ABSTRACT
Our charity's mission is dedicated to beating blood cancer by funding research and supporting those affected. Since 1960, we have invested over 500 million in blood cancer research, transforming treatments and saving lives. Since 2015 there has been a Support Services team within the charity. This service was established to provide information that the blood cancer community can trust, in a language they can understand. By connecting and listening to our community they deepen our understanding and help shape our work. Research suggests that blood cancer patients are more likely than any other patients to leave their diagnosis appointment feeling they do not fully understand their condition. Our service can often consolidate the information given by clinicians. Patients also need advice and support on how to adapt to day-to- day life after their diagnosis. There are challenges that are unique to blood cancer, such as living with cancer as a chronic condition, being on 'watch and wait' or fluctuating remissions and relapses. In 2023 the Support Services team have a 7 day presence on our phone line, email and social media platform where people can communicate with one of our trained blood cancer support officers, or one of three Registered Nurses, all who can provide information about blood cancer diagnosis and help with emotional and practical support. We also run an online community forum where people affected by blood cancer can connect, share experiences and provide peer support. The highly experienced haematology nurses provide a clinical aspect to the support of the Blood Cancer Community that enhances the established patient centred support given historically by the charity. The nurses advanced knowledge and experience of haematological cancers, treatments, side effects, holistic care and NHS process can further guide the community. This is in addition to the invaluable information from their treatment teams. In 2023 the Support Services team are now reaching thousands of the blood cancer community. We understand that in the past 3 years the COVID-19 pandemic and the work of our charity around this will have influenced the significant increase in contacts but equally the robust and trusted services provided through this charity has contributed too.
ABSTRACT
‘Dolphins in the Reservoir' is an interactive recombinant work of moving images, text and sound. It confronts the many social challenges we face through the subjective, contradictory and often uncanny experiences of individuals. Thematically it passes through challenges to health, the environment, and fast-eroding democracy;our attempts to educate order out of chaos;philosophical and scientific ways of thinking about consciousness;and possible futures, including the rise of AI. Its recurrent dolphin theme transmutes many of these ideas.Saturated with media, the individual experiences a multimodal montage of the imaginal and mundane, the institutional and vernacular, the dystopian and utopian.. Juxtaposed and multilayered, the text, images and sound employ polysemy and synaesthesia while the interface evokes a murky, liminal realm. ‘Dolphins' is structured in six distinct cycles, which repeat with variation. A single cycle of the work grows from isolated media fragments towards a dense plurality and diversity. V/users can drive the piece with clicks, and they can drag to rearrange elements. Three preformed musical sources juxtapose acoustic and digitally transformed sound, including sonified Covid-19 wave statistics. ‘Dolphins' features trumpet by internationally renowned soloist John Wallace, our collaborator in (austra)LYSIS, the creative ensemble of which all three authors are part. © 2022, Digital Realism Creative works. All rights reserved.
ABSTRACT
Vaccine hesitancy continues to pose a formidable obstacle to in-creasing national COVID-19 vaccination rates in the US, but this is not the first time that American vaccination efforts have confronted resistance and apathy. This study examines the history of US vaccination efforts against smallpox, polio, and measles, highlighting persistent drivers of vaccine hesitancy as well as factors that helped over-come it. The research reveals that logistical barriers, negative portrayals in the media, and fears about safety stymied inoculation efforts as early as the 18th century and continue to do so. However, vaccine hesitancy has been markedly diminished when trusted community leaders have guided efforts, when ordinary citizens have felt per-sonally invested in the success of the vaccine, and when vaccination efforts have been tied to broader projects to improve public health and social cohesion. Deliberately cultivating such factors could be an effective strategy for lessening opposition today, when COVID-19's distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been. © 2023 by Johns Hopkins University Press.
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Aim: The COVID-19 pandemic has had a global impact on cancer care. However, little is known as to what extent this impact has varied between different countries. Denmark was one of the first European nations to introduce national lockdown measures and achieved comparatively good control of the initial wave. We sought to determine the impact of the pandemic's initial wave on colorectal cancer care and investigate what lessons may be learned for future pandemics. Method(s): The Danish national cancer registry was used to identify patients newly diagnosed with colorectal cancer between 01/03/2020 -01/ 08/2020 (pandemic period) and the corresponding dates in 2019 (pre-pandemic period). This registry comprise > 95% of patients diagnosed with colorectal cancers in Denmark. Data regarding clinicopathological demographics and peri-operative outcomes were retrieved and compared between the two cohorts. Result(s): 2,794 patients were identified during the study period. Surgical practices were unaltered during the pandemic, with no alterations in the use of minimally invasive surgery (colon 84% vs 87%, rectum 93% vs 96%) nor in the formation of anastomoses or stomata noted between cohorts. No significant differences in 30-day or 90-day mortality rates were identified and on multivariable analysis treatment during the pandemic period was not found to be independently associated with peri-operative death. However, a marked reduction in total (359/month versus 201/month, P = 0.008) and screening diagnoses (80/month versus 38/month, P = 0.016) was noted during the pandemic. Conclusion(s): The Covid-19 pandemic had limited impact on the technique or outcomes of colorectal cancer care in Denmark, perhaps due to the success of early control of the initial wave when compared to other European nations. However, a concerning reduction in new diagnoses was still noted, highlighting the need to encourage patients to seek medical attention during the current and future pandemic in order to avoid delays in cancer diagnoses.
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Air cargo plays an important role in supporting global supply chains;this becomes more vital when facing uncertainties in a crisis such as the COVID-19 pandemic. This motivates our study on air cargo forwarding plans, considering demand uncertainties and economic conditions. Cargos are placed into air containers based on weights and volumes, and then flown from regional collection points into a hub, for consolidation before transporting to onward destinations. Decisions are made in advance by cargo forwarders as to the containers to book, both in regions and in the hub, since airlines offer discounts on containers booked in advance;however, cargo quantities are uncertain when advance bookings are made. We develop a two-stage stochastic programming model, where the first stage determines both the quantities and types of air containers to book;the second stage deals with ordering any extra containers, at higher cost, or returning unused containers, as well as making loading and consolidation plans. The objective is to minimise the total expected costs. We then extend it into a multistage case and design a genetic algorithm as the solution method. Experimental results demonstrate that the proposed approaches provide a cost-efficient plan and responsive to demand as it arises. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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The Astrobiology Graduate Conference (AbGradCon) is an annual conference both organized for and by early-career researchers, postdoctoral fellows, and students as a way to train the next generation of astrobiologists and develop a robust network of cohorts moving forward. AbGradCon 2021 was held virtually on 14-17 September 2021, hosted by the Earth-Life Science Institute (ELSI) of Tokyo Institute of Technology after postponement of the in-person event in 2020 due to the COVID-19 pandemic. The meeting consisted of presentations by 120 participants from a variety of fields, two keynote speakers, and other career-building events and workshops. Here, we report on the organizational and executional aspects of AbGradCon 2021, including the meeting participant demographics, various digital aspects introduced specifically for a virtual edition of the meeting, and the submission and evaluation process. The evaluation process of AbGradCon 2021 is unique in that all evaluations are done by the peers of the applicants, and as astrobiology is inherently a broad discipline, the evaluation process revealed a number of trends related to multidisciplinarity of the astrobiology field. We believe that meetings like AbGradCon can provide a unique opportunity for students and early career researchers in astrobiology to experience community building, inter- and multidisciplinary collaboration, and career training and would be a welcome sight in other fields as well. We hope that this report provides inspiration and a basic roadmap for organizing future conferences in any field with similar goals.
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Background/Aims We evaluated the RCN Competency Framework for Rheumatology Nurses published in March 2020. The competency aims to support personal development plans, continuing professional development (CPD) and career progression for rheumatology nurses to advanced practice acting as a benchmarking tool, providing a framework to support succession planning and service development, forming the base for a nationwide standard curriculum for training. This evaluation explores rheumatology nurses' views of the competency, and identify benefits, limitations, and recommendations. Methods We used a sequential research design utilising a questionnaire circulated from 13 March to 25 April 2021 followed by semi-structured interviews between May 2021 and August 2021. Results 106 people responded to the survey, 99 (93%) working as adult rheumatology nurses. There were 55 (52%) band 7 nurses and a wide range of job titles. Most nurses, 93 (87%) had academic qualification at degree or Master's level. Most respondents 77 (73%) were from England. 74 (70%) found out about the competency via the RCN Rheumatology Nursing Forum Facebook page, or via the BSR website (35%). Most (71%) respondents had their present role for five years or more and 103 (50%) nurses had been in their role for more than 10 years. When asked whether they had used the competency in their practice, 57 (54%) said they had. Reasons for using it were;to provide a framework for learning, to use as a benchmarking tool, for CPD, for teaching, to demonstrate skills and knowledge, when managing others, to show managers how their role can develop. Redeployment due to COVID-19 and workforce issues were the main reason why the competency was not implemented fully. However, using it with new staff was cited as beneficial. Free text comments described very good detail and identification of learning needs, giving good understanding of the underpinning knowledge. 15 nurses responded for interviews and 14 were conducted. The average was 12 minutes totalling 171 minutes. We asked why they used the competency, for any potential strengths or limitations, how much time it took to complete, would they use it again, improvement suggestions, if they would recommend it to others, and whether it was easy to locate. People said a paediatric rheumatology module and an accessible course focussed on leadership is needed. When asked to summarise the competency in five words, one said it was 'a reliable tool to improve quality care and set standards for education of nurses'. Conclusion The competency was well received as a strengthening resource for UK rheumatology nurses. We recommended that these competencies are universally adopted. Further dissemination is required and education needs must be addressed. A development framework is planned. Further analysis will be published in 2022. A review of the competency is due in 2023.
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Objectives: As of 05/27/21, 50.5% of the United States population had initiated COVID-19 vaccination. Vaccination rates, safety and efficacy among those on active chemotherapy are not well published. As a first step towards improving cancer patient care, we explored vaccination rates among patients on active chemotherapy to gain insights on its utilization in this population and improve care of cancer patients. Methods: On 01/23/21, McKesson Specialty Health deployed a COVID Vaccine Administration survey within its iKnowMed electronic health record platform. Cancer patients who answered the survey with ongoing chemotherapy 30 days prior to or after 01/01/21 and ≥2 office visits between 01/01/21 and 05/27/21 were included in the study. Self-reported and onsite vaccination, brand, and COVID-19–related information were recorded. Chi-squared tests were used to determine significant differences between groups. Results: Selection criteria yielded 50,423 patients. The study population was 55% female (n=27,923) with a median age of 68 years (min, max 20, 80+). Approximately 60% (n=11,867) reported initiating vaccination, and 40% (n=7,797) reported being fully vaccinated. The majority of patients reported having received the vaccine by Pfizer (52%, n=10,275), followed by Moderna (45%, n=8,836), Janssen (3%, n=540), and AstraZeneca <1%. Vaccination rates did not differ significantly between females (39%, n=10,799) and males (39%, n=8,865). Patients aged ≤69 years had a significantly lower rate than those older (34%, n=8,928 vs 44%, n=10,736;p<0.0001). Patients with metastatic disease had a significantly higher vaccination rate than those without metastasis (40%, n=14,591 vs. 36%, n=5,073;p<0.0001). Conclusions: This study marks an initial review of the first 6 months post emergency use authorization of COVID-19 vaccinations. The survey responses could not be validated with external data sources. Continued research is needed to investigate reasons for lower rates, adverse effects, and treatment selection, and to monitor patient outcomes amongst vaccinated patients on chemotherapy.
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Objectives: On 1/30/20, the World Health Organization declared the COVID-19 pandemic a global emergency. In March 2020, the iKnowMed electronic health records system implemented a screening tool to monitor and report the COVID-19 impact within these at-risk community oncology practices, summarized here. Methods: The study included patients with at least two office visits, on active chemotherapy within the period 30 days prior to 03/01/2020 through 05/19/2021, and within 20 US Oncology Network practices. Screening questions included COVID-19–related symptoms, travel, exposure, and testing Results: Results: A total of 132,457 unique patients satisfied inclusion criteria. Of these, 39% (n=51,620) had at least one screening record, and 564,491 unique screening responses were recorded during the study. A median of 6 (25th- 75th percentiles: 2, 14) screening records per patient was reported. The study population was 67% (n=34,548) female and 58% aged 60-79 years (n=30,042). Approximately 24% (n=12,309) reported having been tested for COVID-19, while 4% (n=499) reported a positive result. Among the COVID-positive patients, 23% (n=114) reported recent symptoms, 9% (n=45) contact with a COVID-positive person, and 1.6% (n=8) travel. Among screened patients (n=51,620), 87% (n=45,164) did not report any symptoms, 77% (n=39,761) did not report any travel outside of their community, and 90 % (n=46,406) did not report exposure to anyone positive for COVID-19. Conclusions: The inclusion of a COVID-19 screening tool within a community oncology EHR provides insights into the effects of the pandemic within a potentially immunocompromised patient population. Descriptive analysis reveals that responses relative to symptoms, travel, and exposure along with percent-positive rates among cancer patients may be lower than the general population. Opportunities to stratify data by stage of disease, metastatic indication and other clinical variables offer future directions for analysis.
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Objectives: The USA declared the COVID-19 pandemic a national emergency on 03/13/20. On 03/17/20, CMS expanded telehealth rules, allowing Medicare to cover telehealth visits like regular visits. This study aims to analyze the utilization of Evaluation & Management (E&M) telehealth options in community oncology pre and post pandemic. Methods: Deidentified patient visits data were obtained from iKnowMed electronic health records between 01/01/18 to 05/24/2021 from 20 US Oncology practices. A combination of patient MRN and date was used as an identifier to report number of visits for all measures. Patient visits with modifiers –GT, –95, and –GQ were classified as telehealth visits. Visit dates without modifiers were defined as non-telehealth (in-office) visits. E&M visits were defined based on standard CPT codes. Results: A total of 5,914,125 unique E&M patient visits were analyzed during the study period. Between Jan-2018 and Mar-2020 (pre-COVID-19), E&M visits rose from 30,000/week to 36,000/week (20%). Fewer than 0.01% of these visits were telehealth. By April 12, 2020, overall E&M visits had dropped 35%, but the telehealth visits had risen to 16%. Since then, the overall E&M visit count remained approximately 5% lower as compared to the pre-COVID-19 trend, and telehealth visits averaged approximately 6% thereafter. Corresponding to the 2nd wave, in Dec-2020 the telehealth proportion rose again to 10%. As of 05/23/2021, telehealth E&M visits represented approximately 5% of the total E&M visits within US Oncology practices. Conclusions: This study provides a timeline of how COVID-19 has impacted E&M visits and telehealth utilization among community oncology practices. The pandemic has led to an increase in E&M telehealth visits that may remain post pandemic. Continued research is necessary to monitor telehealth utilization and its impact on the quality of care, provider finances, and future of community oncology considering rising vaccination rates, CDC guidance, and public sentiment.
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Background Colorectal cancer (CRC) screening programs worldwide have been disruptedduring the COVID-19 pandemic. CRC screening has been well-established to reduce longtermCRC incidence and mortality. Any disruption to screening would reduce these healthbenefits. This study aimed to estimate the impact of hypothetical disruptions to organizedCRC screening programs on short and long-term CRC incidence and mortality in threecountries using microsimulation modelling.Methods Using well-calibrated and validated CRC microsimulation models for Australia(Policy1-Bowel), Canada (OncoSim) and the Netherlands (ASCCA and MISCAN-Colon)participating in the COVID-19 and Cancer Global Modelling Consortium (CCGMC), wesimulated a range of hypothetical scenarios to assess the potential impact of disruptions toscreening on CRC incidence and mortality. All models simulate the adenoma-carcinomapathway, and ASCCA and Policy1-Bowel additionally simulate the serrated pathway. Modelledscenarios varied by disruption duration (3-, 6 and 12-months), post-disruption participationreduction (3-months -50% and 3-months -25%, and 6-months -50%), and catchupscreening strategies (no catch-up, immediate, and 6-months delayed catch-up).Results Without catch-up screening, CRC incidence would increase by 0.1-0.3%, 0.2-0.6%,and 0.4-1.2% over 2020-2050 among individuals aged 50 years and older in the three modelled countries after 3-, 6-, and 12-month disruptions, respectively (Figure 1). CRCmortality would increase by 0.2-0.5%, 0.4-1.0%, and 0.8-2.0% over 2020-2050 amongindividuals aged 50 years and older in the three modelled countries after 3-, 6-, and 12-month disruptions, respectively, compared to undisrupted screening (Figure 2). A 6-monthdisruption without catch-up would result in an estimated 3,552, 2,844 and 803-1,803additional CRC diagnoses and an estimated 1,964, 1,319, and 676-856 additional CRCrelateddeaths in Australia, Canada and the Netherlands, respectively, compared to undisruptedscreening. A post-disruption reduction in participation could increase CRC diagnosesby 0.2-0.9% and CRC-related deaths by 0.5-1.6% compared to undisrupted screeningdepending on the size of the reduction in participation. Providing catch-up could minimizethe impact of the disruption to an increase of 0.0-0.2% in CRC diagnoses and CRCrelateddeaths.Conclusion Although the relative impact of the modelled CRC screening disruptions (whenconsidered over the long-term, 30 years) due to the COVID-19 pandemic appears modest,given a high burden of CRC, there is a substantial impact on CRC diagnoses and deathsacross all countries considered. It is crucial that, if disrupted, screening programs ensureparticipation rates return to previously observed rates and provide catch-up screening whereverpossible, as the impact of any disruption could be considerably larger otherwise.(Image Presented)Change in CRC incidence relative to the comparator scenario (no disruption) by MISCANColon,ASCCA, Policy1-Bowel and OncoSim Abbreviations: CRC, Colorectal Cancer. Note:the base case scenario is the scenario in which a 6-month disruption period from Aprilto September 2020 was assumed, with no catch-up or changes to participation in therecovery period.(Image Presented)Change in CRC mortality relative to the comparator scenario by MISCAN-Colon, ASCCA,Policy1-Bowel and OncoSim Abbreviations: CRC, Colorectal Cancer. Note: the base casescenario is the scenario in which a 6-month disruption period from April to September2020 was assumed, with no catch-up or changes to participation in the recovery period.
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Increasing exclusive breastfeeding rates is an established public health strategy to reduce chronic disease and protect infants from illness. The role of breastfeeding in addressing health disparities takes on new significance as the COVID-19 pandemic has disproportionately impacted some communities in Hawai'i, and those with chronic conditions face increased risk of hospitalization and death. However, there are myriad policy, systemic, and environmental barriers that make it difficult for parents to breastfeed, some of which have been exacerbated by the COVID-19 pandemic. This editorial discusses the importance of breastfeeding in reducing chronic disease, reviews the status of breastfeeding in Hawai'i, explores the challenges parents face in breastfeeding their infants, especially in the time of COVID-19, and presents opportunities for improved access to lactation care to reduce health disparities. ©Copyright 2021 by University Health Partners of Hawai‘i (UHP Hawai‘i).
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In June 2021, over 200 stakeholders, advocates, and visionaries gathered to launch the Healthy Hawai'i Strategic Plan 2030 (HHSP), a 10-year strategic plan for improving the health of Hawai'i residents by preventing and reducing chronic disease and advancing health equity. The HHSP is a guide to enable coordination across common risk factors, program areas, interventions, and strategies for chronic disease prevention and control. Developed during the COVID-19 pandemic, which revealed major areas of susceptibility in our health system infrastructure and magnified existing disparities, the HHSP prioritizes health equity and strives to create sustainable change to transform communities, schools, health care and worksites to support the health of the people of Hawai'i. The HHSP is a living document and partners - present and future - are invited to work together to achieve a healthier future for the people of Hawai'i.
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OBJECTIVES: To assess telemedicine readiness of gynecologic oncology patients, particularly those at risk for care access disparities (increased distance to care, rural populations.). METHODS: Patients at all disease/treatment stages completed an anonymous survey during in-person outpatient appointments at an academic comprehensive cancer center from 1/6/2020 to 2/28/2020, conducted prior to the COVID-19 pandemic, before the introduction of telemedicine in this practice. RESULTS: Of 180 patients approached, 170 completed the survey (94.4%). Mean age was 59.6 years; 73.4% identified as White, 23.7% Black, and 2.9% other race. Ovarian cancer was most common (41.2%), followed by endometrial (27.1%), cervical (20.6%), and vaginal/vulvar (7.1%). Most patients traveled > 50 miles for appointments (63.8%); they were more likely from rural counties with significantly higher travel costs/visit ($60.77 vs $37.98, p = 0.026.) The majority expressed interest in using telemedicine (75.7%) or a smartphone app (87.5%) in their care. The majority of patients with difficulty attending appointments (88.9 vs 70.2%, p = 0.02) or from rural counties (88.7% vs 69.6%, p = 0.03) were interested in telemedicine; those with both characteristics reported 100% interest. The majority in both urban and rural counties had home internet access, and reported similarly high rates of daily use (79% vs 75%). Race and age were not associated with differences in internet access or use or telemedicine interest. CONCLUSIONS: Telemedicine is attractive to the majority of patients and may offer financial/logistical advantages. Patients have high internet use rates and comfort with using technology for healthcare. Telemedicine should be incorporated into standard practice beyond the COVID-19 pandemic to reduce healthcare access disparities.
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Public health officials dealing with pandemics like COVID-19 have to evaluate and prepare response plans. This planning phase requires not only looking into the spatiotemporal dynamics and impact of the pandemic using simulation models, but they also need to plan and ensure the availability of resources under different spread scenarios. To this end, we have developed a visual analytics environment that enables public health officials to model, simulate, and explore the spread of COVID-19 by supplying county-level information such as population, demographics, and hospital beds. This environment facilitates users to explore spatiotemporal model simulation data relevant to COVID-19 through a geospatial map with linked statistical views, apply different decision measures at different points in time, and understand their potential impact. Users can drill-down to county-level details such as the number of sicknesses, deaths, needs for hospitalization, and variations in these statistics over time. We demonstrate the usefulness of this environment through a use case study and also provide feedback from domain experts. We also provide details about future extensions and potential applications of this work.