Determination of the Effects of Prenatal Remdesivir Exposure on Placenta Morphology, Placental IgG Transfer, and Fetal Growth in a Humanized Mouse Model

Remdesivir (RDV) is an antiviral medication used most recently for the treatment of COVID-19. Although no adverse effects were observed on perinatal parameters in reproductive and development toxicology studies at doses up to four-fold clinical area under the curve (AUC) exposures, some researchers have reported that therapeutic levels of RDV may impair early embryogenesis, as observed by in vitro studies. In addition, the influence of prenatal RDV exposure on maternal IgG transfer in the placenta is still unknown. Administration of RDV in pregnant humanized mouse model (Tg32), which expresses the human Fc gamma receptor and transporter (FCGRT) gene, was used to further evaluate potential effects on IgG transfer and concurrent perinatal endpoints. Animals were dosed daily from gestational days (GDs) 10- 14 with 25 mg/kg RDV (GS-5734) via intravenous injection (n=3-5 per group). Concurrent vehicle control animals were dosed intravenously with 12% sulfobutyl ether- beta-cyclodextrin in water (pH3.5;NaOH/HCl). All animals were administered 2 mg/kg human IgG via intravenous injection on GD 14. Placentae and fetuses were collected from dams on GD 14, 15, 16, and 18 and evaluated using histopathology and qPCR for inflammation markers. No abnormal morphologies (necrosis/apoptosis) of placentae were observed between the concurrent control and RDVdosed groups. Additionally, no differences in maternal body weights were observed. There were no statistically significant differences in placenta weights. There were no statistically significant changes in pregnancy parameters (implantation sites and dead fetuses/litter) and fetal weights between the RDV-dosed group and concurrent controls at GD 14, 15, 16, and 18. No changes were observed in transcript levels of inflammation markers in the RDV-dosed group when compared to the concurrent control group. There was a slightly lower ratio of fetal IgG level to maternal IgG levels in the RDV-dosed group;however, no statistically significant differences were observed between the RDV-dosed group and concurrent controls on GD 14, 15, 16, and 18. Our results suggest that a daily dose of 25 mg/kg RDV on GDs 10-14 in humanized mice did not cause adverse effects on placenta and fetal development. (Funded by the Perinatal Health Center of Excellence: E0300201.).

Faculty Perspectives on how to Reimagine International Research for Students in a Virtual World

International research programs for students offer an important opportunity to support students in developing skills in both research and intercultural competence. During the COVID-19 pandemic, many of these programs made the shift to operating virtually, with likely impacts on program outcomes. The purpose of this study was to identify the approaches that program leaders used in adapting international research programs to the virtual environment and explore how these innovations could inform the design of these programs going forward. We conducted eight focus groups with over 40 U.S.-based faculty who had experience running these programs to understand the benefits, challenges, and future potential of incorporating virtual elements into international research programs for students. This paper reports the results of these focus groups and provides suggestions for future program design based on best practices and innovations identified through the development of virtual programs. © 2022 IEEE.

Exploring How Engineering Students Respond to Challenges While Working in Global Virtual Teams

This Research Full Paper aims to understand student experiences on global virtual teams in depth by exploring the challenges that students face, how they approach them, and how they assess their response to overcoming these challenges. During the COVID-19 pandemic, intercultural learning opportunities such as study abroad were limited, and many universities implemented global virtual team projects as an alternative approach to developing intercultural skills. Prior research of these programs has focused on identifying best practices, challenges, and learning outcomes, but has provided few insights into students' experiences in these projects. To explore these experiences, we collected written reflections from 65 students participating in global virtual team projects in the middle and at the end of the semester. We analyzed these data using a thematic analysis approach. We identified three main types of challenges that students experienced: group cohesion, communication, and project management. Students approached these challenges by making changes at the personal and the team level. Most notably, students tended to take a positive view of their approaches to addressing the challenges by suggesting that they found a solution, had a positive learning experience, or identified skills they wanted to improve in future projects. The results of this study can inform the design of global virtual project courses and encourage conversations about team conflict and how to address it while working in virtual cross-cultural environments. © 2022 IEEE.

Predictive Value of Procalcitonin across Disease States within an Inpatient Veteran Population

Background. Procalcitonin (PCT) can be elevated with certain bacterial infections. Debate continues as to how to best use this biomarker to guide antibiotic use. The primary objective of this study was to evaluate the correlation of PCT levels and the presence of bacterial infection on admission in the total population and in different disease states. Methods. This was a multicenter retrospective cross-sectional study of patients admitted with specified infectious diagnoses to two VA Medical Centers from 4/1/ 2019 to 7/1/2021. Patients were stratified into 4 cohorts for analysis;those with COVID-19, sepsis from respiratory source-(S-R), sepsis from non-respiratory source (S-NR), and respiratory source without sepsis (R). Electronic medical records were reviewed to collect the following: initial procalcitonin, cultures, SIRS criteria, comorbidities (CKD, ESRD, HF, immunosuppressed, surgery within the 7 days), and c-reactive protein. PCT elevation was defined as >=0.25 ng/mL. The frequency of positive cultures within 72 hours was evaluated for patients with elevated and normal PCT levels to determine the diagnostic performance of PCT overall and for each cohort. Results. 632 of 664 patients were evaluated in this study. PCT is elevated twice as often in the septic groups as compared to the non-septic groups (figure 1). Positive predictive value (PPV) varies from 27% to 63% as compared to negative predictive value (NPV) 53%-79% among the disease state groups (figure 2). Although small numbers, the NPV of PCT improves to 83% in patients with elevated temperature and white blood cells (WBC) (figure 3). Conclusion. The findings that NPV of PCT appears to be better than PPV, support current recommendations against using this as a diagnostic tool, but rather as a tool to assist with antibiotic de-escalation. Further studies are necessary to confirm whether there are specific markers such as temperature or WBC which may improve the NPV. Our data suggests PCT is less helpful in identifying the presence or absence of bacterial infection in septic versus non-septic patients. (Figure Presented).

Acute STEMI During the COVID-19 Pandemic at a Regional Hospital: Incidence, Clinical Characteristics, and Outcomes

Objectives: The aim of this study was to describe the characteristics and in-hospital outcomes of patients with acute ST-segment elevation myocardial infarction (STEMI) during the early COVID-19 pandemic at Piedmont Athens Regional (PAR), a 330-bed tertiary referral center in Northeast Georgia. Method(s): A retrospective study was conducted at PAR to evaluate patients with acute STEMI admitted over an 8-week period during the initial COVID-19 outbreak. This study group was compared to patients admitted during the corresponding period in 2019. The primary endpoint of this study was defined as a composite of sustained ventricular arrhythmia, congestive heart failure (CHF) with pulmonary congestion, and/or in-hospital mortality. Result(s): This study cohort was composed of 64 patients with acute STEMI;30 patients (46.9%) were hospitalized during the COVID-19 pandemic. Patients with STEMI in both the COVID-19 and control groups had similar comorbidities, Killip classification score, and clinical presentations. The median (interquartile range) time from symptom onset to reperfusion (total ischemic time) increased from 99.5 minutes (84.8-132) in 2019 to 149 minutes (96.3-231.8;P= .032) in 2020. Hospitalization during the COVID-19 period was associated with an increased risk for combined in-hospital outcome (odds ratio, 3.96;P= .046). Conclusion(s): Patients with STEMI admitted during the first wave of the COVID-19 outbreak experienced longer total ischemic time and increased risk for combined in-hospital outcomes compared to patients admitted during the corresponding period in 2019. Copyright © 2022 Turner White Communications Inc.. All rights reserved.

RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS IN THE SETTING OF GRANULOMATOSIS WITH POLYANGIITIS AND COVID-19

SESSION TITLE: COVID-Related Critical Care Cases SESSION TYPE: Case Reports PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm INTRODUCTION: We present a case of rapidly progressive glomerulonephritis in a patient with granulomatosis with polyangiitis and COVID-19 pneumonia. CASE PRESENTATION: A 72 year old man presented to the hospital with shortness of breath, fatigue, fevers, and malaise. Chest x-ray showed bilateral lower lobe infiltrates consistent with COVID-19 pneumonia and creatinine of 1.57, elevated from baseline of 1.30. He was diagnosed with COVID-19 pneumonia and admitted to the Intensive Care Unit due to acute hypoxic respiratory failure and worsening acute kidney injury. Past medical history was significant for granulomatosis with polyangiitis (GPA) with recurrent deep venous thromboses and splenic infarct. Warfarin was held due to supratherapeutic INR on admission. COVID-19 drug therapy was initiated, including baricitinib, remdesivir and decadron. Creatinine began to rise significantly and renal ultrasound was ordered but showed no hydronephrosis or acute abnormality of the kidneys. There was no improvement with administration of fluids, and hemodialysis was initiated due to worsening creatinine with a peak of 12.09 and a strong suspicion for rapidly progressive glomerulonephritis (RPGN) in the setting of GPA. High-dose steroid therapy was started and daily hemodialysis was continued. Patient required transfer to a tertiary care center for multifactorial shock where he continued to receive dialysis therapy. Patient eventually required mechanical ventilation and ultimately expired. DISCUSSION: GPA is an autoimmune small and medium vessel vasculitis most often associated with anti-neutrophil cytoplasmic antibodies (c-ANCA). Without treatment, GPA has a high mortality rate due to systemic vasculitis. Treatment of GPA includes immunosuppressive therapies like rituximab or cyclophosphamide. Environmental and infectious processes are thought to cause GPA. Viruses have also been shown to cause GPA with two such cases documented with SARS-CoV-2. Our case illustrates a patient with known previously GPA who developed RPGN in the setting of COVID-19. RPGN can lead to rapid loss of renal function in GPA and can be the initial presentation of the disease process. However, care must be taken as often the presentation of GPA lung sequela may mimic those of COVID-19, including dyspnea, hemoptysis, and radiographic changes. Obtaining ANCA autoantibodies as well as a urinalysis showing proteinuria can help distinguish GPA and guide clinical judgment in starting high-dose steroid therapy early in renal failure due to RPGN in the setting of COVID-19. CONCLUSIONS: COVID-19 in patients with GPA can trigger renal failure due to RPGN. Reference #1: Bressler MY, Pathak N, Cervellione K, et al. New Onset Granulomatosis with Polyangiitis Associated with COVID-19. Case Rep Dermatol Med. 2021. Reference #2: Hasan MR, Sakibuzzaman M, Tabassum T, Moosa SA. A Case of Granulomatosis with Polyangiitis (Wegener's Granulomatosis) Presenting with Rapidly Progressive Glomerulonephritis. Cureus. 2019. Reference #3: Lutalo PM, D'Cruz DP. Diagnosis and classification of granulomatosis with polyangiitis (aka Wegener's granulomatosis). J Autoimmun. 2014. DISCLOSURES: No relevant relationships by Kristin Davis No relevant relationships by Charles Peng

A CASE OF EGGERTHELLA BACTEREMIA IN A PATIENT WITH COVID-19

SESSION TITLE: COVID-19 Co-Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: We present a case of Eggerthella bacteremia in a patient with COVID-19. CASE PRESENTATION: A 69-year-old woman presented to the emergency room with chief complaint of cough, dyspnea, and malaise. After testing positive with a home COVID-19 test three days earlier, she continued to have worsening respiratory status and was brought in via ambulance. She was found to be tachycardic and hypoxic, requiring high-flow oxygen to maintain saturation in the emergency department. Chest X-ray showed bilateral patchy opacities consistent with multifocal COVID-19 pneumonia, and she was admitted to the intensive care unit for acute hypoxic respiratory failure. COVID-19 drug therapy was initiated, including baricitinib, remdesivir and decadron. Shortly after hospitalization, she began to endorse worsening abdominal pain. Physical exam elicited tenderness to palpation of her right lower quadrant. Abdominal CT scan showed distal ileum fluid collection concerning for possible bowel perforation. She underwent exploratory laparotomy which confirmed perforation, and a small bowel resection with anastomosis was performed. Blood cultures were positive for gram-positive bacilli, which were further identified as Eggerthella species. She required mechanical ventilation for worsening respiratory function post-surgery but remained unresponsive on the ventilator. The patient was administered vancomycin but continued to decline and eventually expired. DISCUSSION: Eggerthella is an anaerobic, gram-positive bacilli present in the gut microflora. Eggerthella infection has most often been reported in intra-abdominal infections. However, cases of bacteremia infection remain sparse. Most infections have been associated with other gastrointestinal processes including Crohn's disease, ulcerative colitis, appendicitis, and diverticulitis abscesses. Our case involved a patient with no significant gastrointestinal history admitted for COVID-19 pneumonia infection on baricitinib complicated by bowel perforation and bacteremia. Bowel perforation is a known risk factor of baricitinib use, and these risks should be discussed with the patient before beginning therapy. Overall mortality for Eggerthella species infection remains high, with some estimates as high as 31%. Much remains unknown about the impact on gut microbiome by SARS-CoV-2, however, early research suggests a higher rate of fungal co-infection in patients with COVID-19. As the literature on COVID-19 expands, more and more unusual pathogens such as Eggerthella may be found to contribute to the morbidity and mortality of patients being treated for COVID-19. CONCLUSIONS: Unusual pathogens such as Eggerthella may complicate a patient's hospital course while undergoing treatment for COVID-19. Reference #1: Alejandra Ugarte-Torres, Mark R Gillrie, Thomas P Griener, Deirdre L Church, Eggerthella lenta Bloodstream Infections Are Associated With Increased Mortality Following Empiric Piperacillin-Tazobactam (TZP) Monotherapy: A Population-based Cohort Study, Clinical Infectious Diseases, Volume 67, Issue 2, 15 July 2018. Reference #2: Gardiner BJ, Tai AY, Kotsanas D, et al. Clinical and microbiological characteristics of Eggerthella lenta bacteremia. J Clin Microbiol. 2015. Reference #3: Lau SK, Woo PC, Fung AM, Chan K-M, Woo GK, Yuen K-Y. Anaerobic, non-sporulating, gram-positive bacilli bacteraemia characterized by 16s rrna gene sequencing. Journal of medical microbiology. 2004. DISCLOSURES: No relevant relationships by Kristin Davis No relevant relationships by Charles Peng

Exploring challenges and opportunities posed by COVID-19 on team working and the delivery of residential neurorehabilitation to children and young people with acquired brain injury

Introduction: COVID-19 has placed major demands on healthcare services and practitioners (HCP's). Research has highlighted resilience, new skills and new ways of working. However, little attention has been paid as to whether challenges faced may have demonstrated or influenced effective change in working practices of individuals and teams delivering neurorehabilitation services to children and young people following an acquired brain injury. Patients and Methods: Exploratory qualitative study. Fourteen HCP's (10 female, 4 male) across 6 occupational disciplines participated in semi-structured interviews (February-May 2021). Transcriptions analysed using thematic content analysis managed in NVivo. Five broad topic areas explored (1) professional roles, role identity and professional autonomy, (2) role boundaries, (3) team working, (4) collective identity in relation to organisational challenges, (5) working practices. Results: A wealth of data was retrieved, analysis of findings from three of the key theme categories presented: Individual Professionalism, Working as Team and, Delivery of Rehabilitation services. Although there was much uncertainty, rapidly changing information and constraints imposed by the pandemic, the professionalism of the team was evident as HCP's regrouped and reviewed how service provision could continue. Personal and professional growth saw teams collectively flourish. Creative solutions led to teams working differently and more cohesively. A greater appreciation of team roles and goals within the specialist environment of paediatric rehabilitation emerged. Conclusions: Changes in structure, processes and provision of services necessitated greater interdisciplinary team integration and sharing of skills and expertise. As confidence and competencies of HCP's grew the potential for a more 24/7 approach to rehabilitation gained wide staff acceptance.

EFFECT OF COVID-19 ON HIP FRACTURE CARE IN WALES - AN ANALYSIS OF HOW ORGANISATION OF SERVICES AFFECTED HOSPITAL LENGTH OF STAY

Introduction The National Hip Fracture Database (NHFD) report that length of stay (LOS) fell (from 19.7 to 16.9 days) in the first year of the COVID-19 pandemic, as patients, families, cares, and staff in health and social care responded to this challenge. This analysis examines trends in Wales where LOS can be profiled very completely as it predominantly remains within a single health board. Method We used data from the NHFD www.nhfd.co.uk to define pre-pandemic LOS (in the year to 1st March 2020) and compare this with the following 18 months. We set figures for all 12 hospitals in Wales against the changes in service organisation which each reported to the NHFD's 2020 Facilities Survey, and against the local incidence of COVID-19 among their hip fracture patients. Results Monthly LOS fell markedly at the pandemic's onset;the national figure falling 8.3 days (from 31.2–22.9 days) between February and June 2020. Overall LOS in Wales fell by 1.6 days across the year as a whole, but this ranged from a fall of 6.3 days in one hospital to a rise of 4.5 days in another. Five hospitals reported a rise in LOS. These hospitals had either never had orthogeriatric support, or lost this to COVID-19 duties, they did not achieve the initial fall in LOS in response to the pandemic, and they reported pressures with ‘outliers’ after the first wave. Unlike other units in Wales they cited problems with workload, particularly in terms of physiotherapy. Discussion NHFD data provide a detailed picture of hospitals’ response to the COVID-19 pandemic, and allow us to examine service factors underpinning their resilience in the face of this challenge. More detailed work should be carried out for the 150 hospitals in England using the same sources of data.

Expansion of a Pathology Resident Wellness Initiative Amidst the COVID-19 Pandemic

Background: The focus on physician wellness and burnout continues to build in the era of the COVID-19 pandemic. The pre- COVID rate of burnout among pathology residents was reported to be approximately 46-52%, but there is little data on this group during the period of COVID-19. Amongst residents as a whole, the burnout rate during the COVID-19 pandemic is about 50%, with 69% of young healthcare workers (ages 18-29) reporting burnout. In addition to the limitations on direct social interaction, uncertainty pertaining to redeployment, risk of exposure to COVID-19, and future job security has added to the challenge of maintaining resident well-being during the pandemic. Design: An established Pathology Resident Wellness Initiative program at a large academic institution was expanded to address the well-being needs of pathology residents during the COVID-19 pandemic. With oversight from senior residents and department leaders, the Pathology Wellness Committee (PWC) planned both virtual and socially distanced in-person events to foster resident wellness while complying with safety guidelines. An annual Wellness Survey was modified in 2020 to assess resident well-being during the pandemic. Results: In compliance with COVID-19 safety guidelines, the PWC creatively designed social events including virtual yoga classes, an outdoor photo scavenger hunt, wellness hikes, holiday events, and periodically provided individually packaged meals and baked goods for residents. The Wellness Survey distributed during the pandemic revealed that 76% of residents felt satisfied or very satisfied with their relationships with coworkers, friends, and family despite social distancing guidelines. There was no significant change in the amount of residents who reported feeling cheerful (p=0.38), fulfilled (p=1.00), or appreciated (p=0.38) more than half of the time compared to pre-COVID results. Conclusions: The COVID-19 pandemic created many unique challenges for maintaining wellness during residency, including for pathology trainees. With expansion of an existing pathology resident Wellness Initiative, our Wellness Committee was able to creatively and safely continue to promote wellness objectives and adapt to the challenge of social distancing during the COVID-19 pandemic.

The impact of the COVID-19 lockdown on greenhouse gases: a multi-city analysis of in situ atmospheric observations

We tested the capabilities of urban greenhouse gas (GHG) measurement networks to detect abrupt changes in emissions, such as those caused by the roughly 6-week COVID-19 lockdown in March 2020 using hourly in situ GHG mole fraction measurements from six North American cities. We compared observed changes in CO2, CO, and CH4 for different mole fraction metrics (diurnal amplitude, vertical gradients, enhancements, within-hour variances, and multi-gas enhancement ratios) during 2020 relative to previous years for three periods: pre-lockdown, lockdown, and ongoing recovery. The networks showed decreases in CO2 and CO metrics during the lockdown period in all cities for all metrics, while changes in the CH4 metrics were variable across cities and not statistically significant. Traffic decreases in 2020 were correlated with the changes in GHG metrics, whereas changes in meteorology and biology were not, implying that decreases in the CO2 and CO metrics were related to reduced emissions from traffic and demonstrating the sensitivity of these tower networks to rapid changes in urban emissions. The enhancements showed signatures of the lockdowns more consistently than the three micrometeorological methods, possibly because the urban measurements are collected at relatively high altitudes to be sensitive to whole-city emissions. This suggests that urban observatories might benefit from a mixture of measurement altitudes to improve observational network sensitivity to both city-scale and more local fluxes.

The River and The Highway: How an Interceptor Failure Produced Solutions

The objective of emergency repairs for TRA is to put critical infrastructure that has failed back in to service immediately to prevent or reduce environmental impacts and to restore wastewater collection and transmission service for our customers. After significant rainfall event in March 2020, the Collection Systems Group for the Trinity River Authority of Texas inspected the external conditions of all of the major interceptor lines in the Central Regional Wastewater System for possible line breaks. On March 26, CSG staff identified a major pipeline failure on the 102-inch pipeline for the West Fork interceptor. The pipeline failed in a section immediately adjacent to the West Fork of the Trinity River while the river was in flood stage from the latest significant rain event. The interceptor was passing over 150 MGD of wastewater meant for the CRWS treatment facility, but a portion of the wastewater flow was escaping from the collapsed pipeline in to the river. Once CSG notified the Construction Services group, of the on-call construction contractor, Flow Line Construction, was contacted and immediately mobilized to stop wastewater leakage and to begin pipeline repairs on the collapsed portion of the pipeline. The solution for the emergency repair was multi-faceted: 1)Construction a massive sandbag wall between the failed pipe and the Trinity River to stop wastewater leaking in to the river and to keep the river from washing out the pipeline work are;2) Build a working surface for excavators to access the pipeline site and to setup of bypass pumps;3) Remove the failed section of pipe from the flow path of the wastewater;4) Install bypass piping and pumping equipment and divert flow from the failed pipeline section;5) Install new segments of pipe to restore the pipeline to serviceable conditions;6) Restore bypass flow back to the interceptor and remove bypass pumps and piping;and 7) Perform all of the work listed above while adhering to rapidly changing conditions due to COVID-19 pandemic without having losing one member of the work force to COVID-19. The Roles and Responsibilities of the project team were: 1) Inspection Supervisor – The owner representative that provides direction to the contractor and coordinates construction plans with in-house engineers;2) Engineer – Provided flow ranges for bypass pumping design, collaborated with the contractor to size and layout the bypass pumps, and oversaw the re-installation of the collapsed pipeline;3) Contractor – The contractor staff includes a professional engineer who collaborated with TRA staff to rapidly develop and implement a plan for demolition and reconstruction. In conclusion, while the work took place in a difficult to access area during a period of greater than normal rain and a pandemic, the pipeline was put back in to service in less than 3 weeks. This was through communication, cooperation, and coordination from the contractor, engineers, and inspection staff. Additionally, the river bank was stabilized and armored to prevent future erosion of the pipeline alignment. Copyright © 2021 Water Environment Federation

Examining the Efficacy of Exam Wrappers in a Computer Science Course

An exam wrapper is a guided reflection activity that students undertake following an exam. Students are typically asked to reflect on their preparation, performance, and plans for preparing for the next exam. The efficacy of exam wrappers for reflective learning has been established in STEM disciplines such as physics, biology, chemistry, and math. Very little research in using exam wrappers in engineering and computing courses has been conducted to date. Two contributions of this paper are (1) a characterization of the recent findings in engineering and computing education literature on the efficacy of exam wrappers, and (2) an analysis of the question types used on those exam wrappers. A third contribution of the paper is an examination of the efficacy of exam wrappers in an upper-level computer science course. The study investigates the relationship between student performance on two midterm exams before and after introducing exam wrappers. Student responses about study habits and reasons for losing points on exams are examined as well. We perform quantitative and qualitative analysis over performance and perception data, respectively. We conclude that exam wrappers can benefit students in both learning gains (as measured by exam performance) and by employing metacognition to improve study habits and behaviors. The paper also contributes to the study of student performance and engagement during the COVID-19 pandemic;in the term under study, the course was taught in a synchronous, remote learning format with an active learning component and online exams. © American Society for Engineering Education, 2021

Psychosocial stressors of parenting and the postpartum period during COVID-19

Objective: Pandemic-related changes produced a major shift for parental roles, responsibilities, and expectations. Our objective was to identify parenting challenges experienced by low-income postpartum mothers during a global pandemic lockdown. Study Design: In this qualitative investigation, we conducted semi-structured interviews with 40 postpartum individuals who gave birth in a single center in Chicago in the first three months of the COVID-19 pandemic (January-March 2020). Interviews addressed issues related to maternal health and well-being, including parental stress, limited access to essential goods, and COVID-related barriers to providing for children. All interviews were conducted via phone, transcribed, and analyzed using the constant comparative method. Results: Of the 40 participants, 50% (n=20) identified as non-Hispanic Black and 38% (n=15) as Hispanic;75% (n=30) were parents of multiple children. The primary parenting-related themes included challenges of parenting multiple children, barriers to self-care, and novel barriers to providing for children (Table). Subthemes within challenges of parenting multiple children include new role as an educator, struggle with entertaining, and time allocation. The barriers to self-care subthemes included lack of free time, changes in self-care and coping strategies, and effects on maternal mental health. The novel barriers to providing for children subthemes included lack of communal support, financial stress, and difficulty obtaining essential needs. Conclusion: Obstetric providers are often a first-line point of contact for postpartum individuals and may benefit from understanding how psychosocial stressors experienced during the pandemic may negatively affect maternal health. Our findings suggest new psychosocial burdens were introduced by the pandemic that challenged individual health and wellbeing during the postpartum period. Findings can inform interventions, which may include enhanced support from the clinical team or connections to community resources, to alleviate postpartum challenges for mothers and their families. [Formula presented]

A Potential Canary in the Coal Mine: A Critical Policy Analysis of the Illinois LSAMP During the COVID-19 Pandemic

The COVID-19 pandemic has continued to impact every industry and test problem-solving capabilities and innovation across the board;education is no exception. As institutions continue to adapt to the impacts of the current public health crisis, colleges and universities are also navigating federal policy prompted by the pandemic. Literature has shown the positive influence of organizations, such as the Louis Stokes Alliances for Minority Participation (LSAMP), and, we argue that they can take a more active intermediary approach, that of an Organizational Buffer, to best support their students during times of uncertainty. Current research highlights the disconnect between STEM education and policy, as well as how the pandemic is disproportionately impacting communities of color. The pervasiveness of whiteness within educational policy and the negative impacts of unequal distribution of resources on students of color in STEM highlight the need to center race in a theoretical framework and policy. The purpose of this study was to understand the policy and communication responses to the pandemic as they pertained to supporting student success in STEM. Using the Theory of Racialized Organizations, which is a qualitative case study approach that leverages diffractive readings, was implemented to understand whether educational policy and communication responses during this time have or perpetuated inequitable systems. Guided by the research question, in what ways do pandemic policies and communications bolster the success of underrepresented minoritized students (URM) majoring in STEM, our study found four versions of policymaking (i.e., Performative, Picking Winners and Losers, Stay in your Lane, and Time Burden) that emerged and did not support URM STEM students equitably and consistently. Based on these findings, we present implications for institutional responses, LSAMP-alliance support, and future research. © Copyright © 2021 Morgan, Callais, Acevedo and Davis.

Key priorities in mental health research: results of a community and provider survey across the US

Objectives: Integrating mental health screening and treatment into cystic fibrosis (CF) centres has led to numerous successes: increased awareness, reduced stigma and greater access to mental health care (Quittner et al., 2020). Given that anxiety and depression screening are now part of routine care, the major aim was to identify the most important, future research priorities in mental health. Method: A 22-item online survey was sent out July 2020 to people with CF (pwCF), caregivers, and US providers in the CF community, who were given 3 weeks to respond. Questions focused on: ranking topics by importance and impact, identifying gaps in our understanding of mental health issues, and priorities and needs during COVID-19. Results: Response time was 7–11 minutes, with 693 community respondents (half pwCF, majority ages 26–45 years) and 352 CF clinicians (mainly social workers, center directors). Substantial agreement was found between community respondents and providers on the top 5 priorities:1) anxiety, 2) depression, 3) effects of psychological symptoms on physical health, 4) risk factors for anxiety/depression, and 5) effects on family functioning and parenting. Although ranked highly, differences emerged for substance misuse and disordered eating, with higher rankings endorsed by providers than community respondents. Priorities for improving outcomes were also similar: 1) greater access to mental health providers and 2) improving mental health interventions. Conclusion: A large-scale survey of CF community members and providers revealed clear consensus on the top research priorities. In addition to increased understanding of anxiety and depression (e.g., risk factors, long-term effects), new topics emerged, including substance misuse, disordered eating, and interactions between medications and mental health (e.g., modulators). Acknowledgement: Cystic Fibrosis Foundation