung function and FeNO testing at a median of 363 (355-370) days post discharge. 26/52 (50%) of individuals had a FeNO>=25 ppb, with a median 35 (28-42): 10/52 (19%) deteriorated from normal to intermediate range and 2/52 from intermediate to high range as compared to initial values. 7/52 (13%) of FeNO results that were abnormal at the first visit, normalized with no additional treatment. Again, no association was found between breathlessness (p=0.48) or cough (p=0.73) at the second visit and a FeNO result >=25ppb. None of the patients with a FeNO >= 25 had a prior diagnosis of asthma. Conclusion(s): The clinical relevance of an intermediate or high FeNO in this cohort is unclear. However, this preliminary work highlights that in a significant proportion of patients, the FeNO is not normal even at 1 year post discharge. The trajectory of these changes and in particular, development of small airways disease are important to study.

Small airways disease post COVID-19: 1 year follow up

Background: Small airway disease (SAD) can occur following viral infection, but the prevalence of this in individuals recovering post SARS-COV2 infection is not known. Aim(s): We sought to assess the prevalence of SAD in patients 1 year post hospital discharge for COVID-19. Method(s): A subset of patients recruited to the PHENOTYPE study (NCT 04459351) underwent forced oscillometry assessment (THORASYS). We assessed the fall in resistance from 5 to 20 Hz (R5-R20) as a marker of peripheral airway dysfunction. A value of >0.07kPa/L/s was used as a cut off definition for small airways dysfunction. All patients had lung function testing and a clinical assessment of symptoms within a median of 7.5 (IQR 4-15) days and median of 7 (IQR 4-11) days, respectively, of small airways testing. Result(s): 40 patients were enrolled between November 2021 and January 2022, at a median of 371 days (IQR 359- 380) post hospital discharge. 31/40 (78%) were male with a median age of 63 (IQR 51-72). The median length of hospital stay was 6.5 days (IQR 4-12). 11/40 patients had required non-invasive ventilation and 29/40 oxygen therapy alone. 11/40 (28%) of patients had evidence of SAD. Self-reported breathlessness (p=0.75) and cough (p=0.50) at 1 year were not increased in SAD. Similarly, there was no association between SAD and ventilatory status (p=0.98), FENO>=25 (p=0.63) or FENO> 50 (p=0.86) at 3 months or FENO >=25 (p=0.87) or FENO>50 (p=0.29) at 1 year. Conclusion(s): Small airways disease is present in patients recovering post COVID-19 but the risk factors for developing this is unclear. Longitudinal studies are required to assess the trajectory and long term impact of small airways pathology.

Use of e-media among pediatric dental professionals and postgraduate students in pediatric dentistry during COVID-19

Background: Health-care providers, particularly pediatric dentists, highly depend on electronic media. This survey attempts to assess how they have taken to e-media to keep themselves abreast of the current situation and use it efficiently. Objectives: To determine attitudes, awareness, and practices of e-media usage among pediatric dental professionals and postgraduate students in pediatric dentistry during the COVID-19. Materials and Methods: A convenience sample of 958 pediatric dental practitioners and postgraduate students in pediatric dentistry from throughout India participated in a descriptive cross-sectional survey. An investigator-designed questionnaire comprising 23 close-ended questions related to the usage and various aspects of e-media before and during the COVID-19 pandemic. Results: Younger generations of pediatric dentistry are more active in the use of e-media. Dentists between the ages of 30 and 50 years are more likely to utilize social media in their profession than dentists above the age of 50 years. For academic purposes and patient communication, e-media was the most popular choice. Conclusion: The Indian pediatric dentistry profession has grown significantly with the use of e-media. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Identifying Targeted and Generalized Offensive Speech from Anti-asian Social Media Conversations

During the Covid-19 pandemic Asian-Americans have been targets of prejudice and negative stereotyping. There has also been volumes of counter speech condemning this jaundiced attitude. Ironically, however, the dialogue on both sides is filled with offensive and abusive language. While abusive language directed at Asians encourages violence and hate crimes against this ethnic group, the use of derogatory language to insult alternative points of view showcases utter lack of respect and exploits people's fears to stir up social tensions. It is thus important to identify and demote both types of offensive content from anti-Asian social media conversations. The goal of this paper is to present a machine learning framework that can achieve the dual objective of detecting targeted anti-Asian bigotry as well as generalized offensive content. Tweets were collected using the hashtag #chinavirus. Each tweet was annotated in two ways;either it condemned or condoned anti-Asian bias, and whether it was offensive or non-offensive. A rich set of features both from the text and accompanying numerical data were extracted. These features were used to train conventional machine learning and deep learning models. Our results show that the Random Forest classifier can detect both generalized and targeted offensive content with around 0.88 accuracy and F1-score. Our results are promising from two perspectives. First, our approach outperforms contemporary efforts on detecting online abuse against Asian-Americans. Second, our unified approach detects both offensive speech targeted specifically at Asian-Americans and also identifies its generalized form which has the potential to mobilize a large number of people in socially challenging situations. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Optimal Procurement of COVID-19 Vaccine with Time-Dependent Holding Cost and Shortages under Cloud Fuzzy Demand Rate

COVID-19 vaccine has emerged as the most powerful weapon against the spread of the coronavirus. Therefore, the management of the vaccine inventory is undoubtedly the most influential and important task for the global distribution of the vaccine. This paper is an attempt to model the vaccine inventory system having time-varying holding costs and partially backlogged shortages. The concept of fuzzy set and cloud pentagonal fuzzy number has been incorporated to make the models more realistic and applicable. Models are solved and validated through numerical examples and graphical representation. Further, sensitivity analysis has been done to identify the most sensitive parameters of all. Finally, managerial insights and conclusions have been drawn to make the vaccine inventory system more robust. © 2023 World Scientific Publishing Company.

Smart Contracts For NGOs and Startups using Blockchain

This paper proposes and emphasizes the requirement of an Blockchain based smart contract for NGO's and startup crowdfunding in the present circumstances. It also highlights the need of an online financial system for indigenous NGO's and seed fund utilization of startups. Conventionally, most charity organizations make use of hard cash for settling its transactions making the process less transparent. However, due to the COVID-19 pandemic, financial system has been largely affected. In this case an online financial transaction cum procurement portal would be crucial for the candidates applying relief in remote locations. The system analyses their eligibility based on their Curriculum Vitae (CV). Proposed system uses Ethereum based smart contract and Truffle Box to build a complete Dapp (decentralized application). Authors have used MetaMask Extension as a cryptocurrency wallet and Ganache blockchain to develop, deploy and test the decentralized application. © 2022 IEEE.

Willingness to vaccinate children against COVID-19 declined during the pandemic.

OBJECTIVES: To document the level of vaccine hesitancy in caregivers' of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3). RESULTS: Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively). CONCLUSIONS: COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.

Opportunities and challenges in food entrepreneurship: In-depth qualitative investigation of millet entrepreneurs

Consumer food preferences are undergoing a rapid transformation, and there has been a heightening of interest in eating healthy, sustainable foods. Food entrepreneurs are cashing in on the trend and are diversifying their existing offerings to include healthier options using alternate ingredients such as millets. However, these entrepreneurs face several challenges, and the actual growth of the market is lower than expected. The present study examines the opportunities and challenges faced by millet entrepreneurs. A total of 25 millet entrepreneurs were interviewed using a semi-structured qualitative design. Key opportunities include increased awareness of millets, people going back to their traditions, and informative food labels were the key opportunities, while a lack of awareness, lack of familiarity, preparation difficulty, sensory attributes, lack of affordability, inferior image, customer distrust, and millets' longer gestational cycle were major challenges. © 2022 The Author(s)

Elevated Risk of Recurrent Ablation in Black Compared to White Patients With Atrial Fibrillation: Another Paradox of Atrial Fibrillation in Blacks

Introduction: Lower prevalence of atrial fibrillation (AF) despite a higher prevalence of risk factors in blacks compared to whites (AF paradox) has been reported. However, less information is available about recurrent ablation events in blacks compared to whites. Method(s): Demographic characteristics and one-year recurrent ablation events were analyzed in AF patients admitted to a community hospital from 2018 to 2021. Result(s): Recurrent AF ablation occurred in 3.7% (16/435) of the study population and was significantly higher in black compared to white patients [9/86 (10.5%) vs. 7/349 (2.0%), respectively, p=0.0001]. Black race and history of atrial flutter were predictors of recurrent AF ablation (p<0.05) within one year of initial ablation. Black patients were younger (p=0.03) with a significantly higher prevalence of hypertension, diabetes, cardiomyopathy/heart failure, thyroid disease, renal disease, sleep apnea, COVID-19, pacemaker/AICD placement, and history of Ventricular tachycardia (Table). Concomitant medications were similar between races besides higher use of antihypertensive medications in black patients (Table). Conclusion(s): In our community hospital setup, black patients with AF had a higher prevalence of comorbidities and significantly higher incidence of one-year recurrent ablation events despite similar therapy compared to white patients. These observations should be explored in a larger prospective study to understand the differential association of comorbidities in black AF patients and associated higher risk for recurrent events.

An Observational Study of Guideline-Directed Medical Therapy Optimization for Patients With Heart Failure With Reduced Ejection Fraction in Telehealth versus In-Person Visits

Introduction: Rates of initiation and dose optimization of guideline-directed medical therapy (GDMT) for heart failure patients with reduced ejection fraction are suboptimal nationally. Recently, virtual medicine has been studied as a potential solution to help overcome barriers limiting GDMT optimization. We evaluated GDMT optimization during telehealth visits compared with in-person visits at Parkland Health, a large urban safety-net health system. Method(s): Parkland has a registry of all patients with an ejection fraction <= 40% on transthoracic echocardiography within the last three years. Using this registry data of patients seen in the Parkland cardiology clinic between September 2021 and February 2022, we compared GDMT prescriptions for patients before and after each clinic visit. We defined an optimization event as the initiation of a new class of GDMT, a switch to an angiotensin receptor/neprilysin inhibitor, or an increase in dosage of any class of GDMT. The rise of Omicron variant COVID-19 cases in Dallas led to a nearly universal shift of in-person to virtual visits in December 2021, allowing us to compare GDMT optimization rates between each visit type. Result(s): From 9/12/21 to 12/24/21, there were 147 visits of which 134 (91%) were in-person. Of these in-person visits, 58.2% led to an optimization event. From 12/25/21 to 2/12/22, there were 97 visits of which 84 (89%) were telehealth visits, all conducted by telephone. Of these telehealth visits, 16.1% led to an optimization event (p<0.001). Baseline characteristics of patients from each period were not significantly different (Table 1). Conclusion(s): Our study demonstrated GDMT optimization was significantly lower in telephone visits compared with in-person visits despite each group having similar demographics and medical co-morbidities. This observation should raise concern over increased reliance on telephone-only encounters, especially in urban resource limited populations. (Figure Presented).

Don't Cop Out: Fulminant Cryptogenic Organizing Pneumonia Following Methamphetamine Inhalation

INTRODUCTION: Cryptogenic organizing pneumonia (COP) accounts for 5% of all ILD cases. Due to a low incidence rate of 1 case per 100,000 persons per annum, it is often misdiagnosed as bacterial pneumonia, but when timely managed, it has an excellent prognosis. We discuss Methamphetamine, a commonly abused stimulant that has unfortunately not yet garnered enough notoriety as a respiratory toxidrome for causing inhalation injury, potentially leading to fulminant COP. DESCRIPTION: A 44-year-old male presented to ED with fevers, cough, and dyspnea gradually worsening over the past two weeks. Of note, he smoked ten cigarettes/day and relapsed to methamphetamines inhalation, the latest use being two weeks prior. On physical exam, oxygen saturation was 70% on RA and had significant bilateral inspiratory crackles. The respiratory Viral Panel, including COVID-19, was negative. Drug screens were negative. Chest X-Ray and CTA showed bilateral ground glass opacities concerning multifocal pneumonia but no pulmonary embolism. Broadspectrum antibiotics were started. For worsening Acute Hypoxemic Respiratory failure (AHRF) on Day 3, he underwent intubation and mechanical ventilation. Further workup for infectious etiologies like S. pneumoniae and Legionella, HIV-1, and sputum and blood cultures were all negative. Initial autoimmune and connective tissue disease workup was within normal limits. Bronchoalveolar lavage (BAL) analysis did not yield an infectious, inflammatory, or neoplastic source. On day 7, he underwent an open lung biopsy which confirmed COP, with histological features of toxic injury. IV glucocorticoids were started, with gradual improvement noticed in AHRF. DISCUSSION: Respiratory failure within 30 days of hospitalization is the most common cause of mortality in fulminant COP.If a patient's history suggests exposure to inhaled amphetamine and have no response to antibiotics for supposed pneumonia, physicians should consider COP to make a timely diagnosis and initiate glucocorticoid treatment to warrant rapid clinical improvement, often seen as early as 72 hours, and prevent future relapses.With Substance use continuing to be a major healthcare problem, now more than ever, healthcare providers must be familiar with respiratory toxidrome to provide timely diagnosis and treatment.

Vaccination During Acute COVID-19 Infection Protects Against 30 Day Adverse Outcomes

Background. Therapeutic vaccination following SARS-CoV-2 infection might stimulate anti-viral immunity and improve patient outcomes. We investigated, amongst previously unvaccinated patients, whether vaccination with the Pfizer, Moderna, or Johnson & Johnson vaccines within 14 days of a positive SARS-CoV-2 test affected 30-day patient outcomes. Methods. Using a deidentified national electronic health record dataset (Optum, Inc.), we identified previously unvaccinated patients who tested positive forCOVID-19 between 12/11/2020 and 12/19/2021. Among this cohort, 1,909 patients received a first vaccine dose within 14 days (vaccinated) while 446,309 did not receive a first dose of vaccine within 30 days of their first positive test (unvaccinated). We performed 1:1 propensity score matching based on age, gender, race, ethnicity, region, BMI, insurance, and comorbidities from the Charlson Comorbidity Index. Next, we compared odds of severe outcomes within 30 days between vaccinated and unvaccinated groups using a partial proportional odds model with the following ordinal severity outcome: no hospitalization, hospitalization, ICU stay, or death (Stata version 17.0, alpha = 0.05). Results. 1,909 vaccinated patients were propensity score-matched to 1,909 unvaccinated patients. The final matched cohort was statistically indistinguishable (p > 0.05) for all metrics used in propensity score calculation. This matched cohort (n = 3,818) was 58.6% female, 67.7% white, 12.6% Hispanic, and 56.4% commercially insured, with a mean age of 50.6 years and a similar comorbidity profile. A partial proportional odds model showed that unvaccinated patients were at increased risk for hospitalization and higher ordered outcomes (OR = 1.19, 95% CI: 1.02-1.39), ICU stay and higher ordered outcomes (OR 1.63, 95% CI: 1.21-2.20), and death (OR 4.57, 95% CI: 2.50-8.37). Conclusion. Among previously unvaccinated patients, those who received a first dose vaccine within 14 days of a positive COVID-19 test were less likely to experience hospitalization, ICU stay, or death compared to matched peers who did not receive a first dose in the acute phase of infection. The sample size of patients vaccinated during the acute phase is limited, so further studies are indicated to evaluate the safety and efficacy of this practice.

Work-Life Balance and Academic Productivity Among College of Medicine Faculty Members During the Evolution of the COVID-19 Pandemic- The New Normal

Background: The persistence of the COVID-19 pandemic and mitigation strategies have shaped a new environment in which we live and work. Objective(s): To evaluate academic medicine faculty members' work stress, home stress, productivity, and self-care in the spring of 2021 compared with the spring of 2020. Method(s): A 93-question survey was distributed in March 2020 and again in March 2021. Data were collected on demographic, family, and academic characteristics;work distribution and productivity before and during the pandemic;perceived stress related to work and home activities;and self-care. Differences were assessed using chi-square and Fisher's exact tests. Result(s): There were 231 (n = 141 women, n = 90 men) faculty members who responded in the spring of 2020 and 118 (n = 60 women, n = 58 men) faculty members who responded in the spring of 2021. A greater proportion of women compared with men reported increased work stress in both surveys. By the spring of 2021, work stress had decreased significantly for men but not for women. A significantly higher proportion of women reported increased stress related to securing funding for research, scholarly productivity, teaching, advising, administrative responsibilities, and clinical responsibilities compared with men. Although research productivity had increased for both genders by the spring of 2021, a larger proportion of women reported disturbed sleep and diet. Caring for young children increased home stress regardless of faculty members' gender. Conclusion(s): Faculty members who are men have more likely adapted to the ''new normal'' by lowering work stressors and increasing productivity, whereas women more likely have adapted by decreasing self-care. The lingering effects of the pandemic have maintained higher work stress, particularly for women and especially for faculty members with young children. Institutional efforts to support those disproportionately affected and ensure well-being of faculty members are critically needed to promote gender parity post-pandemic..