ESMO Management and treatment adapted recommendations in the COVID-19 era: Lung cancer

The COVID-19 pandemic, characterised by a fast and global spread during the first months of 2020, has prompted the development of a structured set of recommendations for cancer care management, to maintain the highest possible standards. Within this framework, it is crucial to ensure no disruption to essential oncological services and guarantee the optimal care.This is a structured proposal for the management of lung cancer, comprising three levels of priorities, namely: tier 1 (high priority), tier 2 (medium priority) and tier 3 (low priority)—defined according to the criteria of the Cancer Care Ontario, Huntsman Cancer Institute and Magnitude of Clinical Benefit Scale.The manuscript emphasises the impact of the COVID-19 pandemic on lung cancer care and reconsiders all steps from diagnosis, staging and treatment.These recommendations should, therefore, serve as guidance for prioritising the different aspects of cancer care to mitigate the possible negative impact of the COVID-19 pandemic on the management of our patients.As the situation is rapidly evolving, practical actions are required to guarantee the best patients’ treatment while protecting and respecting their rights, safety and well-being. In this environment, cancer practitioners have great responsibilities: provide timely, appropriate, compassionate and justified cancer care, while protecting themselves and their patients from being infected with COVID-19. In case of shortages, resources must be distributed fairly. Consequently, the following recommendations can be applied with significant nuances, depending on the time and location for their use, considering variable constraints imposed to the health systems. An exceptional flexibility is required from cancer caregivers.

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Incorporation of plasma-based next-generation sequencing to improve guideline-concordant molecular testing in patients with newly diagnosed metastatic nonsquamous non-small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.14 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 14-14

Author(s):

Charu Aggarwal ◽

Melina Elpi Marmarelis ◽

Wei-Ting Hwang ◽

Dylan G. Scholes ◽

Aditi Puri Singh ◽

...

Keyword(s):

Clinical Practice ◽

Practice Change ◽

Molecular Testing ◽

Tier 2 ◽

Newly Diagnosed ◽

Next Generation ◽

First Line ◽

Tier 1 ◽

Tier 3 ◽

The Impact

14 Background: Current NCCN guidelines recommend comprehensive molecular profiling for all newly diagnosed patients with metastatic non-squamous NSCLC to enable the delivery of personalized medicine. We have previously demonstrated that incorporation of plasma based next-generation gene sequencing (NGS) improves detection of clinically actionable mutations in patients with advanced NSCLC (Aggarwal et al, JAMA Oncology, 2018). To increase rates of comprehensive molecular testing at our institution, we adapted our clinical practice to include concurrent use of plasma (P) and tissue (T) based NGS upon initial diagnosis. P NGS testing was performed using a commercial 74 gene assay. We analyzed the impact of this practice change on guideline concordant molecular testing at our institution. Methods: A retrospective cohort study of patients with newly diagnosed metastatic non-squamous NSCLC following the implementation of this practice change in 12/2018 was performed. Tiers of NCCN guideline concordant testing were defined, Tier 1: complete EGFR, ALK, BRAF, ROS1, MET, RET, NTRK testing, Tier 2: included above, but with incomplete NTRK testing, Tier 3: > 2 genes tested, Tier 4: single gene testing, Tier 5: no testing. Proportion of patients with comprehensive molecular testing by modality (T NGS vs. T+P NGS) were compared using one-sided Fisher’s exact test. Results: Between 01/2019, and 12/2019, 170 patients with newly diagnosed metastatic non-Sq NSCLC were treated at our institution. Overall, 98.2% (167/170) patients underwent molecular testing, Tier 1: n = 100 (59%), Tier 2: n = 39 (23%), Tier 3/4: n = 28 (16.5%), Tier 5: n = 3 (2%). Amongst these patients, 43.1% (72/167) were tested with T NGS alone, 8% (15/167) with P NGS alone, and 47.9% (80/167) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS: 95.7% (79/80) compared to T alone: 62.5% (45/72), p < 0.0005. Prior to the initiation of first line treatment, 72.4% (123/170) patients underwent molecular testing, Tier 1: n = 73 (59%), Tier 2: n = 27 (22%) and Tier 3/4: n = 23 (18%). Amongst these, 39% (48/123) were tested with T NGS alone, 7% (9/123) with P NGS alone and 53.6% (66/123) with T+P NGS. A higher proportion of patients underwent comprehensive molecular testing (Tiers 1+2) using T+P NGS, 100% (66/66) compared to 52% (25/48) with T NGS alone (p < 0.0005). Conclusions: Incorporation of concurrent T+P NGS testing in treatment naïve metastatic non-Sq NSCLC significantly increased the proportion of patients undergoing guideline concordant molecular testing, including prior to initiation of first-line therapy at our institution. Concurrent T+P NGS should be adopted into institutional pathways and routine clinical practice.

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Study protocol for COvid-19 Vascular sERvice (COVER) study: The impact of the COVID-19 pandemic on the provision, practice and outcomes of vascular surgery

10.1101/2020.05.27.20114322 ◽

2020 ◽

Author(s):

Ruth A Benson

Keyword(s):

Vascular Surgery ◽

Service Provision ◽

British Society ◽

Tier 2 ◽

Patient Level ◽

Tier 1 ◽

Ethical Approval ◽

The Uk ◽

Tier 3 ◽

The Impact

ABSTRACTBackgroundThe novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Furthermore, many vascular surgical patients are elderly with multiple comorbidities putting them at increased risk of COVID-19 and its complications. There is an urgent need to investigate the impact on patients presenting to vascular surgeons during the COVID-19 pandemic.Methods and AnalysisThe COvid-19 Vascular sERvice (COVER) study has been designed to investigate the worldwide impact of the COVID-19 pandemic on vascular surgery, at both service provision and individual patient level. COVER is running as a collaborative study through the Vascular and Endovascular Research Network (VERN) with the support of numerous national (Vascular Society of Great Britain and Ireland, British Society of Endovascular Therapy, British Society of Interventional Radiology, Rouleaux Club) and an evolving number of international organisations (Vascupedia, SingVasc, Audible Bleeding (USA), Australian and New Zealand Vascular Trials Network (ANZVTN)). The study has 3 ‘Tiers’: Tier 1 is a survey of vascular surgeons to capture longitudinal changes to the provision of vascular services within their hospital; Tier 2 captures data on vascular and endovascular procedures performed during the pandemic; and Tier 3 will capture any deviations to patient management strategies from prepandemic best practice. Data submission and collection will be electronic using online survey tools (Tier 1: SurveyMonkey® for service provision data) and encrypted data capture forms (Tiers 2 and 3: REDCap® for patient level data). Tier 1 data will undergo real-time serial analysis to determine longitudinal changes in practice, with country-specific analyses also performed. The analysis of Tier 2 and Tier 3 data will occur on completion of the study as per the prespecified statistical analysis plan.Ethical ApprovalEthical approval from the UK Health Research Authority has been obtained for Tiers 2 and 3 (20/NW/0196 Liverpool Central). Participating centres in the UK will be required to seek local research and development approval. Non-UK centres will need to obtain a research ethics committee or institutional review board approvals in accordance with national and/or local requirements.ISRCTN: 80453162 (https://doi.org/10.1186/ISRCTN80453162)Ethical Approval: 20/NW/0196 Liverpool Central, IRAS: 282224

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Study protocol for COvid-19 Vascular sERvice (COVER) study: The impact of the COVID-19 pandemic on the provision, practice and outcomes of vascular surgery

PLoS ONE ◽

10.1371/journal.pone.0243299 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0243299

Author(s):

Ruth A. Benson ◽

Sandip Nandhra ◽

Keyword(s):

Vascular Surgery ◽

Service Provision ◽

Resource Scarcity ◽

Research Network ◽

Tier 2 ◽

Longitudinal Changes ◽

Patient Level ◽

Tier 1 ◽

Tier 3 ◽

The Impact

Background The novel Coronavirus Disease 2019 (COVID-19) pandemic is having a profound impact on global healthcare. Shortages in staff, operating theatre space and intensive care beds has led to a significant reduction in the provision of surgical care. Even vascular surgery, often insulated from resource scarcity due to its status as an urgent specialty, has limited capacity due to the pandemic. Furthermore, many vascular surgical patients are elderly with multiple comorbidities putting them at increased risk of COVID-19 and its complications. There is an urgent need to investigate the impact on patients presenting to vascular surgeons during the COVID-19 pandemic. Methods and analysis The COvid-19 Vascular sERvice (COVER) study has been designed to investigate the worldwide impact of the COVID-19 pandemic on vascular surgery, at both service provision and individual patient level. COVER is running as a collaborative study through the Vascular and Endovascular Research Network (VERN), an independent, international vascular research collaborative with the support of numerous national and international organisations). The study has 3 ‘Tiers’: Tier 1 is a survey of vascular surgeons to capture longitudinal changes to the provision of vascular services within their hospital; Tier 2 captures data on vascular and endovascular procedures performed during the pandemic; and Tier 3 will capture any deviations to patient management strategies from pre-pandemic best practice. Data submission and collection will be electronic using online survey tools (Tier 1: SurveyMonkey® for service provision data) and encrypted data capture forms (Tiers 2 and 3: REDCap® for patient level data). Tier 1 data will undergo real-time serial analysis to determine longitudinal changes in practice, with country-specific analyses also performed. The analysis of Tier 2 and Tier 3 data will occur on completion of the study as per the pre-specified statistical analysis plan.

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The impact of the COVID-19 pandemic on the psychosocial condition of students in Poland and Ukraine

10.31234/osf.io/wz8s7 ◽

2020 ◽

Author(s):

Piotr Długosz ◽

Yana

Keyword(s):

Distance Learning ◽

Negative Impact ◽

Well Being ◽

Survey Method ◽

Psychosocial Condition ◽

On Line ◽

Line Survey ◽

The Impact ◽

Emotional Condition ◽

Double Measurement

The article presents the results of research on psychosocial condition among Polish and Ukrainian students during the quarantine. The aim of the research was to verify the impact of the pandemic and its accompanying phenomena on the well-being of youth. In order to achieve this goal, the CAWI on-line survey method with double measurement was used. The first measurement carried out at the beginning of the quarantine resulted in 3659 filled out surveys in Poland and 739 in Ukraine. The second measurement conducted at the end of distance learning brought 1978 filled out surveys in Poland and 411 in Ukraine. The results of research indicate that the quarantine had a negative impact on the psychosocial condition of youth. The deterioration of emotional condition and the increase in mental disorders has been observed. Due to the pandemic and distance learning, the mental health of youth deteriorated significantly. Polish youth were negatively influenced by the pandemic to a greater extent than young Ukrainians.

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Optimal Timing for Launching Installation of Tier 2 and 3 Systems of School-Wide Positive Behavioral Interventions and Supports

Journal of Positive Behavior Interventions ◽

10.1177/1098300721996084 ◽

2021 ◽

pp. 109830072199608

Author(s):

Angus Kittelman ◽

Sterett H. Mercer ◽

Kent McIntosh ◽

Robert Hoselton

Keyword(s):

Longitudinal Study ◽

Behavioral Interventions ◽

Structural Equation ◽

Equation Modeling ◽

Optimal Timing ◽

First Year ◽

Tier 2 ◽

Positive Behavioral Interventions ◽

Tier 1 ◽

Tier 3

The purpose of this longitudinal study was to examine patterns in implementation of Tier 2 and 3 school-wide positive behavioral interventions and supports (SWPBIS) systems to identify timings of installation that led to higher implementation of advanced tiers. Extant data from 776 schools in 27 states reporting on the first 3 years of Tier 2 implementation and 359 schools in 23 states reporting on the first year of Tier 3 implementation were analyzed. Using structural equation modeling, we found that higher Tier 1 implementation predicted subsequent Tier 2 and Tier 3 implementation. In addition, waiting 2 or 3 years after initial Tier 1 implementation to launch Tier 2 systems predicted higher initial Tier 2 implementation (compared with implementing the next year). Finally, we found that launching Tier 3 systems after Tier 2 systems, compared with launching both tiers simultaneously, predicted higher Tier 2 implementation in the second and third year, so long as Tier 3 systems were launched within 3 years of Tier 2 systems. These findings provide empirical guidance for when to launch Tier 2 and 3 systems; however, we emphasize that delays in launching advanced systems should not equate to delays in more intensive supports for students.

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The Impact of the COVID-19 Pandemic on the Working Conditions, Employment, Career Development and Well-Being of Refugee Researchers

Societies ◽

10.3390/soc11030071 ◽

2021 ◽

Vol 11 (3) ◽

pp. 71

Author(s):

Ourania Tzoraki ◽

Svetlana Dimitrova ◽

Marin Barzakov ◽

Saad Yaseen ◽

Vasilis Gavalas ◽

...

Keyword(s):

Online Survey ◽

Negative Impact ◽

Well Being ◽

Appropriate Technology ◽

Public Authorities ◽

Policy Makers ◽

Home Setting ◽

The Public ◽

Work From Home ◽

The Impact

The ongoing ‘refugee crisis’ of the past years has led to the migration of refugee researchers (RRs) to European countries. Due to the COVID-19 pandemic, RRs often had to work from home and/or to continue their social, cultural and economic integration process under new conditions. An online survey carried out to explore the impact of the pandemic on the refugee researchers showed that RRs found it difficult to adapt their everyday working life to the ‘home’ setting. The majority have had neither a suitable work environment at home nor the appropriate technology. Although they stated that they are rather pleased with the measures taken by the public authorities, they expressed concern about their vulnerability due to their precarious contracts and the bureaucratic asylum procedures, as the pandemic has had a negative impact on these major issues. The majority of RRs working in academia seem not to have been affected at all as far as their income is concerned, while the majority of those employed in other sectors became unemployed during the pandemic (58%). Recommendations are provided to the public authorities and policy makers to assist RRs to mitigate the consequences of the pandemic on their life.

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COVID-19 Pandemic and Quality of Life among Romanian Athletes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084065 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4065

Author(s):

Germina-Alina Cosma ◽

Alina Chiracu ◽

Amalia Raluca Stepan ◽

Marian Alexandru Cosma ◽

Marian Costin Nanu ◽

...

Keyword(s):

Quality Of Life ◽

Trait Anxiety ◽

Negative Impact ◽

Well Being ◽

Quality Of Life Scale ◽

Life Scale ◽

Personality Item ◽

The Impact ◽

The Relationship

The aim of this study was to analyze athletes’ quality of life during the COVID-19 pandemic. The study involved 249 athletes between 15 and 35 of age, M = 21.22, SD = 5.12. The sample was composed of eight Olympic Games medalists, three European medalists, 67 international medalists, and 63 national medalists. The instruments used were: (1) COVID-19 Anxiety Scale, (2) Athlete Quality of Life Scale, (3) Impact of Pandemic on Athletes Questionnaire, and (4) International Personality Item Pool (IPIP Anxiety, Depression, and Vulnerability Scales). The results indicate significant differences in COVID-19 anxiety depending on the sport practiced, F (9239) = 3.81, p < 0.01, showing that there were significant differences between sports. The negative impact of the COVID-19 pandemic mediates the relationship between trait anxiety and the athletes’ quality of life. The percentage of mediation was 33.9%, and the indirect effect was −0.11, CI 95% (−0.18, −0.03), Z = −2.82, p < 0.01. Trait anxiety has an increasing effect on the intensity of the negative impact of the COVID-19 pandemic, 0.23, CI 95% (.10, 0.35), Z = 3.56, p < 0.01, and the negative impact of the COVID-19 pandemic has a decreasing effect on quality of life, −0.47, CI 95% (−0.67, −0.27), Z = −4.62, p < 0.01. Gender and age did not moderate the relationship between the negative impact of COVID-19 and athletes’ quality of life. The results of the study highlighted the impact that social isolation and quarantine have on athletes’ affective well-being.

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Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

Journal of Radiotherapy in Practice ◽

10.1017/s1460396921000303 ◽

2021 ◽

pp. 1-11

Author(s):

Ernest Osei ◽

Ruth Francis ◽

Ayan Mohamed ◽

Lyba Sheraz ◽

Fariba Soltani-Mayvan

Keyword(s):

Cancer Care ◽

Healthcare Professionals ◽

Negative Impact ◽

System Level ◽

Care Continuum ◽

Cancer Services ◽

Number Of Patients ◽

Prevention Programmes ◽

Screening And Prevention ◽

The Impact

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.

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Red tape and psychological capital: a counterbalancing act for professionals in street-level bureaucracies

Journal of Professions and Organization ◽

10.1093/jpo/joaa024 ◽

2020 ◽

Author(s):

A Dudau ◽

G Kominis ◽

Y Brunetto

Keyword(s):

Local Government ◽

Organizational Behavior ◽

Psychological Capital ◽

Negative Impact ◽

Practical Implication ◽

Well Being ◽

Government Employees ◽

Street Level ◽

Red Tape ◽

The Impact

Abstract Assuming that red tape is inevitable in institutions, and drawing on positive organizational behavior, we compare the impact of individual psychological capital on the ability of street-level bureaucrats (SLBs) with different professional backgrounds to work within the confines of red tape. The two SLB professions investigated here are nurses and local government employees; and the work outcomes of interest to this study are well-being and engagement. The findings show that red tape has a different impact on each professional group but, encouragingly, they also indicate that psychological capital has a compensatory effect. Implications include nurses requiring more psychological resources than local government employees to counteract the negative impact of red tape. A practical implication for managers is that, if perception of red tape in organizations is set to increase or to stay constant, enhancing the psychological capital of professionals in SLB roles, through specific interventions, may be beneficial to professionals and organizations alike.

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Impact of COVID-19 on the Health and Well-being of Informal Caregivers of People with Dementia: A Rapid Systematic Review

Gerontology and Geriatric Medicine ◽

10.1177/23337214211020164 ◽

2021 ◽

Vol 7 ◽

pp. 233372142110201

Author(s):

M. Courtney Hughes ◽

Yujun Liu ◽

Abby Baumbach

Keyword(s):

Negative Impact ◽

Living Arrangement ◽

Informal Caregivers ◽

Well Being ◽

Rapid Review ◽

People With Dementia ◽

Psychosocial Resilience ◽

Quantitative Descriptive ◽

The Impact ◽

Health And Well Being

Background: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, raised worldwide concern. Since then, the COVID-19 pandemic has negatively influenced health and wellness across the globe and caused nearly three million deaths. This study focuses on informal caregivers of people with dementia, a disease that affects about 50 million older adults worldwide and requires much caregiving support. Objective: Examine the current literature on the impact of COVID-19 on the health and well-being of informal caregivers for people with dementia. Method: This rapid review was conducted across five electronic databases for quantitative and qualitative articles published through March 15, 2021. Results: The 10 studies included in this review reported quantitative descriptive data from across the globe; however, no studies existed from the U.S. or East Asia countries. All of the studies examined the psychological rather than physical impact of COVID-19 and highlighted risk and protective factors in the areas of psychosocial (resilience, neuropsychiatric, and social isolation), sociodemographic (gender and education), and environmental (home confinement, living arrangement, and dementia stage). Conclusion: COVID-19 has had a considerable negative impact on the psychological well-being of informal caregivers of people with dementia, namely causing more depression and anxiety than pre-pandemic.

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