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1.
Heliyon ; 8(11): e11552, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2105016

ABSTRACT

Background: The COVID-19 outbreak has changed nearly all societal domains, including medical rehabilitation. Social distancing measures impacted patients as well as health professionals during the rehabilitation process. Enhancing patient participation should not be forgotten during exceptional situations, as restrictive measures are related to the self-determination of patients. Aim: In this exploratory trend study, we aimed to examine the association between COVID-19 restrictions with patients' motivation, their perception of the patient-provider-relationship, their participation in the rehabilitation process and their current state of health at the beginning of their rehabilitation. Methods: Adopting an exploratory approach, we compared data from a convenience sample of two different groups of patients, who stayed at a cardiac rehabilitation clinic at two different time periods: before the COVID-19 lockdown of rehabilitation clinics (n = 128) and after reopening during the COVID-19 period (n = 137). We used questionnaires on motivation for rehabilitation, patient-provider-relationship, patient activation and perceived state of health. We conducted t-tests and regression analysis to determine whether there were differences by gender, age, heart failure status, preferred form of decision-making (shared/not-shared) and time of rehabilitation (before/during COVID-19) related to the outcome variables. Results: Participants evaluated the quality of the patient-provider-relationship in a better way after the reopening of the rehabilitation clinics during the COVID-19 period (p < 0.05), their motivation, participation in the rehabilitation process and their current state of health at the beginning of their rehabilitation was comparable to the group before the COVID-19 lockdown of rehabilitation clinics. Differences in scepticism concerning the treatment and the quality of the patient-provider-relationship were related (p < 0.05) to age and the preferred form of decision-making. Differences in active participation were related (p < 0.05) to sex and differences in the perceived state of health (p < 0.05) to a heart failure diagnosis. Conclusions: Treatment providers could use the time patients spend in isolation after arrival to prepare them for virtual goal-setting conversations to enhance patient participation in exceptional situations.

2.
Expert Systems with Applications ; JOUR: 119262,
Article in English | ScienceDirect | ID: covidwho-2104915

ABSTRACT

The onset of the COVID-19 pandemic has changed consumer usage behavior towards mobile payment (m-payment) services. Consumer usage behavior towards m-payment services continues to increase due to access to usage experiences shared through online consumer reviews (OCRs). The proliferation of massive OCRs, coupled with quick and effective decisions concerning the evaluation and selection of m-payment services, is a practical issue for research. This paper develops a novel decision evaluation model that integrates OCRs and multi-attribute decision-making (MADM) with probabilistic linguistic information to identify m-payment usage attributes and utilize these attributes to evaluate and rank m-payment services. First and foremost, the attributes of m-payment usage discussed by consumers in OCRs are extracted using the Latent Dirichlet Allocation (LDA) topic modeling approach. These key attributes are used as the evaluation scales in the MADM. Based on an unsupervised sentiment algorithm, the sentiment scores of the text reviews regarding the attributes are calculated. We convert the sentiment scores into probabilistic linguistic elements based on the probabilistic linguistic term set (PLTS) theory and statistical analysis. Furthermore, we construct a novel technique known as probabilistic linguistic indifference threshold-based attribute ratio analysis (PL-ITARA) to discover the weight importance of the usage attributes. Subsequently, the positive and negative ideal-based PL-ELECTRE I methodology is proposed to evaluate and rank m-payment services. Finally, a case study on selecting appropriate m-payment services in Ghana is examined to authenticate the validity and applicability of our proposed decision evaluation methodology.

3.
Computers & Industrial Engineering ; JOUR: 108811,
Article in English | ScienceDirect | ID: covidwho-2104549

ABSTRACT

The COVID-19 pandemic hit the medical supply chain, creating a serious shortage of medical equipment. To meet the urgent demand, one realistic way is to collect abandoned medical equipment and then remanufacture, where the disassembled modules are shared with all stock-keeping units (SKUs) to improve utilization. However, in an emergency, the equipment should be processed sequentially and immediately, which means the decision is short-sighted with limited information. We propose a hybrid combinatorial remanufacturing (HCR) strategy and develop two reinforcement learning frameworks based on Q-learning and double deep Q network to find the optimal recovery option. In the frameworks, we transform HCR problem into a maze exploration game and propose a rule of descending epsilon-greedy selection on reweighted valid actions (DeSoRVA) and Espertate knowledge dictionary to combine the cost-minimizing objective with human judgment and the global state of the problem. A real-time environment is further implemented where the quality status of the in-transit equipment is unknown. Numerical studies show that our algorithms can learn to save cost, and the larger scale of the problem is, the more cost-down can be achieved. Moreover, the sophisticated knowledge refined by Espertate is effective and robust, which can handle remanufacturing problems at different scales corresponding to the volatility of the pandemic.

4.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; JOUR(1-B):No Pagination Specified, 84.
Article in English | APA PsycInfo | ID: covidwho-2101857

ABSTRACT

Innovation in causal inference and implementation of electronic health record systems are rapidly transforming medical care. In this dissertation, we present three examples in which use of methods in causal inference and large electronic health record data address existing challenges in medical decision-making. First, we use principles of causal inference to examine the structure of randomized trials of biomarker targets, which have produced divergent results and controversial clinical guidelines for management of hypertension and other chronic diseases. We discuss four key threats to the validity of trials of this design. Second, we use methods in causal inference for adjustment of time-varying confounding to estimate the effect of time-varying treatment strategies for hypertension. We report the results of a study which used longitudinal electronic health record data from a prospective virtual cohort of veterans. Third, we use individual-level electronic health record data to predict the need for critical care resources during surges in COVID-19 cases, to aid hospital administrators with resource allocation in periods of crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

5.
Ann Oper Res ; : 1-43, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1820664

ABSTRACT

The year 2020 can be earmarked as the year of global supply chain disruption owing to the outbreak of the coronavirus (COVID-19). It is however not only because of the pandemic that supply chain risk assessment (SCRA) has become more critical today than it has ever been. With the number of supply chain risks having increased significantly over the last decade, particularly during the last 5 years, there has been a flurry of literature on supply chain risk management (SCRM), illustrating the need for further classification so as to guide researchers to the most promising avenues and opportunities. We therefore conduct a bibliometric and network analysis of SCRA publications to identify research areas and underlying themes, leading to the identification of three major research clusters for which we provide interpretation and guidance for future work. In doing so we focus in particular on the variety of parameters, analytical approaches, and characteristics of multi-criteria decision-making techniques for assessing supply chain risks. This offers an invaluable synthesis of the SCRA literature, providing recommendations for future research opportunities. As such, this paper is a formidable starting point for operations researchers delving into this domain, which is expected to increase significantly also due to the current pandemic.

6.
BMC Med Ethics ; 23(1): 45, 2022 04 19.
Article in English | MEDLINE | ID: covidwho-1798405

ABSTRACT

BACKGROUND: Commentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units (ICUs). Our aim was twofold: (1) to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and (2) determine the association between the ethical climate, moral distress, and intention to leave. METHODS: We performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire (EDMCQ) and the Measure of Moral Distress for Healthcare Professionals (MMD-HP) tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave. RESULTS: Nurses perceived the ethical climate for decision-making as less favorable than physicians (p < 0.05). They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/Pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units (3.54 ± 0.66 vs. 3.43 ± 0.81 vs. 3.30 ± 0.69; respectively; both p ≤ 0.05) and also demonstrated lower moral distress scores (both p < 0.05) and lower "intention to leave" scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated (r = -0.58, p < 0.001); moral distress and "intention to leave" was positively correlated (r = 0.52, p < 0.001); and ethical climate and "intention to leave" were negatively correlated (r = -0.50, p < 0.001). CONCLUSIONS: Significant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care.


Subject(s)
Attitude of Health Personnel , Intention , Child , Cross-Sectional Studies , Hospitals , Humans , Infant, Newborn , Intensive Care Units , Job Satisfaction , Morals , Stress, Psychological , Surveys and Questionnaires
7.
Health Evidence Network synthesis report|76 ; BOOK
Article in English | WHOIRIS | ID: covidwho-2101132

ABSTRACT

This report explores how knowledge translation (KT) and cultural contexts are conceptualized and utilized, with a focus on health policy-making theory and practice. KT takes place within cultural contexts that can powerfully frame what policy problems are and what type of research is accepted by policy-makers. This is illustrated with studies from the COVID-19 pandemic regarding the use of face masks across cultures and of the influence of cultural contexts on KT and evidence-informed decision-making arising from the Black Lives Matter movement. Many Indigenous cultures conceptualize physical health in a holistic manner that encompasses both social and ecological aspects, which are often not considered in the biomedical understanding of health. Effective KT within local cultural contexts requires going beyond general categories (such as Indigenous culture) and assumptions about particular types of culture. Some KT models and frameworks include local context as a factor in translation, identifying community-, culture- and language-focused strategies to improve cultural competency for health-care interventions. Policy considerations are suggested that support the adoption of complex understandings of cultures in knowledge production, communication, translation and use.

8.
Eur J Med Res ; 27(1): 223, 2022 Oct 29.
Article in English | MEDLINE | ID: covidwho-2098456

ABSTRACT

PURPOSE: Gamma knife radiosurgery (GK) is a commonly used approach for the treatment of intracranial lesions. Its radiation response is typically not immediate, but delayed. In this study, we analyzed cases from a prospectively collected database to assess the influence of COVID-19 pandemic on the decision making in patients treated by gamma knife radiosurgery. METHODS: From January 2019 to August 2021, 540 cases of intracranial lesions were treated by GK with 207 cases before COVID-19 pandemic as a control. During the COVID-19 pandemic, 333 cases were similarly treated on patients with or without the COVID-19 vaccination. All the GK treated parameters as well as time profile in the decision making were analyzed. The parameters included age, sex, characteristic of lesion, targeted volume, peripheral radiation dose, neurological status, Karnofsky Performance Status (KPS), time interval from MRI diagnosis to consultation, time interval from the approval to treatment, frequency of outpatient department (OPD) visit, and frequency of imaging follow-up. RESULTS: Longer time intervals from diagnosis to GK consultation and treatment were found in the pandemic group (36.8 ± 25.5/54.5 ± 27.6 days) compared with the pre-COVID control (17.1 ± 22.4/45.0 ± 28.0 days) or vaccination group (12.2 ± 7.1/29.6 ± 10.9 days) (p < 0.001, and p < 0.001, respectively). The fewer OPD visits and MRI examinations also showed the same trends. High proportion of neurological deficits were found in the pandemic group (65.4%) compared with the control (45.4%) or vaccination group (58.1%) (p < 0.001). The Charlson comorbidity in the pandemic group was 3.9 ± 3.3, the control group was 4.6 ± 3.2, and the vaccination group was 3.1 ± 3.1. There were similar inter-group difference (p < 0.001). In multiple variant analyses, longer time intervals from the diagnosis to consultation or treatment, OPD frequency and MRI examination were likely influenced by the status of the COVID-19 pandemic as they were alleviated by the vaccination. CONCLUSIONS: The decision making in patients requiring gamma knife treatment was most likely influenced by the status of the COVID-19 pandemic, while vaccination appeared to attenuate their hesitant behaviors. Patients with pre-treatment neurological deficits and high co-morbidity undergoing the gamma knife treatment were less affected by the COVID-19 pandemic.


Subject(s)
Brain Neoplasms , COVID-19 , Radiosurgery , Humans , Radiosurgery/adverse effects , Radiosurgery/methods , COVID-19/epidemiology , Pandemics , COVID-19 Vaccines , Retrospective Studies , Decision Making , Follow-Up Studies , Treatment Outcome
9.
Scand J Trauma Resusc Emerg Med ; 29(1): 173, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-2098403

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic and the risk of an extensive overload of the healthcare systems have elucidated the need to make decisions on the level of life-sustaining treatment for patients requiring hospitalisation. The purpose of the study was to investigate the proportion and characteristics of COVID-19 patients with limitation of life-sustaining treatment decisions and the degree of patient involvement in the decisions. METHODS: A retrospective observational descriptive study was conducted in three Danish regional hospitals, looking at all patients ≥ 18 years of age admitted in 2020 with COVID-19 as the primary diagnosis. Lists of hospitalised patients admitted due to COVID-19 were extracted. The data registration included age, gender, comorbidities, including mental state, body mass index, frailty, recent hospital admissions, COVID-19 life-sustaining treatment, ICU admission, decisions on limitations of life-sustaining treatment before and during current hospitalisation, hospital length of stay, and hospital mortality. RESULTS: A total of 476 patients were included. For 7% (33/476), a decision about limitation of life-sustaining treatment had been made prior to hospital admission. At the time of admission, one or more limitations of life-sustaining treatment were registered for 16% (75/476) of patients. During the admission, limitation decisions were made for an additional 11 patients, totaling 18% (86/476). For 40% (34/86), the decisions were either made by or discussed with the patient. The decisions not made by patients were made by physicians. For 36% (31/86), no information was disclosed about patient involvement. CONCLUSIONS: Life-sustaining treatment limitation decisions were made for 18% of a COVID-19 patient cohort. Hereof, more than a third of the decisions had been made before hospital admission. Many records lacked information on patient involvement in the decisions.


Subject(s)
COVID-19 , Denmark/epidemiology , Humans , Patient Participation , Retrospective Studies , SARS-CoV-2
10.
J Surg Educ ; 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2095711

ABSTRACT

OBJECTIVE: The abrupt cessation of in-person education due to the COVID-19 pandemic has made it difficult for preclerkship students to explore a career in surgery. To supplement the lack of exposure, the Surgical Exploration and Discovery (SEAD) program was transitioned to an entirely virtual format. This study aims to describe the virtual SEAD program and evaluate its effectiveness as a career decision-making (CDM) intervention. DESIGN: The week-long program was delivered on Microsoft Teams, featured 11 surgical specialties, and comprised four activities: live demonstrations, virtual operating room observerships, career talks, and technical skills workshops. The program was evaluated using the four levels of the Kirkpatrick model: (1) reactions, (2) knowledge, (3) CDM behaviors - assessed using the Career Decision-making Difficulties Questionnaire (CDDQ) - and (4) results. The latter was indirectly assessed using CDDQ scores from an in-person SEAD program, where lower CDDQ scores indicate less difficulty with CDM. SETTING: Faculty of Medicine at the University of Ottawa in Ontario, Canada. PARTICIPANTS: Forty pre-clerkship students (27 first and 13 second year students) at the University of Ottawa RESULTS: Level 1: 97.5% of participants rated the program as good or very good. Live demonstration and technical skills workshops were the highest rated activities. Level 2: participants' scores on knowledge-based questions about a surgical career significantly increased following the program (pre: 9/25 vs post: 15/25, p = 0.008). Level 3: overall mean CDDQ scores (±SD) decreased difficulties with significantly following the program (pre: 45.6 ± 10.5 vs post: 38.8 ± 10.9, p < 0.001), which indicates decreased CDM difficulties. Level 4: Except for one sub-category, the difference in mean CDDQ scores between the virtual and in-person programs were not significantly different. CONCLUSION: The program received the positive reactions and significantly increased participants' knowledge. The change in CDDQ scores following the virtual program suggests it may reduce career decision-making difficulties in the short-term. In-person surgical exposure remains important; however, a hybrid model may be valuable in resource limited settings. WC: 300.

11.
BMC Emerg Med ; 22(1): 170, 2022 10 24.
Article in English | MEDLINE | ID: covidwho-2089162

ABSTRACT

BACKGROUND: Acute appendicitis is the most common cause of acute abdomen. During the pandemic, to contain the spread of COVID-19, there were some integral changes in the medical processes based on the pandemic prevention policy, especially regarding emergency surgery. This study was conducted to investigate whether this pandemic also impacted the decision-making for both patients and medical personnel along with the treatment outcomes. METHODS: Patients of age 18 years or older who were diagnosed clinically and radiologically with acute appendicitis between Jan 1, 2017, and Dec 31, 202,0 were reviewed. The data of 1991 cases were collected and used for this study. Two groups were formed, one group before and the other group after the outbreak. The gathered data included gender, age, appendiceal fecalith, outcomes of treatment, and long-term outcomes of non-operation (8 months follow-up). We also collected details of surgical cases from the above two groups. This data also included age, gender, appendiceal fecalith, fever, jaundice, length of onset before presenting to an emergency department (ED), anesthesia, surgery, white cell count, pathology, complications, and length of stay. We compared the above data respectively and analyzed the differences. RESULTS: Compared to the period before the outbreak, patient visits for acute appendicitis remarkably dropped (19.8%), but surgical cases showed no change (dropped by roughly 5%). There were significant differences (P < 0.05) in failure of non-operation(after the pandemic 8.31% vs. before pandemic 3.22%), interval appendectomy(after pandemic 6.29% vs. before pandemic 12.84%), recurrence(after pandemic 23.27% vs. before pandemic 14.46%), and outcomes of recurrence. There was a significant difference (P < 0.05) in anesthesia method, surgery way, and complications( before pandemic 4.15% vs. after pandemic9.89% P < 0.05) in patients who underwent the surgery. There was no statistical difference (P > 0.05) concerning age, gender, fever, jaundice, appendiceal fecalith, white cell count, and length of onset before presenting to the ED. CONCLUSION: The current pandemic prevention policy is very effective, but some decision-making processes of doctor-patient have changed in the context of COVID-19 pandemic, that further influenced some treatment outcomes and might lead to a potential economic burden. It is essential to address the undue concern of everyone and optimize the treatment process.


Subject(s)
Appendicitis , COVID-19 , Fecal Impaction , Humans , Infant , Adolescent , Appendicitis/epidemiology , Appendicitis/surgery , Appendicitis/diagnosis , COVID-19/epidemiology , Pandemics , Fecal Impaction/epidemiology , Appendectomy/methods , Acute Disease , Retrospective Studies , Length of Stay
12.
Understanding Complex Systems ; JOUR: 139-159,
Article in English | Scopus | ID: covidwho-2085256

ABSTRACT

COVID-19 has created many economic disruptions in the way a supply chain (SCs) is being managed. The rapid spread of the contagion has impacted tremendously the meat processing, food service and poultry SCs. Botswana being an underdeveloped country adopted supply chain management best practices to stay afloat during the pandemic. The lessons learned from Botswana can be used in developing countries to highlight the needed essential SCs elements during a pandemic. Botswana strong competitive advantages during crisis appears to be: service, operations, inbound and outbound logistics. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

16.
JMIR Public Health Surveill ; 8(11): e38898, 2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2079988

ABSTRACT

BACKGROUND: Several risk factors have been identified for severe COVID-19 disease by the scientific community. In this paper, we focus on understanding the risks for severe COVID-19 infections after vaccination (ie, in breakthrough SARS-CoV-2 infections). Studying these risks by vaccine type, age, sex, comorbidities, and any prior SARS-CoV-2 infection is important to policy makers planning further vaccination efforts. OBJECTIVE: We performed a comparative study of the risks of hospitalization (n=1140) and mortality (n=159) in a SARS-CoV-2 positive cohort of 19,815 patients who were all fully vaccinated with the Pfizer, Moderna, or Janssen vaccines. METHODS: We performed Cox regression analysis to calculate the risk factors for developing a severe breakthrough SARS-CoV-2 infection in the study cohort by controlling for vaccine type, age, sex, comorbidities, and a prior SARS-CoV-2 infection. RESULTS: We found lower hazard ratios for those receiving the Moderna vaccine (P<.001) and Pfizer vaccine (P<.001), with the lowest hazard rates being for Moderna, as compared to those who received the Janssen vaccine, independent of age, sex, comorbidities, vaccine type, and prior SARS-CoV-2 infection. Further, individuals who had a SARS-CoV-2 infection prior to vaccination had some increased protection over and above the protection already provided by the vaccines, from hospitalization (P=.001) and death (P=.04), independent of age, sex, comorbidities, and vaccine type. We found that the top statistically significant risk factors for severe breakthrough SARS-CoV-2 infections were age of >50, male gender, moderate and severe renal failure, severe liver disease, leukemia, chronic lung disease, coagulopathy, and alcohol abuse. CONCLUSIONS: Among individuals who were fully vaccinated, the risk of severe breakthrough SARS-CoV-2 infection was lower for recipients of the Moderna or Pfizer vaccines and higher for recipients of the Janssen vaccine. These results from our analysis at a population level will be helpful to public health policy makers. Our result on the influence of a previous SARS-CoV-2 infection necessitates further research into the impact of multiple exposures on the risk of developing severe COVID-19.


Subject(s)
COVID-19 , Viral Vaccines , Humans , Male , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Vaccination , Hospitalization
17.
Fam Pract ; 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2077741

ABSTRACT

BACKGROUND: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end. OBJECTIVES: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. METHODS: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients' medical trajectories were collected using a biographical approach. RESULTS: The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. CONCLUSION: GPs should first systematically explore patients' aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.

18.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 83(12-B):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-2074007

ABSTRACT

The central purpose of this quantitative research was to examine the relationships between leadership styles, job satisfaction, and employee decision-making self-efficacy in the Mid-Atlantic hotel industry during a crisis. This research's theoretical framework is based on the transformational, transactional, laissez-faire leadership styles, job satisfaction, and the Crisis Leader Efficacy in Assessing and Deciding (C-Lead). According to Callahan (2020), the COVID-19 pandemic is fertile ground for new research within the hotel industry. This investigation utilized the following reliable instruments: (MLQ, MSQ, and C-LEAD) to examine the relationships between variables. Cross-sectional data from a total of 150 participants within this industry was collected using the third-party vendor Qualtrics. The data was then examined using IBM software Statistical Product and Service Solutions (SPSS). The findings revealed that leadership styles positively and negatively impact job satisfaction and decision-making self-efficacy during a crisis. This research added to the body of literature and provided a platform for further research by discussing the relationships between leadership styles, job satisfaction, and decision-making self-efficacy in the hotel industry in the mid-Atlantic region during a crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

19.
Behav Sci (Basel) ; 12(10)2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2071242

ABSTRACT

Different inner and external determinants might explain an individual's willingness to get the vaccine for COVID-19. The current study aims at evaluating the effects of trust in mainstream information sources on individuals' willingness to get the vaccine and the moderator role of the message framing. Six hundred and thirty-four participants (68.5% females and 31.5% males) were enrolled in an online survey. Participants filled out a questionnaire assessing: trust in mainstream information sources and vaccinal attitude (trust in vaccine benefit, worries over unforeseen future effects, concerns about commercial profiteering, and preference for natural immunity). In addition, participants were randomly exposed to one of four conditions of framing information about the vaccine (gain-probability; gain-frequency; loss-probability; loss-frequency). Results showed that trust in vaccine benefit (b = 9.90; 95% CI: 8.97, 11.73) and concerns about commercial profiteering (b = -4.70; 95% CI: -6.58, -2.81) had a significant effect on the intention to get the vaccine. Further, a significant interaction was observed between loss-gain and trust in vaccine benefit and between frequency-probability and concerns about commercial profiteering. Future vaccination campaigns should consider the individuals' concerns about vaccine benefit and economic profits to efficaciously deliver frequency-framed or probability-framed information.

20.
Acta Chir Belg ; : 1-7, 2022 Sep 21.
Article in English | MEDLINE | ID: covidwho-2069941

ABSTRACT

BACKGROUND: The COVID-19 pandemic was declared a public health emergency in March 2020. The British National Health Service (NHS) redirected medical attention towards prioritising COVID-19-positive patients in favour of less urgent care affecting cancer service provision. This study aims to explore experiences of healthcare professionals (HCPs) and investigate the impact of COVID-19 on decision-making in surgical oncology. METHODS: HCPs with experience in surgical oncology were recruited from January 2021 to June 2021. Qualitative semi-structured telephone interviews were conducted and transcribed verbatim. Interviews were conducted until data saturation. Thematic analysis was used to identify frequently discussed themes. RESULTS: A total of 13 participants were interviewed, identifying three main pandemic-related challenges: multi-disciplinary team (MDT) processes - telephone pre-operative assessments impoverished information elicited from in-person examination; service delivery - personal protective equipment (PPE) added complexity to surgical practice and more difficult communication; work routines - increased workload to deliver COVID-safe remote practices and decreased training time. CONCLUSIONS: COVID-19 influenced cancer service provision with teams making significant changes to ensure that effective clinical reasoning and surgical standards were maintained. Managing safe COVID-19 surgical care impacted daily-life and work stressors. Post crisis, service delivery is looking to integrate telemedicine within care whilst reducing its impact on workload and in-practice training.

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