Understanding effects of COVID-19 on undergraduate academic stress, motivation and coping over time

The rapid and unprecedented shift from face-to-face instruction to remote online learning as a consequence of the COVID-19 pandemic had a substantial impact on teaching and learning in Higher Education: students had to adapt to a new way of learning, away from typical campus settings and their peers, and to new forms of assessments. This study examined academic stress, learning strategies, motivation and ways of coping from a sample of 177 unique students from a large London university, collecting primary data via survey at three time points during the academic year 2020/21 when teaching was remote and online only. Our findings show how patterns in academic stress, learning strategies, motivation and coping vary over the course of the academic year giving novel insight into how student learning and adaptation to the situation changed over time. We also report on differences in these patterns according to year group and for those students who are the first-in-family to attend university and those who are not. Based on these findings we identify priority areas where higher education institutions should support undergraduate students and provide evidence that some groups of students may need more and targeted support to secure their ongoing learning and well-being. © 2023 The Authors. Higher Education Quarterly published by John Wiley & Sons Ltd.

What are the unintended consequences of protest? A panel analysis linking anti-Corona-protest to satisfaction with democracy in Austria

Survey data from the Austrian Corona Panel Project show that in November 2021 about 17% of Austrians support the demonstrations against the measures to contain the Corona pandemic. At the same time, the proportion of people who think that demonstrations against the measures should be allowed has decreased by 5 percentage points. This suggests a broad approval of the measures within the population and a rejection of those who demonstrate against them. However, according to the impression in media coverage, the protesters themselves are not influenced by this. While there are already well-established findings on the attitudes shared by people who participate in the Corona protests, only little is known about the impact of the protests on citizens who do not take part in them. This question is relevant insofar as research has shown that establishing new norms, such as those produced by the pandemic, depends to a decisive degree on the (perceived) norm compliance of fellow citizens. Public protest can be understood as a signal of non-compliance, which could lead to a dwindling acceptance of the measures. At the same time, it can negatively influence the satisfaction with the democracy of those who comply with the measures. Our study contributes to a better understanding of the influence of protests on democracy satisfaction, perceptions of protests, one's own democratic attitudes and solidarity with others, and sheds light on what non-intended effects protest can have. The analysis reveals that trust, positive government evaluation, and societal cohesion result in higher satisfaction with democracy. © 2023, The Author(s).

4-Organ Sofa Score as Tool to Triage Crrt Use in Covid-19 Patients during Crisis Standards of Care

INTRODUCTION: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is associated with high mortality, especially in the setting of COVID-19. During the peak of the delta wave in New Mexico in late 2021, crisis standards of care were declared and strategies to ration care were explored. Our hypothesis is that a simplified SOFA score in patients with COVID-19 and AKI-RRT may predict short-term mortality. METHOD(S): We retrospectively analyzed all COVID-19 patients started on CRRT for AKI in the medical ICU at our center between April 2020 and July 2021. A 4-organ SOFA score (4OSS), with renal and neurologic sub-scores excluded, was calculated at the time of CRRT initiation. Neurologic sub-score was excluded because it is subjective, inconsistently documented, and confounded by the frequent use of sedation and paralysis in severe COVID-19. ECMO patients were included and assigned the maximum respiratory sub-score. Patients started on RRT at an outside hospital, found to be incidentally COVID-positive, or on chronic dialysis were excluded. P values were obtained using 1-sided Mann-Whitney U tests. RESULT(S): 63 total COVID-19 patients on CRRT were identified with 73% 30-day mortality and 83% in-hospital mortality. The median 4OSS was 8 in both in-hospital survivors and non-survivors with interquartile range [IQR] of 4-9 and 7-9.75, respectively (difference between groups non-significant, p = 0.075). The median 4OSS was 7 [5.5- 8.5] and 8 [7-10] in 30-day survivors and non-survivors, respectively (p = 0.018). Those with 4OSS of >=10 (n=13, 20.6%) had 100% in-hospital mortality. CONCLUSION(S): Similar to other analyses of SOFA score in COVID-19, 4OSS at CRRT initiation in patients with COVID-19 and AKI-RRT appears to have limited prognostic ability, with substantial overlap in scores between survivors and non-survivors. However, while additional multicenter studies are needed, 4OSS of >=10 may identify a group of about 20% of COVID-19 patients with AKI-RRT and mortality approaching 100%. Given the absence of a superior validated metric, a 4OSS of >=10 may be a reasonable tool for triage of CRRT in the setting of crisis standards of care and CRRT machine or supply shortages. At a minimum, 4OSS could inform goals of care discussions prior to CRRT initiation in patients with COVID-19 complicated by AKI-RRT.

Reasons for declining a pharmacist-led telehealth study among oncology patients initiating oral anti-cancer drugs

Background: During the COVID-19 pandemic, remote cancer care, and video communication in particular, has become increasingly common in the context of routine visits and clinical trials. Though this medium has the potential to augment patient-provider communication, telehealth also raises concerns about the digital divide promoting disparities in access to cancer care. In this study, we surveyed oncology patients who declined to participate in a pilot study looking at a one-time pharmacist-led video visit for patients initiating oral anti-cancer medications to evaluate their primary reason for declining the intervention. Method(s): Between June 2021 and June 2022, we conducted a prospective survey among adult oncology patients at Columbia University Medical Center (CUMC) who declined a pilot study looking at a video visit intervention for patients initiating oral anti-cancer medications to assess the primary barriers to participation. The survey categorized specific reasons for decline into telehealth- related barriers (no access to electronic device, inability to navigate video visits specifically, patient preference for in person care) and trial-related barriers (patient too tired/unwell, no time to participate, not interested in this study specifically, not interested in clinical trial participation in general), and patients were asked to select the primary reason for declining among the list of options. Result(s): Twenty-three patients completed the survey (82% completion rate). Among 23 respondents, 9 patients (39%) described a technology-related barrier to participation, including 7 (30%) who owned a mobile device with video capacity, but did not know how to use video technology well enough for the visit, 1 (4%) who did not own a device with video capacity, and 1 (4%) who preferred in person visits. Fourteen respondents cited a reason unrelated to telehealth for declining participation, including 7 (30%) who did not feel the study would benefit them, 3 (13%) who did not have time, 2 (9%) who were too tired to participate in a study, and 2 (9%) who were not interested in participating in any kind of clinical trial. Conclusion(s): Video-based telehealth visits have become increasingly common in routine cancer care and clinical trials. Among oncology patients who declined participation in a pilot study looking at a pharmacist-led video consultation, over a third cited telehealth-related barriers to participation, the majority of whom had a mobile device, but did not know how to use video technology well enough to participate. Focusing efforts on training patients to use technology, particularly video communication, may help address the digital divide in cancer care.

Enteral feed delivery in patients with COVID-19 admitted to a Nightingale intensive care unit (ICU)

Introduction: Optimal calorie delivery is around 80% of predicted energy requirements.1 Underfeeding critical care patients may cause harm in some long stay patients.2 ESPEN guidelines state if oral intake is not possible, enteral nutrition should commence within 48 hours. Calorie delivery can be increased to 80-100% after day three of admission to ICU.3 The Nightingale ICU was situated on an acute ward which was modified to function as an ICU. This was to facilitate increased admissions of COVID-19. The Nightingale dietetic team were redeployed from acute and community settings in from within the trust, with various levels of ICU experience. The team provided seven day dietetic cover based on a rota, including bank holidays. Objectives: The aim of this audit was to evaluate enteral feed delivery and the number of days taken to reach target rate of feed compared to the regimen set by the dietitian, in patients with COVID-19 admitted to Nightingale ICU. Methods: At each review, dietitians calculated enteral feed delivery over the preceding 24 hours as a percentage of the target regimen, from the input recorded on the fluid balance chart. The number of days to reach enteral feed delivery targets were calculated relative to dietetic plans. All patients who required enteral nutrition from 15/10/ 2020 until 11/03/2021 were eligible for inclusion. Days where enteral feed was not required, target rate of enteral feed was not yet due to be achieved, parenteral nutrition was required, or following ICU discharge and end of life care were excluded. Days where enteral nutrition delivery information was unavailable were also excluded from the analysis. No imputation was used to estimate missing data. Results: The data consisted of a total of 116 patients. Following exclusions, the total number of patients included in the analysis was 107. Mean age was 63.6 ± 9.4 years.Mean body mass index (BMI) was 32.7 ± 7.4kg/m2. Number of enteral feed days per patient was 11. Patients with COVID-19 admitted to Nightingale ICU received a median of 84% of their enteral feeding regimen. The feeding regimen set by the dietitian aimed to achieve target rate of feed by 3.1 days. The data analysis showed the mean number of days until the target was achieved was 3.5 days. Conclusion: Results are based on a homogenous COVID-19 ICU cohort. Dietetic staffing levels were increased, and seven-day working was provided in response to the COVID-19 pandemic compared to a standard ICU. Quantifying common reasons for feed interruptions could be explored further. Despite suboptimal COVID-19 Nightingale ICU conditions, enteral feed delivery and time taken to reach target rate of feed was in keeping with ESPEN guidelines.

PROTECTIVE EFFICACY of A GASTROINTESTINAL SARS-CoV-2 VACCINE

Background: SARS-CoV-2 remains a global threat, despite the rapid deployment but limited coverage of multiple vaccines. Alternative vaccine strategies that have favorable manufacturing timelines, greater ease of distribution and improved coverage may offer significant public health benefits, especially in resource-limited settings. Live oral vaccines have the potential to address some of these limitations;however no studies have yet been conducted to assess the immunogenicity and protective efficacy of a live oral vaccine against SARS-CoV-2. Thus far, we assessed whether oral administration of live SARS-CoV-2 in non-human primates might offer prophylactic benefits. Methods: In this study, we assessed the immunogenicity of gastrointestinal (GI) delivery of SARS-CoV-2 and the protective efficacy against intranasal and intratracheal SARS-CoV-2 challenge in rhesus macaques. Esophagogastroduodenoscopy (EGD) administration of 106 50% Tissue Culture Infectious Dose (TCID50) of SARS-CoV-2 elicited low levels of serum neutralizing antibodies (NAb), which correlated with modestly diminished viral loads in nasal swabs (NS) and Bronchoalveolar Lavage (BAL) post-challenge. In addition, mucosal NAb titers from the rectal swabs (RS), NS, and BAL and Spike-specific T-cell responses appear to be below the limit of detection post-vaccination. Replicating virus was only observed in 44% of macaques and on limited number of dates post vaccination, suggesting limited, if any, productive infection in the GI tract. Results: We demonstrate that GI delivery of live 1x106 TCID50 SARS-CoV-2 elicited modest immune responses and provided partial protection against intranasal and intratracheal challenge with SARS-CoV-2. Moreover, serum neutralizing antibody titers correlated with protective efficacy. Conclusion: These data provide proof-of-concept that an orally administered vaccine can protect against respiratory SARS-CoV-2 challenge, but the limited immunogenicity and protective efficacy observed here suggests that the oral vaccine approach will require optimization.

104 The new virtual reality of CF care: Lessons learned in setting up a remote sampling service

Background: Regular microbiological sampling via cough swab or sputum collection is vital in CF care to detect early infection and implement timely optimal treatment [1]. Our service identifies on average 34 new Pseudomonas aeruginosa growths per year. Prior to the COVID-19 pandemic samples were performed routinely in pediatric CF outpatient clinic every 2-3 months by health care professionals and more frequently during pulmonary exacerbation;9 samples per patient per year on average. In March 2020 the UK went into its first lockdown, and 90% of our CF clinic appointments became virtual (video). A remote sampling service was rapidly implemented by the pediatric physiotherapy team. Methods: Sample packs with paid postage and compliant with Royal Mail regulations (UN3373) were sent out with written instructions. Parents wereaskedtotaketheirchild's sample, and avideo ofhowto complete and package the sample were provided. A physiotherapist was available virtually to guide the parent in sampling where necessary. Results: From July to December 2020, 640 sample packs were sent out to 340 children with CF in advance of their virtual clinic or following an urgent request. Only 588 (81.7%) specimens were returned, despite chasing late samples during the virtual clinic or sending reminders via text, required in approximately 25% of cases. Returned samples were received between 2 and 26 days of being taken. Conclusion: The postage delays experienced were concerning, not onlyas it increased the risk of the CF team missing the result, but also as Public Health England UK standards for microbiology investigations state that sputum should be processed promptly to reduce overgrowth with contaminants. Therefore, allresults received via post should be interpreted with caution, particularly if delayed [2]. The remote sample service was time-consuming, introduced a newcost to the service, and became harder to maintain as face-to-face services increased. However, as an urgent service improvement initiative it was successful as it picked up 35 new P. aeruginosa cases in 2020, which was in keeping with previous years' P. aeruginosa growths. This model has led to a more sustainable hospitalwide remote sampling service being established, now run by non-clinical teams. Remote sampling can now be requested electronically, saving time. Individualized QR codes are sent with the packs to be scanned by patients whenpostingthe specimen backThis informs the clinical teamso samples are not missed and can be actioned in a timely fashion.

Immunometabolic Dysregulation at the Intersection of Obesity and COVID-19.

Obesity prevails worldwide to an increasing effect. For example, up to 42% of American adults are considered obese. Obese individuals are prone to a variety of complications of metabolic disorders including diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease. Recent meta-analyses of clinical studies in patient cohorts in the ongoing coronavirus-disease 2019 (COVID-19) pandemic indicate that the presence of obesity and relevant disorders is linked to a more severe prognosis of COVID-19. Given the significance of obesity in COVID-19 progression, we provide a review of host metabolic and immune responses in the immunometabolic dysregulation exaggerated by obesity and the viral infection that develops into a severe course of COVID-19. Moreover, sequela studies of individuals 6 months after having COVID-19 show a higher risk of metabolic comorbidities including obesity, diabetes, and kidney disease. These collectively implicate an inter-systemic dimension to understanding the association between obesity and COVID-19 and suggest an interdisciplinary intervention for relief of obesity-COVID-19 complications beyond the phase of acute infection.

A framework for monitoring movements of pandemic disease patients based on GPS trajectory datasets

The rapid spread of contagious diseases poses a colossal threat to human existence. Presently, the emergence of coronavirus COVID-19 which has rightly been declared a global pandemic resulting in so many deaths, confusion as well as huge economic losses is a challenge. It has been suggested by the World Health Organization (WHO) in conjunction with different Government authorities of the world and non-governmental organizations, that efforts to curtail the COVID-19 pandemic should rely principally on measures such as social distancing, identification of infected persons, tracing of possible contacts as well as effective isolation of such person(s) for subsequent medical treatment. The aim of this study is to provide a framework for monitoring Movements of Pandemic Disease Patients and predicting their next geographical locations given the recent trend of infected COVID-19 patients absconding from isolation centres as evidenced in the Nigerian case. The methodology for this study, proposes a system architecture incorporating GPS (Global Positioning System) and Assisted-GPS technologies for monitoring the geographical movements of COVID-19 patients and recording of their movement Trajectory Datasets on the assumption that they are assigned with GPS-enabled devices such as smartphones. Accordingly, fifteen (15) participants (patients) were selected for this study based on the criteria of residency and business activity location. The ensuing participants movements generated 157, 218 Trajectory datasets during a period of 3 weeks. With this dataset, mining of the movement trace, Stay Points (hot spots), relationships, and the prediction of the next probable geographical location of a COVID-19 patient was realized by the application of Artificial Intelligence (AI) and Data Mining techniques such as supervised Machine Learning (ML) algorithms (i.e., Multiple Linear Regression (MLR), k-Nearest Neighbor (kNN), Decision Tree Regression (DTR), Random Forest Regression (RFR), Gradient Boosting Regression (GBR), and eXtreme Gradient Boosting regression(XGBR) as well as density-based clustering methods (i.e., DBSCAN) for the computation of Stay Points (hot spots) of COVID-19 patient. The result of this study showed clearly that it is possible to determine the Stay Points (hot spots) of a COVID-19 patient. In addition, this study demonstrated the possibility of predicting the next probable geographical location of a COVID-19 patient. Correspondingly, Six Machine Learning models (i.e., MLR, kNN, DTR, RFR, GBR, and XGBR) were compared for efficiency, in determining the next probable location of a COVID-19 patient. The result showed that the DTR model performed better compared to other models (i.e., MLR, kNN, RFR, GBR, XGBR) based on four evaluation matrices (i.e., ACCURACY, MAE, MSE, and R2) used. It is recommended that less developed Countries consider adopting this framework as a policy initiative for implementation at this burgeoning phase of COVID-19 infection and beyond. The same applies to the developed Countries. There is indication that GPS Trajectory dataset and Machine Learning algorithms as applied in this paper, appear to possess the potential of performing optimally in a real-life situation of monitoring a COVID-19 patient. This paper is unique given its ability to predict the next probable location of a COVID-19 patient. In the review of extant literature, prediction of the next probable location of a COVID-19 patient was not in evidence using the same Machine Learning algorithms. [ABSTRACT FROM AUTHOR] Copyright of Wireless Networks (10220038) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Satisfactory implementation of paediatric virtual clinics and the perspectives of parents

Aim To assess whether virtual clinics result in a reduction in unnecessary clinic appointments, whilst maintaining a high parental satisfaction rate. Methods Parents of children waiting greater than 36 months were called about the continued need for their appointment. Clinic outcome data was quantified and a phone survey of a random sample of participating parents was undertaken to assess their virtual clinic experience. Results 66% (154 children) no longer required appointments. 20 parents participated in the phone survey. 90% (18) agreed/strongly agreed that they had enough time to speak to the Consultant/CNS. 80% (16) reported they were satisfied with the telephone consultation. 35% (7) highlighted their frustration at not being contacted sooner. Positive remarks included the personal nature of the phone consultations, and reassurance that their children hadn’t been removed from the waiting list. The main disadvantage voiced was the lack of warning for the phone call. Conclusion Virtual clinics lead to a reduction in required face-to-face appointments, whilst maintain parental satisfaction. However, it is important to note, our study referenced patients waiting greater than 36 months. Introducing this new type of effective consultation is more important than ever given the need to reduce social interactions during this COVID-19 Pandemic.

The impact of COVID-19 on the prescribing practice of specialist cystic fibrosis physiotherapist non-medical prescribers in the UK

Background: In the first wave of the COVID-19 pandemic, people with cystic fibrosis (pwCF) in the UK were asked to ‘shield’ at home whilst many specialist CF staff were redeployed. CF services had to rapidly adapt to the changing circumstances and traditional roles were blurred as services were redesigned to try to maintain quality CF care alongside minimising risk of COVID-19. Objective: To examine the impact of COVID-19 on the prescribing practice of CF physiotherapist non-medical prescribers (CFPT-NMPs) in the UK. Method: A bespoke online questionnaire was sent to all members of the ACPCF NMP group in July 2020. Results: 19/27 CFPT-NMPs completed the questionnaire (6 adults, 12 kids and 1 both). A greater proportion of adult CFPT-NMPs (6/6, 100%) than kids (3/12, 25%) or both (0/1, 0%) had been redeployed to non-CF areas. All reported COVID-19 had changed their prescribing practice, with an overall trend towards prescribing outside their CF speciality 5/8 (63%). In adults the trend was towards less frequent prescribing (4/5, 80%) with an increase in the different types of medication prescribed (3/4, 75%);in kids there was an increase in frequency of prescribing (7/10, 70%) but no trend in change of types of medication prescribed. 14/18 (78%) reported a delay or cessation in completing non-urgent drug response assessments (DRAs). The 22% of respondents reporting no delay in DRAs were working in kids. The 11/18 (61%) who had completed DRAs reported large variability within the DRA process, specifically around use of PPE and outcome measures. Conclusion: COVID-19 has significantly impacted the delivery of CF care and CFPT-NMP's prescribing practice. Many DRAs, the gateway to pwCF accessing appropriate inhaled medications, have been delayed. This was more likely in the adult population, highlighting the greater impact COVID-19 has had on adult CF services. COVID-19-specific DRA guidance has subsequently been produced by our ACPCF NMP group, facilitating timely and safe practice nationally.

Impact of COVID-19 pandemic on crude mortality rates associated with acute kidney injury requiring continuous renal replacement therapy: A single-center study

RATIONALE Acute kidney injury requiring renal replacement therapy (AKI-RRT) in the intensive care unit (ICU) is associated with significant mortality, with short-term death rates often exceeding 50% in modern cohtorts.1 Similarly high mortality with AKI-RRT has been reported in multiple U.S. cohorts of patients with coronavirus disease 2019 (COVID-19)2-4, but none have specifically focused on the outcomes of AKI treated with continuous RRT (CRRT) in the ICU or compared the outcomes of AKI-CRRT to COVID-negative controls. METHODS We carried out a retrospective review of all patients admitted to the University of New Mexico Hospital and initiated on CRRT in January to October 2020 and compared outcomes between those with and without symptomatic COVID-19. Patients felt to be incidentally infected with COVID-19 and those with end-stage kidney disease (ESKD) were excluded. Crude death rates in AKI-CRRT patients with and without COVID-19 were compared by chisquared test. Patients discharged before 30 days were assumed alive at 30 days. RESULTSA total of 102 patients were treated with 103 CRRT treatments over the 10-month period. Of these, two felt to be incidentally infected were excluded. Ten with ESKD, including three with COVID-19, were also excluded. Of the remaining 90 with AKI-CRRT, 30 were treated for symptomatic COVID-19 starting in April 2020 and had 30-day and in-hospital mortality rates of 67.7% and 80.0%, respectively. Of the 60 COVID-19-negative patients with AKI-CRRT, the 30-day and in-hospital mortality rates were 58.3 and 63.3%, respectively (p = 0.44 and = 0.11, respectively, versus COVID-positive patients). When broken into pre-pandemic and post-pandemic groups, the 30-day and in-hospital death rates for AKI-CRRT in COVID-negative patients were 56.5% and 60.9% in January to March and 59.5% and 64.9% in April to October, respectively (p = >0.05 for both comparisons). CONCLUSIONS These data confirm the high mortality associated with AKI-CRRT in the setting of severe COVID-19. Though not statistically significant in this limited sample, the trend for higher in-hospital mortality in COVID-19 patients suggests the mortality of AKI-CRRT in this setting may be higher than other ICU patients. Notably, the mortality of AKI-CRRT in COVIDnegative patients did not significantly differ before and after the start of the pandemic. Overall, while conclusions about the independent effect of COVID-19 are limited with these unadjusted data, awareness of the high mortality of AKI-CRRT in the setting of COVID-19 may be useful in discussing prognosis and goals of care in these patients.

Microbial fuel cell: Bio-energy production from Nigerian corn starch wastewater using iron electrodes

The emerging increasing issues with the use of fossil fuel-derived energy resources and related challenges like pollution, global warming and climate change are boosters for adoption of renewable energy resource. Energy is a key criteria for socio-economic development of any nation, thus the search for an environmentally-friendly solution. Microbial Fuel Cell (MFC) is a promising method for the generation of green energy from waste. This study investigated the use of Nigerian corn starch wastewater as substrate for a dual-chamber MFC set-up. Iron electrodes were used for electron transfer. Up to 1.43 mA current, 0.97 V, 8.10 mA/cm2 maximum current density and 7.7 mW/cm2 maximum power density was achieved in 9 days of the experiment. The results present a relatively improved version when compared to previous studies. The experiment proves a promising alternative energy source for off-grid power solution, during Covid-19 and post-Covid-19 era.