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1.
Cytotherapy ; 25(6 Supplement):S245-S246, 2023.
Article in English | EMBASE | ID: covidwho-20245241

ABSTRACT

Background & Aim: With larger accessibility and increased number of patients being treated with CART cell therapy, real-world toxicity continues to remain a significant challenge to its widespread adoption. We have previously shown that allogeneic umbilical cord blood derived (UCB) regulatory T cells (Tregs) can resolve uncontrolled inflammation and can treat acute and immune mediated lung injury in a xenogenic model as well as in patients suffering from COVID-19 acute respiratory distress syndrome. The unique properties of UCB Tregs including: i) lack of plasticity when exposed to inflammatory micro-environments;ii) no requirement for HLA matching;iii) long shelf life of cryopreserved Tregs;and iv) immediate product availability for on demand treatment, makes them an attractive source for treating acute inflammatory syndromes. Therefore, we hypothesized that add-on therapy with UCB derived Tregs may resolve uncontrolled inflammation responsible for CART cell therapy associated toxicity. Methods, Results & Conclusion(s): UCB Tregs were added in 1:1 ratio to CART cells, where no interference in their ability to kill CD19+ Raji cells, was detected at different ratios : 8:1 (80.4% vs. 81.5%);4:1 (62.0% vs. 66.2%);2:1 (50.1% vs. 54.7%);1:1 (35.4% vs. 44.1%) (Fig 1A). In a xenogenic B cell lymphoma model, multiple injections of Tregs were administered after CART injection (Fig 1B), which did not impact distribution of CD8+ T effector cells (Fig 1C) or CART cells cells (Fig 1D) in different organs. No decline in the CAR T levels was observed in the Tregs recipients (Fig 1E). Specifically, no difference in tumor burden was detected between the two arms (Fig 2A). No tumor was detected in CART+Tregs in liver (Fig 2B) or bone marrow (Fig 2C). A corresponding decrease in multiple inflammatory cytokines in peripheral blood was observed in CART+Tregs when compared to CART alone (Fig 2D). Here we show "proof of concept" for add-on therapy with Tregs to mitigate hyper-inflammatory state induced by CART cells without interference in their on-target anti-tumor activity. The timing of Tregs administration after CART cells have had sufficient time for forming synapse with tumor cells allows for preservation of their anti-tumor cytotoxicity, such that the infused Tregs home to the areas of tissue damage to bind to the resident antigen presenting cells which in turn collaborate with Tregs to resolve inflammation. Such differential distribution of cells allow for a Treg "cooling blanket" and lays ground for clinical study. [Figure presented]Copyright © 2023 International Society for Cell & Gene Therapy

2.
Journal of the American College of Surgeons ; 236(5 Supplement 3):S96, 2023.
Article in English | EMBASE | ID: covidwho-20244642

ABSTRACT

Introduction: The COVID-19 pandemic has negatively impacted clinical experience and case volumes. Surgical simulation is now an even more powerful training tool and, to maximize potential, we must ensure learner engagement. Our aim was to identify barriers to surgical simulation engagement and strategies to mitigate these. Method(s): Scoping search was performed with a trained librarian of PubMed, EMBASE and Web of Science. Title and screening were completed with inclusion criteria: articles describing barriers to engagement with surgical simulation. After full text screening, data was extracted from included articles: type of study, MERSQI score, type/number of participants, barriers to engagement and strategies to mitigate these. Result(s): Twenty-nine manuscripts were included with 951 faculty and 2,467 residents. The majority (86%) were in high income countries (HIC) and four in LMICs. Most were surveys (22/29), and five involved semi-structured interviews/focus groups. Mean adjusted MERSQI score was 8. Commonest barriers to HIC engagement were learner clinical duties (9/25), lack of learner time (13/25), lack of learner interest/motivation (9/25) and lack of faculty time or interest to participate (12/25). In LMIC, commonest barriers were lack of simulation lab/equipment (4/4), cost (3/4) and inadequate supervision (3/4). Strategies to improve HIC engagement were mandatory/protected resident simulation training (9/25) and, in LMIC, low cost simulators (4/4) and sharing resources (2/4). Conclusion(s): Identification of barriers to simulation engagement is crucial for successful learning. Given the increased importance of simulation education due to the COVID-19 pandemic, surgical educators should strategize to maximize engagement.

3.
Medical Journal of Peking Union Medical College Hospital ; 14(2):431-436, 2023.
Article in Chinese | EMBASE | ID: covidwho-20244427

ABSTRACT

Objective To investigate the impact of dynamic adaptive teaching model on surgical education. Methods Due to the COVID-19 pandemic in 2020, we adopted dynamic adaptive teaching model in the Department of Breast Surgery, Peking Union Medical College Hospital, which divided the whole curriculum into several individual modules and recombined different modules to accommodate to student's levels and schedules. Meanwhile, adaptive strategy also increased the proportion of online teaching and fully utilized electronic medical resources. The present study included quantitative teaching score (QTS) recorded from January 2020 to June 2020, and used the corresponding data from 2019 as control. The main endpoint was to explore the impact of dynamic adaptive teaching model on overall QTS and its interaction effect with trainer's experience and student category. Results Totally, 20 trainers and 181 trainees were enrolled in the present study. With implementation of dynamic adaptive strategy, the overall QTS decreased dramatically (1.76+/-0.84 vs. 4.91+/-1.15, t=4.85, P=0.005). The impact was consistent irrespective of trainers' experience (high experience trainers: 0.85+/-0.40 vs. 2.12+/-0.44, t=4.98, P=0.004;medium experience trainers: 0.85+/-0.29 vs. 2.06+/-0.53, t=4.51, P=0.006;and low experience trainers: 0.10+/-0.16 vs. 0.44+/-0.22, t=2.62, P=0.047). For resident (including graduate) and undergraduate student teaching, both QTS was lower with dynamic strategy (residents: 0.18+/-0.34 vs. 0.97+/-0.14, t=4.35, P=0.007;undergraduate students 1.57+/-0.55 vs. 3.77+/-1.24, t=3.62, P=0.015), but dynamic strategy was effective for post-doc student subgroup and reached comparable QTS as traditional model (0.00+/-0.00 vs. 0.17+/-0.41, t=1.00, P=0.363). Conclusions Dynamic adaptive teaching strategy could be a useful alternative to traditional teaching model for post-doc students. It could be a novel effective solution for saving teaching resources and providing individualized surgical teaching modality.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

4.
Endocrine, Metabolic and Immune Disorders - Drug Targets ; 23(4):578, 2023.
Article in English | EMBASE | ID: covidwho-20243836

ABSTRACT

Background: East during COVID-19 is a potentially serious and fatal new infection that first broke out in Italys North Eastduring Spring 2020. Among subjects considered more clinically vulnerable, patients with adrenal insufficiency (AI) have a known increased risk of infections, that could lead to poor prognosis and death due to adrenal crisis. Even the psychological and sociooccupational impact of COVID-19 could affect the health of AI patients, requiring a dynamic and continuous adaptation of the daily glucocorticoid (GC) therapy. Aim(s): To investigate if AI patients have a higher risk for COVID-19 infection than the general population, all residents in the red zone Veneto, in North-East Italy. Moreover, based on a purpose-built ADDI-COVID questionnaire, the study aimed to evaluate the subjective perception of an increased risk for COVID-19 infection and pandemic-related psycho-social impact, working life and self-adjustments of GC therapy. Method(s): Open-label, cross-sectional monocentric study on 84 (65 primary and 19 secondary) AI patients, all resident in Veneto, followed-up at the Endocrinology Unit, University-Hospital of Padua, for at least 3 years, in good and stable clinical conditions. At the end of the first COVID-19 wave (by August 2020), all patients underwent serological investigation of anti-SARS-CoV2 IgG and ADDI-COVID questionnaire. All AI patients enrolled were contacted during March-April 2021 to evaluate eventual COVID-19 infection occurrence after the second and third waves, completing a follow-up period of about 12 months. Result(s): All AI patients resulted negative to the serological test for anti-SARS-CoV2 IgG at the end of the first wave of COVID-19. After the second and third pandemic waves, COVID-19 infection occurred in 8 (10%) patients, and none needed intensive care or hospitalization. Half patients felt an increased risk of COVID-19 infection, significantly associated with an increased stress (p = 0,009) and the consequent increase of GC stress-dose (p = 0,002). Only one patient reported adrenal crisis stress correlated. The great majority of the 61 (73%) worker patients changed their working habits during the lockdown, which was inversely related with COVID-19-related stress (p = 0,0015). A significant association was found between workers and endocri- nologist contact (p= 0,046) since 18 among 20 AI patients who contacted the endocrinologist were workers. Discussion and Conclusion(s): Patients with AI residence in Veneto did not show a higher incidence of COVID19-infection compared with general population residents in Veneto after the first pandemic waves. However, the perception of increased COVID- 19 infection risk significantly impacted the psychological well-being, working habits and GC daily doses of AI patients. Especially during this pandemic period, therapeutic patient education was crucial to prevent and treat situations or conditions that could lead to an adrenal crisis. The endocrinologic consultation could help to strengthen the awareness of AI patients, especially if they were workers.

5.
Neurology and Clinical Neuroscience ; 2023.
Article in English | EMBASE | ID: covidwho-20243163

ABSTRACT

Neurological symptomatology is a crucial component of neurological expertise. The committee for fostering board-certified neurologists in the Japanese Society of Neurology (JSN) has hosted an educational activity for residents before the board examination, "The seminar for fostering board-certified neurologists" since 2004. In particular, the autumn seminar has been characterized by small group hands-on of neurological examinations and the evaluations of higher brain function. Besides this, hands-on seminar of neurological examinations by regional branches has been promoted by the JSN. In the Kanto Ko-shin-etsu branch, "The first hands-on seminar of neurological examinations" started in 2023 after a 3-year-suspension due to COVID-19. The most important educational activities in neuromuscular electrodiagnosis (EDx) is the "Neuromuscular diagnostics seminar" hosted since 2004 by the Japanese Society of Clinical Neurophysiology (JSCN). The majority of tutors and participants are neurologists. This seminar is also characterized by small-group, hands-on workshops. We have also run the overseas seminar, "Tokyo Super EMG hands-on," since 2013. These have undoubtedly contributed to enhancing the level of neuromuscular electrodiagnosis not only in Japan but also in other Asian countries. I have conducted studies on neurological symptomatology and neuromuscular electrodiagnosis, which are directly linked to enhancing clinical practice of neurologists through educational activities such as review articles or lectures. Due to the fact that symptomatology is crucial in neurological expertise, neurology is a basic specialty around the world except in Japan. In 2018, the JSN decided to aim to make neurology a basic specialty and continues to make efforts to attain this goal.Copyright © 2023 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd.

6.
Early Intervention in Psychiatry ; 17(Supplement 1):25, 2023.
Article in English | EMBASE | ID: covidwho-20242555

ABSTRACT

Aims: Children and adolescents were affected in various ways by the measures due to COVID-19 pandemic. The aims of this study were to investigate and compare the effects on mental health across age, to identify latent class trajectories of emotional and behavioural problems over 12-months and to examine the association of classes of trajectories with baseline demographic and clinical predictors. Method(s): Children (n = 1854) and adolescents (n = 1243) from the general population were assessed baseline, at 6-, 9-, and 12-month follow-up. They were eligible if they were residents in Austria, Germany, or Switzerland, were parents/caregivers of a child aged between 7 and 10 years or adolescents >=11 years, had sufficient German language skills and provided informed consent. Results and Conclusion(s): Significant age-effects were found regarding type and frequency of problems. While children had the largest increase in aggressive behaviours, adolescents reported the largest increase in emotional problems. Sociodemographic variables, exposure to and appraisal of COVID-19, psychotherapy before COVID-19 and parental mental health significantly predicted change in problemscores (F >= 3.69, p <= .001). Using growth mixture modelling, a oneclass solution was detected for the trajectory of aggressive behaviours and a two- and three-class solution for withdrawn/depression and anxiety/depression. A substantial proportion of children and adolescents experienced age-related mental health problems during the different stages of the COVID-19 pandemic. These results suggest that psychological problems of specific sub-groups should be monitored over the longer-term and interventions to improve communication, emotion regulation, and appraisal style should be offered to risk groups.

7.
Journal of the American College of Surgeons ; 236(5 Supplement 3):S98-S99, 2023.
Article in English | EMBASE | ID: covidwho-20241612

ABSTRACT

Introduction: With two cycles of virtual residency interviews, we evaluated applicants' perceptions and behavior. Method(s): All 2021 and 2022 general surgery interviewees at our institution were surveyed. Analyses were conducted using chi-square and t-tests. Result(s): Cumulatively, 134 of 238 interviewees responded (56.3%). Respondents were 50.3% male, 83% white, and 27.2 years old (SD 2.9). Candidates applied to more programs due to interviews being virtual (61%), but this effect decreased in 2022 (38%, p=0.2). Similarly, they endorsed accepting more interviews (54% in 2021 and 45% in 2022, p=0.6) with a median of 17 interviews in 2021 and 15 in 2022 (p=0.18). 27.6% reported expanding their geographic reach. The advantages were consistently saving money (96%), saving time (50%), and avoiding COVID-19 (44%). Top limitations were the inability to observe interpersonal interactions (61.2%), increased difficulty comparing programs (58.2%) and less exposure to current residents and faculty (57.4%). In the 2022 cycle, 84.7% of candidates felt the common supplemental application was not worth their time because it did not improve their application. 95% of respondents 'signaled' their top five programs, from which 20% received no interview offers and only 3% received offers from all. Conclusion(s): Virtual interviews led applicants to expand their geographic range and increase the number of programs to which they applied;however, 2022 saw a dampening of this effect. Perceived limitations did not improve in 2022, and the supplemental application was not valued by applicants. The benefits of virtual interviews must be balanced against the intangible ability to observe program culture.

8.
Journal of Psychosomatic Research ; Conference: 10th annual scientific conference of the European Association of Psychosomatic Medicine (EAPM). Wroclaw Poland. 169 (no pagination), 2023.
Article in English | EMBASE | ID: covidwho-20241240

ABSTRACT

Objectives: This study aimed to determine the prevalence, most common symptoms and sociodemographic factors associated with depression among physicians in a government COVID-Center in Davao City, Philippines. Methodology: This cross-sectional study collected data from resident physicians from July to August 2020. Result(s): Two hundred fifty-one (251) out of 376 physicians responded (68.39% response rate). The average age was 30 years old, majority were female (58.57%, 147), single (78.88%, 198), frontline workers (77.29%, 194), with average hospital experience of 2.0 years. Ninety-six (38.26%) were assigned in surgical departments while 155 (61.75%) worked in nonsurgical departments. There were twelve respondents (4.78%) who had a history of psychiatric illness and 31 (12.35%) had previous psychiatric intervention, while 66 (26.29%) had a history of medical illness. Eighty-five (33.86%) had depression using PHQ-9;57 (22.71%) as mild, 19 (7.57%) moderate, 7 (2.79%) moderately severe and 2 (0.8%) severe. Out of 85 residents who were depressed, the most common symptoms were: low energy (81, 95.29%);anhedonia (76, 89.41%);and feeling depressed (72, 84.70%). Medical illness was associated with higher levels of depression. Physicians with a history of psychiatric illness, psychiatric intervention and medical illness had significantly higher levels of depression. Conclusion(s): More than a third (33.86%) of physicians screened positive for depression. Current mental health programs must be strengthened and made specific, to prevent and address depression especially among those who have a history of psychiatric and medical illness.Copyright © 2023

9.
Value in Health ; 26(6 Supplement):S62, 2023.
Article in English | EMBASE | ID: covidwho-20238911

ABSTRACT

Objectives: We estimated the cost-effectiveness of non-pharmaceutical interventions (NPI), vaccines, and the combination of NPI and vaccines in managing the COVID pandemic. Method(s): A dynamic transmission model was constructed to simulate the incidence of COVID infections and deaths among community-dwelling Singapore residents. Using this model, we compared the cost and outcomes of NPI (border control measures, safe distancing and mask wearing) versus no NPI in an unvaccinated and a vaccinated population. The analysis was conducted from the societal perspective over a one year time horizon, with data based on the COVID situation in Singapore during Jan 2021 to Dec 2021. Costs of vaccination, adverse events, masks, self-testing using rapid antigen tests, test-trace-isolate (TTI), outpatient visits, hospitalization, productivity loss and reduced sales receipt from retail and food and beverages industries were included. Health loss from adverse events, TTI and COVID infection and deaths were also included. Result(s): Among the scenarios compared, vaccination combined with NPIs yield the lowest cost (S$7.6 billion), while no vaccination with NPIs had the highest costs (S$49.1 billion). The largest loss in QALYs from the population was seen from the scenario without vaccination or NPIs. Using a dominance approach, vaccination combined with NPIs is cost saving with an ICER of -S$213 billion per QALY, compared to no vaccination with lockdown measures. The results show that NPIs alone without vaccination only delays transmission, but does not significantly change the total number of cases observed in the population. Vaccination is both cost saving and health saving as the difference in cases averted from vaccination and their associated costs, is far greater than the additional costs required to vaccinate the public. Conclusion(s): Both vaccination and NPI are critical strategies for managing the COVID pandemic. In the presence of vaccine, NPIs continue to offer benefits in terms of reduced number of infections and deaths.Copyright © 2023

10.
Cancer Research Conference: American Association for Cancer Research Annual Meeting, ACCR ; 83(7 Supplement), 2023.
Article in English | EMBASE | ID: covidwho-20238133

ABSTRACT

Lack of access to cancer prevention education, early screening, and timely treatment, particularly in low socioeconomic, underserved communities, are cited as substantial barriers to improving survivorship. Outreach educational efforts with on-site screenings offered in partnership with community groups are known to be valuable in encouraging community members' uptake of healthy behaviors and adherence to screening recommendation. To create more engaging events, a community-academic partnership, We Engage 4 Health (WE4H), co-created 11 unique 4-panel comic-style stories designed to be read aloud together as attendees visit each event table. These colorful stories are shared on boards that stand on each table and are offered in both English and Spanish at this time. Many tables also have an accompanying hands-on activity. Together, they lead to meaningful "low stakes" discussions which support understanding of seemingly complex health information. Story topics include the cause of cancer (Cells Gone Wrong), cancer risk factors (Reducing Your Risk), the role of primary care in cancer screening (Primary Care for Prevention), the purpose of research (short Research Ready) and details about specific cancer types (Combatting Colon Cancer, Blocking Breast Cancer, Looking for Lung Cancer, Silencing Skin Cancer, Hindering HPV, and Professional Prostate Protection) and COVID-19 (Take Your Best Shot FAQs). A health passport is used to facilitate table visitation and survey collection at each table enables meaningful evaluation of the event as well as provides the community hosts and their partners baseline cancer data to inform future programing. In 2022, WE4H and the University of Cincinnati Cancer Center partnered with three different communities to co-host pilot events that served over 100 adult residents. Community, research interns and university students volunteered to work the tables at the event and received training prior. Post event surveys and discussions indicated that community partners appreciated the different take on a health fair event. Most volunteers indicated that they would enjoy volunteering again. Attendees indicated that they liked the graphic-style story format used and most preferred it to text and text with graphics approaches. Taken together, the data indicates that Reducing Your Risk events are useful in meaningfully engaging hard to reach, at risk attendees. Additional in-person and virtual events are being planned for 2023 as an approach to reach the medically underserved throughout our region.

11.
Applied Radiology ; 52(3):28-29, 2023.
Article in English | EMBASE | ID: covidwho-20236392
12.
Journal of the American College of Surgeons ; 236(5 Supplement 3):S101-S102, 2023.
Article in English | EMBASE | ID: covidwho-20231695

ABSTRACT

Introduction: The COVID-19 pandemic has had widespread effects on the healthcare system. For trainees, one particular detriment has been the cancellation of elective operations, reducing clinical experience and procedural volumes. Measures instituted to combat the pandemic have resulted in decreased cancellation of elective cases to varying degrees. The aim of this study is to evaluate the ongoing effect of the pandemic on resident operative volume. Method(s): Operative case numbers of general surgical graduates in 2019, 2020, and 2021 were extracted from the Accreditation Council for Graduate Medical Education case logs. Data included mean total cases/graduate and means for individual case types. Data was considered by overall number of cases and cases performed as surgeon chief. Analysis of variance was employed to compare groups with p<0.05 considered significant. Result(s): Mean total major cases differed significantly among groups with reduced volume noted for 2020 graduates but no difference in volume between 2019 and 2021 graduates (1070.5+/-150 vs 1054.8+/-155 vs 1074.1+/-164, p=0.0041). This same pattern was noted for surgeon chief total cases (288.6+/-69 vs 264.4+/-67 vs 286.2+/-73, p<0.0001) as well as several major general surgery subcategories including cases involving the stomach, small intestine, large intestine, biliary system, among others. Conclusion(s): Despite continued reduction in and alteration of elective surgery practice, improved pandemic measures have allowed for increased surgical volume. This has translated to increased operative experience for graduating surgical trainees that are comparable to case numbers that preceded the pandemic. Ramifications for the 2020 graduating cohort as well subsequent cohorts require continued evaluation.

13.
Am Surg ; : 31348211031848, 2021 Jul 10.
Article in English | MEDLINE | ID: covidwho-20244398

ABSTRACT

Virtual residency interviews during COVID-19 pandemic created a need for residency programs to use social media to increase their visibility and connect with potential applicants. This was, however, new and a road never travelled for many programs. This report describes how our General Surgery Residency Program increased its presence through social media by using various exposure methods and approaches, including diversifying presence and developing candid personalized content. Results suggest that these methods have increased our exposure and reach from an average of 7 people per post to posts reaching over 4500 people. Moreover, the video posts introducing our residents and faculty provided the highest activity and reach. Thus, appropriate use of social media with described interventions and new content creation could exponentially increase the visibility of a residency program. Moreover, educating faculty and residents on the use and importance of social media could increase their interest and participation as well.

14.
Am Surg ; : 31348211060414, 2021 Dec 22.
Article in English | MEDLINE | ID: covidwho-20234437

ABSTRACT

BACKGROUND: The COVID-19 pandemic has disrupted traditional resident recruitment practices, requiring virtual interviews and new forms of outreach. Social media, such as Twitter, is one tool programs can use to connect with applicants. This study sought to assess changes in Twitter use during the COVID-19 pandemic among general surgery programs. METHODS: Twitter and residency program websites were queried for public Twitter accounts related to general surgery residency programs. Publicly available tweets for available accounts were reviewed for all posts for the period March 15, 2019-November 25, 2020. Thematic analysis of each tweet was performed, and engagement was determined by likes and retweets on each tweet. RESULTS: The number of programs with active Twitter accounts increased after the onset of COVID-19 pandemic, as did the number of tweets, likes-, and retweets-per-tweet. There was a significant increase in the number of tweets regarding resident promotion, program promotion, and virtual event promotion. Tweets received more likes-per-tweet if the subject was program promotion and resident promotion than tweets regarding virtual events. All results were statistically significant (P < .05). DISCUSSION: Twitter use and engagement with residency programs have increased significantly since pandemic onset. Engagement is highest for tweets regarding program and resident promotion as measured by likes-per-tweet and highest for program promotion and virtual events as measured by retweets-per-tweet. Given the nearly nationwide increase in Twitter engagement after pandemic onset, programs should consider the impact of Twitter as a means of communication with applicants and program branding.

15.
Am Surg ; : 31348231177935, 2023 May 25.
Article in English | MEDLINE | ID: covidwho-20243850

ABSTRACT

In response to the COVID-19 pandemic, nonemergent surgery was postponed in efforts to limit disease spread. To determine whether these changes affected vascular integrated resident (VR) and fellow (VF) operative volume, Accreditation Council for Graduate Medical Education (ACGME) case log data was reviewed. Case volume and standard deviation for each major category was for graduates of 2020 and 2021 were compared to the year prior to the pandemic, 2019. There were only 3 significant changes when comparing 2020/2021 to the prepandemic baseline of 2019, with increase in abdominal obstructive cases for VRs (8.1 in 2021 vs 5.9 in 2019, P = .021), an increase in upper extremity cases for VFs (18.9 in 2021 from 15.8 in 2019, P = .029), and a decrease in venous cases for VFs (39.6 in 2021 from 48.4 in 2019, P = .011). Postponing nonemergent surgery did not translate to significant changes in operative cases for graduating VRs and VFs.

16.
Pharmacol Res Perspect ; 11(3): e01104, 2023 06.
Article in English | MEDLINE | ID: covidwho-20242845

ABSTRACT

Medicines-related harm is common in older people living in residential aged care facilities (RACFs). Pharmacists offering services in the aged care sector may play a key role in reducing medicines-related injury. This study aimed to explore Australian pharmacists' views toward reducing the risk of medicines-related harm in older residents. Qualitative, semi-structured interviews were conducted with 15 Pharmacists across Australia providing services (e.g., through the provision of medication reviews, supplying medications, or being an embedded pharmacist) to RACFs identified via convenience sampling. Data were analyzed by thematic analysis using an inductive approach. Medicines-related harm was thought to occur due to polypharmacy, inappropriate medicines, anticholinergic activity, sedative load, and lack of reconciliation of medicines. Pharmacists reported that strong relationships, education of all stakeholders, and funding for pharmacists were facilitators in reducing medicines-related harm. Pharmacists stated that renal impairment, frailty, staff non-engagement, staff burnout, family pressure, and underfunding were barriers to reducing medicines-related harm. Additionally, the participants suggested pharmacist education, experience, and mentoring improve aged care interactions. Pharmacists believed that the irrational use of medicines increases harm in aged care residents, and medicines-specific (e.g., sedative load) and patient-specific risk factors (e.g., renal impairment) are associated with injuries in residents. To reduce medicines-related harm, the participants highlighted the need for increased funding for pharmacists, improving all stakeholders' awareness about medicines-associated harms through education, and ensuring collaboration between healthcare professionals caring for older residents.


Subject(s)
Medication Errors , Pharmacists , Aged , Humans , Australia , Hypnotics and Sedatives , Renal Insufficiency , Medication Errors/prevention & control , Homes for the Aged
17.
Ann Otol Rhinol Laryngol ; : 34894221115753, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-20237300

ABSTRACT

The COVID-19 pandemic led to a temporary lapse in the development of otolaryngology trainee operative skills due to the cancellation of elective procedures and redeployment of trainees and attendings to COVID-19 units. Although transient, this disruption provided an opportunity for otolaryngology programs to develop contingency plans and formalize nascent simulation training curricula. Integration of formal simulation training alongside current didactic and surgical education may offset lost exposure during surgically lean times while providing the framework and resources for enhanced baseline training. Here, we provide an up-to-date overview of surgical simulation models in otolaryngology and identify easily implementable, low-cost, low fidelity models for junior trainees. By taking advantage of rapid advancements in technology and a paradigm shift to a more hands-on approach in medical education, formal simulation training may prove to be a beneficial tool at all stages of residency training, allowing for expanded peer-mentored skill development and providing a safe haven during unforeseen disruptions in surgical case volume.

18.
J Cancer Educ ; 2022 Sep 09.
Article in English | MEDLINE | ID: covidwho-20242399

ABSTRACT

The COVID-19 pandemic catalyzed the integration of a virtual education curriculum to support radiation oncologists in training. We report outcomes from Radiation Oncology Virtual Education Rotation (ROVER) 2.0, a supplementary virtual educational curriculum created for radiation oncology residents globally. A prospective cohort of residents completed surveys before and after the live virtual webinar sessions (pre- and post-surveys, respectively). Live sessions were structured as complex gray-zone cases across various core disease sites. Resident demographics and responses were summarized using means, standard deviations, and proportions. Nine ROVER sessions were held from October 2020 to June 2021. A total of 1487 registered residents completed the pre-survey, of which 786 attended the live case discussion and 223 completed post-surveys. A total of 479 unique radiation oncology residents (of which 95, n = 19.8%, were international attendees) from 147 institutions (national, n = 81, 55.1%; international, n = 66, 44.9%) participated in the sessions. There was similar participation across post-graduate year (PGY) 2 through 5 (range n = 86 to n = 105). Of the 122 unique resident post-surveys, nearly all reported learning through the virtual structure as "very easy" or "easy" (97.5%, n = 119). A majority rated the ROVER 2.0 educational sessions to be "valuable or "very valuable" (99.2%, n = 121), and the panelists-attendee interaction as "appropriate" (97.5%, n = 119). Virtual live didactics aimed at radiation oncology residents are feasible. These results suggest that the adoption of the ROVER 2.0 curricula may help improve radiation oncology resident education.

19.
J Environ Psychol ; 89: 102056, 2023 Aug.
Article in English | MEDLINE | ID: covidwho-20238013

ABSTRACT

Introduction: The COVID-19 pandemic and associated lockdown restrictions prolonged residents' exposure to their home environment. The impact of lockdowns could be heightened for apartment residents as they typically have smaller, less versatile homes, and share communal and circulation spaces. This study examined changes in apartment residents' perceptions and experiences of their dwelling before and after the Australian COVID-19 national lockdown. Methods: Participants consisted of 214 Australian adults who completed a survey on apartment living between 2017 and 2019 and a follow-up survey in 2020. Questions focused on residents' perceptions of their dwelling design, apartment living experiences, and personal life events/changes due to the pandemic. Differences between pre- and post-lockdown periods were assessed via paired sample t-tests. The lived experience of a subset of residents (n = 91) following lockdown was also assessed using qualitative content analysis of free-text responses to an open-ended survey item. Results: Compared to the pre-pandemic period, after the lockdown residents reported less satisfaction with the amount/layout of their apartment space and private open space (e.g., balconies or courtyards). Increased noise annoyance from indoor and outdoor noise sources was also reported, however disputes with neighbours decreased. The qualitative content analysis highlighted a complex interplay of personal, social and environmental impacts of the pandemic on residents. Conclusions: Findings suggest an increased 'dose' of the apartment facilitated by stay-at-home orders negatively influenced residents' apartment perceptions. Design strategies that maximise spacious, flexible dwelling layouts with health-promoting elements (e.g., enhanced natural light/ventilation and private open space) are recommended to promote healthy and restorative living environments for apartment residents.

20.
Clin Orthop Surg ; 15(3): 343-348, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-20237938

ABSTRACT

Background: In the coronavirus disease 2019 (COVID-19) era, surgical resident education depends largely on virtual materials. With the help of point-of-view (POV) cameras, educational videos have become widely used for surgical training. A video recorded from the surgeon's POV helps demonstrate the procedure. We made training movies of the surgical approach to distal radius fractures for residents using a head-mounted video recording system with a laser point targeting device (LPTD). Methods: A 15-minnute movie of the trans-flexor carpi radialis approach for distal radius fractures was made. A POV camera was assembled with an LPTD and strapped on the surgeon's head. This enabled maintenance of the surgical field while recording the procedure. A shorter version of the clip was also made to investigate trainee preference. We asked 24 trainees to watch the two versions of the video and complete a short questionnaire. Results: All trainees felt that the movie made with a POV camera was more efficient than existing materials. Only 1 (4.2%) felt that the laser pointer hindered the view. Four of the 23 trainees (16.7%) felt dizzy while watching the video. Of the two versions, 16 trainees (66.7%) preferred the shorter, edited version. The average score for the video was 8.42 out of 10. Conclusions: A video recording system in the operating room that uses an LPTD-POV camera is an efficient way to produce educational material, particularly for surgical residents during the COVID-19 era.


Subject(s)
COVID-19 , Internship and Residency , Wrist Fractures , Humans , Operating Rooms , Video Recording/methods
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