Quantification of the burden, unmet needs, management, and COVID 19 impact of living with Pompe disease in the UK: results of an online patient survey

Pompe disease is a rare, progressive, multisystemic disease. Here we report results of an online quantitative survey of people living with late-onset Pompe disease (LOPD) in the UK, with the aim to better understand and quantify their experiences throughout the disease journey. 37 participants (male, n=19 [51%];mean age, 54.1 years;mean age at symptom onset, 33.2 years;mean age at LOPD diagnosis, 42.5 years;received ≥1 misdiagnosis, n=17 [46%]) completed the survey consisting of 42 questions in January 2022. Results revealed that most participants received assistance with day-to-day living (n=30, 81%), with the most frequent LOPD-associated symptoms being walking difficulties (n=35, 95%), fatigue (n=35, 95%) and muscle weakness (n=34, 92%). 26 participants (70%) were being treated with standard-of-care enzyme replacement therapy (ERT) at the time of the survey;14 (54%) of those for >10 years and 20 (77%) deeming their condition to have deteriorated since treatment began. Several patients receiving ERT mentioned the need for more efficacious or novel treatments (n=6, 23%) and the use of a delivery method less invasive than intravenous (n=5, 19%) as desired improvements to ERT. Many participants stated the provision of ancillary therapies (eg physiotherapy [n=27, 73%], dietary advice [n=18, 49%]) and mental health counselling [n=17, 46%]) would help them better manage their condition. The COVID-19 pandemic has been a period of increased anxiety and physical deterioration for many participants, with 50% (n=13) of those on ERT stating their treatment had been interrupted due to the pandemic. However, several people mentioned initiation of home-based/self-administered therapies (n=4, 11%) and reduced travel (n=5, 14%) as beneficial outcomes of the pandemic. Findings from this study further characterise the challenges faced by people living with LOPD, highlighting the need for varied patient support and more efficacious treatment options. [ FROM AUTHOR] Copyright of Neuromuscular Disorders is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Living with Pompe disease in the UK: characterising the patient journey, burden on physical and emotional quality of life, and impact of COVID-19

Pompe disease is a rare, progressive, multisystemic disease. We evaluated the burden, unmet needs and management landscape of people living with late-onset Pompe disease (LOPD) based on their own experiences and the opinions of healthcare professionals (HCPs). The objectives were to better understand the experiences of LOPD patients in the UK, including their diagnostic and treatment journeys;the impact of LOPD on quality of life;their experiences during the COVID-19 pandemic;and the concordance between patients' and HCPs' perceptions of living with LOPD. In-depth qualitative interviews were conducted with 27 participants living with LOPD (male, n=13 [48%];mean age, 56 years;mean age at diagnosis, 43 years). Interviews revealed that the diagnostic process was typically long and distressing, with most participants emphasising a desire for reduced times to diagnosis, referral to a specialist and treatment initiation. The most frequently reported LOPD-associated symptoms were walking difficulties (n=27, 100%) and fatigue (n=26, 96.3%). For many participants, the COVID-19 pandemic has been a period of increased anxiety and physical deterioration. In-depth qualitative interviews were also conducted with 8 HCPs (specialist nurses, n=4;metabolic consultants, n=2;cardiologist, n=1;physiotherapist, n=1): although HCPs had similar views to patients of the challenges of living with LOPD and patients' unmet needs, their responses suggested a reduced awareness of the acute emotional changes experienced by patients at different stages of the disease journey. HCPs emphasised the need to manage patients' expectations around available therapies, and that the increased use of technology in consultations and treatment was a positive outcome of the COVID-19 pandemic. Findings from this study further characterise the challenges faced by people living with LOPD, particularly during the COVID-19 pandemic. [ FROM AUTHOR] Copyright of Neuromuscular Disorders is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Impact of COVID-19 on the Clinical Experience and Training of Undergraduate Student Radiographers internationally: The Clinical Tutors' perspective.

INTRODUCTION: The impact on the clinical training and education of healthcare students by COVID-19 has been documented. However, the thoughts and experiences of clinical tutors (CTs) about radiography students attending for clinical training and education during this now elongated period beyond first recognition of the virus has not been explored. This paper will discuss data collected from CTs in the UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) who were compared because of their similarities in delivery based on individual 'rules of engagement' devised by their various health departments. AIM: The purpose of this study was to examine the clinical tutors' thoughts and experiences of supervising radiography students attending clinical placement during the COVID-19 pandemic. METHODS: The UK Devolved Nations (UKDN) and the United Arab Emirates (UAE) were selected for comparison on an international level as they are geographically distinct with a comparable population and education accredited/acknowledged by the Society and College of Radiographers (SCoR). Data was collected data from CTs across the UKDN and the UAE. The study used an online questionnaire (Google Forms) with closed questions in four themes including: students' experiences, impact on students' clinical placement, attitude of the clinical staff and the potential effects of COVID-19 on future graduates' skills and competencies. Further data was gathered on the experience of CTs mentoring students during the COVID-19 pandemic. RESULTS: Data were collected from 59 CTs (81%, n = 48) from UKDN and (19%, n = 11) UAE. Twenty-seven (46%) respondents reported that COVID-19 had a negative impact on clinical practical experience. However, 32 (54%) identified that COVID-19 had no impact on student supervision/feedback or on clinical achievements. Eleven (19%) respondents thought that students should not have been on clinical placement during the pandemic but a further 51% (n = 30) were happy with the students on placement and expressed willingness to delegate work to students. Interestingly, 58% (n = 34) of CTs suggested that future graduates may need a longer preceptorship after they graduate due to receiving decreased clinical experience during the pandemic. Overall, 78% (n = 46) of respondents thought that students improved their clinical confidence by working directly with COVID-19 positive patients. CONCLUSION: The current study has identified conflicting opinions across CTs in different clinical departments. Whilst some felt that students should not be in the hospital during the pandemic, others reported that working directly with COVID-19 patients had a positive impact on students as it improved their clinical confidence. Despite the challenges presented by COVID-19, CTs were able to provide direct clinical supervision and feedback to students on clinical placement throughout the pandemic. Nevertheless, future graduates may need a longer preceptorship period due to decreased clinical experience during the pandemic. IMPLICATIONS FOR PRACTICE: Clinical placements should continue during subsequent COVID-19 waves of infection or future pandemics to ensure development of skills in resilience and adaptability. Underdeveloped skills due to a decreased range of examinations can be rectified when any wave of the infection subsides by providing tailored training based on individual student's needs.

The radiography students' perspective of the impact of COVID-19 on education and training internationally: a across sectional survey of the UK Devolved Nations (UKDN) and the United Arab Emirates (UAE).

INTRODUCTION: The overnight change in hospital practice and service delivery during the COVID-19 pandemic raises the question whether undergraduate radiography students received an adequate clinical experience. Many students had their clinical placements cancelled, deferred or replaced with simulated learning. As a way of dealing with the pandemic some hospitals were dedicated to COVID-19 patients only resulting in many elective procedures being cancelled. Many patients also chose to stay away from the hospital out of fear of infection or the desire to reduce the burden on staff. This resulted in a limited range of examinations and clinical experience for those students who were able to complete their clinical placement. AIM: This study aims to investigate the impact of COVID-19 on the education and training of radiography students internationally in the United Kingdom Devolved Nations (UKDN) and the United Arab Emirates (UAE), to determine any possible impact on their future careers. METHOD: Ethical permission was sought and granted from the Research Ethics Committees (ID: 21-04-12-02 and ID:21/0032). An online survey was developed using Google Forms and link was shared with students via email. RESULTS: 262 students participated in the study [UAE (n = 60, 23%) and UKDN (n = 202, 77%)]. 72% stated that their clinical skills have improved and 82% were confident in the choice of radiography as a career. Participants from UAE displayed a higher tendency towards anxiety (p = 0.009). Students who were on clinical placements during the COVID-19 pandemic and worked with COVID-19 positive patients displayed less ongoing concern relating to COVID-19 (p = 0.004). 78% of the participants did not require wellbeing advice or request any type of wellbeing support from the higher education institutions (HEIs). Nevertheless, the study found that wellbeing of students was found to be negatively affected during the pandemic. CONCLUSION: Completing clinical placement during the COVID-19 pandemic allowed the continuation of education as students were allowed to improve their skills, confidence and resilience in coping with uncertainties and challenges. Undergraduate students should not be excluded from the clinical department during subsequent waves of COVID-19 or future pandemics to ensure continued workforce planning is possible. IMPLICATIONS FOR PRACTICE: HEIs should find solutions to compensate students for the loss of practical experience and skills due to the decreased number of patients in some areas of radiography practice. Providing academic and career counselling can assist students achieve their professional objectives and decrease the risk of attrition and problems upon qualification.

A Qualitative Analysis of Barriers to Peri-Discharge Care for Patients with COPD and OSA Overlap

Rationale: Patients with chronic obstructive pulmonary disease (COPD) suffer heightened morbidity, mortality, and readmission rates. COPD is co-prevalent with obstructive sleep apnea (OSA) in 20-60% of patients, and patients with COPD/OSA overlap are at higher risk for hospital readmission and mortality compared to COPD alone. Current COPD readmission reduction programs are focused on decreasing COPD readmissions;however, few explore impactful comorbid conditions. No study has identified peri-discharge barriers in the acute care setting from the perspective of patients with COPD/OSA or healthcare workers to identify areas of improvement. Methods: Semi-structured interviews, conducted via telephone (recorded) of hospitalized patients with COPD/OSA and acute care healthcare workers were conducted at an urban academic medical center (11/2020-1/2021) among a convenience sample of recruited participants. All recordings were transcribed and uploaded to NVivo, which facilitated thematic analysis, using an a priori codebook. Coding was conducted in rounds, and meetings were used to resolve differences and update the codebook as needed. This iterative process continued until all transcripts were analyzed. Results: Thirty-five participants were interviewed, 27 healthcare workers (HCW), 4 nurses, 6 respiratory therapists, 5 physicians, 3 case managers, 4 social workers, and 5 pharmacists, and 8 patients. The HCWs interviewed served an average of 7.5 years, were <50 years old (81.5%), and most were female (74.1%), white (81.5%), and non-Hispanic (100%). HCW respondents identified barriers that mapped to four main levels: patient, team, hospital, and the healthcare system. Select barriers HCWs identified included health literacy, patient cognitive impairments, peri-discharge time management, lack of resources for patients post-discharge, cost, and insurance. All patient interviewees were <50 years old, most were male (62.5%), white (62.5%), and non-Hispanic (87.5%). Select barriers patients identified included current SES status, care team discussions, disease burden (visits to ED/hospital), follow-up care (including transportation), and perceptions of healthcare due to COVID-19. Conclusion: Healthcare workers and COPD/OSA patients report multilevel hospital discharge barriers. To improve barriers to care for these complex patients, multilevel interventions addressing noted barriers are needed.

Analysis of challenges for blockchain adoption within the Indian public sector: an interpretive structural modelling approach

Purpose>Blockchain is one of the most significant emerging technologies that is set to transform many aspects of industry and society. However, it has several major technical, social, legal, environmental and ethical complexities that offer significant challenges for mainstream use within the public sector. The coronavirus disease 2019 (COVID-19) pandemic has compelled many public sector employees to work remotely, highlighting a number of challenges to blockchain adoption within the Indian context signifying the pertinence of this research topic in the post-pandemic era. This study offers insight to researchers and policymakers alike on how such challenges are interdependent within this important subject.Design/methodology/approach>We explored 16 unique sets of challenges selected from the literature and gathered data from nine experts from government settings, healthcare and education sectors and academia who have significant knowledge and experience of blockchain implementation and use in their respective organisations. The implementation of Interpretive Structural Modelling (ISM) and Matriced' Impacts Croise's Multiplication Appliquée a UN Classement (MICMAC) provided a precise set of driving, linkage and dependent challenges that were used to formulate the framework.Findings>The developed ISM framework is split into six different levels. The results suggest that the bottom level consists of challenges such as “Lack of standards (C9)” and “Lack of validation (C10)” form the foundation of the hierarchical structure of blockchain adoption. However, the topmost level consists of a highly dependent challenge termed “adoption of blockchain in the public sector (C16)”. The research filters the selected set of five challenges to develop a parsimonious model and formulated six propositions to examine the impact of “lack of standard (C9)”, “lack of validation (C10)” on “security issues (C3)” and “privacy concerns (C2)”, which eventually determine individuals' “reluctance to use blockchain technology (C12)”.Originality/value>This research fills a key gap in exiting research by exploring the key challenges in blockchain adoption within the public sector by developing a valuable framework to model this important topic. To the best of our knowledge, this is the first paper to address these challenges and develop a parsimonious model for challenges of blockchain adoption in the public sector settings.

A deep dive into testing and management of COVID-19 for Australian high performance and professional sport. (Special Issue: COVID19 - moving forward.)

The purpose of testing for any communicable disease is to support clinicians in the diagnosis and management of individual patients and to describe transmission dynamics. The novel coronavirus is formally named SARS-CoV-2 and the clinical disease state resulting from an infection is known as COVID-19. Control of the COVID-19 pandemic requires clinicians, epidemiologists, and public health officials to utilise the most comprehensive, accurate and timely information available to manage the rapidly evolving COVID-19 environment. High performance sport is a unique context that may look towards comprehensive testing as a means of risk mitigation. Characteristics of the common testing options are discussed including the circumstances where additional testing may be of benefit and considerations for the associated risks. Finally, a review of the available technology that could be considered for use by medical staff at the point of care (PoC) in a high-performance sporting context is included.

PrEP Use, Sexual Behaviour, and PrEP Adherence Among Men who have Sex with Men Living in Wales Prior to and During the COVID-19 Pandemic.

We examined PrEP use, condomless anal sex (CAS), and PrEP adherence among men who have sex with men (MSM) attending sexual health clinics in Wales, UK. In addition, we explored the association between the introduction of measures to control transmission of SARS-CoV-2 on these outcomes. We conducted an ecological momentary assessment study of individuals in receipt of PrEP in Wales. Participants used an electronic medication cap to record PrEP use and completed weekly sexual behaviour surveys. We defined adherence to daily PrEP as the percentage of CAS episodes covered by daily PrEP (preceded by ≥ 3 days of PrEP and followed by ≥ 2 days). Sixty participants were recruited between September 2019 and January 2020. PrEP use data prior to the introduction of control measures were available over 5785 person-days (88%) and following their introduction 7537 person-days (80%). Data on CAS episodes were available for 5559 (85%) and 7354 (78%) person-days prior to and following control measures respectively. Prior to the introduction of control measures, PrEP was taken on 3791/5785 (66%) days, there were CAS episodes on 506/5559 (9%) days, and 207/406 (51%) of CAS episodes were covered by an adequate amount of daily PrEP. The introduction of pandemic-related control measures was associated with a reduction in PrEP use (OR 0.44, 95%CI 0.20-0.95), CAS (OR 0.35, 95%CI 0.17-0.69), and PrEP adherence (RR = 0.55, 95%CI 0.34-0.89) and this may have implications for the health and wellbeing of PrEP users and, in addition to disruption across sexual health services, may contribute to wider threats across the HIV prevention cascade.

Living with Pompe disease in the UK: Characterizing the patient journey and burden on physical, emotional and social quality of life

Pompe disease is a rare, progressive, multisystemic disease with heterogenous presentation. We evaluated the burden, unmet needs and evolving management landscape for people living with late-onset Pompe disease (LOPD) based on their own experiences. The objective was to better understand the experiences of people living with LOPD in the UK, including their diagnostic and treatment journeys;the potential impact of LOPD on their quality of life;and the impact of COVID-19 on their lives, HCP interactions and the care they received. Following an invitation from a patient advocacy organization and completion of an eligibility questionnaire, in-depth qualitative interviews were conducted with 27 participants living with LOPD (male, n = 13 [48%];mean age, 56 years;mean age at diagnosis, 43 years;received ≥1 misdiagnosis, n = 9 [33%]). Participants' diagnostic journeys typically included the following phases: undetected symptoms;noticeable symptoms;HCP visits and misdiagnosis;diagnosis. The diagnostic process was typically long and distressing, with most participants emphasizing a desire for reduced times to diagnosis, referral to a specialist HCP and treatment initiation. The most frequent LOPD-associated symptoms mentioned by participants were walking difficulties (n = 27, 100%), fatigue (n = 26, 96.3%) and balance issues (n = 22, 81.5%);participants stated the most important symptoms to treat were walking difficulties (n = 15, 55.6%), fatigue (n = 10, 37.0%) and breathing problems (n = 10, 37.0%). For most participants, the COVID-19 pandemic has been a period of increased anxiety, low mood and physical deterioration. The results of these interviews provide a very full understanding of the emotional journey experienced by individuals living with LOPD in the UK and enabled the construction of a unique infographic visually representing an archetypal patient journey. Findings from this study further characterize challenges faced by people living with LOPD (e.g., delays in diagnosis and/or treatment initiation, treatment satisfaction) and the impact of these challenges on daily life. Supported by Amicus Therapeutics.

Coming full circle: Past, present, and future research on ethnic-racial socialization

When this special issue was first proposed in 2019, we endeavored to push forward scholarship about the various ways in which individuals, interactions, and settings communicate messages to children and youth about ethnicity and race. In particular, we aimed to broaden the scope of our current understanding of ethnic-racial socialization through the inclusion of theory and research that took a more expansive approach. We sought papers focused on multiple agents of socialization, including settings, that also (a) featured diverse ethnic-racial groups and national contexts, (b) covered a wide swath of development, from early childhood through emerging adulthood, (c) employed varied methodological approaches, and (d) centered intersectional perspectives. As the world continues to change shape in the face of the ongoing Covid-19 pandemic and broad-based racial justice movements, this special issue feels ever more urgent and pressing. The articles presented in this special issue are diverse and expansive in their focus, approach, content, and findings. Yet, despite their breadth, they offer critical insight into three key questions facing the study of ethnic-racial socialization: Where are we coming from? Where are we now? And where are we headed?

Performance and Deployment Status of MUSCAT: a 1500-Pixel LEKID-Based mm-Wave Camera for the Large Millimeter Telescope

The Mexico-UK Sub-Millimetre Camera for AsTronomy (MUSCAT) is a 1.1-mm band receiver consisting of 1,500 single-colour lumped-element kinetic inductance detectors and is scheduled for deployment to the Large Millimeter Telescope (LMT) after the ongoing COVID-19 pandemic. MUSCAT is designed to utilise the full field of view of the LMT's upgraded 50-m primary mirror (approximately 4'). Here we will present the as-measured performance of MUSCAT from the final lab-verification testing prior to shipping to the LMT. We will also explain the overall design of MUSCAT including the novel technologies utilised-such as continuous cooling using sorption coolers and a miniature dilutor, and horn-coupled LEKIDs-for which MUSCAT will provide a first on-sky demonstration.

Building better futures: decent work, inclusion and careers support services in the UK

The concepts of decent work, inclusion and supporting individuals to find pathways to learning and work opportunities present new opportunities and real challenges. Job security, roles and labour markets are changing rapidly. We focus on how the UK careers support landscape in each of the four home nations is changing in response to the pandemic. We argue that the quasi-market, experimental approach to careers provision in England has significantly weakened young people’s access to professionally-trained advisers. We outline a 'spaces and places paradigm' to reframe careers support in transformative ways. Our results show fragmented policies in England will not create the level of support needed by individuals, particularly those most vulnerable in the aftermath of Covid-19, to build better futures for themselves. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Feasibility and acceptability of a novel home-based oral glucose tolerance test using continuous glucose monitoring for the diagnosis of gestational diabetes

Aim: Gestational diabetes diagnosis has been challenging during the covid-19 pandemic. We assessed the feasibility of a novel home-based OGTT using continuous glucose monitoring (CGM) to identify hyperglycaemia in pregnancy. Methods: Women with a singleton pregnancy at 28 weeks' gestation with ≥1 risk factor for gestational diabetes attending antenatal glucose testing were recruited to a pilot single-centre prospective observational study. A Dexcom G6 continuous glucose monitoring sensor was sited (receiver masked) and women were asked to take a 75g OGTT solution (Rapilose) on day four after a 10 hour overnight fast. Qualitative interviews were performed with 20 participants using telephone or video conferencing using a pre-determined interview schedule and thematically analysed using NVIVO software. Results: Forty-six women completed a home OGTT with 7.4 days of CGM. 40/46 (87.0%) took the glucose solution as instructed, and 16 (34.8%) had CGM glucose readings at 0, 60 and 120 minutes which met WHO criteria for gestational diabetes diagnosis. These women had evidence of hyperglycaemia on other CGM metrics: increased mean CGM glucose (106 vs. 92 mg/dl (5.9 vs. 5.1 mmol);p < 0.001) and time-above- range (≥140 mg/dl;≥7.8 mmol/l;6.8 vs. 2.0%;p = 0.006). Time-in- range was not significantly different. Women found the CGM painless, convenient and reassuring to use. All 20 women interviewed would recommend CGM with a home OGTT for diagnosis of gestational diabetes. Conclusions: A home-based antenatal OGTT using CGM is feasible, acceptable to pregnant women and identifies women with hyperglycaemia in pregnancy. Remote OGTTs using CGM may improve testing capacity during the covid- 19 pandemic.

Quest for a Cure: Potential Small-Molecule Treatments for COVID-19, Part 2

During the first year of the outbreak of the COVID-19 pandemic, many drugs and drug candidates have been evaluated as treatment options. None yet has proved to be an effective cure, but progress in controlling the disease has been made. In June 2020 we published an article that described the mechanistic rationale behind the repurposing of seven licensed drugs in clinical trials for the treatment of COVID-19 and reviewed synthetic routes to these drugs. Several developments have occurred since then. Remdesivir (trade name Veklury) has been approved for use in the U.S. and Europe. Dexamethasone, a steroid drug first approved in 1959, has shown mortality reduction in severe COVID patients. Molnupiravir, a new and promising oral antiviral drug, is being studied in late-stage clinical trials. In this review, we update synthetic work that has been recently published on remdesivir, provide an overview of several routes to molnupiravir, and review classical routes to dexamethasone as well as some of those more recently developed. ©

Impact of COVID-19 pandemic on information management research and practice: Transforming education, work and life: SSIS

The COVID-19 pandemic has forced many organisations to undergo significant transformation, rethinking key elements of their business processes and use of technology to maintain operations whilst adhering to a changing landscape of guidelines and new procedures. This study offers a collective insight to many of the key issues and underlying complexities affecting organisations and society from COVID-19, through an information systems and technological perspective. The views of 12 invited subject experts are collated and analysed where each articulate their individual perspectives relating to: online learning, digital strategy, artificial intelligence, information management, social interaction, cyber security, big data, blockchain, privacy, mobile technology and strategy through the lens of the current crisis and impact on these specific areas. The expert perspectives offer timely insight to the range of topics, identifying key issues and recommendations for theory and practice.

Acute chloroquine poisoning: a comprehensive experimental toxicology assessment of the role of diazepam. (Special Issue: The pharmacology of COVID-19.)

Background and Purpose: Resurgence in the use of chloroquine as a potential treatment for COVID-19 has seen recent cases of fatal toxicity due to unintentional overdoses. Protocols for the management of poisoning recommend diazepam, although there are uncertainties in its pharmacology and efficacy in this context. The aim was to assess the effects of diazepam in experimental models of chloroquine cardiotoxicity. Experimental Approach: In vitro experiments involved cardiac tissues isolated from rats and incubated with chloroquine alone or in combination with diazepam. In vivo models of toxicity involved chloroquine administered intravenously to pentobarbitone-anaesthetised rats and rabbits. Randomised, controlled treatment studies in rats assessed diazepam, clonazepam and Ro5-4864 administered: (i) prior, (ii) during and (iii) after chloroquine and the effects of diazepam: (iv) at high dose, (v) in urethane-anaesthetised rats and (vi) co-administered with adrenaline. Key Results: Chloroquine decreased the developed tension of left atria, prolonged the effective refractory period of atria, ventricular tissue and right papillary muscles, and caused dose-dependent impairment of haemodynamic and electrocardiographic parameters. Cardiac arrhythmias indicated impairment of atrioventricular conduction. Studies (i), (ii) and (v) showed no differences between treatments and control. Diazepam increased heart rate in study (iv) and as with clonazepam also prolonged the QTc interval in study (iii). Combined administration of diazepam and adrenaline in study (vi) improved cardiac contractility but caused hypokalaemia. Conclusion and Implications: Neither diazepam nor other ligands for benzodiazepine binding sites protect against or attenuate chloroquine cardiotoxicity. However, diazepam may augment the effects of positive inotropes in reducing chloroquine cardiotoxicity.

Compassionate leadership during COVID-19: An ABC approach to the introduction of new medical graduates as Foundation interim Year 1s (FiY1s)

Background: Increasingly challenging workplaces detrimentally affect doctors' well-being and patient care. The General Medical Council's € ABC' compassionate leadership model aims to improve doctor well-being. When COVID-19 emerged, a 4 Nation agreement facilitated early graduation and provisional registration of final year medical students and deployment of new graduates into Foundation interim Year 1 (FiY1) positions. We report how the Northern Ireland Medical and Dental Training Agency (NIMDTA) applied compassionate leadership to the induction of FiY1s. Methods: Employing € What matters to you', we identified FiY1s' educational objectives and reviewed information dissemination options within distancing restrictions. A dedicated FiY1 webpage summarised requirements and resources. A regional digital induction with a well-being emphasis facilitated flexible completion. Welcome packs promoted belonging while a € buddy system' delivered support. Collaboration with other stakeholders created staggered follow-up video conferences providing practical and psychological support, removing communication barriers. Findings: Feedback showed high FiY1 satisfaction with the global introduction to practice (83%) and 82% felt valued by NIMDTA and by Trusts after process completion. Conclusion: Applying compassionate leadership to induction creates positive effects on doctors' feeling of value and aligns with organisational strategic aims to support, develop and retain doctors in training programmes. We envision this model being applied to future postgraduate induction programmes. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.