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Shah R, Loo CE, Hanna NM, Hughes S, Mafra A, Fink H, McFerran E, Garcia M, Acharya S, Langselius O, Frick C, Niyigaba J, Lasebikan N, Steinberg J, Sullivan R, Bray F, Ilbawi AM, Ginsburg O, Chiam K, Cylus J, Caruana M, David M, Hui H, Canfell K, Soerjomataram I. Global review of COVID-19 mitigation strategies and their impact on cancer service disruptions. J Cancer Policy 2024; 41:100486. [PMID: 38830535 DOI: 10.1016/j.jcpo.2024.100486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/15/2024] [Accepted: 05/24/2024] [Indexed: 06/05/2024]
Abstract
During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19. Included studies reported on individuals with cancer or cancer care services, focusing on strategies/programs aimed to reduce delays and disruptions. Extracted data were grouped into four functions (governance, financing, service delivery, and resource generation) and sub-functions of the health system performance assessment framework. We included 30 studies from 16 countries involving 192,233 patients with cancer. Multiple mitigation approaches were implemented, predominantly affecting sub-functions of service delivery to control COVID-19 infection via the suspension of non-urgent cancer care, modified treatment guidelines, and increased telemedicine use in routine cancer care delivery. Resource generation was mainly ensured through adequate workforce supply. However, less emphasis on monitoring or assessing the effectiveness and financing of these strategies was observed. Seventeen studies suggested improved service uptake after mitigation implementation, yet the resulting impact on cancer diagnosis and care has not been established. This review emphasizes the importance of developing effective mitigation strategies across all health system (sub)functions to minimize cancer care service disruptions during crises. Deficiencies were observed in health service delivery (to ensure equity), governance (to monitor and evaluate the implementation of mitigation strategies), and financing. In the wake of future emergencies, implementation research studies that include pre-prepared protocols will be essential to assess mitigation impact across cancer care services.
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Affiliation(s)
- Richa Shah
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France.
| | - Ching Ee Loo
- Centre for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | | | - Suzanne Hughes
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Allini Mafra
- Cancer Epidemiology and Prevention Team, Public Health Expertise, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Hanna Fink
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Montse Garcia
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), Early Detection of Cancer Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | | | - Oliver Langselius
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Clara Frick
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jean Niyigaba
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Richard Sullivan
- King's College London, Institute of Cancer Policy, Guy's Hospital, London, UK
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - André Michel Ilbawi
- Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland
| | | | - Karen Chiam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Jonathan Cylus
- WHO Barcelona Office for Health Systems Financing, World Health Organization Regional Office for Europe, Barcelona, Spain; London School of Hygiene and Tropical Medicine Faculty of Public Health, London, UK
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Michael David
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia; School of Medicine & Dentistry, Griffith University, Gold Coast, Australia
| | - Harriet Hui
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
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Freeman T, Mackean T, Sherwood J, Ziersch A, O’Donnell K, Dwyer J, Askew D, Shakespeare M, D’Angelo S, Fisher M, Browne A, Egert S, Baghbanian V, Baum F. The Benefits of Cooperative Inquiry in Health Services Research: Lessons from an Australian Aboriginal and Torres Strait Islander Health Study. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:171-182. [PMID: 38146191 PMCID: PMC10955798 DOI: 10.1177/27551938231221757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023]
Abstract
Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research.
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Affiliation(s)
- Toby Freeman
- Stretton Health Equity, The University of Adelaide, Adelaide, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kim O’Donnell
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Judith Dwyer
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | - Madison Shakespeare
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Shane D’Angelo
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Matthew Fisher
- Stretton Health Equity, The University of Adelaide, Adelaide, Australia
| | - Annette Browne
- The University of British Columbia Faculty of Applied Science, Vancouver, Canada
| | - Sonya Egert
- Southern Qld Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care - Inala Indigenous Health, Queensland Health, Inala, Australia
| | - Vahab Baghbanian
- Central Australian Aboriginal Congress, Alice Springs, Australia
| | - Fran Baum
- Stretton Health Equity, The University of Adelaide, Adelaide, Australia
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Fox L, Santaolalla A, Handford J, Sullivan R, Torode J, Vanderpuye V, Pramesh C, Mula-Hussain L, AlWaheidi S, Makaroff LE, Kaur R, Mackay C, Mukherji D, Van Hemelrijck M. Redefining Cancer Research Priorities in Low- and Middle-Income Countries in the Post-COVID-19 Global Context: A Modified Delphi Consensus Process. JCO Glob Oncol 2023; 9:e2300111. [PMID: 37561978 PMCID: PMC10857688 DOI: 10.1200/go.23.00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE The post-COVID-19 funding landscape for cancer research globally has become increasingly challenging, particularly in resource-challenged regions (RCRs) lacking strong research ecosystems. We aimed to produce a list of priority areas for cancer research in countries with limited resources, informed by researchers and patients. METHODS Cancer experts in lower-resource health care systems (as defined by the World Bank as low- and middle-income countries; N = 151) were contacted to participate in a modified consensus-seeking Delphi survey, comprising two rounds. In round 1, participants (n = 69) rated predetermined areas of potential research priority (ARPs) for importance and suggested missing ARPs. In round 2, the same participants (n = 49) rated an integrated list of predetermined and suggested ARPs from round 1, then undertook a forced choice priority ranking exercise. Composite voting scores (T-scores) were used to rank the ARPs. Importance ratings were summarized descriptively. Findings were discussed with international patient advocacy organization representatives. RESULTS The top ARP was research into strategies adapting guidelines or treatment strategies in line with available resources (particularly systemic therapy) (T = 83). Others included cancer registries (T = 62); prevention (T = 52); end-of-life care (T = 53); and value-based and affordable care (T = 51). The top COVID-19/cancer ARP was strategies to incorporate what has been learned during the pandemic that can be maintained posteriorly (T = 36). Others included treatment schedule interruption (T = 24); cost-effective reduction of COVID-19 morbidity/mortality (T = 19); and pandemic preparedness (T = 18). CONCLUSION Areas of strategic priority favored by cancer researchers in RCRs are related to adaptive treatment guidelines; sustainable implementation of cancer registries; prevention strategies; value-based and affordable cancer care; investments in research capacity building; epidemiologic work on local risk factors for cancer; and combatting inequities of prevention and care access.
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Affiliation(s)
- Louis Fox
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Aida Santaolalla
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Jasmine Handford
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Richard Sullivan
- Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Julie Torode
- Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | - Verna Vanderpuye
- National Centre for Radiotherapy, Oncology and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | - C.S. Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Layth Mula-Hussain
- Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman
| | - Shaymaa AlWaheidi
- Global Oncology Group, Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
| | | | - Ranjit Kaur
- Advanced Breast Cancer Global Alliance, Petaling Jaya, Malaysia
| | - Clara Mackay
- World Ovarian Cancer Coalition, Toronto, ON, Canada
| | - Deborah Mukherji
- Naef K Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), Centre for Cancer, Society and Public Health, King's College London, London, United Kingdom
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Schnack H, Lubasch JS, Zinkevich A, Pawel A, Uthoff SAK, Ansmann L, von Kutzleben M. [Health Services research in Germany in Times of COVID-19: How Does the Pandemic Influence Research Processes, Methods and the Personal Situation of Researchers? An Online Survey]. DAS GESUNDHEITSWESEN 2023; 85:495-504. [PMID: 37315565 PMCID: PMC10442905 DOI: 10.1055/a-2055-0904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has a massive impact on social life, the healthcare system, and also on health services research. However, the effects of the pandemic on research processes, methods, and the personal situation of researchers has not been investigated so far. Guided by the question of how research processes and methods are adapted to the challenges posed by COVID-19 and how researchers perceive the impact of the pandemic on their personal situation, an online survey of health services researchers was conducted from June to July 2021. The results showed that a large proportion of research projects have had delays due to recruitment and/or data collection issues. Two-thirds of the respondents who had already collected data since the beginning of the pandemic (March 2020) were unable to collect data in the originally planned form and relied primarily on digital data collection methods. The analysis of the open-ended survey responses showed that the pandemic had a massive impact on all phases of the research process: key challenges included difficult field access, problems in achieving planned sample sizes, and concerns about data quality. Regarding their personal situation, researchers perceived the reduction of personal contacts, and the resulting lack of visibility as negative, while at the same time they benefited from the easy digital contact possibilities. Overall, the study provides an initial assessment of how the COVID-19 pandemic affected health services research and researchers. It shows that after the initial "shock" of the first lockdown in March 2020, pragmatic and often innovative ways were found to carry out projects under the pandemic conditions. However, the increased use of digital communication forms and data collection methods brings numerous challenges, but also methodological impulses.
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Affiliation(s)
- Helge Schnack
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
| | - Johanna Sophie Lubasch
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
| | - Anna Zinkevich
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
| | - Amelie Pawel
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
| | - Sarah Anna Katharina Uthoff
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
| | - Lena Ansmann
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
| | - Milena von Kutzleben
- Abteilung Organisationsbezogene Versorgungsforschung, Department
für Versorgungsforschung, Fakultät für Medizin und
Gesundheitswissenschaften, Carl von Ossietzky Universitat Oldenburg, Oldenburg,
Germany
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Cancer research in the midst of COVID-19. NATURE CANCER 2022; 3:1409-1411. [PMID: 36539495 DOI: 10.1038/s43018-022-00483-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic posed several challenges to cancer research including halting of trials, reduced recruitment and protocol violations related to inflexible processes followed in clinical trials. Researchers adopted innovative measures to mitigate these problems and continue studies without compromising their quality. This review collates these adaptations that could well continue after the pandemic. RECENT FINDINGS The COVID-19 pandemic forced researchers globally to adopt innovative measures to overcome the challenges of the pandemic. These included protocol amendments to adjust to the pandemic and travel restrictions, and increased use of digital technologies. 'Virtual' clinical trials were conducted increasingly with adaptations in ethics and regulatory approvals, patient recruitment and consenting, study interventions and delivery of study medications, trial assessments, and monitoring. Many of these adaptations are safe and feasible, without compromising study quality and data integrity. Although these may not be universally applicable in all types of research, they bring many benefits including more diverse patient participation, less burden on patients for study procedures and reduced resources to conduct trials. SUMMARY The COVID-19 pandemic has affected cancer research adversely; however, learnings from the pandemic and adaptations from researchers are likely to improve the efficiency of clinical research beyond the pandemic.
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Affiliation(s)
| | - C.S. Pramesh
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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Jia R, Bahoo R, Cai Z, Jahan M. The Hexaco Personality Traits of Higher Achievers at the University Level. Front Psychol 2022; 13:881491. [PMID: 35496234 PMCID: PMC9051429 DOI: 10.3389/fpsyg.2022.881491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
This study attempted to explore the personality traits of higher achievers at the university level. The core objective of this investigation was to illustrate the nature of personality traits of the higher achievers' students. To study this phenomenon, a quantitative research approach was used. The students were chosen by using a purposive sampling technique and included 758 high achievers enrolled in various programs at the Chinese universities. Based on the Hexaco model of personality, a questionnaire was used to gather information from respondents as a research tool to examine the personality traits of position holders after an extensive review of the relevant literature. Tool validity was determined by following the face, content, construct (convergent and discriminant validity) validation process. This investigation concluded that honesty, emotionality, and openness to experience were very high among the higher achievers' students. Only honesty in female higher achievers' students was significantly high than male, remaining factors "extraversion, agreeableness, conscientiousness, and openness to experience" were significantly high among male higher achievers' students. Moreover, the higher achievers of science group students were more extraversion, agreeableness, and conscientiousness than arts group students. However, higher achievers in hostels were more emotional and agreeableness than the day scholars. Overall step-wise regression analysis, indicated that agreeableness and extraversion factor has significant influence on higher achievers.
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Affiliation(s)
- Ruofan Jia
- School of Humanities and Social Science, Xi’an Jiaotong University, Xi’an, China
| | - Rabia Bahoo
- Department of Education, The Government Sadiq College Women University Bahawalpur, Bahawalpur, Pakistan
| | - Zhendong Cai
- Department of Philosophy and Religion, Research Center for Philosophy of Science and Technology, Northeastern University, Shenyang, China
| | - Musarrat Jahan
- Department of Special Education, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
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