A Literature Review of the Effects of Air Pollution on COVID-19 Health Outcomes Worldwide: Statistical Challenges and Data Visualization.

Several peer-reviewed papers and reviews have examined the relationship between exposure to air pollution and COVID-19 spread and severity. However, many of the existing reviews on this topic do not extensively present the statistical challenges associated with this field, do not provide comprehensive guidelines for future researchers, and review only the results of a relatively small number of papers. We reviewed 139 papers, 127 of which reported a statistically significant positive association between air pollution and adverse COVID-19 health outcomes. Here, we summarize the evidence, describe the statistical challenges, and make recommendations for future research. To summarize the 139 papers with data from geographical locations around the world, we also present anopen-source data visualization tool that summarizes these studies and allows the research community to contribute evidence as new research papers are published.

Evaluation of Viral Inactivation on Dry Surface by High Peak Power Microwave (HPPM) Exposure.

Previous research has shown that virus infectivity can be dramatically reduced by radio frequency exposure in the gigahertz (GHz) frequency range. Given the worldwide SARS-CoV-2 pandemic, which has caused over 1 million deaths and has had a profound global economic impact, there is a need for a noninvasive technology that can reduce the transmission of virus among humans. RF is a potential wide area-of-effect viral decontamination technology that could be used in hospital rooms where patients are expelling virus, in grocery and convenience stores where local populations mix, and in first responder settings where rapid medical response spans many potentially infected locations within hours. In this study, we used bovine coronavirus (BCoV) as a surrogate of SARS-CoV-2 and exposed it to high peak power microwave (HPPM) pulses at four narrowband frequencies: 2.8, 5.6, 8.5, and 9.3 GHz. Exposures consisted of 2 µs pulses delivered at 500 Hz, with pulse counts varied by decades between 1 and 10,000. The peak field intensities (i.e. the instantaneous power density of each pulse) ranged between 0.6 and 6.5 MW/m2 , depending on the microwave frequency. The HPPM exposures were delivered to plastic coverslips containing BCoV dried on the surface. Hemagglutination (HA) and cytopathic effect analyses were performed 6 days after inoculation of host cells to assess viral infectivity. No change in viral infectivity was seen with increasing dose (pulse number) across the tested frequencies. Under all conditions tested, exposure did not reduce infectivity more than 1.0 log10. For the conditions studied, high peak power pulsed RF exposures in the 2-10 GHz range appear ineffective as a virucidal approach for hard surface decontamination. © 2023 Bioelectromagnetics Society.

Observed Reductions in the Infectivity of Bioaerosols Containing Bovine Coronavirus Under Repetitively Pulsed RF Exposure.

OBJECTIVE: The purpose of the present study is to investigate the inactivation of bioaerosols containing Bovine Coronavirus, BCov, under repetitively pulsed radio frequency (RF) electromagnetic exposure. METHODS: These experiments were performed in a waveguide containing a flowing aerosol stream and were limited to a single RF waveform: ∼2 µs square envelope, 5.6 GHz, 4.8 kHz repetition rate. Aerosol streams were exposed to RF electric field amplitudes in the range of 41.9 +/- 6.2 kV/m. Under laminar flow conditions, 75% of the total collected aerosol stream spends 0.85 seconds or less in the RF exposure region. RESULTS: Application of the RF waveform changes mean survival rate of the aerosolized BCov by -0.58 decades (roughly a 74% reduction) and impacted the variance and standard deviation of the experimental results, with the RF exposure data showing an 800% increase in variance and 196% increase in standard deviation over the control results. Experimental results were compared to those from an analytic electromagnetic-heating inactivation model. CONCLUSION: The comparison indicated the feasibility that the observed reduction in BCov survival rate might be due to a combination of thermal effects and non-thermal electric field effects. SIGNIFICANCE: Developing better insight into the mechanisms of inactivation is important for understanding the potential limits of efficacy for this method. Additionally, these results contribute an important baseline for the impact of electromagnetic fields on aerosolized pathogens.

Outcomes of a Robust Addiction Medicine Curriculum in Undergraduate Medical Education

Introduction: In January 2018, the Michigan Department of Health and Human Services convened a meeting of the Deans of the seven medical schools to discuss opioid-related training in undergraduate medical education (UME). At that time six of the seven medical schools in Michigan did not have board-certified addiction physicians on their core faculty. UME curriculum is critical to teaching and training of physicians. It empowers their ability to deliver quality and effective addiction treatment. A current challenge is that the number of curricular hours devoted to addiction medicine training is just a fraction of the time dedicated to other chronic diseases. To bridge this gap, MI CARES set out to recruit and retain a physician(s) from each of the seven medical schools to become board-certified in addiction medicine. This collaboration has had significant implications. There is now a board-eligible or a board-certified addiction medicine specialist on core faculty at each university. In early 2020, medical students at Michigan State University College of Human Medicine (MSU-CHM) teamed up to advocate for an elective in addiction medicine. This effort signaled an unmet need in the current curriculum. Implementing addiction medicine curriculum during medical school can boost students' confidence in their ability to screen, manage, and treat people with substance use disorders. Method(s): In May of 2021, during the COVID-19 pandemic, MSU launched a 4-week addiction medicine 75.5-hour elective. To reduce Zoom fatigue amongst students and faculty, the course used active learning, including problem-based learning (PBL), team-based learning (TBL), and peer instruction (PI). An advisory committee of college leadership, medical students, and staff met bi-monthly to discuss implementation, content, and intersession approval. The curriculum was made available as asynchronous online modules combined with guided didactics for small groups, including student and faculty resources, and large group meetings with expert and patient panels. Online asynchronous modules provided background didactics with advanced addiction topics as PBLs for TBL. Result(s): As part of the course requirements, students were asked to complete pre-post self-reported attitudes survey, adopted from the substance abuse attitudes survey (saas). The statements were closed-ended and consisted of Likert scale responses. The survey included statements regarding permissiveness, treatment intervention, treatment optimism and non-moralism. Students were surveyed prior to the first day of class, 3-months and 6-months later.When asked if substance use disorder is a treatable disease in the pre intersession survey, 61% of students agreed and 31% strongly agreed;in the post intersession survey, 28% agreed and 67% strongly agreed;in the 6-month follow-up, 21% agree and 79% strongly agreed. The pre-intersession survey indicated that 64% agreed and 33% strongly agreed that alcohol use disorder is a treatable disease;in the post survey 28% of students agreed and 67% strongly agreed;in the 6-month follow-up, 21% agree and 79% strongly agreed. The survey asked how much they agreed that a person with a substance use disorder is unpleasant to work with as patients. The pre-survey showed that 57% strongly disagreed and 43% strongly disagreed;in the post survey, 61% strongly disagree, 31% disagree, and 8% are neutral;in the 6-month follow-up, 64% strongly disagree, 21% disagree and 14% are neutral.

The Benefits of Expanding the Incident Management Program in Utah

A 2018 study of performance measures for the Utah Department of Transportation's (UDOT) Incident Management Team (IMT) program concluded that the program was cost effective and benefited Utah motorists. During the 2018 legislative session, UDOT received funding to expand its IMT program. To determine the benefits of expanding the IMT program, a comparison of performance measures for 2018 and 2020 incident data was conducted. In addition, data regarding the affected volume, the excess travel time, and the excess user cost associated with incident congestion were gathered. The effects of the COVID-19 pandemic affected traffic volumes during this study, and statistical analyses were utilized to account for volume differences between the two years. Results indicated that the expansion of the IMT program has allowed UDOT to respond more consistently to incidents and respond to a larger quantity of incidents over a larger coverage area and in extended operating hours. © ASCE.

A metabletic investigation on the impact of living, learning, and leading university reform in the pandemic shadow

This study was designed to provide insight and to reflect upon the impact of the COVID-19 pandemic on living, learning, and leading in universities. The research methodology drew on metabletic phenomenology, which is an inspired approach developed by J.H. van den Berg and followers in the latter part of the twentieth century. Metabletics is the study of significant change, a shift in existence, and phenomenology seeks to capture the lived-experience of the phenomenon. Phenomenology encourages the researcher to insert themselves into the research and present their findings through narrative, prose, poetry, and metaphor. In keeping with this approach, the chapter includes three original poems on living, learning and leading university reform in the pandemic shadow. The study also exposed the inadequacies of many contemporary western university business models to cope with the changes demanded during the pandemic. In particular, the immediate transition to online and remote learning and the dramatic decline in international students due to extended border closures. In practice phenomenology promotes the technique of raising questions rather than providing answers and this study follows this strategy when discussing the need for university reform © 2022 Elsevier Ltd. All rights reserved.

‘ARE YOU CONCERNED ABOUT ME TODAY’ - AN MDT APPROACH TO IMPROVING DELIRIUM RECOGNITION

Introduction Delirium is a common neuropsychiatric syndrome that increases the likelihood of adverse outcomes for patients admitted to hospital. Delirium is preventable and treatable. Recognition of the syndrome is challenging. Our aim was to increase this recognition through robust inpatient screening, utilising a multi-disciplinary team (MDT) approach. Method Stakeholder analysis for a quality improvement project revealed that junior doctors were members of the team most likely to perform a 4AT. Plan, do, study, act (PDSA) cycles were carried out: 1. Junior doctor engagement 2. Verbal prompts in huddle 3. Healthcare assistant (HCA) questionnaires. Results Baseline data showed that on average 0.6% patients had new 4AT over one week on elderly care wards. Intervention 1 involved 4AT handouts given to junior doctors. Number of 4ATs was 3% of patients per week. Intervention 2 used prompts in the morning MDT huddle, asking about concerns for patients. This increased the number of patients having 4AT per week to 6.5%. HCAs did not attend huddles and were targeted in the third intervention. A questionnaire with delirium information and the subsequent question ‘are you concerned about this patient’ was placed in patient bedside folders. This gave opportunity for HCAs to escalate patients to huddle so 4ATs could be carried out. The questionnaire was completed for 62% of patients, but only 1.4% patients were flagged up and subsequently had 4AT. This time was complicated however by the wards becoming Covid-19 wards. Conclusion Delirium is common however there is missed opportunity for earlier identification. Utilising HCAs with bedside questionnaires was time efficient and ensured robust escalation to prompt further investigation. When incorporated into huddle this could lead to more delirium diagnoses if carried out over a longer period, outside of the Covid-19 pandemic and on a ward solely populated with elderly care patients.

Interactive propaganda: How fox news and donald trump co-produced false narratives about the COVID-19 crisis

This chapter proposes an interactive propaganda model that accounts for a novel development in the role of media in a struggling American democracy, namely the co-production of systemic disinformation between government and media to influence public opinion and behavior. Using the coronavirus crisis as a case, we found that the interaction between the Trump administration and Fox News that produced persistent disinformation about hydroxychloroquine as a miracle cure for COVID-19 included four elemental processes: (1) both Trump and Fox actively monitoring the information environment to identify propaganda material;(2) Trump and/or Fox cueing the other with the manufactured disinformation;(3) both sides monitoring and amplifying each other;and (4) both addressing criticism and adjusting for areas of conflicting interest. Different from traditional propaganda as top-down communication that typically flows from government to media and other societal echo chambers, interactive propaganda may be a political communication pattern that marks a shift toward an illiberal regime where the state forms partnerships with the media to consolidate its rule. © 2022 selection and editorial matter, Peter Van Aelst and Jay G. Blumler.

Covid-19 exposes Canada’s ableism

COVID-19 has imposed numerous challenges onto Canadians including income insecurity, reduced access to healthcare, and last-minute workplace adaptations. Although these obstacles have altered the lives of thousands, many people in the disability community have been struggling with these challenges for years. This paper outlines how Canada’s response to the COVID-19 pandemic uncovers the pervasive ableist attitudes that are present at both the government and societal levels. © 2021, University of Toronto. All rights reserved.

Disparities in Video and Telephone Visits Among Older Adults During the COVID-19 Pandemic: Cross-Sectional Analysis.

BACKGROUND: Telephone and video telemedicine appointments have been a crucial service delivery method during the COVID-19 pandemic for maintaining access to health care without increasing the risk of exposure. Although studies conducted prior to the pandemic have suggested that telemedicine is an acceptable format for older adults, there is a paucity of data on the practical implementation of telemedicine visits. Due to prior lack of reimbursement for telemedicine visits involving nonrural patients, no studies have compared telephone visits to video visits in geriatric primary care. OBJECTIVE: This study aimed to determine (1) whether video visits had longer durations, more visit diagnoses, and more advance care planning discussions than telephone visits during the rapid implementation of telemedicine in the COVID-19 pandemic, and (2) whether disparities in visit type existed based on patient characteristics. METHODS: We conducted a retrospective, cross-sectional analysis of patients seen at two geriatric clinics from April 23 to May 22, 2020. Approximately 25% of patients who had telephone and video appointments during this time underwent chart review. We analyzed patient characteristics, visit characteristics, duration of visits, number of visit diagnoses, and the presence of advance care planning discussion in clinical documentation. RESULTS: Of the 190 appointments reviewed, 47.4% (n=90) were video visits. Compared to telephone appointments, videoconferencing was, on average, 7 minutes longer (mean 37.3 minutes, SD 10 minutes; P<.001) and had, on average, 1.2 more visit diagnoses (mean 5.7, SD 3; P=.001). Video and telephone visits had similar rates of advance care planning. Furthermore, hearing, vision, and cognitive impairment did not result in different rates of video or telephone appointments. Non-White patients, patients who needed interpreter services, and patients who received Medicaid were less likely to have video visits than White patients, patients who did not need an interpreter, and patients who did not receive Medicaid, respectively (P=.003, P=.01, P<.001, respectively). CONCLUSIONS: Although clinicians spent more time on video visits than telephone visits, more than half of this study's older patients did not use video visits, especially if they were from racial or ethnic minority backgrounds or Medicaid beneficiaries. This potential health care disparity merits greater attention.