ABSTRACT
Traditional chemical engineering homework and in-class problems are often theoretical or simplified and lack societal context. However, a design made without context may only work for the demographics of the person(s) creating the design and unmarries the work of chemical engineers from the tangible impacts the field has on the world. In these contextless problems, students aren't given the opportunity to consider the positive or negative impact of their design on different demographic groups. Working towards de-centering western civilization, being sensitive to oppressions, integrating more cultural context and ethics into teaching, and reflecting on the role of identity in and outside chemical engineering will encourage critical thinking with an equity lens [1]. In light of the ongoing COVID-19 pandemic and anti-Black and anti-Asian racism and violence, institutes of higher learning, which have historically exacerbated systemic inequalities that disproportionately impact minorities and people of color, need to critically rethink and redesign curriculum to be more widely inclusive, accommodating, and thoughtful of social justice. Incorporating context, such as the context in human-centered design or service learning, provides relevancy for students and improves learning, engagement, and increased community engagement [2]-[3]. There are already examples of institutions and faculty incorporating social justice and environmental considerations into their curriculum through human-centered design and service learning and a few who are incorporating context into class examples [4]. However, we have yet to see evidence of incorporating anti-racist and social justice principles in a systematic and curriculum-wide way within a chemical engineering context. Thus, we present an approach to normalize anti-racism and social justice ideals throughout curriculum, rather than presenting them as one-off, disconnected ideas, such that these become virtues students gain and take with them into their professional careers after graduating. Our work is part of a larger effort of the Anti-Racism, Diversity, Equity, and Inclusion (ARDEI) Committee in the Chemical and Biological Engineering Department at Northwestern University, which is comprised of undergraduate students, graduate students, and faculty. The larger goal of the committee is to work together to build and contribute to a Department that is diverse, equitable, and inclusive through actionable ideas that the Department can pursue together to make lasting change in its culture. Collectively we tackled the initiative of incorporating anti-racism and social justice into the undergraduate curriculum. We aimed to find a low-cost, low-barrier-to-entry method for faculty to include anti-racism and social justice into the classroom. Specifically, we advocate for the inclusion of these principles into homework problems and course project designs at all course levels. In order to achieve this goal and get faculty support, we decided to create a bank of example problems, spanning freshmen to senior courses, incorporating critical thinking or example problems with the context of anti-racism and social justice. We subsequently shared these example problems with the faculty and invited them to bring example problems from their courses to a workshop where we help them incorporate these principles into the desired problem. We also aimed to incorporate anti-racism and social justice principles into lectures. For example, in the senior design course, topics of environmental and social justice are worked into lectures along with the term-long process design project, where traditionally economic and technical evaluations were emphasized, now environmental and societal impact evaluations are required for decision making in the feasibility study. Though most faculty are not trained in anti-racism work, we hope to alleviate this challenge and lower the barrier by working with them to create these examples. Additionally, we must carefully manage our work to ensure the anti-racism and social justice ontexts and materials included do not lead to unintentional harm. We hope our work will serve as an example that other institutions can follow to incorporate anti-racism and social justice into the chemical engineering curriculum. However, we importantly note that this should not be the only actions taken by an institution to participate in anti-racism and social justice;otherwise the inclusion of anti-racism into courses will be seen as hypocritical if the institution is not also working towards making more equitable, inclusive, safe learning spaces. This work can be seen as one of many important steps in creating these improved learning spaces and ideally lead to more anti-racist and socially just engineers. © 2021 American Institute of Chemical Engineers. All rights reserved.
ABSTRACT
INTRODUCTION: African American and Hispanic patients have been disproportionately affected by infection with SARS-CoV-2 and subsequent coronavirus disease (COVID-19). Initial data suggests that these populations are more likely to suffer severe illness requiring hospitalization compared to Whites. We sought to further investigate the effects of race and ethnicity on critical care outcomes in hospitalized COVID-19 patients within the ethnically diverse area of the District of Columbia. METHODS: We performed a single-center, review of a prospective registry of 233 patients hospitalized with COVID-19 at an urban, academic hospital in Washington, D.C. Demographic and clinical data was gathered from chart review. We compared mean admission SOFA and APACHE scores, along with rates of ICU admission, intubation and mortality between White, Black, Hispanic, and Other ethnicities. RESULTS: Of the admitted patients 3.8% (n=9) were White, 70% (n=166) were Black, and 17% (n=41) Hispanic, with 7.7% (n=18) unknown or other race. The mean admission SOFA score for White, Black and Hispanic patients were 3.14, 2.65 and 1.88, respectively. The mean APACHE scores for Whites, Blacks, and Hispanics were 15.25, 17.85, and 14.75, respectively. 56% (n=5) of Whites, 29% (n=48) of Blacks, and 41% (n=17) of Hispanics were admitted to the ICU. Intubations occurred in 44% (n=4) of Whites, 17% (n=28) of Blacks, and 37% (n=15) of Hispanics. Mortality rates were 22% (n=2), 30% (n=49), and 29% (n=12) in Whites, Blacks, and Hispanics, respectively. CONCLUSIONS: According to estimates by the US census bureau, the population of the District of Columbia is 46% White, 46% Black, and 11.3% Hispanic. Our data demonstrates a disproportionate hospitalization rate in minorities affected by COVID-19. Despite lower ICU admission and intubation rates, Blacks had a high mortality rate. There was a disproportionately high utilization of the ICU care, intubation and mortality amongst Hispanics. Further investigation is necessary to examine causes of these significant health disparities and to prevent further health inequalities amongst minorities.
ABSTRACT
INTRODUCTION: Since the outbreak of the COVID-19 pandemic, advising patients on when to seek care for their symptoms has been a challenge. Patients may present to the hospital late in their disease course and only when symptom severity cannot be avoided any longer due to lack of access to healthcare or fear of hospitalization. It is unclear if these delays in care affect clinical treatments or hospital outcomes. We aimed to determine if the reported length of pre-admission symptoms in COVID-19 patients was associated with significant differences in critical care outcomes. We hypothesized that patients who delayed care would experience worse outcomes. METHODS: We utilized registry data on hospitalized COVID-positive patients from an urban, academic, medical center. All patients with a finalized dataset were included. Patients were stratified by length of symptoms (1-5 days, 6-10 days or more than 10 days) prior to admission. We compared the rate of ICU admission, SOFA and APACHE scores on admission, intubation status, and mortality. Chisquare tests and logistic regression models were used. RESULTS: A total of 247 patients were included. The mean age was 62 years and 47.87% were female. Of these patients, 78 (33.5%) were admitted to the ICU. There was no significant difference in ICU admission rate between groups (1-5 days: 26.9%;6-10 days: 35.3%;>10 days: 37.9%;p=0.30). There was no significant difference in SOFA or APACHE score categories by group (p=0.64 and p=0.90, respectively). Additionally, there were no significant differences in rate of intubation (p=0.12), or in-hospital mortality (p=0.33). After controlling for age, BMI, and gender, logistic regression analysis demonstrated no significant difference between groups for rate of ICU admission, rate of intubation, or in-hospital mortality. CONCLUSIONS: We have demonstrated that the reported length of pre-admission symptoms in COVID-positive patients was not a significant predictor of outcomes. We had hypothesized patients with longer duration of pre-admission symptoms would exhibit worse outcomes. However, we posit the expeditious development and implementation of remote monitoring programs and outpatient management by our institution could have allowed for timely intervention in patients whose clinical status was deteriorating.