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1.
17th Annual ACM/IEEE International Conference on Human-Robot Interaction, HRI 2022 ; 2022-March:1095-1099, 2022.
Article in English | Scopus | ID: covidwho-2097604

ABSTRACT

Anthropomorphic robots may reduce loneliness in older people, however, acceptance is requisite for adoption. We collected the experiences of 10 people aged 80-92 who used a pre-market social robot, GenieConnect, for between 2 to 35 days during the COVID19 pandemic restrictions. GenieConnect is a table-top robot with a large face and animated eyes, designed for support and companionship. The robot asked 'how are you feeling, Name' each day and delivered lifestyle prompts such as medication reminders. We observed conflicting responses from participants - five expressed positive responses, three negative (two of these withdrew) and two neutral. Positive comments included 'feeling not alone';'having someone to talk to';and enjoying being asked 'how are you feeling'. Negative comments were mainly related to not liking the eyes. Design adaptations were made to increase acceptance. We conclude that robots like GenieConnect could reduce loneliness when a user-centred design approach is taken. © 2022 IEEE.

2.
British Journal of Surgery ; 109:vi32, 2022.
Article in English | EMBASE | ID: covidwho-2042545

ABSTRACT

Aim: Virtual consultations (VC) in breast surgery have been successfully utilised during the COVID pandemic and have potential to reduce the costs of outpatient clinics as well as increase patient satisfaction. We aimed to assess the utility and safety of VC in new patient clinics in women under 30, which are considered a low-risk subgroup. Method: Data was prospectively collected on 118 women aged under 30 who were referred from primary care to the breast clinic between December 2020 and April 2021. Clinicopathological data was collected on referrals, imaging and follow up. Results: Median age was 24 years (range 17-30). The commonest presenting symptoms were a lump (69%), breast pain (16%) and nipple symptoms (14%). The VC was performed via video in 63 (53%) patients and via telephone alone in 55 (47%). Nineteen patients (16%) were reassured and discharged directly from VC. Ninety-four patients (80%) underwent an outpatient ultrasound with a sonographer trained in clinical palpation. Twenty-six (27%) ultrasounds showed benign pathology with the remainder being normal. Six biopsies were performed, all of which were benign. Seventeen (14%) patients required a face-to-face appointment with a breast surgeon after ultrasound or biopsy. Ninety-four (79%) patients were discharged after VC + ultrasound alone. No patients required surgery. Conclusions: Utilising VC, the majority of new referrals in women under 30 did not require face-to-face appointments. VC have potential to reduce burden on new patient clinics whilst improving patient convenience. Early data suggest a low risk of compromising safety in this subgroup.

3.
JQ: Justice Quarterly ; : 1-26, 2022.
Article in English | Academic Search Complete | ID: covidwho-2017227

ABSTRACT

Policies implemented to control the COVID-19 (C19) pandemic have faced public resistance. We examined this issue via an experimental vignette study embedded in a May 2020 national (U.S.) survey conducted by YouGov. Specifically, we explore how the public perceived a local policymaker proposing a C19-related isolation policy, based on the policy’s invasiveness or its punitivity. We find that more intrusive and more punitive policies generally resulted in colder feelings towards, and harsher perceptions of, the policymaker. However, our results suggest that the main driver of public sentiment towards the policymaker was the invasiveness of the proposed policy, with the policy's punitivity being less impactful. We discuss these findings in relation to policymaking, policy support and compliance, and tradeoffs between informal/formal controls, and intrusive/punitive policies. [ FROM AUTHOR] Copyright of JQ: Justice Quarterly is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

4.
Journal of General Internal Medicine ; 37:S294, 2022.
Article in English | EMBASE | ID: covidwho-1995705

ABSTRACT

BACKGROUND: The rapid conversion to telehealth services as an alternative to in-person ambulatory care in response to COVID-19 required abrupt adaptations by patients with diabetes and their providers, that may have resulted in poorer outcomes for subgroups of the population. METHODS: We conducted a longitudinal population study from a diabetes registry with clinical and administrative data maintained for all patients with diabetes seen at an academic medical center. From this registry, we identified all patients seen at least once in the year before and after 03/20/20 at any of the 16 ambulatory care clinics at this site (n=9760) who also had ≧ 1 HbA1c value in both periods (n=4710), and those with ≧ 2 visits and ≧ 2 HbA1c values in the same periods (n=1553). We compared patient characteristics (age, gender, race/ethnicity, Charlson comorbidity score), clinic site [Federally Qualified Health Centers (FQHCs) vs. other ambulatory care sites], total number of ambulatory visits and number of telehealth visits, mean HbA1c mean value and % in poor control (HbA1c ≧ 9%) for both groups of patients. We used odds ratios for bivariate comparisons and logistic regression for multivariable analyses. RESULTS: The mean age of patients with ≧ 1 visit in the pre-post periods was 62.5 [SD 14.0], 47% were female, 40% were Hispanic, 28% had a Charlson score greater than the median, 37% were seen at an FQHC, and 18.9% had poor glycemic control (HbA1c ≧9%). Characteristics for patients with ≧ 2 visits were comparable. Poor control was more likely among those seen at FQHC sites (OR=3.17, p<.0002), those ≧65 years (OR=3.53, p<.0001), those with substantial comorbidity (Charlson ≧ median value, OR=1.40, p=.0011), Hispanic patients (OR=3.08, p<.0001) and those seen by telehealth (OR=1.59, p<.0001). Results for patients with ≧ 2 visits and corresponding HbA1c values were comparable. Parameter estimates from the logistic regression model predicting HbA1c ≧ 9% were all statistically significant and in the expected direction for the variables considered. CONCLUSIONS: Telemedicine is currently being considered for continuation as an accepted, efficient and safe mode of healthcare delivery. However, it may not be effective for specific subgroups of patients with chronic diseases such as diabetes in which patient partnership and the provider patient relationship are key to optimizing outcomes. Further, advances in the delivery of telehealth care, including easily accessed high quality technologies are needed to ensure that remote healthcare delivery does not further increase disparities in health outcomes, particularly for the poor, underserved, minorities, elderly and those with complex diseases.

5.
Sport Business and Management-an International Journal ; : 20, 2022.
Article in English | Web of Science | ID: covidwho-1985432

ABSTRACT

Purpose The purpose of this study is to critically examine the financial health and performance of the English and Australian cricket networks. This includes the county cricket clubs (CCC) and state and territory cricket associations (STCA) affiliated to the England and Wales Cricket Board (ECB) and Cricket Australia (CA) respectively, as well as the ECB and CA themselves. The authors apply resource dependency theory to understand if there are any financial dependencies within the networks of cricket in England and Australia. Design/methodology/approach The data for this research was obtained from the financial statements of the ECB, the 18 affiliated CCCs, CA and the six affiliated STCAs. This sample covers the last 5 years of financial information (2014-2019) for all the organisations at the time of writing. Ratio analysis was conducted on all organisations within the sample to assess financial health and performance. Findings Both CCCs and STCAs show signs of poor financial health. There is a clear dependence on the financial support they receive from the ECB and CA respectively and this dependence appears more prominent in Australia. The ECB and CA have better financial health which ultimately allows them to financially support the CCCs and STCAs. Originality/value The ECB and CA are facing difficult financial decisions to remain financially secure themselves due to the impact of COVID-19 but also to support their affiliated clubs. The affiliated clubs do not generate sufficient revenues and must diversity their revenue streams if they are to become financially self-sustaining. This financial structure and distribution mechanism will be vital in safeguarding the future of some of England's and Australia's most important cricket organisations.

6.
Journal of University Teaching and Learning Practice ; 19(4), 2022.
Article in English | Scopus | ID: covidwho-1971003

ABSTRACT

Since 2011 the School of Media and Communication at RMIT University has been actively supporting an ethos of belonging throughout their learning and teaching. In 2017 ‘belonging’ became a formal university priority, embedded in the institution’s strategy and dispersed across Colleges and Schools through a range of activities and interventions. However, in the supercomplex COVID-19 landscape, practices of belonging are being reconsidered and reimagined for online learning environments. This paper outlines some of the reasons why belonging should be prioritised during times of intense change and complexity. We outline a range of responsive initiatives that have assisted staff and students as they rapidly shifted to a learning and teaching environment. Indeed, given our grounding in the field of media and communication, we seek to demonstrate that embracing supercomplexity through a disciplinary focus can in fact be productive for staff and students alike. Through this discussion we demonstrate how a belonging strategy at the institutional level can be translated as embedded practice at the level of the discipline and within micro-level classroom interventions. © 2022, University of Wollongong. All rights reserved.

7.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925438

ABSTRACT

Objective: To describe changes in daily activity measured by wearable sensors in participants with Parkinson's disease (PD) following the COVID-19 pandemic. Background: Digital tools provide objective, frequent and sensitive data collection in real-world settings. In a natural history study of PD, participants used wearable sensors before and after COVID-19 shutdowns. Design/Methods: At research visits throughout this two-year study at the University of Rochester Medical Center, participants wore sensors with accelerometer and gyroscopic capabilities and completed questionnaires. Following each visit, participants wore sensors remotely for 7 days during waking hours. Participant position and activity from days 1-6 of wear was classified from sensor data. Results: Prior to March 14 2020, when COVID-19 shutdowns began in Monroe County, NY, 17 participants with PD (70.4 (6.3) years) and 13 controls (61.1 (13.5) years) completed a baseline visit. All 30 later completed a month 12 visit after COVID-19 shutdowns. Sensor wear was comparable at baseline (13.9 (1.4) hours/day) and month 12 (13.74 (2.1) hours/day). At month 12, PD participants walked an average of 1709 (1457) steps/day, approximately 17% less than at baseline (2048 (1416) steps/day), with considerable individual variation. PD participants spent approximately 20% more time lying while awake at month 12 (112.7 (149.9) min) than at baseline (93.6 (103.1) min). Daytime sleep did not increase from baseline (39.6 (39.3) min) to month 12 (39.2 (32.8) min). PD and control participants reported greater anxiety and depression at month 12. From baseline to month 12, controls had similar activity trends as participants with PD, but walked more, spent less time lying, had less daytime sleep, and reported less depression and anxiety at both time points. Conclusions: Following the emergence of COVID-19, participants with PD walked less and spent more time resting. These data provide an objective measure of the pandemic's impact on a small cohort of individuals with PD.

8.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925153

ABSTRACT

Objective: A substantial number of COVID long-haulers have developed POTS, which warrants further investigation. This study is intended as a first look at a new and growing patient population that is bringing greater attention to the prevalent autonomic disease of POTS. Background: POTS (Postural Orthostatic Tachycardia Syndrome) is a disorder of autonomic dysregulation involving overactive compensation for postural blood pressure changes. This debilitating syndrome can be associated with small fiber neuropathy and a broad spectrum of autonomic symptoms including palpitations, changes in sweating, and gastrointestinal problems like constipation. Respiratory and gastrointestinal viruses have been known to cause onset of POTS pathophysiology. In approximately 10% of COVID cases, patients experience long-term health effects after the conclusion of their COVID infection. These patients are called COVID “long-haulers.” Design/Methods: We conducted a chart review of 25 Cleveland Clinic post-COVID POTS patients who are mostly female (84%) to learn about this patient population's distribution of top symptoms, comorbidities, autonomic testing, and autonomic questionnaire scores. Top three symptoms were determined based on the physician's note from the patients' initial visit to the Cleveland Clinic Neurology Department. Results: Our chart review revealed a high occurrence of excitatory comorbidities such as chronic migraine (44%) and irritable bowel syndrome (24%). In addition, when assessing patients' top three POTS symptoms, we found that palpitations, fatigue, and dyspnea were affecting patients most. As with POTS in general, autonomic testing outside of tilt table testing (85.7%) shows variable results with QSART (50%), skin punch biopsy (37.5%), deep breathing (14.3%), and Valsalva testing (0%) all showing positivity rates of 50% or less for our patient sample. Conclusions: Post-COVID POTS could be an excitatory process with hyperadrenergic signaling based on the symptoms and comorbidities. We hope that this chart review will be the launching point for future studies aimed at achieving greater understanding of the post-COVID POTS phenomenon.

9.
Global Advances in Health and Medicine ; 11:75-76, 2022.
Article in English | EMBASE | ID: covidwho-1916528

ABSTRACT

Methods: This cluster-randomized pilot compared 5-minute slow DB with treatment-as-usual among four 12th-grade public high school classes. Students individually participated in the curriculum after school during COVID-19-related hybrid teaching, with DB 3 times/week and breath science education once/week. Feasibility was based on overall compliance and qualitative assessments. Preliminary effectiveness was measured with the State-Trait Anxiety Inventory (STAI) and a timed-exhale carbon dioxide tolerance test (CO2TT). Descriptive statistics and repeated analysis of variance were performed to quantify and compare cross-sectional and temporal outcomes between classes and time periods. Human subjects research approval was granted through WCG-IRB. Results: Forty-two students consented to participate. Intervention and effectiveness assessments' compliance varied from 29-91% across classes and weeks, and decreased on average 40% from baseline to follow-up. Compliance of ease/ tolerability assessments ranged from 41% to 86%, and averaged 55% for open-ended assessments. Usefulness, ease and tolerability ratings for the DB ranged from 1.63±0.74 to 2.88±0.35 on scales of 0-3 (“not at all” - “very much”);and from 2.24±0.84 to 2.60±0.55 for effectiveness assessments. Students reported enjoying the DB, CO2TT, and breath science;some found the extended exhales challenging and the curriculum and assessments time-consuming. Outcome measures demonstrated trends towards improvements (e.g., improved STAI and CO2TT before-to-after breathing exercises), but were not statistically significant. Background: Nearly 1 in 3 US adolescents meet the criteria for anxiety, an issue that has worsened with the COVID-19 pandemic. We developed a video-based, 5-week, slow diaphragmatic breathing (DB) stress-reduction curriculum for high school students and evaluated its feasibility and preliminary effectiveness. Conclusion: Implementation of this 5-week slow breathing curriculum was feasible and tolerable to this cohort. Compliance, tolerability, and effectiveness may be improved with in-class participation. Future research on simple and accessible slow-breathing exercises is warranted to address today's adolescent stress-management crisis.

11.
European Journal of Surgical Oncology ; 48(5):e200, 2022.
Article in English | EMBASE | ID: covidwho-1881969

ABSTRACT

Aim: Virtual consultations (VC) in breast surgery have been successfully utilised during the COVID pandemic and have potential to reduce the costs of outpatient clinics as well as increase patient satisfaction. We aimed to assess the utility and safety of VC in new patient clinics in women under 30, which is considered a low-risk subgroup. Methods: Data was prospectively collected on 118 women aged under 30 who were referred from primary care to the breast clinic between December 2020 and April 2021. Clinicopathological data was collected on referrals, imaging and follow up. Results: Median age was 24 years (range 17-30). The commonest presenting symptoms were a lump (69%), breast pain (16%) and nipple symptoms (14%). The VC was performed via video in 63 (53%) patients and via telephone alone in 55 (47%). Nineteen patients (16%) were reassured and discharged directly from VC. Ninety-four patients (80%) underwent an outpatient ultrasound with a sonographer trained in clinical palpation. Twenty-six (27%) ultrasounds showed benign pathology with the remainder being normal. Six biopsies were performed, all of which were benign. Seventeen (14%) patients required a face-to-face appointment with a breast surgeon after ultrasound or biopsy. Ninety-four (79%) patients were discharged after VC + ultrasound alone. No patients required surgery. Conclusion: Utilising VC, the majority of new referrals in women under 30 did not require face-to-face appointments. VC have potential to reduce burden on new patient clinics whilst improving patient convenience. Early data suggest a low risk of compromising safety in this subgroup.

12.
American Journal of Respiratory and Critical Care Medicine ; 205:1, 2022.
Article in English | English Web of Science | ID: covidwho-1881022
13.
Managing Sport and Leisure ; 27(1/2):72-78, 2022.
Article in English | CAB Abstracts | ID: covidwho-1778856

ABSTRACT

This commentary serves to provide a rapid analysis of the impact of coronavirus disease 2019 (COVID-19) on sporting mass gatherings. The focus of this commentary surrounds sporting mass gatherings and strategies to mitigate the spread of COVID-19, with a particular focus on the UEFA EURO 2020 competition. Further references to the 2020 Olympic Games, and community recreational football are made. The intention is to stimulate discussion, analysis, interest and research on what the initial impact of COVID-19 has on sport. COVID-19 could fundamentally change the way sport operates in the future and requires further analysis. We hope this commentary provides an interesting record and reference point for future research and practice of those operating in sporting organisations. Learning lesson from this crisis, must ensure sport managers and practitioners are better prepared in sport and society for similar events in the future.

14.
Managing Sport and Leisure ; 27(1/2):102-112, 2022.
Article in English | CAB Abstracts | ID: covidwho-1769088

ABSTRACT

COVID-19 has sent a shockwave into society and sport. As result of this, sport and football resuming without spectators - fans or supporters, has brought a number of financial issues that has threatened the sustainability and future of many clubs. This commentary unpicks what has happened and some of the tensions, decision-making and consequences surrounding the return of spectators. The commentary presents the case that spectators are key to the survival of football clubs and that the United Kingdom Government must reverse their decision to not let spectators return. Now more than ever, these words hold substance, meaning and truly matter to clubs and their networked communities, "Football without fans is nothing".

15.
Non-conventional in English | National Technical Information Service, Grey literature | ID: grc-753629

ABSTRACT

According to the Centers for Disease Control and Prevention, as of June 30, 2020, the United States has documented more than 2.5 million confirmed cases and more than 125,000 deaths due to COVID-19. To facilitate the U.S. response to the pandemic, numerous federal agencieshave awarded contracts for critical goods and services to support federal, state, and local response efforts. GAOs prior work on federalemergency response efforts has found that contracts play a key role, and that contracting during an emergency can present unique challenges as officials can face pressure to provide goods and services as quickly as possible. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) included a provision for GAO to provide a comprehensive review of COVID-19 federal contracting. This is the first in a series of GAO reports on this issue. This report describes, among other objectives, key characteristics of federal contracting obligations awarded in response to the COVID-19 pandemic. Future GAO work will examine agencies planning and management of contracts awarded in response to the pandemic, including agencies use of contracting flexibilities provided by the CARES Act. GAO analyzed data from the Federal Procurement Data System-Next Generation on agencies reported government-wide contract obligations for COVID-19 through June 11, 2020. GAO also analyzed contract obligations reported at the Departments of Health and Human Services, Defense, Homeland Security,and Veterans Affairsthe highest obligating agencies.

16.
Molecular Genetics and Metabolism ; 132:S354-S356, 2021.
Article in English | EMBASE | ID: covidwho-1735110

ABSTRACT

Previous studies of genome sequencing (GS) in critically ill childrenhave made use of either modified hardware or working procedureswhich would be difficult, if not impossible, to integrate into existingclinical workflows1. Our lab’s transition from exome sequencing (ES) to GS offered an opportunity to implement in-house rapid genomesequencing (rGS) in critically ill children in a manner which couldintegrate with existing clinical workflows. We conducted a feasibilityand implementation pilot by offering rGS to child-parent triosconcurrently undergoing clinical rapid ES (rES) via a reference lab.The purpose of this study was to identify and address operationalbarriers to implementation of a rGS program capable of communicatinga preliminary result within 7 days of consent. We consideredthis time span to be more reflective of clinical realities than lab-quotedturnaround times (TAT) which typically start at sample receipt andthus do not account for challenges in sample acquisition and pre-testcounseling in a critical care setting, nor the impact of shipping times.Here we present data on TAT and lessons learned from the first 27subjects enrolled.Using rapid cycle improvement methodologies, we identified fourdistinct but inter-related workflows requiring optimization:1. Pre-analytic: patient identification through acquisition ofsamples2. Wet-lab: extraction through sequencing3. Bioinformatics: secondary and tertiary analysis as well as rapididentification of causal variants4. Return of resultsFigure 1 summarizes TAT across cases, demonstrating the markedimprovements in TAT with our programmatic approach to improvement.We used our first 9 cases to determine a baseline TAT for theentire process and to delineate the 4 main workflows (above). Atbaseline, excluding cases delayed by COVID-19 restrictions, mean TATwas 17.12 days (3 sequential deviant range: 7.05–27.19 days).Following deployment of our programmatic approach to rGS, meanTAT fell to 6.19 days (3 sequential deviant range: 0.51–11.87 days).Table 1 summarizes the observations and insights, by workflow, whichimpacted upon TAT and/or implementation. The single biggest impacton TAT was optimization of bioinformatics by removing all manualsteps between starting sequencing and producing human interpretable,filtered, annotated output of high-priority variants for interpretation.The second biggest source of improvement was optimization ofthe sequencing itself as well as prioritizing sample processing for andaccess to sequencing runs. While variant ranking is helpful in identifying causal variants, in 9/10 cases with a diagnostic findingthe causal variant(s)were obvious to the study teamwithin minutes ofviewing the annotated variant list, regardless of variant rank. (Figure Presented) As time required for sequencing and analytic workflows fell, therelative contribution of other workflows to overall TAT shifted and itbecame more obvious that early identification and utilization of thisapproach is very important in lowering overall time to diagnosis(Figure 2). In 6/10 cases with a diagnostic finding, the initial approachof the clinical team was NOT rES (and thus patients were not eligiblefor rGS on a research basis). Had rGS been the initial diagnosticmodality chosen, a diagnosis could have been reached in a median 12days sooner (range 2–28 days). There were also several cases wheresequencing was delayed when one or both parents did not present tothe lab to provide a blood sample in a timely manner. Optimization ofsequencing or analytic workflows cannot meaningfully improveoutcomes either of these situations.Our findings suggest some important considerations for institutionsdeveloping or seeking to improve rapid sequencing programs for acuteand critically ill children: (Table Presented) • Optimization of computational resource utilization and phenotypecuration saves more time than improved variant filtering orprioritization.• Obtaining samples from parents is non-trivial.• Even trained geneticists may fail to recognize appropriatecandidates for rGS.

17.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326886

ABSTRACT

The 4C Mortality Score (4C Score) was designed to risk stratify hospitalised patients with COVID-19. We assessed inclusion of 4C Score in COVID-19 management guidance and its documentation in patients’ case notes in January 2021 in UK hospitals. 4C Score was included within guidance by 50% of sites, though score documentation in case notes was highly variable. Higher documentation of 4C Score was associated with score integration within admissions proformas, inclusion of 4C Score variables or link to online calculator, and management decisions. Integration of 4C Score within clinical pathways may encourage more widespread use.

18.
Organised Sound ; 26(3):340-353, 2021.
Article in English | Web of Science | ID: covidwho-1586077

ABSTRACT

In this article we present the Networked Music Performance Library, which documents research and practice in the field of networked music performance. The library was developed in response to the skyrocketing interest in networked music due to social distancing and travel restrictions during the COVID-19 pandemic in 2020. In this article, we discuss the library's working environment and briefly describe several similar earlier projects by other researchers. The main goals we set for the library were to collect materials, organise accessible and straightforward ways of navigating the collection, including knowledge from a wider context of time-based arts (theatre, dance and other time-based art forms), and create a community of users and contributors. We describe the main methods we use to find the works for the library and examine the current state of our collection, which has grown in the last year. Through an analysis of the entries' metadata, we provide several examples of professionals' use of the library. Current library users include performing musicians, teachers and composers. As the project is ongoing, we outline the scope of our future work as well as analyse several possible post-COVID applications for networked music, which include assisting socially isolated musicians, teaching, travel and new pandemics. We also show how this library could contribute to the development of new electroacoustic approaches.

19.
Neurol Sci ; 43(3): 1503-1511, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1540229

ABSTRACT

BACKGROUND: Neurology residents are particularly vulnerable to burnout because of the novel logistical and clinical challenges brought about by the coronavirus disease 2019 (COVID-19) pandemic. Despite its implications, knowledge on burnout and its predictors among neurology residents is lacking. This study aimed to determine the prevalence of burnout among neurology residents during the pandemic, to compare burnout subscale scores and sociodemographic and work characteristics, and to explore residents' perceptions on how to address burnout. METHODS: We conducted a cross-sectional survey among all 120 residents from the nine institutions in the Philippines offering neurology residency programs from March to August 2020. We obtained sociodemographic and work characteristics using questionnaire. We measured burnout using the Maslach Burnout Inventory. We performed an inductive thematic analysis to analyze perceptions on how to reduce burnout. RESULTS: The response rate was 71.67% (86/120). The mean age was 30.1 ± 3.1 years. Using predefined subscale critical boundaries, the prevalence of burnout was 94% (95% CI 89, 99). The lack of compensation and number of on-duty days influenced emotional exhaustion scores. The number of on-duty days influenced depersonalization scores. Thematic analysis revealed five themes: increasing manpower; self-care; reducing clerical tasks; improving work environment; and adequate compensation. CONCLUSIONS: The prevalence of burnout among neurology residents during the COVID-19 pandemic was alarmingly high. Reforms in hiring policies, work-hour management, manpower organization, work environment, and logistics may be considered.


Subject(s)
COVID-19 , Internship and Residency , Neurology , Adult , Burnout, Psychological , Cross-Sectional Studies , Humans , Neurology/education , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
20.
Annals of Oncology ; 32:S530, 2021.
Article in English | EMBASE | ID: covidwho-1432841

ABSTRACT

Background: Outcomes in RAS-mutant metastatic colorectal cancer (mCRC) remain poor and patients have limited therapeutic options. Adavosertib is the first small molecule inhibitor of WEE1 kinase. We hypothesised that aberrations in DNA replication seen in mCRC with both RAS and TP53 mutations would sensitise tumours to WEE1 inhibition. Methods: Patients with newly diagnosed mCRC were registered into FOCUS4 and tested for TP53 and RAS mutations. Those with both mutations who were stable or responding after 16 weeks of chemotherapy were randomised 2:1 between Adavosertib or active monitoring (AM). The primary outcome was progression-free-survival (PFS). Results: Between Jul 2017 and Mar 2020 718 patients were registered into FOCUS4;247 (34%) were RAS/TP53-mutant. 69 patients were randomised from 25 UK hospitals (44 to Adavosertib;25 to AM) and recruitment terminated early due to COVID-19 and following DMEC review of efficacy data. Adavosertib was associated with a PFS improvement over AM (median 3.61 vs 1.87 months;HR=0.35[95% CI 0.18-0.68], p=0.0022). In pre-specified subgroup analysis, Adavosertib activity was greater in left-sided tumours HR=0.24 [95% CI 0.11–0.51], versus right-sided HR=1.02 [95% CI 0.41–2.56] (interaction p=0.043). Adavosertib activity was limited to tumours with KRAS12/13 mutations, rather than mutations in extended KRAS or NRAS (interaction p=0.01). Overall survival (OS) was not improved with Adavosertib vs AM (median 14.0 vs 12.8 months;HR=0.92[95%CI 0.44-1.94], p=0.93);however in left-sided tumours, median OS was 14.1 vs 11.3 months (HR=0.37 [95%CI 0.15-0.87]) and 6.5 vs 15.5 months in right-sided (HR=2.15 [95%CI 0.72-6.43], interaction p=0.0047). Adavosertib was well tolerated;grade 3 toxicities were diarrhoea (9%), nausea (5%) and neutropenia (7%). Conclusions: In this phase II randomised trial, Adavosertib improved PFS compared with AM and demonstrates potential as a well-tolerated therapy for RAS/TP53-mutant mCRC. Activity was greater in patients with left-sided tumours, with potential impact on OS. Further testing is required in this sizable population of unmet need. Clinical trial identification: ISRCTN90061546. Legal entity responsible for the study: The authors. Funding: MRC/NIHR, CRUK, AstraZeneca. Disclosure: J. Seligmann: Financial Interests, Personal, Invited Speaker: Pierre Fabre;Financial Interests, Personal, Invited Speaker: Merck Serono;Financial Interests, Personal, Advisory Board: Pierre Fabre;Financial Interests, Personal, Expert Testimony: Roche Diagnostics;Financial Interests, Personal, Invited Speaker: Servier. T. Maughan: Financial Interests, Personal, Advisory Board: AstraZeneca;Financial Interests, Personal, Advisory Board: Pierre Fabre;Financial Interests, Personal, Advisory Board: Pfizer;Financial Interests, Institutional, Funding: AstraZeneca;Financial Interests, Institutional, Funding: Psioxus;Financial Interests, Institutional, Funding: Merck KGAA. All other authors have declared no conflicts of interest.

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