Structural under-reporting of informed consent, data handling and sharing, ethical approval, and application of Open Science principles as proxies for study quality conduct in COVID-19 research: a systematic scoping review.

BACKGROUND: The COVID-19 pandemic required science to provide answers rapidly to combat the outbreak. Hence, the reproducibility and quality of conducting research may have been threatened, particularly regarding privacy and data protection, in varying ways around the globe. The objective was to investigate aspects of reporting informed consent and data handling as proxies for study quality conduct. METHODS: A systematic scoping review was performed by searching PubMed and Embase. The search was performed on November 8th, 2020. Studies with hospitalised patients diagnosed with COVID-19 over 18 years old were eligible for inclusion. With a focus on informed consent, data were extracted on the study design, prestudy protocol registration, ethical approval, data anonymisation, data sharing and data transfer as proxies for study quality. For reasons of comparison, data regarding country income level, study location and journal impact factor were also collected. RESULTS: 972 studies were included. 21.3% of studies reported informed consent, 42.6% reported waivers of consent, 31.4% did not report consent information and 4.7% mentioned other types of consent. Informed consent reporting was highest in clinical trials (94.6%) and lowest in retrospective cohort studies (15.0%). The reporting of consent versus no consent did not differ significantly by journal impact factor (p=0.159). 16.8% of studies reported a prestudy protocol registration or design. Ethical approval was described in 90.9% of studies. Information on anonymisation was provided in 17.0% of studies. In 257 multicentre studies, 1.2% reported on data sharing agreements, and none reported on Findable, Accessible, Interoperable and Reusable data principles. 1.2% reported on open data. Consent was most often reported in the Middle East (42.4%) and least often in North America (4.7%). Only one report originated from a low-income country. DISCUSSION: Informed consent and aspects of data handling and sharing were under-reported in publications concerning COVID-19 and differed between countries, which strains study quality conduct when in dire need of answers.

Adaptations to a cohort study in response to the COVID-19 pandemic: insights from Growing Up in Ireland.

Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort '98 who were recruited into the study at age nine years and Cohort '08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort '08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants' lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.

Characteristics of successful government-led interventions to support healthier populations: a starting portfolio of positive outlier examples.

Despite progress on the Millennium and Sustainable Development Goals, significant public health challenges remain to address communicable and non-communicable diseases and health inequities. The Healthier Societies for Healthy Populations initiative convened by WHO's Alliance for Health Policy and Systems Research; the Government of Sweden; and the Wellcome Trust aims to address these complex challenges. One starting point is to build understanding of the characteristics of successful government-led interventions to support healthier populations. To this end, this project explored five purposefully sampled, successful public health initiatives: front-of-package warnings on food labels containing high sugar, sodium or saturated fat (Chile); healthy food initiatives (trans fats, calorie labelling, cap on beverage size; New York); the alcohol sales and transport ban during COVID-19 (South Africa); the Vision Zero road safety initiative (Sweden) and establishment of the Thai Health Promotion Foundation. For each initiative a qualitative, semistructured one-on-one interview with a key leader was conducted, supplemented by a rapid literature scan with input from an information specialist. Thematic analysis of the five interviews and 169 relevant studies across the five examples identified facilitators of success including political leadership, public education, multifaceted approaches, stable funding and planning for opposition. Barriers included industry opposition, the complex nature of public health challenges and poor interagency and multisector co-ordination. Further examples building on this global portfolio will deepen understanding of success factors or failures over time in this critical area.

'We delivered at home out of fear': Maternity Care in Rural Nigeria During the COVID-19 Pandemic.

Background and Objective: The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We assessed maternal health service utilization, predictors, and childbirth experiences amidst COVID-19 restrictions in a rural community of Kumbotso, Kano State, in northern Nigeria. Methods: Using an explanatory mixed methods design, 389 mothers were surveyed in January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with a sub-sample (n=20). Data were analyzed using logistic regression models and the framework approach. Results: Less than one-half (n=165, 42.4%) of women utilized maternal health services during the period of COVID-19 restrictions compared with nearly two-thirds (n=237, 65.8%) prior to the period (p<0.05). Non-utilization was mainly due to fear of contracting COVID-19 (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), and harassment by security personnel (n=24, 10.7%). The utilization of maternal health services was associated with participant's post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), and employment type (civil service, aOR=4.60, 95% CI: 1.17-19.74) (p<0.001), business aOR=1.94, 95% CI:1.19- 4.12) (p=0.032) and trading aOR=1.62, 95% CI:1.19-2.94) (p=0.04)). Women with higher household monthly income (≥ N30,000, equivalent to 60 US Dollars) (aOR=1.53, 95% CI:1.13-2.65) (p=0.037), who adhered to COVID-19 preventive measures and utilized maternal health services before the COVID-19 pandemic were more likely to utilize those services during the COVID-19 restrictions. In contrast, mothers of higher parity (≥5 births) were less likely to use maternal health services during the lockdown (aOR=0.30, 95% CI:0.10-0.86) (p=0.03). Utilization of maternal services was also associated with partner education and employment type. Conclusion and Global Health Implications: The utilization of maternal health services declined during the COVID-19 restrictions. Utilization was hindered by fear of contracting COVID-19, transport challenges, and harassment by security personnel. Maternal and partner characteristics, adherence to COVID-19 preventive measures, and pre-COVID maternity service utilization influenced attendance. There is a need to build resilient health systems and contingent alternative service delivery models for future pandemics.

Comparison of mRNA vaccine effectiveness against COVID-19-associated hospitalization by vaccination source: Immunization information systems, electronic medical records, and self-report-IVY Network, February 1-August 31, 2022.

BACKGROUND: Accurate determination of COVID-19 vaccination status is necessary to produce reliable COVID-19 vaccine effectiveness (VE) estimates. Data comparing differences in COVID-19 VE by vaccination sources (i.e., immunization information systems [IIS], electronic medical records [EMR], and self-report) are limited. We compared the number of mRNA COVID-19 vaccine doses identified by each of these sources to assess agreement as well as differences in VE estimates using vaccination data from each individual source and vaccination data adjudicated from all sources combined. METHODS: Adults aged ≥18 years who were hospitalized with COVID-like illness at 21 hospitals in 18 U.S. states participating in the IVY Network during February 1-August 31, 2022, were enrolled. Numbers of COVID-19 vaccine doses identified by IIS, EMR, and self-report were compared in kappa agreement analyses. Effectiveness of mRNA COVID-19 vaccines against COVID-19-associated hospitalization was estimated using multivariable logistic regression models to compare the odds of COVID-19 vaccination between SARS-CoV-2-positive case-patients and SARS-CoV-2-negative control-patients. VE was estimated using each source of vaccination data separately and all sources combined. RESULTS: A total of 4499 patients were included. Patients with ≥1 mRNA COVID-19 vaccine dose were identified most frequently by self-report (n = 3570, 79 %), followed by IIS (n = 3272, 73 %) and EMR (n = 3057, 68 %). Agreement was highest between IIS and self-report for 4 doses with a kappa of 0.77 (95 % CI = 0.73-0.81). VE point estimates of 3 doses against COVID-19 hospitalization were substantially lower when using vaccination data from EMR only (VE = 31 %, 95 % CI = 16 %-43 %) than when using all sources combined (VE = 53 %, 95 % CI = 41 %-62%). CONCLUSION: Vaccination data from EMR only may substantially underestimate COVID-19 VE.

Collaborative comparisons: A pragmatist approach towards designing large-scale, comparative qualitative research

This article draws lessons for organizing and designing large-scale qualitative comparative research in turbulent, rapidly evolving, real-world settings. The challenge to the researcher is that such studies need to meet conflicting requirements of rigor, relevance, and responsiveness. Recognizing that in such settings scientific research cannot be insulated from its environment, the article discusses a pragmatist approach to comparative research design. Using the case of the SolPan project (Solidarity in Times of a Pandemic), a large-scale and longitudinal qualitative comparative study of people's experiences during the Covid pandemic, the article presents basic principles of pragmatist research design, such as problem-orientation, design-in-action, and the use of a plurality of evidence. It then argues that interpretation is at the heart of all comparison, and that large-scale qualitative comparative research combines the detailed contextual richness of interpretive explanation, the systematicity, robustness and transparency of large-N comparative analysis, and the flexibility of emergent design. We describe the design and methodology of SolPan and illustrate this with an empirical example. First, we argue that research design and project organization are continuous and reframe comparative research design as generative organization. Second, we describe the use of computer-assisted qualitative data analysis software to assist in analysing large amounts of interview data. In the final section we describe some of the limitations of this large-scale qualitative comparative research.Copyright © 2022 The Authors

Implementing a Data Integration Infrastructure for Healthcare Data – A Case Study

Conducting epidemiologic research usually requires a large amount of data to establish the natural history of a disease and achieve meaningful study design, and interpretations of findings. This is, however, a huge task because the healthcare domain is composed of a complex corpus and concepts that result in difficult ways to use and store data. Additionally, data accessibility should be considered because sensitive data from patients should be carefully protected and shared with responsibility. With the COVID-19 pandemic, the need for sharing data and having an integrated view of the data was reaffirmed to identify the best approaches and signals to improve not only treatments and diagnoses but also social answers to the epidemiological scenario. This paper addresses a data integration scenario for dealing with COVID-19 and cardiovascular diseases, covering the main challenges related to integrating data in a common data repository storing data from several hospitals. Conceptual architecture is presented to deal with such approaches and integrate data from a Portuguese hospital into the common repository used to explore data in a standardized way. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Worldwide Trends in Registering Real-World Studies at ClinicalTrials.gov: A Cross-Sectional Analysis.

Objective: The purpose of this study was to characterize real-world studies (RWSs) registered at ClinicalTrials.gov to help investigators better conduct relevant research in clinical practice. Methods: A retrospective analysis of 944 studies was performed on February 28, 2023. Results: A total of 944 studies were included. The included studies involved a total of 48 countries. China was the leading country in terms of the total number of registered studies (37.9%, 358), followed by the United States (19.7%, 186). Regarding intervention type, 42.4% (400) of the studies involved drugs, and only 9.1% (86) of the studies involved devices. Only 8.5% (80) of the studies mentioned both the detailed study design type and data source in the "Brief Summary". A total of 49.4% (466) of studies had a sample size of 500 participants and above. Overall, 63% (595) of the studies were single-center studies. A total of 213 conditions were covered in the included studies. One-third of the studies (32.7%, 309) involved neoplasms (or tumors). China and the United States were very different regarding the study of different conditions. Conclusion: Although the pandemic has provided new opportunities for RWSs, the rigor of scientific research still needs to be emphasized. Special attention needs to be given to the correct and comprehensive description of the study design in the Brief Summary of registered studies, thereby promoting communication and understanding. In addition, deficiencies in ClinicalTrials.gov registration data remain prominent.

Evolving Science on Cardiovascular Disease Among Hispanic/Latino Adults: JACC International.

The landmark, multicenter HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is the largest, most comprehensive, longitudinal community-based cohort study to date of diverse Hispanic/Latino persons in the United States. The HCHS/SOL aimed to address the dearth of comprehensive data on risk factors for cardiovascular disease (CVD) and other chronic diseases in this population and has expanded considerably in scope since its inception. This paper describes the aims/objectives and data collection of the HCHS/SOL and its ancillary studies to date and highlights the critical and sizable contributions made by the study to understanding the prevalence of and changes in CVD risk/protective factors and the burden of CVD and related chronic conditions among adults of diverse Hispanic/Latino backgrounds. The continued follow-up of this cohort will allow in-depth investigations on cardiovascular and pulmonary outcomes in this population, and data from the ongoing ancillary studies will facilitate generation of new hypotheses and study questions.

The grief of loss among breast cancer patients during the COVID-19 pandemic: How can palliative care workers help?

BACKGROUND: Cancer patients suffer from different losses. Studies have focused on examining grief resulting from cancer diagnosis and grief among caregivers of cancer patients and parents who lost their child to cancer. However, there are no studies on the grief resulting from losing a loved one in cancer patients. OBJECTIVE: This study examined female breast cancer patients' grief and aimed to reveal how palliative care can help breast cancer who experience the grief of losing a loved one. METHODS: The study applied the qualitative case study design conducted with 10 women with breast cancer; their ages ranged from 47 to 54 years. Data were collected during 18 in-depth interviews by asking semi-open-closed questions. RESULTS: Thematic analysis found that losing a partner negatively affected breast cancer patients' mental health. The grief experience among breast cancer patients has many symptoms: sadness, severe anxiety, sleep disturbance, loneliness, and isolation. Results also indicated many risk factors that increase grief symptoms among breast cancer patients, such as quarantine procedures during the COVID-19 outbreak, extreme emotional attachment to a partner, guilt, self-blame, and social relations. Patients with breast cancer can face grief experienced by coping strategies such as: resorting to God, prayer, patience, and reading the Holy Qur'an. The results also emphasize the importance of integrating palliative care with treatment for breast cancer patients who experience the grief of loss. CONCLUSION: The grief of loss among breast cancer patients is a complex experience. These findings have many applied aspects that benefit planning counseling and psychological programs to increase positive coping strategies for those patients with breast cancer suffering from grief of loss disorder and provide psychological services that protect them from risk factors and reduce grief symptoms which reduce the effectiveness of cancer treatments due to the symptoms of traumatic loss of a partner. These findings also emphasize the importance of palliative care for cancer patients with complex distress.

Designing a Pseudo-Haptics Study for Virtual Anesthesia Skills Development

Pseudo-haptics refers to the simulation of haptic sensations without the use of haptic interfaces, using, for example, audiovisual feedback and kinesthetic cues. Given the COVID-19 pandemic and the shift to online learning, there has been a recent interest in pseudo-haptics as it can help facilitate psychomotor skills development away from simulation centers and laboratories. Here we present work-in-progress that describes the study design of a pseudo-haptics for virtual anesthesia skills development. We anticipate this work will provide greater insight to pseudo-haptics and its application to anesthesia-based training. © 2022 IEEE.

Knowledge and Attitude of Nurses about the Current COVID-19 Outbreak in Turkey

This study aims to analyze nurses' knowledge levels and attitudes towards COVID-19 during the second peak period of the COVID-19 epidemic in Turkey and test the structural relationship between knowledge levels and attitudes with structural equation modeling. The hospital-based cross-sectional study design was employed in the study. The research population consisted of nurses working in three different private hospitals in Istanbul, with international quality and accreditation certificates. The data were collected by the researchers themselves by using face-to-face and online survey techniques. The total number of questionnaires that were evaluated and used in the analysis of the data is 390. SPSS and AMOS package programs were used in the analysis of the data. The quantitative research method was used. Descriptive statistics, independent sample t-test, ANOVA test, and structural equation modeling were applied to the data. Structural equation analysis revealed the direct effect of the nurses' COVID-19 knowledge level on attitude toward COVID-19 has an acceptable index of fit. Furthermore, the relationship between the level of knowledge toward COVID-19 and the female gender was found to be significant. In general, the level of knowledge of the nurses participating in the study about COVID-19 was found to be high, and it was observed that they had a more optimistic attitude towards preventing COVID-19 and keeping the process under control. An increase in knowledge about COVID-19 has led to an increase in the behavior of a more optimistic attitude towards prevention and control of COVID-19.Copyright © 2022 Necati Ozpinar. All Rights Reserved.

Altered pre-existing SARS-CoV-2-specific T cell responses in elderly individuals

Pre-existing SARS-CoV-2-specific T cells, but not antibodies, have been detected in some unexposed individuals. This may account for some of the diversity in clinical outcomes ranging from asymptomatic infection to severe COVID-19. Although age is a risk factor for COVID-19, how age affects SARS-CoV-2-specific T cell responses remains unknown. We found that pre-existing T cell responses to specific SARS-CoV-2 proteins, Spike (S) and Nucleoprotein (N), were significantly lower in elderly donors (>70 years old) than in young donors. However, substantial pre-existing T cell responses to the viral membrane (M) protein were detected in both young and elderly donors. In contrast, young and elderly donors exhibited comparable T cell responses to S, N, and M proteins after infection with SARS-CoV-2. These data suggest that although SARS-CoV-2 infection can induce T cell responses specific to various viral antigens regardless of age, diversity of target antigen repertoire for long-lived memory T cells specific for SARS-CoV-2 may decline with age;however, memory T cell responses can be maintained by T cells reactive to specific viral proteins such as M. A better understanding of the role of pre-existing SARS-CoV-2-specific T cells that are less susceptible to age-related loss may contribute to development of more effective vaccines for elderly people.Copyright © 2021

Academic experiences of "Zoom-fatigue" as a virtual streaming phenomenon during the COVID-19 pandemic

This phenomenological exploratory multiple-case study design was conducted at an open distance e-learning university and a traditional contact residential university, and it was found that the participants viewed video conferencing under the COVID-19 lockdown period as an exhausting experience. A second major finding revealed that the participants were empowered with digital literacy skills to use video conferencing effectively. The current findings add to a growing body of literature on video conferencing with a focus on Zoom fatigue. Further research might explore the lived Zoom experiences of administrators, students, and a larger group of faculties over a longer period. The study findings must be considered when planning and implementing video conferencing for academics and students in open distance e-learning contexts. This study showed that video conferencing is one tool in the emergence of a digital zoom revolution that has radically changed the workspace. The evidence from this study suggests that Zoom fatigue is a reality check for work-related health management. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Vaccination Status of Hospitalized Patients with Covid-19 Infection during 4th Wave in Tertiary Care Hospital of Pakistan

Background: The first COVID-19 vaccination was developed in December 2020. Effectiveness of different vaccines to prevent symptomatic COVID infection varies from 50% to 95% while effectiveness at preventing the critical disease and death ranges between 79 to 100%. Aim(s): To see vaccination status of hospitalized patients with COVID infection and to compare severity & mortality among vaccinated and non-vaccinated patients during 4th wave of COVID-19. Method(s): This cross-sectional study was conducted in the Department of Pulmonology Shaikh Zayed Hospital, Lahore. The duration of study was 4 months from 01-07-2021 to 31-10-2021. Result(s): Total 121 patients having ages between 28 and 85 years;there were 77(63.6%) males & 44 (36.4%) females.Twenty four (20%) study participants were fully vaccinated, 14% were partially vaccinated and 66% of patients were not vaccinated. Most of the fully vaccinated patents had mild disease (58.3%), while, non-vaccinated patients either had severe disease (57.5%) or they were in critical condition (22.5%). All deaths in our study were recorded in non-vaccinated patients (28.8%). Conclusion(s): We concluded that patients who are fully vaccinated have less severe disease and low mortality rate as compared to non-vaccinated patients.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

How to Conduct International Geriatric Rehabilitation Research?

With an ageing global population and an increasing focus on aging in place, the number of people in need of geriatric rehabilitation (GR) is rapidly increasing. As current GR practice is very heterogenous, cross-country comparisons could allow us to learn from each other and optimise the effectiveness of GR. However, international GR research comes with many challenges. This article summarises the facilitators and barriers relating to the recruitment of rehabilitation centres, the inclusion of patients, and data collection, as experienced by experts in the field of international GR research. The three most important methodological recommendations for conducting cross-national collaborative research in the field of GR are (1) make use of existing (inter)national networks and social media to aid recruitment of GR centres; (2) clearly define the GR treatment, setting, and patient characteristics in the inclusion criteria; and (3) use a hierarchical study structure to communicate transparently and regularly with both national and local coordinators. International GR research would greatly benefit from the implementation of a core dataset in regular GR care. Therefore, future studies should focus on developing an international consensus regarding the outcomes and corresponding cross-culturally validated measurement instruments to be used during GR.

Design and analysis of outcomes following SARS-CoV-2 infection in veterans.

BACKGROUND: Understanding how SARS-CoV-2 infection impacts long-term patient outcomes requires identification of comparable persons with and without infection. We report the design and implementation of a matching strategy employed by the Department of Veterans Affairs' (VA) COVID-19 Observational Research Collaboratory (CORC) to develop comparable cohorts of SARS-CoV-2 infected and uninfected persons for the purpose of inferring potential causative long-term adverse effects of SARS-CoV-2 infection in the Veteran population. METHODS: In a retrospective cohort study, we identified VA health care system patients who were and were not infected with SARS-CoV-2 on a rolling monthly basis. We generated matched cohorts within each month utilizing a combination of exact and time-varying propensity score matching based on electronic health record (EHR)-derived covariates that can be confounders or risk factors across a range of outcomes. RESULTS: From an initial pool of 126,689,864 person-months of observation, we generated final matched cohorts of 208,536 Veterans infected between March 2020-April 2021 and 3,014,091 uninfected Veterans. Matched cohorts were well-balanced on all 39 covariates used in matching after excluding patients for: no VA health care utilization; implausible age, weight, or height; living outside of the 50 states or Washington, D.C.; prior SARS-CoV-2 diagnosis per Medicare claims; or lack of a suitable match. Most Veterans in the matched cohort were male (88.3%), non-Hispanic (87.1%), white (67.2%), and living in urban areas (71.5%), with a mean age of 60.6, BMI of 31.3, Gagne comorbidity score of 1.4 and a mean of 2.3 CDC high-risk conditions. The most common diagnoses were hypertension (61.4%), diabetes (34.3%), major depression (32.2%), coronary heart disease (28.5%), PTSD (25.5%), anxiety (22.5%), and chronic kidney disease (22.5%). CONCLUSION: This successful creation of matched SARS-CoV-2 infected and uninfected patient cohorts from the largest integrated health system in the United States will support cohort studies of outcomes derived from EHRs and sample selection for qualitative interviews and patient surveys. These studies will increase our understanding of the long-term outcomes of Veterans who were infected with SARS-CoV-2.

Digital public health leadership in the global fight for health security.

The COVID-19 pandemic highlighted the need to prioritise mature digital health and data governance at both national and supranational levels to guarantee future health security. The Riyadh Declaration on Digital Health was a call to action to create the infrastructure needed to share effective digital health evidence-based practices and high-quality, real-time data locally and globally to provide actionable information to more health systems and countries. The declaration proposed nine key recommendations for data and digital health that need to be adopted by the global health community to address future pandemics and health threats. Here, we expand on each recommendation and provide an evidence-based roadmap for their implementation. This policy document serves as a resource and toolkit that all stakeholders in digital health and disaster preparedness can follow to develop digital infrastructure and protocols in readiness for future health threats through robust digital public health leadership.

A Weekly Diary Study on Playful Study Design, Study Engagement, and Goal Attainment: The Role of Proactive Personality.

Students' learning processes are heavily impeded by the COVID-19 pandemic. Students are experiencing more online learning environment and less face-to-face idea exchange, which may make them feel exhausted and demotivated. Using self-determination and proactivity theories, we propose and examine whether playful study design (PSD)-a proactive study strategy including designing fun and designing competition in learning tasks-is effective in fostering study engagement, which, in turn, improves study goal attainment during the COVID-19 period. Moreover, we examine whether students who are high in proactive personality will benefit more (e.g., reach a higher level of study engagement) when using the PSD strategy. We collected data using a weekly diary approach during four consecutive weeks, including 97 people and 308 within-person observations. Results of multilevel analyses showed that weekly PSD was positively related to weekly study engagement, and in turn, facilitated weekly goal attainment. Moreover, we found that proactive personality moderated and strengthened the positive associations between PSD and goal attainment, study engagement and goal attainment, but not for the relationship between PSD and study engagement. Overall, we provide one of the first attempts to demonstrate how PSD strategy can be used in student study life to improve study engagement and reach their goals. We shed light on how proactive personality can safeguard the success of PSD strategy. Theoretical and practical contributions are discussed.

Overcoming the challenges of recruiting and interviewing patients following critical illness.

BACKGROUND: The strict restrictions implemented in England during the COVID-19 pandemic meant it was no longer possible to recruit or interview participants in person. However, virtual recruitment and interviews are not without their challenges, particularly when exploring sensitive topics. AIM: To discuss how to overcome some of the challenges involved in recruiting and interviewing participants who have been critically ill with COVID-19. DISCUSSION: An exploratory, descriptive study was conducted involving interviews with 20 people who had been critically ill with COVID-19 and had been discharged from two community-based healthcare settings in London, England. Participants were interviewed at home after being discharged from hospital after at least one month. The sensitivity of the research topic meant strategies for recruiting and interviewing needed to be adapted, including involving patient experience facilitators, using virtual interviews, managing the distress of participants and self-care for the researchers. CONCLUSION: The adaptations used in this study can be used in research involving people who have been critically ill. IMPLICATIONS FOR PRACTICE: Researchers can explore innovative ways to recruit participants using hospital or community staff who are not usually involved in research. Virtual interviews require additional skills, such as building rapport with participants, so may require additional training. A distress protocol for participants should always be considered when discussing sensitive topics. Self-care and debrief strategies for interviewers are also critical.