Results and patient satisfaction from an early access infant hearing detection clinic.

INTRODUCTION: National recommendations in the United States specify that all infants with hearing impairment should be identified by 3 months of age. Infants who fail universal newborn hearing screening (UNHS) require follow up testing after hospital discharge. Follow up testing may be difficult to obtain in some communities within the ideal time frame. A rapid access multidisciplinary clinic was established for failed UNHS. The objective of this study is to report outcomes and patient satisfaction from an early access hearing detection clinic. METHODS: Infants that failed UNHS were seen in the multidisciplinary clinic between 1/1/19 and 2/28/22. Patients underwent automated auditory brainstem response (ABR) and distortion product otoacoustic emissions testing and consulted with an otolaryngology nurse practitioner. Failed results were followed by diagnostic ABR. Surveys were administered at the beginning and end of the appointment. RESULTS: In total, 169 infants were seen at a mean age of 8.4 weeks (95%CI 7.5, 9.4). Repeat testing was abnormal in 38 (22.4%). Diagnostic ABR was performed at an average age of 13.7 weeks (n = 34, 95% CI: 10.8, 16.6) and led to a diagnosis of hearing loss in 18 infants. Twenty-seven parents completed surveys at the initial visit. Anxiety level among patients with normal repeat testing (n = 20) decreased from 1.9 to 1.2 (p = .002), while anxiety level among those with abnormal repeat testing (n = 7) was not statistically different before and after (2.1 vs 2.7, p = .2). Satisfaction level was 3.7 ± 0.7 (scored 1-4). All parents reported having a better understanding of their child's hearing problem after the visit. DISCUSSION: This novel nurse practitioner-led early hearing detection clinic enabled timely diagnosis of hearing loss and reassurance to families without hearing loss. Age at hearing loss diagnosis compares favorably to published cohorts.

Personal hardship narrows the partisan gap in COVID-19 and climate change responses.

The COVID-19 pandemic in the United States was characterized by a partisan gap. Democrats were more concerned about this novel health threat, more willing to socially distance, and more likely to support policies aimed at mitigating the spread of the virus than Republicans. In cross-sectional analyses of three nationally representative survey waves in 2020, we find that adverse experience with COVID-19 is associated with a narrowing of the partisan gap. The mean difference between Republicans and Democrats in concern, policy support, and behavioral intentions narrows or even disappears at high levels of self-reported adverse experience. Reported experience does not depend on party affiliation and is predicted by local COVID-19 incidence rates. In contrast, analyses of longitudinal data and county-level incidence rates do not show a consistent relationship among experience, partisanship, and behavior or policy support. Our findings suggest that self-reported personal experience interacts with partisanship in complex ways and may be an important channel for concern about novel threats such as the COVID-19 pandemic. We find consistent results for self-reported experience of extreme weather events and climate change attitudes and policy preferences, although the association between extreme weather and experience and climate change is more tenuous.

Examining evidence for the Finite Pool of Worry and Finite Pool of Attention hypotheses

The Finite Pool of Worry (FPW) hypothesis states that humans have finite emotional resources for worry, so that when we become more worried about one threat, worry about other threats decreases. Despite its relevance, no conclusive empirical evidence for the hypothesis exists. We leverage the sudden onset of new worries introduced by the COVID-19 pandemic as a natural experiment to test the FPW hypothesis and a related hypothesis, the Finite Pool of Attention (FPA) hypothesis. The FPA hypothesis proposes that when we pay more attention to one threat, our attention to other threats decreases. To test these two hypotheses, we assessed self-reported attention, self-reported worries, and Twitter/news attention to various threats (climate change, terrorism, economic problems, and others) throughout the pandemic in three countries (USA, Italy, and China). We find that as attention to and worry about COVID-19 increases, attention to climate change decreases, but worry does not. Our results are confirmed by further analysis of a large, longitudinal U.S. sample. We find that public perceptions that COVID-19 and climate change are related do not fully explain the positive relationship in worry between the two hazards. In summary, our findings suggest that while there may be a Finite Pool of Attention to threats, there is limited evidence for a Finite Pool of Worry.

Advancing Equity in Academic Medicine Through Holistic Review for Faculty Recruitment and Retention.

The Association of American Medical Colleges (AAMC) in 2007 developed the Holistic Review Framework for medical school admissions to increase mission-aligned student diversity. This approach balances an applicant's experiences, attributes, and metrics during the screening, interview, and selection processes. Faculty recruitment provides its own set of challenges, and there is persistent underrepresentation of certain racial and ethnic minority groups and women in faculty and leadership positions in U.S. academic health centers (AHCs). In 2019, the AAMC initiated a pilot program to adapt and implement the framework for use in faculty recruitment at AHCs. In this Invited Commentary, the authors describe the pilot implementation of the Holistic Review Framework for Faculty Recruitment and Retention and share lessons learned to date. Although the pilot proceeded during 2020, institutional implementation was impacted by the COVID-19 pandemic and racial justice movement. Pilot institutions encountered hiring freezes, reductions in funding, and restrictions on in-person meetings due to COVID-19 that resulted in both barriers and opportunities in implementing the framework. Renewed commitment to racial justice was associated with increased momentum and urgency for the implementation of faculty holistic review at the majority of pilot institutions. Common themes from the pilot leads' experiences included the importance of achieving "buy in," having a dedicated implementation team, and being explicit about core values. Other themes included the importance of adaptability and flexibility to meet the needs of different institutions and mission areas. The faculty holistic review framework has shown promise as an approach to advancing faculty diversity goals. The pilot institutions will continue to share best practices, track outcomes, implement quality improvement, and disseminate findings to assist other institutions and health care communities with their endeavors to recruit and retain diverse faculty.

Voting in a global pandemic: Assessing dueling influences of Covid-19 on turnout

Abstract Objective We investigate the impact of a global health crisis on political behavior. Specifically, we assess the impact of Covid-19 incidence rates, and the impact of temporal and spatial proximity to the crisis, on voter turnout in the 2020 Brazilian municipal elections. Methods We use Ordinary Least Squares and Spatial Durbin Error models to evaluate sub-national variation in municipal-level Covid-19 incidence and voter turnout. We include controls for political, economic, health, and state context. Results Ceteris paribus, increasing deaths in the month leading up to the election from 0.01 to 1 per 1000 people is associated with a 5 percentage point decrease in turnout;higher cases and deaths earlier in the pandemic are generally associated with higher turnout. Covid-19 incidence rates in nearby municipalities affect local turnout in the same directions. Conclusion Higher Covid-19 incidence near the time of the election decreases voter turnout, while incidence farther from the election increases voter turnout.

Thyroid axis and COVID 19

Introduction: Non-thyroidal illness syndrome (NTIS) is also known as low T3 syndrome. NTIS is characterized by low plasma T3, low or normal T4, or elevated reverse T3 (rT3), with normal or slightly decreased TSH. NTIS is a strong predictor of poor prognosis in critically ill hospitalized patients. Different thyroid hormone profiles were defined during critical illness. High fT4 with a low fT3 level in patients with coronary heart disease were significantly related to mortality. If NTIS is a physiologic response to a systemic inflammation or a maladaptation status is controversial. NTIS with low fT3 and a lower fT3/fT4 ratio was referred in patients with COVID-19. Furthermore, angiotensin-converting enzyme (ACE) 2, an receptor in the pathogenesis of COVID-19, was demonstrated to be expressed in the thyroid gland. SARS-CoV-2- related thyroiditis is recognized. The effects of COVID-19 on the thyroid axis remain uncertain. Objectives: We aimed to study the characteristics of thyroid hormone levels in inpatients with COVID-19. Methods: Prospective study: 57 covid-19 patients (29/57 ♂) with criteria for admission to a medical clinic from August to November 2020. Median age was 56 years (range(R) : 21-89). 3,6% was asymptomatic, 14,3% mild, 28,6% moderate and 53,6% severe. fT4, TT3, TSH, TgAb and TPOAb were analysed in addition to studies due to their underlying pathology. Data are expressed as median and R or mean ± SD and % Results: The median of TSH was 1.77 uUI/ml (R: 0.02-64.9), the X ± SD of fT4 and TT3 was 1.22 ± 0.3 ng/ml and 72.3 ± 23.04 ng/dl respectively. Forty two/ 57 patients presented low T3. The profiles observed in this group are described in table 1. Two patients with positive TPOAb had high TSH, low T3 and normal fT4 and 3 only low T3. Image: Conclusion: 1-In this population of COVID-19 patients upon admission to hospitalization and excluding one clinical hypothyroid patient 73, 7% presented low T3. 2- In the patient with clinical hypothyroidism and negative antibodies as well as those with altered TSH, low TT3 and normal or high fT4 we cannot exclude destructive or autoinmune thyroiditis until the evolution is known. 3-Classic NTI with low T3, low o normal fT4 and nomal TSH was observed in 42, 1% patients. 4- It should be noted the high prevalence of patients with low TT3, high fT4 and normal TSH. We consider that is another face of NTI in COVID-19 as it was referred in patients with coronary disease.To our knowledge, this is the first descriptive report of different faces of NTI in COVID 19 patients.

Addressing the psychosocial needs of students attending online classes during this Covid-19 pandemic.

An earlier article discusses that the Coronavirus pandemic stirred a challenging situation for many educators in online classes. The correspondence proposes that teachers in a work-from-home environment should be provided with psychosocial supports to address the mental and emotional stresses caused by the Covid-19 pandemic. It is also noted that the outbreak of the Coronavirus disease poses a serious threat to millions of students enrolled in online classes. The shifting from face-to-face classes to online classes caused students to experience psychological or psychosocial distress. In response to the previous article, this paper presents how students' psychosocial needs should be addressed through psychosocial supports.

Emphasizing truthfulness in COVID-19 test declarations.

In previous correspondence, it was explained that faking COVID-19 diagnostic tests and vaccination certifications posits serious concerns for matters of ethics and economics. With this, we suggest, in this paper, the importance of giving emphasis to being truthful in declaring their COVID-19 diagnostic test results and vaccination certificates. Also, in being truthful, it is emphasized in this paper that honesty and transparency in regard to the said results and certificates are necessary in ensuring public health and promoting awareness during the COVID-19 pandemic.

Age is Associated With Increased Expression of Pattern Recognition Receptor Genes and ACE2, the Receptor for SARs-Cov-2: Implications for the Epidemiology of COVID-19 Disease (preprint)

Background: Older aged adults and those with pre-existing conditions are at highest risk for severe COVID-19 associated outcomes. Methods: Using a large dataset of genome-wide RNA-seq profiles derived from human dermal fibroblasts (GSE113957) we investigated whether age affects the expression of pattern recognition receptor (PRR) genes and ACE2, the receptor for SARS-CoV-2. Results:  Older age was associated with increased expression of PRR genes, ACE2 and four genes that encode proteins that have been shown to interact with SAR2-CoV-2 proteins.  Conclusions: Assessment of PRR expression might provide a strategy for stratifying the risk of severe COVID-19 disease at both the individual and population levels.  

AGE IS ASSOCIATED WITH INCREASED EXPRESSION OF PATTERN RECOGNITION RECEPTOR GENES AND ACE2, THE RECEPTOR FOR SARS-COV-2: IMPLICATIONS FOR THE EPIDEMIOLOGY OF COVID-19 DISEASE (preprint)

Older aged adults and those with pre-existing conditions are at highest risk for severe COVID-19 associated outcomes. Using a large dataset of genome-wide RNA-seq profiles derived from human dermal fibroblasts (GSE113957) we investigated whether age affects the expression of pattern recognition receptor (PRR) genes and ACE2, the receptor for SARS-CoV-2. Older age was associated with increased expression of PRR genes, ACE2 and four genes that encode proteins that have been shown to interact with SAR2-CoV-2 proteins. Assessment of PRR expression might provide a strategy for stratifying the risk of severe COVID-19 disease at both the individual and population levels.