The corona pandemic and participatory governance: Responding to the vulnerabilities of secondary school students in Europe.

Adolescents in secondary schools have limited susceptibility to the SARS-COV-2 virus, but paradoxically are considered to be carrying the highest psychosocial burden during this pandemic. The aim of our European multi-country qualitative research was to investigate the COVID-19 crisis response in secondary schools and the role of national, regional, and local stakeholders in contributing to a participatory governance approach. We carried out 11 months of qualitative fieldwork, which included 90 respondents from the Netherlands, Ireland, and Finland for in-depth interviews and/or group discussions. Participant observation was conducted in four secondary schools to explore the interplay of day-to-day formal and informal practices of crisis governance. Our findings contribute to a better understanding of what efforts were made to facilitate participatory governance and where a bottom-up approach would have served useful in successfully implementing the COVID-19 mitigation strategies. Moreover, we show how these mitigation strategies have led to unintended consequences, such as students' difficulties with isolation and associated mental health problems, and the struggles of socialization when returning to a physical school environment. Our findings highlight the importance of the school environment in the socio-emotional developments of adolescents. We introduce the TAPIC-R model to analyze good governance, advancing the existing TAPIC model with an emphasis on the role of resilience in shaping participatory governance. We argue this is urgently needed during crises to strengthen engagement of the community, including vulnerable groups and achieve positive outcomes within and across policy structures and action domains.

Impact of the Covid-19 Pandemic on Delivery of Acute and Post-Acute Care to Patients with Newly Diagnosed Traumatic Spinal Cord Injury.

Aim To investigate the impact of the first wave of the Covid-19 pandemic on the care of patients with newly acquired traumatic spinal cord injury (TSCI) in Ireland Methods A prospective audit of patients with newly acquired TSCI from 1st March to 30th June 2020 was undertaken. Cases were drawn from referrals received through the National Spinal Injuries Unit (NSIU) and neurosciences centres. The standard of care guidelines used were from National Health Service (NHS) England standards, the Irish Integrated Care Pathway and British Association of Spinal cord Injury Specialist (BASCIS) COVID-19 guidelines. Results Nineteen patients sustained a TSCI during the study period. Thirteen patients (68%) were treated in the NSIU, eleven of whom were subsequently repatriated to non-specialist centres. Twelve patients (63%) waited an average of 113.8 ± 33.4 days for admission to specialist in-patient rehabilitation. Nine patients (75%) had developed at least one secondary complication by the time of admission. Conclusion With the exception of waiting time for specialist in-patient rehabilitation, delivery of TSCI care during this period was similar to the care previously recorded. Shortcomings in service provision are long-standing and highlight the need for timely implementation of an integrated trauma network for Ireland.

Association of Neighborhood-Level Factors and COVID-19 Infection Patterns in Philadelphia Using Spatial Regression

As of August 2020, there were ~6 million COVID-19 cases in the United States of America, resulting in ~200,000 deaths. Informatics approaches are needed to better understand the role of individual and community risk factors for COVID-19. We developed an informatics method to integrate SARS-CoV-2 data with multiple neighborhood-level factors from the American Community Survey and opendataphilly.org. We assessed the spatial association between neighborhood-level factors and the frequency of SARS-CoV-2 positivity, separately across all patients and across asymptomatic patients. We found that neighborhoods with higher proportions of individuals with a high-school degree and/or who were identified as Hispanic/Latinx were more likely to have higher SARS-CoV-2 positivity rates, after adjusting for other neighborhood covariates. Patients from neighborhoods with higher proportions of individuals receiving public assistance and/or identified as White were less likely to test positive for SARS-CoV-2. Our approach and its findings could inform future public health efforts.

Navigating uncharted waters: preparing COVID-19 capable nurses to work in a transformed workplace

The coronavirus pandemic has placed immense pressure on emergency rooms and intensive care units, highlighting the critical role of interprofessional teamwork as nurses, nurse practitioners, physicians and physician assistants are finding that colleagueship and communication are not sufficient to manage the intensity of care. Emotional support to address stress and fatigue is also essential. Nurses employed in long-term care, public health, home care and the range of community based settings may have limited support for crisis response. Many of these organisations are small and lack the education capacity of the larger health systems, by focusing on a new era of emergency preparedness, accelerated adoption of telemedicine, and team-based interprofessional care delivery.