Evaluating the Implementation of a Multi-Technology Delivery of a Mental Health and Wellbeing System of Care Within a Youth Sports Development Program During the COVID-19 Pandemic

The COVID-19 pandemic presents challenges to the provision of community programs and access to mental health services for young people. We examined the feasibility, reach, and acceptability of multi-technology delivery of an integrated system that assesses and provides feedback on youth mental health and wellbeing and connects them to care within the context of a youth sports development program. The system was delivered via computer, telephone, and teleconference with 66 adolescent boys participating in a rugby league development program in three communities in Australia. Young people completed online wellbeing and mental health measures (Assess step), parents were provided with telephone feedback on results, support, and referral options (Reflect step), and youth received teleconferenced workshops and online resources (Connect step). The multi-technology delivery was feasible to implement, and reach was high, with barriers experienced at the Assess step but minimally experienced at the Reflect and Connect steps. Delivering the system via multiple forms of technology was rated as highly beneficial and enjoyable by young people. Players improved in self-reported prosocial behaviour, gratitude, and anxiety symptoms from pre- to post-program. Strong collaboration between researchers, organisational personnel, and community members is important for achieving these outcomes.

COVID-19 UNMASKED: LONGITUDINAL COHORT STUDY EXAMINING MENTAL HEALTH OF YOUNG CHILDREN AND THEIR CAREGIVERS DURING THE PANDEMIC

Background: Studies investigating child well-being during the COVID-19 pandemic have largely focused on schoolaged children. Young children are still at considerable risk of being negatively impacted and this may have long-term consequences for their developmental trajectories across the lifespan. Objectives: To examine the mental health (MH) outcomes for young children (1-5 years of age) and caregivers and to identify the key risk and protective factors for child and caregiver emotional well-being. Methods: COVID-19 unmasked is a prospective longitudinal cohort study consisting of an online survey completed at four time points (baseline, 3, 6 and 12 months). The survey was launched in Australia during May 2020 and is part of a global collaboration with eight other countries. Child mental health was assessed by the Patient-Reported Outcomes Measurement Information System Early Childhood (PROMIS-EC) and the Depression, Anxiety and Stress Scale (DASS-21) was used to assess parent MH. Findings: Overall, approximately 34% of Australian children have experienced high to very high levels of irritability, anxiety, depressive symptoms and sleep disturbance. There was a significant increase in MH difficulties for children and caregivers who experienced the second extended lockdown in Victoria. Young children in Australia have experienced similar or higher levels of MH difficulties in comparison to children living in other countries (i.e. the United Kingdom, the United States, Turkey, the Netherlands, Spain). Conclusion: Findings indicate that the challenges very young children are facing during the pandemic should not be underestimated. Targeted intervention is needed to support young children and their caregivers in coping with the ongoing COVID-19 pandemic.

Bacterial components suppress experimental acute lung injury through regulatory T-cells

Introduction: The induction of regulatory T cells (Tregs) is indicated as a potential therapeutic strategy in inflammatory lung diseases including, asthma, viral-induced pneumonia, viral-induced acute lung injury (ALI), severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and SARSCoV- 2-induced ALI. We previously identified that components of the bacteria Streptococcus pneumoniae (T + P) are able to increase Tregs to suppress experimental allergic airways disease, however, this mechanism of suppression and therapy has not been examined in ALI. Methods: We established a murine model of ALI using aerosolized LPS (100 μg/ml) in BALB/c mice. ALI was measured by the presence of neutrophils in the airways up to 96 hours post-exposure, and Tregs and dendritic cells were assessed by flow cytometry. To assess the therapeutic of T + P in ALI and the mechanisms involved, the combination was administered prior to LPS exposure in the absence or presence of anti-CD25. Results: Treatment with T + P significantly reduced total airway inflammation and suppressed the neutrophil chemokine C-X-C motif chemokine ligand 1 (Cxcl1) compared to Saline+LPS alone in experimental ALI. The numbers of Tregs were reduced in experimental ALI model and were restored by T + P treatment. Depletion of Tregs with anti- CD25 confirmed that the suppressive effects of T + P on ALI was through the induction of Tregs. Conclusion: Treatment with S. pneumoniae components T + P suppresses neutrophilic inflammation in ALI through immunoregulatory mechanisms that involve Tregs and may be a novel treatment for ALI including in COVID-19.

Using technology to teach foundational writing skills in early elementary grades

Many children leave elementary school without either skills or enthusiasm for writing, which may have negative impacts on their future academic achievement and lifelong learning. Due to the sudden impacts of COVID-19, virtual instruction, and inequities in resources, new challenges for writing instruction have emerged, which require educators to develop novel, technologically enhanced strategies for developing young writers' skills. In the present chapter, the authors provide (1) an in-depth review of the developmental trajectories of writing from birth through third-grade;(2) discuss how models of technology pedagogy, including TPACK and SAMR, may be integrated with emergent writing skills;and (3) provide strategies and resources related to technology to empower early childhood and early elementary teachers with effective writing instructional practices and digital tools. Early childhood educators may become empowered with suggestions and guidance for integrating technology with early literacy development. © 2021, IGI Global.

Comparing the quantitative fit-testing results of half-mask respirators with various skin barriers in a crossover study design: a pilot study.

BACKGROUND: Clinicians around the world are experiencing skin breakdown due to the prolonged usage of masks while working long hours to treat patients with COVID-19. The skin damage is a result of the increased friction and pressure at the mask-skin barrier. Throughout the COVID-19 pandemic, clinicians have been applying various skin barriers to prevent and ameliorate skin breakdown. However, there are no studies to our knowledge that assess the safety and efficacy of using these skin barriers without compromising a sufficient mask-face seal. AIM: To conduct the largest study to date of various skin barriers and seal integrity with quantitative fit testing (QNFT). METHODS: This pilot study explored whether the placement of a silicone scar sheet (ScarAway®), Cavilon™, or Tegaderm™ affects 3M™ half-face mask respirator barrier integrity when compared to no barrier using QNFT. Data were collected from nine clinicians at an academic level 1 trauma centre in New Jersey. FINDINGS: The silicone scar sheet resulted in the lowest adequate fit, whereas Cavilon provided the highest fit factor when compared to other interventions (P < 0.05). CONCLUSION: These findings help inform clinicians considering barriers for comfort when wearing facemasks during the COVID-19 pandemic and for future pandemics.

PND29 Results from a Prospective Study Comparing the Cost Effectiveness of a NOVEL Neurology Lead Outpatient Plasma Exchange Service to the Standard IVIG at the Wessex Neurological Centre, UK

Introduction: Plasma exchange (PLEX) is an effective treatment for antibody-mediated neurological disorders and has been shown to be equally efficacious to intravenous immunoglobulin (IVIg)1. PLEX is often performed in an intensive care environment via membrane filtration which requires central venous access. However, PLEX can also be delivered with a centrifugation system via peripheral access, for example with the Spectra OptiaÒ apheresis system. We compared the economic cost of PLEX delivered by a neurology service for both outpatients and inpatients against the standard model of care with IVIg treatment. Method: We prospectively collected data from all neurology patients receiving PLEX between May 2019 and May 2020. The cost of PLEX delivered in an outpatient setting for an average 80Kg person was calculated and compared to the equivalent cost of delivering IVIg. Results: A total of 44 patients received PLEX during this period, which included the first two months of the COVID-19 pandemic in the UK. 357 exchanges were performed over 12 months. A total of 247 (69.3%) of the exchanges were delivered in an outpatient setting at a cost of £348,630. The predicted equivalent cost for outpatients receiving IVIg as an alternative, is £541,522, based on an average commercial price. The annual cost saving for PLEX over IVIg is £192,892. In addition, delivering outpatient PLEX led to a redundancy of 247 inpatient hospital beds stays. Conclusion: This prospective study of a novel outpatient neurology PLEX service, demonstrates that, delivered in this way, PLEX supersedes IVIg. It provides equal or better clinical outcomes1, at a lower cost. An opportunity cost of underutilising PLEX should be considered by publicly funded healthcare systems. Further studies are underway to study the cost-effectiveness of PLEX in this cohort of patients. References: 1. Osman C, Jennings R, El-Ghariani K, et al. Pract Neurol 2020, 20:92-99

Animal and translational models of SARS-CoV-2 infection and COVID-19.

COVID-19 is causing a major once-in-a-century global pandemic. The scientific and clinical community is in a race to define and develop effective preventions and treatments. The major features of disease are described but clinical trials have been hampered by competing interests, small scale, lack of defined patient cohorts and defined readouts. What is needed now is head-to-head comparison of existing drugs, testing of safety including in the background of predisposing chronic diseases, and the development of new and targeted preventions and treatments. This is most efficiently achieved using representative animal models of primary infection including in the background of chronic disease with validation of findings in primary human cells and tissues. We explore and discuss the diverse animal, cell and tissue models that are being used and developed and collectively recapitulate many critical aspects of disease manifestation in humans to develop and test new preventions and treatments.