Was the diagnosis of gestational diabetes from 34 weeks gestation of pregnancy more prevalent during Covid-19 due to the change in how gestational diabetes was diagnosed?

Aim: During Covid we noticed that more women were being diagnosed with Gestational Diabetes (GDM) from 34 weeks gestation than prior to Covid. It was suspected that this was due to how GDM was diagnosed, from Oral Glucose Tolerance Test (OGTT) prior to Covid to HbA1c with Fasting or Random Blood Glucose (RBG) during Covid. Method(s): An audit of our GDM database was performed, looking at rates of late GDM diagnosis from 2018-present. Result(s): Prior to Covid the late diagnosis rate was 14-15%. In 2020 and 2021 this increased to 27.7%. This year diagnosis is only by OGTT, and the rate has dropped to 21%. There was also a significant rise in the number of women who were being diagnosed from 34 weeks gestation whom had previously been tested for GDM earlier in their pregnancy. In 2018 and 2019 52-56% of these women had previously been tested. In 2020 this increased up to 84% and fell to 74% in 2021. This year the rate has fallen to 67%. In 2018 and 2019 all women had been diagnosed using OGTT's. In 2020 61% of women had previously been tested for GDM by HbA1c and RBG, with this increasing to 84% in 2021. This year only 10% had previously been tested using HbA1 and RBG. Conclusion(s): The sharp increase in late diagnosis of GDM during the Covid seems to be related to the change in diagnostic testing and shows that OGTT is the more accurate way to diagnose GDM and not HbA1c with RBG.

Tribalism and Compassion in the Age of a Pandemic

This essay draws on resources in philosophy, psychology, and related social sciences—specifically, works by Joshua Greene, Jonathan Haidt, George Lakoff, and Martha Nussbaum—to analyze the moral and political dimensions of the recent polarization in the United States related to the COVID-19 pandemic. Three questions are addressed: (a) What psychological factors may have contributed to this polarization? (b) Why have conservatives and liberals taken the positions they have on issues relating to the pandemic (e.g., masks, economic reopening, vaccines, science)? and (c) How can we reduce this polarization and work more effectively with others to face societal challenges, despite our differences? © 2022 Society for Values in Higher Education. All rights reserved.

Considering community care in public health responses: A national study regarding palliative care during a prolonged coronavirus disease 2019 lockdown.

OBJECTIVE: To describe changes in palliative care characteristics, utilisation and outcomes in Victoria during a period of enhanced public health management and a prolonged lockdown due to coronavirus disease 2019. METHODS: A national retrospective cohort study with palliative care service setting comparisons in Victoria and other mainland states was conducted. RESULTS: Analysis of 48 non-Victorian services (n=53,428 patients) and 20 Victorian services (n=31,125 patients) showed that for community services, patient volume, average length of stay, functional dependency and the proportion of admissions in a deteriorating phase increased during the lockdown in Victoria, yet little changed in comparator states. Regarding inpatient services, the management of family/carer problems remained constant in comparator states, yet substantial fluctuations in outcomes in Victoria were observed. CONCLUSIONS: As health systems adapt to changing circumstances during the pandemic, the ability to upscale community services is critical. Addressing the implications of shifting inpatient care to the community needs attention. IMPLICATIONS FOR PUBLIC HEALTH: Our study highlights the need to ensure community care providers are adequately considered within public health management responses. 'Joined up' policy and implementation across care settings are essential, especially as major barriers to infection control and increased utilisation may be evident in the community during the coronavirus disease 2019 pandemic.

UK DNA working group eDNA week, January 2022

Here, we report on eDNA week, an international conference held online as a five-day series of webinars from January 17, 2022, to January 21, 2022. The conference was organized by the UK DNA working group, which has witnessed considerable growth and application of eDNA research since its founding and first conference in 2014. The 2022 event, held online due to the COVID-19 pandemic, provided an opportunity to invite international researchers who are leading the field, without the usual constraints of conference location. Compared with the previous UK-based in-person conferences, there was greater international participation amongst the 514 people who registered to attend the event. To emphasize the importance of collaboration between sectors in driving forward DNA monitoring, a session was devoted to presentations by participants from governmental agencies, and another to those from commercial companies developing and utilizing DNA tools. The industry and stakeholder sessions were accompanied by state-of-the-art presentations delivered by a global group of DNA/eDNA researchers from 11 countries. These sessions were complemented by an open forum session for reflection and discussion. © 2022 The Authors. Environmental DNA published by John Wiley & Sons Ltd.

2022: a veterinary year in review

With life slowly returning to normal after Covid-19, 2022 brought with it new challenges dominated by infectious diseases and rising costs. Kathryn Clark reports.

UK DNA working group eDNA week, January 2022

Here, we report on eDNA week, an international conference held online as a five-day series of webinars from January 17, 2022, to January 21, 2022. The conference was organized by the UK DNA working group, which has witnessed considerable growth and application of eDNA research since its founding and first conference in 2014. The 2022 event, held online due to the COVID-19 pandemic, provided an opportunity to invite international researchers who are leading the field, without the usual constraints of conference location. Compared with the previous UK-based in-person conferences, there was greater international participation amongst the 514 people who registered to attend the event. To emphasize the importance of collaboration between sectors in driving forward DNA monitoring, a session was devoted to presentations by participants from governmental agencies, and another to those from commercial companies developing and utilizing DNA tools. The industry and stakeholder sessions were accompanied by state-of-the-art presentations delivered by a global group of DNA/eDNA researchers from 11 countries. These sessions were complemented by an open forum session for reflection and discussion. © 2022 The Authors. Environmental DNA published by John Wiley & Sons Ltd.

DEVELOPING A VOLUNTEER WORKFORCE FOR A LARGE LYMPHOEDEMA SERVICE TO SUPPORT THE CLINICAL TEAM TO CONTINUE SERVICES TO PATIENTS DURING THE COVID-19 PANDEMIC

Background St Oswald's provides a large and specialist Lymphoedema Service which has traditionally been predominantly clinic-based at their main hospice site. Due to the impact of COVID-19, the service had to quickly pivot to provide much more domiciliary based care - to adhere to new infection control measures and respond to shielding patients' needs. To adhere to the practical nature of the care as well as safeguarding regulations, the domiciliary visits had to be carried out by two lymphoedema nurses and it became apparent that recruitment of additional volunteers would be extremely beneficial and allow more patients to benefit from care. Aims To increase the number of volunteers recruited and inducted into their role to allow the lymphoedema service to maintain services during the pandemic. Methods To respond to an increased need for domiciliary care, in April 2020 St Oswald's Hospice begun recruitment by advertising the volunteer role on social media. Following recruitment, volunteers were inducted and trained. During this time, staff engagement sessions were carried out and a clinical Volunteering Steering Group was set up to review and evaluate the project. Results Over 40 new volunteers recruited, with 20-30 currently volunteering in the service. Other benefits have included: meaningful collaboration between a lymphoedema service and volunteering department, funding sourced for a volunteer coordinator for lymphoedema service to continue to build on this success, and reaching new volunteer audiences as the role engaged a much younger cohort of volunteers than traditional volunteers. Conclusion The rapid flexing of the service supported by the Volunteering Department allowed services to be maintained, patients continued to receive assessment and treatment at home, which many prefer. In addition an unseen benefit has been volunteer enjoyment and a reporting that the experience of volunteering has been beneficial in particular in seeking university and other employment placements.

ELECTROCHEMICAL CAPILLARY-FLOW DRIVEN IMMUNOASSAY FOR DETECTION OF SARS-COV-2 NUCLEOCAPSID PROTEIN

As the COVID-19 pandemic continues, there remains a need for fast, accurate and low-cost diagnostic tests to prevent outbreaks. We have developed an electrochemical capillary-flow driven immunoassay (eCaDI) capable of detecting SARS-CoV-2 nucleocapsid (N) protein in self-administered nasal samples at the point of care (POC). The low-cost device is made of polyester and adhesive films and provides sequential delivery of sample and reagents to a detection zone integrating a screen-printed carbon electrode (SPCE) modified with anti-N protein antibodies from a single addition of sample, automating the steps of an ELISA. The modified electrodes are highly sensitive and selective for COVID-19 N protein and were successfully applied to test clinical samples. The novelty of this work resides in the integration of sensitive electrochemical detection with pump-free capillary-flow assay, providing accuracy at the POC. Previously reported systems are slow and/or require multiple user steps reducing the utility for POC applications relative to the system reported here. © 2021 MicroTAS 2021 - 25th International Conference on Miniaturized Systems for Chemistry and Life Sciences. All rights reserved.

The Resurgence of Candida auris in California during the Novel Coronavirus (COVID-19) Pandemic, May 2020-May 2021

Background. In February 2019, California (CA) experienced its first C. auris outbreak in Orange County (OC). The CA Department of Public Health (CDPH) and OC with the Centers for Disease Control and Prevention (CDC), mounted a successful containment response;by November 2019, cases were limited to low-level spread in OC long-term acute care hospitals (LTACH). In May 2020, C. auris cases began to surge in OC, followed by extensive spread in six other southern CA local health jurisdictions (LHJ). CDPH with LHJ and CDC, initiated an aggressive, interjurisdictional containment response. Methods. We carried out response and preventive point prevalence surveys (PPS), onsite infection prevention and control (IPC) assessments, and in-service trainings at outbreak and interconnected hospitals and skilled nursing facilities in six LHJ. Other regional activities included: epidemiologic investigation, contact and discharge tracking and screening;increasing laboratory testing capacity;screening patients admitted to and from LTACH;statewide healthcare facility (HCF) education and outreach;sending regional outbreak HCF lists to all HCF;and biweekly state-LHJ coordination calls. The Antibiotic Resistance (AR) Lab Network supported testing. Results. From May 2020-May 2021, we conducted screening at 226 HCF, and identified 1192 cases at 93 HCF, mostly through screening (n=1109, 93%) and at LTACH (n=906, 76%);we identified 113 (10%) cases at ACH, including 35 (31%) in COVID-19-burdened units. Cases peaked in August 2020 (n=93) and February 2021 (n=191) and have since declined, with C. auris resurgence mirroring COVID-19 incidence. We conducted 98 onsite IPC assessments, and identified multiple, improper IPC practices which had been implemented in response to COVID-19, including double-gloving and -gowning, extended use of gowns and gloves outside patient rooms, and cohorting according to COVID-19 status only. Figure 1. C. auris and COVID-19 Cases in California through May 2021, and C. auris Cases by Local Health Jurisdiction (LHJ) May 2020-May 2021 Conclusion. The C. auris resurgence in CA was likely a result of COVID-19-related practices and conditions. An aggressive, coordinated, interjurisdictional C. auris containment response, including proactive prevention activities at HCF interconnected with outbreak HCF, can help mitigate spread of C. auris and potentially other novel AR pathogens.

Evaluating student attitudes and learning at remote collegiate soil judging events

As with many aspects of teaching, the COVID-19 pandemic forced soil judging teams to attempt new strategies towards achieving student learning outcomes. Soil judging Regions IV and V hosted remote regional contests in October 2020 in place of traditional, in-person contests typically held each fall. We conducted pre- and post-contest surveys to assess student learning outcomes, attitudes, and reflections on the remote contest experience compared to past, in-person contest experiences. We received 108 total responses from students who participated in the Region IV and Region V remote soil judging contests (>80% response rate). In self-reported learning outcomes, there were no significant gains post-contest and there were minimal differences between students in Regions IV and V. Female students, students with more soil judging experience, and students who had taken more soil science courses agreed more strongly that soil science is important, that they planned to pursue careers in soil science, and that they gained important skills from soil judging. Finally, students who previously participated in contests reported that they gained more knowledge and enjoyed in-person contests more than the remote contests held in Fall 2020. Thus, while it is possible to replicate some aspects of the soil judging experience in a remote contest, other aspects that are critical to student engagement are lost when teams are unable to gather at the contest location and examine soils in the field. © 2021 The Authors. Natural Sciences Education published by Wiley Periodicals LLC on behalf of American Society of Agronomy

'Virtually Pen Green': developing a synchronous teaching response for adult learners studying early childhood degree programmes during COVID-19

This article explores an idea the researchers are calling Andragogical Isomorphism. The idea being that adults who are motivated to learn become academic when in non-linear relationships with other learners and their tutors. When all are able to be curious, vulnerable and confident shifts in academic capabilities occur. The global pandemic COVID-19 in 2020 brought with it exceptional challenges in education across the globe. Adaptations to teach virtually were expected almost immediately, educators needed to facilitate learning experiences in an unfamiliar, virtual world with little or no previous training. Research was conducted to gather feedback to capture how the recreation of face-to-face teaching online impacted female, undergraduate early years students. The researchers spent time reflecting on the principles that underpin their practice of working with mature learners. Essential elements of social constructivism alongside the critical nature of highly effective andragogical practice and the importance of practice wisdom/life experiences are explored. The benefits of reflection and gaining academic recognition are considered, as are the implications of these within the sector. The results suggest a principled synchronous teaching approach that attends to emotional and cognitive needs, could lead to internalising an altered sense of self in academia - Andragogical Isomorphism.

Adaptive COVID-19 treatment trial data management: ensuring success in a constantly-evolving, highdemand pandemic environment

Remdesivir (GS-5734) was identified as a promising therapeutic candidate for COVID-19, at a time when no therapeutic agents had shown to be efficacious for the treatment of coronavirus disease 2019 (COVID-19). A series of rapid randomized, double-blind, placebocontrolled Adaptive COVID-19 Treatment Trials were developed, all written into one Protocol document, to evaluate the safety and efficacy of novel therapeutic agents in hospitalized adults diagnosed with COVID- 19. The first study (ACTT-1) was a multi-center trial conducted in 73 sites globally (N = 1062), that demonstrated remdesivir shortened the time to recovery in adults who were hospitalized with COVID-19 and had evidence of lower respiratory tract infection. This presentation focuses on the unique challenges presented by the high-profile Adaptive COVID-19 Treatment Trial and how the data management team ensures its success in this pandemic environment. Typically, a data management team may take several weeks or months to design and build a database upon receipt of a new protocol but due to the high priority of the Adaptive COVID-19 Treatment Trial study, the database was initially built in 2 days. Having such a short turnaround time meant the team had to focus on critical items such as randomization and forms that collected data related to safety signals. Flexibility was also important since study sites were being identified and activated on a rolling basis, and many were international which meant various formatting differences, specifically with laboratory results. For both internal and external stakeholders to ensure proper communication and organization, it was crucial to maintain a proper balance of collaboration yet still identifying clear leaders of functional groups to avoid having ''too many cooks in the kitchen.'' Scheduling frequent meetings and utilizing collaboration software, rather than relying on email communication, helped all parties to brainstorm and resolve issues efficiently. The Adaptive COVID-19 Treatment Trial was divided into multiple stages (called ACTTs) where each new Adaptive COVID-19 Treatment Trial introduced a different therapeutic combination. Each Adaptive COVID-19 Treatment Trial was designed to enroll over 1000 trial participants across 100+ sites, and it was not uncommon for the stages to overlap, creating many challenges with data management. Data queries were often sent to sites weekly or even multiple times a week, and data managers would go above and beyond by working nights and weekends to accommodate the high workload and shortened timeframe. Safety and endpoint data were the top priority during data cleaning and the volume of queries was not just a challenge for the data management team but also for the sites that had to juggle the trial in addition to clinically managing their COVID patients who had a brand new disease. Meeting deadlines was essential but doing so at the expense of the cleanliness of the data was not an acceptable option, so new processes had to be implemented in order to avoid this from occurring. It was also critical to be ''audit-ready'' at all times due to the high-profile nature of the study, so an internal team was dedicated to ensuring that all documentation was present and complete throughout the course of the study. Mock audits were held so that issues could be resolved a Food and Drug Administration audit. In this presentation, four speakers will introduce the study in more detail and demonstrate how being more adaptable and communicative enabled the data management team, in collaboration with the other study stakeholders, to successfully manage the trial. Each presentation will last approximately 20 min and they are listed below in more detail and in chronological order. The remaining 10 min will be devoted to a question and answer session with audience members. National Institutes of Health Clinical Project Manager Ms Nomicos is a Clinical Project Manager at the National Institute of Allergy and Infectious Disease who, along with several other Clinical Project Managers, was respons ble for general oversight of study conduct and contractors on the Adaptive COVID-19 Treatment Trial. Ms Nomicos will introduce the ACCT trial and provide some background information, as well as briefly explain the study objectives, design, and procedures. Ashley Bowersox, MPH (Emmes) Ms Bowersox is a Senior Data Manager in the Vaccine and Infectious Diseases group, supporting the Clinical and Epidemiological Studies in Infectious Diseases. She served as the Forms Design Lead and DM Project Manager on the Adaptive COVID-19 Treatment Trial. Ms Bowersox will discuss database design considerations and in particular the need to build the database with flexibility to accommodate rolling identification and activation of study sites as well as attention to the unique needs of the international sites participating in the study. Ashley Wegel, CCRA, MEd (Emmes) Ms Wegel is an Associate Project Leader in the Vaccine and Infectious Diseases group, supporting the Clinical and Epidemiological Studies in Infectious Diseases. She served as the Forms Design Lead and DM Project Manager on the Adaptive COVID-19 Treatment Trial. Ms Wegel will present site management and data management strategies for meeting incredibly demanding database freeze and lock timelines required by sponsor to support safety reviews and publications and continuously improve upon forms design and interface for each new stage. Kelly Clark (Duke Human Vaccine Institute) Ms Clark is a Clinical Research Coordinator in the Duke Vaccine Trials Unit at the Duke Human Vaccine Institute, one of the enrolling sites on Adaptive COVID-19 Treatment Trial. Ms Clark will discuss the challenges of working on a rapid study with tight timelines, requiring quick responses to a large volume of research data queries, while clinically managing their COVID patients who had an unfamiliar and daunting new disease.

Don't know what you've got (til it's gone)-supporting and sustaining committed palliative care volunteers

Background: Palliative Care volunteers are positioned with unique knowledge and experience as a support for those at end-of-life, and are chosen for their maturity, empathy, and capacity for reflection. The suspension of palliative care volunteer services during the COVID-19 pandemic necessitated them being disconnected from their caring role in Palliative Care, and their supports in the Palliative Care sector. This offered an opportunity to explore issues related to volunteer commitment, support and retention. Aim: To explore the experience of Volunteers during the COVID-19 pandemic, and their perceptions of connection, engagement and support from their local service. Method: Volunteers from three services in two health districts were invited to complete an anonymous on-line qualitative survey six months after the cessation of services due to the COVID-19 pandemic. Data were collated using the Clinical Excellence Commission QARS platform and summary statistics prepared. A comparison of life satisfaction pre COVID and 6 months after service suspension employed McNemar's Test. Results: There were 53 responses (response rate of 50%). Overwhelmingly the volunteers indicated that their role added to their life satisfaction, and not being able to volunteer had been a significant factor in its decrease. Over 80% of the volunteers indicated they intend to return to palliative care volunteering. The key themes identified were their relationships with patients and families, and being part of a team;and the giving/community service aspect of the role, as well as the connection with the volunteer manager. Conclusion: Palliative Care volunteering is highly beneficial to volunteers themselves, as well as being an important community resource in the holistic care of those at the end-of-life. Managers of volunteers will best serve their volunteer program if they focus on the key themes identified in recruitment, training and ongoing support.

Status update of LLAMAS - A wide field-of-view visible passband IFU for the 6.5m Magellan telescopes

The Large Lenslet Array Magellan Spectrograph (LLAMAS) is an NSF-funded facility-class Integral Field Unit (IFU) spectrograph under construction for the 6.5-meter Magellan Telescopes. It covers a 37"×37" solid angle with 2,400 optical fibers efficiently coupled by a double-sided microlens-array, producing R = 2, 000 spectra with 0.75" spatial resolution. Its broad passband from λ = 350 - 970nm offers access to line and continuum measurements over a wide range in redshift. Light is multiplexed by the IFU into 8 compact, carbon-fiber bench mounted spectrographs utilizing VPH grisms. We employed several trades on cost-performance ratio while optimizing LLAMAS' system design including: (a) Splitting the passband between 3 fast all-refractive camera systems with modest entrance pupils, (b) limiting the fibers per unit (i.e. slit length) and building more spectrographs to leverage on production volume, and (c) using a commercial CCD camera built around a common detector (e2v 42-40) and thermoelectric + liquid cooling. To boost blue throughput and achieve high-quality sky subtraction the spectrograph cluster is mounted next to the focal plane on a folded Cassegrain port with gravity-invariant support. This also allows the instrument to deploy quickly, and be fully accessible within 10 minutes on any night, serving as a facility unit for observing astrophysical transients. A sub-sized IFU (169 fibers), mounted in a full-sized front end package with a single spectrograph (2 cameras) was delivered to Magellan in March 2020. We present as-measured laboratory performance from this prototype, though on-sky commissioning was unfortunately cancelled because of the COVID-19 pandemic. This contribution therefore focuses on subsequent design evolution and status of the full facility instrument. © 2020 SPIE

COVID-19 in Kidney Transplant Patients From a Large UK Transplant Center: Exploring Risk Factors for Disease Severity.

BACKGROUND: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised concern for the health of immunocompromised individuals, who are potentially at higher risk of more severe infection and poorer outcomes. As a large London transplant center serving a diverse patient population, we report the outcomes of SARS-CoV-2 infection in our cohort of 2848 kidney and/or pancreas transplant patients. METHODS: Data were obtained retrospectively for all transplant patients who attended hospital during the peak of the pandemic and had a positive nasopharyngeal SARS-CoV-2 test. RESULTS: Sixty-six patients were found to be positive for SARS-CoV-2. Twenty percent were treated as outpatients, 59% were admitted to the general ward, and 21% required intensive care. Treatment consisted of reduced immunosuppression, antibiotics for pneumonia or sepsis, and other supportive treatments. Within our cohort, 12 patients died (18%), with an overall mortality of 0.4%. Predictive risk factors for COVID-19 severity were explored. CONCLUSIONS: Severe disease was associated with lower hemoglobin prior to COVID-19 diagnosis and lower lymphocyte count at the time of diagnosis but not age, sex, ethnicity, or preexisting comorbidities. Lower glomerular filtration rate and higher C-reactive protein were associated with more severe disease. Despite no use of hydroxychloroquine, azithromycin, antiviral, or immunomodulatory medications, our mortality rate (kidney and pancreas transplant patients) is similar to current international rates.