The adequacy of personal protective equipment (PPE) and infection prevention and control (IPC) training in UK medical students and interim Foundation Year 1 (FiY1) doctors during the COVID-19 ...pandemic is unknown, as is its impact on COVID-19-related anxiety.
Cross-sectional, multi-centre study analysing self-reported adequacy of PPE and IPC training and correlation to a modified pandemic anxiety scale. Participants were current medical students and FiY1 doctors in the UK. Data were collected by an online survey.
Participants reported that they received insufficient PPE information (43%) and IPC training (56%). Significantly, fewer participants identifying as women or BAME/mixed ethnicity reported receiving sufficient PPE information, compared with those identifying as men and White British/White Other, respectively. COVID-19-related anxiety was significantly higher in those without sufficient reported PPE or IPC training, in women compared with men, and in FiY1 doctors compared with medical students.
With medical students currently volunteering in and imminently returning to hospitals in an educational capacity, levels of self-reported PPE and IPC training are sub-optimal. Better training is paramount to avoid harm to patients and healthcare professionals and to reduce COVID-19-related anxiety among medical students and FiY1 doctors.
Formal leadership training is typically targeted at senior health professionals. The Healthcare Leadership Academy (HLA) was formed in 2016 to provide a leadership programme for students and ...early-career health professionals. This study analyses the effectiveness of the HLA scholarship programme as an intervention for improving interest in and preparing scholars for future leadership roles.
Survey data was used to assess the effectiveness of the HLA Scholarship program in cultivating leadership development. Questions required either multiple-choice, free text, ranking or Likert scale ('strongly agree', 'agree', 'neither agree nor disagree', 'disagree', 'strongly disagree) responses. Participants spanned six regions (London, Newcastle, Bristol, Belfast, Edinburgh, and Amsterdam) in four countries (England, Scotland, Northern Ireland, and the Netherlands). Descriptive statistical analyses were conducted, and insights were drawn from the open-ended survey questions using a leadership framework.
Seventy participants who underwent the course between 2016 and 2020 completed the questionnaire. Nearly all (99%) found that the training provided on the programme had equipped them to be more effective leaders, with 86% of respondents stating that they were more likely to take on leadership roles. Nearly all (97.1%) found the course to be either of good or very good quality. Nineteen insights were identified from free text responses that fitted under one of the four themes of the leadership framework: "optimising", "resolving uncertainty", "enhancing adaptability", and "promulgating a vision".
Healthcare leadership is a non-negotiable component of healthcare delivery in the 21st Century. As healthcare professionals, it is our duty to be effective leaders confident and competent in navigating the increasingly complex systems within which we operate for the benefit of ourselves, colleagues, and patients. By accounting for known shortcomings and developing ameliorative measures, the HLA Scholarship programme addresses unmet needs in a structured manner to support effective long-term healthcare leadership development.
Background:
The COVID-19 pandemic has caused a surge in research activity while restricting data collection methods, leading to a rise in survey-based studies. Anecdotal evidence suggests this ...increase in neurosurgical survey dissemination has led to a phenomenon of survey fatigue, characterized by decreased response rates and reducing the quality of data. This paper aims to analyze the effect of COVID-19 on neurosurgery surveys and their response rates, and suggest strategies for improving survey data collection.
Methods:
A search was conducted on March 20, 2021, on Medline and EMBASE. This included the terms “neurosurgery,” “cranial surgery,” “spine surgery,” and “survey” and identified surveys written in English, on a neurosurgical topic, distributed to neurosurgeons, trainees, and medical students. Results were screened by two authors according to these inclusion criteria, and included articles were used for data extraction, univariable, and bivariable analysis with Fisher's exact-test, Wilcoxon rank-sum test, and Spearman's correlation.
Results:
We included 255 articles in our analysis, 32.3% of which were published during the COVID-19 pandemic. Surveys had an average of 25.6 (95% CI = 22.5–28.8) questions and were mostly multiple choice (78.8%). They were disseminated primarily by email (75.3%, 95% CI = 70.0–80.6%) and there was a significant increase in dissemination
via
social media during the pandemic (OR = 3.50, 95% CI = 1.30–12.0). COVID-19 surveys were distributed to more geographical regions than pre-pandemic surveys (2.1 vs. 1.5,
P
= 0.01) and had higher total responses (247.0 vs. 206.4,
P
= 0.01), but lower response rates (34.5 vs. 51.0%,
P
< 0.001) than pre-COVID-19 surveys.
Conclusion:
The rise in neurosurgical survey distribution during the COVID-19 pandemic has led to survey fatigue, reduced response rates, and data collection quality. We advocate for population targeting to avoid over-researching, collaboration between research teams to minimize duplicate surveys, and communication with respondents to convey study importance, and we suggest further strategies to improve response rates in neurosurgery survey data collection.
Haptoglobin is the body's first line of defence against the toxicity of extracellular haemoglobin released following a subarachnoid haemorrhage (SAH). We investigated the haptoglobin response after ...SAH in cerebrospinal fluid (CSF) and serum. Paired CSF and serum samples from 19 controls and 92 SAH patients were assayed as follows: ultra-performance liquid chromatography for CSF haemoglobin and haptoglobin, immunoassay for serum haptoglobin and multiplexed CSF cytokines, and colorimetry for albumin. There was marked CSF haptoglobin deficiency: 99% of extracellular haemoglobin was unbound. The quotients for both CSF/serum albumin (qAlb) and haptoglobin (qHp) were used to compute the CSF haptoglobin index (qHp/qAlb). CSF from SAH patients had a significantly lower haptoglobin index compared to controls, especially in Haptoglobin-1 allele carriers. Serum haptoglobin levels increased after SAH and were correlated with CSF cytokine levels. Haptoglobin variables were not associated with long-term clinical outcomes post-SAH. We conclude that: (1) intrathecal haptoglobin consumption occurs after SAH, more so in haptoglobin-1 allele carriers; (2) serum haptoglobin is upregulated after SAH, in keeping with the liver acute phase response to central inflammation; (3) haptoglobin in the CSF is so low that any variation is too small for this to affect long-term outcomes, emphasising the potential for therapeutic haptoglobin supplementation.
The issue was the implementation of a thoughtless policy—a policy that simply aimed to fulfil a promise made in July, 2020, of a minimally disrupted Christmas without full consideration of the ...current context2 or the unique effects of such a heavy-handed approach on certain communities.1 Regardless of the intended consequences, if a policy has an inequitable effect, it is discriminatory. The UN Human Rights Committee rightly claimed that this policy, which applied the same rule for everyone, disproportionately harmed the rights of women to manifest their religious beliefs, confined them to their homes, impeded their access to public services, and marginalised them.4 Equality does not negate discrimination. There is considerable evidence that minority ethnic individuals are less likely to adhere to advice when they feel discriminated against.5 The best public health strategy involves listening to the data.
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