Using Community-Based Implementation Frameworks and Strategies to Address Food Insecurity During the COVID-19 Pandemic: A Scoping Review

This scoping review aims to describe the main barriers to food security imposed by the COVID-19 pandemic in low-income U.S. households, identify effective community-based implementation frameworks and strategies, and discuss the lessons learned from implementing community-based approaches during the COVID-19 pandemic. Most cited barriers were categorized into the Community/Society-Policy category of "Social determinants of health in communities." Out of the twelve included studies, only five (42%) adopted an implementation framework in their food-insecurity interventions. This study can guide the development and sustainability of food programming during emergencies with possible transfer of lessons learned to food programs in low-income populations.Copyright © 2022 Taylor & Francis Group, LLC.

Yo-Yo Machines

Yo-Yo Machines are playful communication devices designed to help people feel socially connected while physically separated. We designed them to reach as many people as possible, both to make a positive impact during the COVID-19 pandemic and to assess a self-build approach to circulating research products and the appeal of peripheral and expressive communication devices. A portfolio of four distinct designs, based on over 30 years of research, were made available for people to make by following simple online instructions (yoyomachines.io). Each involves connecting a pair of identical devices over the internet to allow simple communication at a distance. This paper describes our motivation for the project, previous work in the area, the design of the devices, supporting website and publicity, and how users have made and used Yo-Yo Machines. Finally, we reflect on what we learned about peripheral and expressive communication devices and implications for the self-build approach.

The Effects of COVID-19 School Closures on Physical Fitness in Adolescents

Purpose: This study examined differences in measures of health-related physical fitness in adolescents before and after extended school closures due to COVID-19. Method: The sample consisted of 298 students (135 males and 163 females) from a laboratory high school. Data were collected through FITNESSGRAM assessments. A repeated-measures multivariate analysis of covariance was calculated to analyze differences in fitness before and after COVID-19 closures, including McNemar-Bowker and McNemar tests. Results: Statistically significant differences were identified for Progressive Aerobic Capacity Endurance Run (-4.2%;1.8 mlmiddotkg(-1)middotmin(-1)) and curl-up (-12.5%;7.9 repetitions). In addition, 18.8% fewer students were classified within the Healthy Fitness Zone for Progressive Aerobic Capacity Endurance Run, 4% for curl-up, 10.8% for push-up, and 6.4% for sit and reach. Conclusion: Results of this study demonstrate that there was a significant decline in physical fitness for secondary students during extended school closures and social isolation as a result of COVID-19.

Vital Measurements of Hospitalized COVID-19 Patients as a Predictor of Long COVID: An EHR-based Cohort Study from the RECOVER Program in N3C

It is shown that various symptoms could remain in the stage of post-acute sequelae of SARS-CoV-2 infection (PASC), otherwise known as Long COVID. A number of COVID patients suffer from heterogeneous symptoms, which severely impact recovery from the pandemic. While scientists are trying to give an unambiguous definition of Long COVID, efforts in prediction of Long COVID could play an important role in understanding the characteristic of this new disease. Vital measurements (e.g. oxygen saturation, heart rate, blood pressure) could reflect body's most basic functions and are measured regularly during hospitalization, so among patients diagnosed COVID positive and hospitalized, we analyze the vital measurements of first7 days since the hospitalization start date to study the pattern of the vital measurements and predict Long COVID with the information from vital measurements. © 2022 IEEE.

Analyzing historical diagnosis code data from NIH N3C and RECOVER Programs using deep learning to determine risk factors for Long Covid

Post-acute sequelae of SARS-CoV-2 infection (PASC) or Long COVID is an emerging medical condition that has been observed in several patients with a positive diagnosis for COVID-19. Historical Electronic Health Records (EHR) like diagnosis codes, lab results and clinical notes have been analyzed using deep learning and have been used to predict future clinical events. In this paper, we propose an interpretable deep learning approach to analyze historical diagnosis code data from the National COVID Cohort Collective (N3C)1 to find the risk factors contributing to developing Long COVID. Using our deep learning approach, we are able to predict if a patient is suffering from Long COVID from a temporally ordered list of diagnosis codes up to 45 days post the first COVID positive test or diagnosis for each patient, with an accuracy of 70.48%. We are then able to examine the trained model using Gradient-weighted Class Activation Mapping (GradCAM) to give each input diagnoses a score. The highest scored diagnosis were deemed to be the most important for making the correct prediction for a patient. We also propose a way to summarize these top diagnoses for each patient in our cohort and look at their temporal trends to determine which codes contribute towards a positive Long COVID diagnosis. © 2022 IEEE.

Exploring multi-stakeholder value co-creation as an entrepreneurial approach to survival and sustainability: The case of Pennine Pubs

This case focuses on the entrepreneurial use of multi-stakeholder value co-creation to emerge stronger from challenging trading conditions. In particular, it examines Pennine Pubs, a small-/medium-sized enterprise (SME) operating several rural public houses, which are licensed to sell food and alcoholic drinks to guests. Based in Northern England, it has adapted commercial strategies to mitigate government-enforced Covid-19 lockdowns. Pennine Pubs' Managing Director is currently considering how to build upon the multi-stakeholder value co-creation strategy which emerged quickly immediately before and during the first lockdown period, when customers were prohibited from visiting pubs. He expects the outcome to be a more refined and sustainable commercial strategy which retains the most significant benefits of his lockdown-period innovations. The case considers how co-creation is applied as a reaction to unforeseen business challenges, and how it can underpin proactive strategies to capitalise upon favourable trading conditions. The concept is explored in the context of rapidly evolving, unpredictable and highly problematic constraints upon retail trade, and the 'new normal' of customers returning to retail premises, albeit with expectations modified by recent experiences. Finally, the case considers the impact of SMEs collaborating with suppliers, customers and other stakeholders to co-create mutual, commercially sustainable value.

COVID-induced Severe Global Axonal Neuropathy and Association with Anti-ganglioside Antibodies: A Case Report

Case Diagnosis: Severe global axonal neuropathy Case Description or Program Description: A 36-year-old healthy male presented with fever and body aches, found to be COVID positive. During hospitalization, he became hypoxic and obtunded, requiring emergent intubation. Physical exam notable for flaccid paralysis of extremities with diffuse atrophy. Patient opened his eyes without following commands. He was treated with a prolonged course of steroids, Remdesivir and antibiotics for COVID-19 pneumonia. Due to diffuse weakness, Nerve Conduction Studies (NCS)/ Electromyography (EMG) performed showed acute motor and sensory axonal neuropathy (AMSAN), a severe subtype of acute inflammatory demyelinating polyneuropathy (AIDP). Subsequently, the patient received 5 days of IVIG and 7 sessions of plasmapheresis but failed extubation. Setting(s): University hospital Assessment/Results: On NCS, the patient had absent sensory and motor responses to direct stimulation in the extremities. The sensory study included radial, ulnar, median and sural nerves. The motor studies included musculocutaneous, median, ulnar, peroneal and tibial nerves. EMG of selected extremities revealed fibrillations in all major muscle groups. Muscle recruitment was not assessed due to mental status. Neurological work-up including CTH and MRI spine was negative for a central process. LP was inconclusive. Additional studies notable for anti-ganglioside GQD1 antibody positive. Discussion (relevance): There continues to be neuromuscular compromise precipitated by COVID-19. The patient presented with global weakness of the entire musculature including the muscles of respiration. As evidenced by anti-GQ D1 IgG antibody and NCS/EMG, the patient presented with acute motor and sensory axonal neuropathy (AMSAN), which is the most severe form of AIDP. Conclusion(s): Within the literature, anti-ganglioside antibodies occur within 25% of AIDP and 50% of patients with the axonal variant of AIDP. There has been previous investigation regarding the relationship of Anti-ganglioside GM antibodies in GBS and the relationship with Campylobacter Jejuni infection. It is important to identify that this same relationship may be present with COVID-19, necessitating further research.

Measuring the Impact of Conversational Technology Interventions on Adolescent Wellbeing: Quantitative and Qualitative Approaches

In order to help adolescents cope with loneliness during the social distancing and isolation imposed by the COVID-19 pandemic, we designed a conversational agent programmed to distract users from negative thoughts and advise them on strategies to improve their wellbeing. In order to assess the effects of the agent intervention on adolescent participants, we performed quantitative analysis of their self-reported mood states and qualitative analysis of their subjective views and opinions on the agent to help us understand their experiences. Trends in the quantitative data point to minimal changes in participants' wellbeing and loneliness after interactions with the experimental agent. However, qualitative data on adolescent experiences suggests short and long-term positive effects of the experimental interactions. In reporting our findings, we aim to bring attention to the importance of the qualitative data for understanding human experiences with technology, as well as the limitations of the instruments developed in the field of psychology for human-information interaction research. 85th Annual Meeting of the Association for Information Science & Technology ;Oct. 29 – Nov. 1, 2022 ;Pittsburgh, PA. Author(s) retain copyright, but ASIS&T receives an exclusive publication license.

Talk it Out: Teen Reactions to a Supportive Conversational Agent

COVID-19 measures of isolation exacerbated the negative feeling, particularly in younger and older populations. We tested a voice conversational agent designed to support teens by offering interactions based on five types of behavioral interventions (compassion, self-compassion, positive psychology, mindfulness, and humor), and examined teen reactions to these interventions. Thirty-nine adolescents were asked to assess one randomized interaction a day for fifteen days. All five intervention types received positive ratings, with self-compassion scoring the highest and compassion scoring the lowest by the participants. Participants shared more positive than negative feedback about the interaction scenarios, the perceived agent’s personality and conversational flow. Positive feedback emphasized enjoyment and benefits of the interaction, empathetic traits in the agent’s responses, a sense of validation, and moments for self-reflection fostered by the interactions. Participants enjoyed the conversation flow that felt similar to a natural conversation. Negative comments generally revolved around perception of the impersonal agent, inappropriate pace of conversation (too slow/fast) or number of conversational turns, and dislike of some interaction topics. Recommendations based on this exploratory work are included. 85th Annual Meeting of the Association for Information Science & Technology ;Oct. 29 – Nov. 1, 2022 ;Pittsburgh, PA. Author(s) retain copyright, but ASIS&T receives an exclusive publication license.

Multidisciplinary Engagement of Diverse Students in Computer Science Education through Research Focused on Social Media COVID-19 Misinformation

The ongoing COVID-19 pandemic has disrupted vital elements of personal and public health, society, and education. Increasingly with the viral pandemic, misinformation on health and science issues has been disseminated online. We developed an undergraduate training program focused on producing and presenting research to combat the rampant spread of this misinformation. Online misinformation represents a complex, multidisciplinary problem. Consequently, recruitment of students to the program was not exclusive to those from Computer Science or Science, Technology, Engineering, and Math (STEM) educational backgrounds. Participants were actively recruited from fields such as Linguistics, Social and Political sciences. This data analytics outreach program aimed to train educationally and demographically diverse undergraduate students in computational techniques and presentation skills through guided research regarding the current burst of misinformation. Over ten weeks, participants were instructed in an online curriculum covering five milestones: Python programming, data processing, machine learning with natural language processing, visualization, and presentation. Subsequently, participants were engaged in Computer Science research analyzing a real-world data set gathered from Twitter™ 1 between January and June 2020. Participants were organized into teams to investigate subtopics within the broader subject of misinformation: 1) detecting social media bot accounts, 2) identifying propaganda with computational methods, and 3) studying the discourse surrounding science preprints (i.e., papers that have been posted to the Internet but have not been peer reviewed). The program culminated in an exposition where each team presented research results to program officers, senior faculty, deans, government officials, and industry experts. Here we present the program curriculum, metrics of educational effectiveness, and feedback collected from participants. © American Society for Engineering Education, 2022.

Environmental Health Is a Hidden Treasure

The author discusses the need for environmental health (EH) professionals to push for the field's importance in public health, that was apparent during the coronavirus disease 2019 (COVID-19) pandemic, as of 2022. Topics covered include EH's thrust toward clean air, food, and water and a safe and healthy setting for living, and its gold standard status in public health education. Also noted is the National Environmental Health Association's (NEHA) evolving marketing of the profession.

At-risk patient and healthcare provider perspectives on clinical trial participation for ductal carcinoma in situ

Background: Significant challenges exist in recruiting newly diagnosed ductal carcinoma in situ (DCIS) patients to participate in presurgical intervention trials. Perceived motivators and barriers to participation have not been formally studied from the patient or healthcare provider (HCP) perspective. Based on our experience in the Promise Study (NCT02694809), we hypothesized that delaying surgery and concern for side effects are barriers to trial participation and that access to new treatments and financial benefits are motivators. To improve recruitment, we conducted focus groups to better understand barriers and motivators for trial participation in our patient population. Methods: Three focus groups with post-menopausal women (PMW) without history of DCIS, one focus group with patients previously treated for DCIS, and two HCP focus groups were conducted. Due to COVID-19, the focus groups took place online via videoconferencing and included participants from across the United States. A thirdparty facilitator generated discussion on predetermined topics including knowledge of DCIS, clinical trial recruitment materials, hormone replacement therapy, healthcare delivery and clinical trials during COVID-19, and perceived motivators and barriers to trial participation in general and specifically for women with DCIS. Here, we focus on comparing perceived influential factors for patient participation in DCIS clinical trials in PMW and HCP focus groups. Qualitative thematic analysis was completed on focus group transcripts in NVivo. Results: PMW had no knowledge of DCIS prior to the focus groups and believed DCIS should be removed promptly. PMW believed barriers to DCIS clinical trial participation included the potential for the study drug to cause harm, distrust of medicine, and the fact that DCIS is not life-threatening. PMW identified helping future DCIS patients, accessing better treatment, and easing anxiety as motivators for DCIS trial participation. HCPs believed patients were motivated by increased monitoring by the medical team, financial incentive, and access to newer treatment. HCPs believed that delays in DCIS surgery, the potential for the intervention to be harmful or ineffective, and the trial causing patient anxiety were barriers. Neither group emphasized time commitment as a barrier to DCIS trial participation. PMW were not motivated by financial incentives. Conclusions: Knowledge about DCIS is lacking in PMW. PMW and HCPs agreed that the risk of harm caused by study interventions is a deterrent to trial participation and that access to superior treatment is a motivator. However, PMW and HCPs did not agree on other motivators and barriers which could lead to missed recruitment opportunities. Providing educational materials on DCIS and addressing motivators and barriers to clinical trial participation may increase recruitment to presurgical DCIS trials.

Attitudes Toward COVID-19 Vaccination Among Occupational Therapy Professionals and Students in Early 2021

Purpose: After the widespread transmission of the novel coronavirus that causes COVID-19, the first COVID-19 vaccination received emergency use authorization in the United States in December of 2020. Current research has shown the authorized COVID-19 vaccines to be safe and effective at preventing severe illness. At the time of this study, there appears to be no published research on the attitudes and receipt of COVID-19 vaccinations among occupational therapy professionals and students. The purpose of this study is to describe the attitudes and receipt of COVID-19 vaccinations among occupational therapy professionals and students in early 2021. Methods: A total of 114 occupational therapy professionals and students (age = 41 +/- 15, years of certified experience = 13 +/- 13) opened the survey link and completed the instrument. Participants were sent an electronic survey via email that collected demographic information and assessed attitudes and receipt of COVID- 19 vaccination. Data was downloaded and analyzed using a commercially available statistics package. Results: The majority of occupational therapy professionals in this study agreed on some level that they were comfortable (Strongly Agree = 36.0%, Agree = 16.7%, Somewhat Agree = 10.5%). Most occupational therapy professionals and students stated they had or would receive a COVID-19 vaccination. The majority of participants reported personal, household, and community safety as the primary considerations for receiving a COVID-19 vaccination. In general, these factors were a larger factor for participants than public perception or personal liberties being infringed upon. Conclusions: The findings of this study suggest a majority of occupational therapy professionals and students are comfortable with the current level of approvals for available COVID-19 vaccinations, and at the time of the survey had or intending to be vaccinated. As occupational therapy professionals and students continue to work in day-to-day patient care, it is imperative to consider the best means of educating occupational therapy professionals and students on the potential benefits of COVID-19 vaccinations.

Using Machine Learning to Predict Development of Heart Failure, during Post-Acute COVID-19, by Race and Ethnicity

Roughly 6 million Americans have Heart Failure (HF), and this number could increase to 8 million by 2030 [1]. As of early 2022, about 76 million Americans have been diagnosed with novel coronavirus (COVID-19) and of those, around 900,000 have subsequently died [2]. Our goal for this paper is two-fold: 1) use machine learning (ML) algorithms to predict the development of HF during the post-Acute COVID-19 period, with emphasis on race and ethnicity, and 2) determine how feature importance differs across the race and ethnicity groups. We apply Logistic Regression, Random Forest Classifier [3], and XGBoost Classifier [4] to predict the development of HF in patients of various races and ethnicities during the post-COVID period. These models show promising results for the use of ML algorithms to predict the development of HF in patients post-COVID. © 2022 IEEE.

Characteristics and Outcomes of Stroke Patients with Concurrent SARS-CoV-2 Infection from March 1, 2020 to February 28, 2021: An Analysis from the N3C Database

Objective: To test the association of SARS-CoV-2 infection with increased stroke severity in individuals with ischemic and hemorrhagic stroke during the first year of the COVID-19 pandemic in the US. Background: Studies have shown that patients with ischemic stroke (IS) and concurrent COVID19 have increased stroke severity. These analyses were limited by use of prepandemic era controls or by use of a sample from the early pandemic when stroke care delivery was affected by lockdown. Data on the severity of hemorrhagic stroke (HS) in patients with COVID-19 are sparse. Design/Methods: Using the National Institute of Health (NIH) National COVID Cohort Collaborative (N3C) database, we identified patients diagnosed with stroke between Mar 1, 2020 - Feb 28, 2021. Hospitalized stroke patients with concurrent COVID-19 (stroke within 3 months after or one week prior to positive SARS-CoV-2 PCR or AG lab test) were matched to all other hospitalized stroke patients in a 1:3 ratio. Nearest neighbor matching with a caliper of 0.25 was used for most clinical and demographic factors;exact matching for race/ethnicity and site. Within our matched sample, we used Poisson regression to calculate stroke severity incident rate ratio (IRR). Results: Our query identified 10394 patients hospitalized with IS with NIHSS scores upon admission (802 with concurrent COVID-19 and 9592 without) and 2138 patients hospitalized with HS with admission NIHSS scores (181 with concurrent COVID-19 and 1957 without). Average NIHSS was greater in concurrent groups with both IS and HS (11.1 vs 7.68, p<0.001 and 15.7 vs 11.7, p<0.001 respectively). Propensity matched analysis demonstrated that stroke patients with concurrent COVID-19 had increased NIHSS (IS: IRR=1.4, 95% CI:1.3-1.5, p<0.001;HS: IRR=1.3, 95% CI:1.2-1.5, p<0.001). Conclusions: This analysis suggests that the association between increased stroke severity and COVID-19 remained as stroke care utilization normalized. Further work will center on the interaction between COVID-19 illness severity and stroke severity.

Attitudes and Usage of Face Masks During the COVID-19 Pandemic Among Occupational Therapy Professionals in Texas

Purpose: Following the widespread transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), multiple business and schools drastically reduced face-to-face services. Additionally, many state and local governments enacted face mask mandates and other legislations aimed at decreasing the spread of the virus. Current research is being conducted to evaluate the epidemiology, recognition, treatment, and prevention of coronavirus disease 2019 (COVID-19), the disease associated with SARS-CoV-2. At the time of this study, there is no published research on the attitudes and usage of face masks or face coverings among certified occupational therapy professionals during the COVID-19 Pandemic. The purpose of this study is to describe the attitudes and usage of face masks or face coverings among occupational therapy professionals in the state of Texas during the COVID-19 pandemic. Methods: A total of 107 occupational therapy professionals (age= 42 +/- 12, years of certified experience = 18 +/- 11) opened the survey link and completed the instrument. Participants were sent an electronic survey via email that collected demographic information and assessed attitudes and usage of face masks or face coverings. Data was downloaded and analyzed using a commercially available statistics package. Results: The overwhelming majority of occupational therapy professionals in this study agreed on some level that the use of face masks to mitigate the transmission of SARS-CoV2 was strongly supported by the available evidence (Strongly Agree = 65.4%, Agree = 19.6%, Somewhat Agree = 5.6%). Most occupational therapy professionals also reported that their institutions currently had a mandate in place requiring face masks during patient encounters and coworker interactions (Patient Encounters = 94.4%, Coworker Interactions = 86.9%). Most occupational therapy professionals reported wearing face masks the majority of the time when entering public spaces. Occupational therapy professionals cited the influence of their personal use of face masks was for personal health, health of those in their household, and the health of their patients. Conclusions: The findings of this study suggest a majority of occupational therapy professionals in Texas are wearing face masks or face coverings, even when not actively involved in patient care or other aspects of their jobs. Future research should be conducted to assess the use of face masks among other allied health care professions.

Help Spread the Word-Environmental Health Is Public Health

Brown expresses his gratitude to all the environmental health professionals who were the unsung heroes of the COVID-19 pandemic. Environmental health professionals stepped up to the plate and performed a variety of tasks that provided their peers and the public with important insight into the value of their profession. Here, he stresses that as the world is reopening from the COVID- 19 pandemic, environmental health needs to seize the opportunity to educate the public, policy makers, and key stakeholders of the technical, scientific expertise required to become a Registered Environmental Health Specialist/Registered Sanitarian (REHS/RS).

HIGHER COVID-19 POSITIVITY and LOWER VACCINATIONS among PEOPLE WHO USE DRUGS

Background: The COVID-19 pandemic has disproportionately impacted people who use illicit drugs and misuse prescription drugs (PWUD), including increased risk for infection with SARS-CoV-2, clinical COVID-19, and poorer health outcomes. The reasons for this disparity are multifactorial and may include numerous social and structural factors. Yet, little is known about COVID-19 testing and vaccinations among PWUD. Methods: This cross-sectional study was conducted in Miami, Florida, USA between March and September 2021 with the support of the National Institutes of Health Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) initiative. Participants had to be 18 years of age and older and willing to be tested for COVID-19. Recruitment included convenience and snowball sampling. The RADx-UP survey (available at https://radx-up.org/) was administered via telephone. Results: A total of 931 participants were enrolled in the study;median age was 59 (53, 64) years, 65.5% were Black, 32.1% Hispanic, and 69.2% had a household income of less than $15,000 in 2019. Nearly a third of participants (32.6%) used drugs. Additionally, 37.6% smoked cigarettes, and 5.2% consumed alcohol for four or more days per week. Twenty percent of participants had never been tested for COVID-19. Of those who reported ever being tested, 14.1% reported ever being positive for SARS-CoV-2, with 67.2% of those having moderate-to-severe symptoms and 26.7% reporting being hospitalized due to COVID-19. Overall, 19 (2.2%) participants tested positive for SARS-CoV-2 at the time of the study, which was more frequent among PWUD than drug non-users (4.2% vs. 1.2%, respectively;p=0.004). PWUD, compared to drug non-users, were less likely to be vaccinated against COVID-19 (66.7% vs. 75.2% for any one dose, respectively;p=0.006). Compared to drug non-users, PWUD had 3.62 (95% CI: 1.41, 9.30;p=0.008) times higher odds of being positive for SARS-CoV-2 based on rt-PCR testing at the time of interview, and 0.66 (95% CI: 0.49, 0.89;p=0.006) times lower odds of being at least partially vaccinated against COVID-19. Conclusion: People who use drugs may be at increased risk of contracting SARS-CoV-2 and developing COVID-19, which could be in part related to lower vaccination rates in addition to comorbidities and lifestyle factors. Testing and immunization plans are needed that are specific for PWUD, considering the barriers and facilitators of this population.

Yo-Yo Machines Self-Build Devices that Support Social Connections During the Pandemic

Yo-Yo Machines are playful communication devices designed to help people feel socially connected while physically separated. We designed them to reach as many people as possible, both to make a positive impact during the COVID-19 pandemic and to assess a self-build approach to circulating research products and the appeal of peripheral and expressive communication devices. A portfolio of four distinct designs, based on over 30 years of research, were made available for people to make by following simple online instructions (yoyomachines.io). Each involves connecting a pair of identical devices over the internet to allow simple communication at a distance. This paper describes our motivation for the project, previous work in the area, the design of the devices, supporting website and publicity, and how users have made and used Yo-Yo Machines. Finally, we reflect on what we learned about peripheral and expressive communication devices and implications for the self-build approach. © 2022 ACM.