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Canadian Journal of Surgery ; 63(4):E370-E373, 2020.
Article in English | ProQuest Central | ID: covidwho-1678631


What have become more clear than a unifying definition of leadership, however, are many of the features and concepts that make a skilled leader. "5 Dr. Pellegrini eloquently outlined a number of updated leadership principles that included 1) be present (being visible is the most important thing a leader can do in a time of crisis to quell anxiety and uncertainty;2) communicate frequently (outline updates and corresponding actions often);3) communicate thoroughly (share more rather than less, and connect with the team rather than dictate to the team);4) communicate truthfully (members will have already collected substantial amounts of information, so err on the side of over-informing and being truthful);and 5) exercise pragmatic optimism (truth anchored in reality).5 Effective crisis management includes each of these concepts with an added dose of resilience and patience. "6 Times of challenge and stress can also help improve previously poor team performance with the timely addition of exceptional leadership.7 The emotional glue of any group or culture remains a common sense of identity and purpose, or in the case of COVID-19, a common enemy. [...]great leaders ruthlessly protect their people;encourage connection, collaboration, and collective ownership;and thereby nurture a safe environment of trust, respect and family.

Ultrasound J ; 14(1): 2, 2022 Jan 03.
Article in English | MEDLINE | ID: covidwho-1594888


BACKGROUND: SARS-CoV-2 infection, manifesting as COVID-19 pneumonia, constitutes a global pandemic that is disrupting health-care systems. Most patients who are infected are asymptomatic/pauci-symptomatic can safely self-isolate at home. However, even previously healthy individuals can deteriorate rapidly with life-threatening respiratory failure characterized by disproportionate hypoxemic failure compared to symptoms. Ultrasound findings have been proposed as an early indicator of progression to severe disease. Furthermore, ultrasound is a safe imaging modality that can be performed by novice users remotely guided by experts. We thus examined the feasibility of utilizing common household informatic-technologies to facilitate self-performed lung ultrasound. METHODS: A lung ultrasound expert remotely mentored and guided participants to image their own chests with a hand-held ultrasound transducer. The results were evaluated in real time by the mentor, and independently scored by three independent experts [planned a priori]. The primary outcomes were feasibility in obtaining good-quality interpretable images from each anatomic location recommended for COVID-19 diagnosis. RESULTS: Twenty-seven adults volunteered. All could be guided to obtain images of the pleura of the 8 anterior and lateral lung zones (216/216 attempts). These images were rated as interpretable by the 3 experts in 99.8% (647/648) of reviews. Fully imaging one's posterior region was harder; only 108/162 (66%) of image acquisitions was possible. Of these, 99.3% of images were interpretable in blinded evaluations. However, 52/54 (96%) of participants could image their lower posterior lung bases, where COVID-19 is most common, with 99.3% rated as interpretable. CONCLUSIONS: Ultrasound-novice adults at risk for COVID-19 deterioration can be successfully mentored using freely available software and low-cost ultrasound devices to provide meaningful lung ultrasound surveillance of themselves that could potentially stratify asymptomatic/paucisymptomatic patients with early risk factors for serious disease. Further studies examining practical logistics should be conducted. TRIAL REGISTRATION: ID ISRCTN/77929274 on 07/03/2015.

Canadian journal of surgery. Journal canadien de chirurgie ; 63(4):E372-E373, 2020.
Article in French | EuropePMC | ID: covidwho-1557926
Can J Surg ; 63(22): S2-S4, 2020 05 01.
Article in English | MEDLINE | ID: covidwho-1024420


Summary: During the coronavirus disease 2019 (COVID-19) pandemic, delaying lifesaving cancer surgeries must be done with extreme caution and thoughtfulness. Modelling indicates that delays in high-risk cancer surgeries beyond 6 weeks could affect long-term outcomes for thousands of Canadians. Consequently, it is possible that postponing cancer surgery without consideration of its implications could cost more lives than can be saved by diverting all surgical resources to COVID-19. This article provides general guidance on supporting curative surgical treatment where appropriate and with available resources.

Coronavirus Infections , Critical Care , Neoplasms/surgery , Pandemics , Pneumonia, Viral , Surgical Procedures, Operative , Betacoronavirus , COVID-19 , Canada/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Decision Making , Humans , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Time Factors
Can J Surg ; 63(2): e164, 2020 04 03.
Article in English | MEDLINE | ID: covidwho-1021690
Can J Surg ; 63(3): E313, 2020 06 04.
Article in English | MEDLINE | ID: covidwho-892394
Can J Surg ; 63(4):272-273, 2020.
Article in English, French | MEDLINE | ID: covidwho-742549