Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago.

INTRODUCTION: Opioid overdoses in Chicago are unevenly distributed, affecting medically underserved neighborhoods most acutely. Innovations in reaching patients perceived to be hard-to-reach (e.g., unstably housed, marginalized), especially in these underserved neighborhoods, are urgently needed to combat the overdose crisis. This study characterizes the pilot year of a mobile medical unit partnership between a large urban academic center and a community-based harm reduction organization in Chicago. METHODS: This is a retrospective cohort study of all patients who were seen on a mobile medical unit focused on providing low-threshold buprenorphine and primary care in areas with high opioid overdose rates on Chicago's West Side. Treatment episodes were accrued between July 1, 2021, and June 30, 2022 in the first year of operation. The main outcomes were number of patients seen, demographic characteristics of patients, and reason(s) for visit over time. RESULTS: The study saw 587 unique patients on the mobile medical unit between July 1, 2021, and June 30, 2022. Approximately 64.6 % were African American, and more than half lacked active insurance or could not confirm insurance status at the time of visit. The most common reason for initial visit was COVID-19 vaccination (42.4 %), and the most common reason for follow-up visit was buprenorphine treatment (51.0 %). Eleven patients initially presented for other health concerns and later returned to initiate buprenorphine. CONCLUSIONS: The mobile medical unit successfully reached nearly 600 patients in traditionally medically underserved Chicago neighborhoods with the highest overdose rates. The mobile unit's integrated approach met a variety of health needs, including buprenorphine initiation, with a unique opportunity for postoverdose initiation. Several patients initiated buprenorphine after presenting for different health concerns, showing the potential of an integrated approach to build on past mobile outreach programs and reach people with opioid use disorder who are not yet ready to initiate treatment.

Going Virtual: Adapting an Institutional Annual Bereavement Event During the COVID-19 Pandemic.

Our institution's annual bereaved family event was modified to a virtual format during the COVID-19 pandemic. While necessary to comply with physical distancing directives, the transition also provided greater accessibility for families. Virtual events were feasible and appreciated by attendees. Future hybrid bereavement events should be considered to allow families more flexibility and accessibility.

Design Futuring for Love, Friendship, and Kinships: Five Perspectives on Intimacy

Human relationships, intimacy and the role of technology within it constantly change, catapulted in 2020 by COVID-19. We take this social rupture as an opportunity to reimagine possible futures for love, friendship, and kinships. Through design futuring and related approaches, we offer five prompts we developed for imagining alternative futures exploring a diverse range of intimacies. Through generating responses to the prompts, we offer alternative intimate futures as well as reflections on how such 'prompts for futuring' can be generative for design research. Our work extends calls for diversifying design futuring, imploring design researchers to consider diverse and inclusive ways of designing for futures, especially for human relationships and intimacy. © 2022 Owner/Author.

TheWorksheet School: COVID-19 Lockdown and Online Schooling in Public Schools of Delhi

The COVID-19 pandemic led to the closure of educational institutions across India, which meant that all schooling activities shifted overnight to online platforms. This posed a problem for students from low-income communities who may not have the necessary infrastructure to participate fully in online school. To mitigate this, the Government of Delhi introduced a worksheet based education system for all public schools in the national capital to ensure no student was denied education. This paper discusses a qualitative study conducted between July to December 2020 with grade 10 students from Delhi public schools, their teachers and parents to understand: (1) the effect of a new shared home-school context and (2) the emergence of a 'Worksheet School' infrastructure created to facilitate learning and teaching in low-resourced schools. We reveal how the home as a new site for learning affected students' participation in online school, how the worksheets were re-purposed to support schooling activities and how WhatsApp was used for delivering educational instructions and the fostering of community learning. We discuss implications for equitable access to online learning materials and future work that aims to further study online learning environments in low-resource communities. © 2021 ACM.

Providing Psychological Support to Parents of Childhood Cancer Survivors: 'Cascade' Intervention Trial Results and Lessons for the Future.

We conducted a three-armed trial to assess Cascade, a four-module group videoconferencing cognitive behavior therapy (CBT) intervention for parents of childhood cancer survivors currently aged <18 years. We allocated parents to Cascade, an attention control (peer-support group), or a waitlist. The primary outcome was parents' health-related quality of life (PedsQL-Family Impact/EQ-5D-5L) six months post-intervention. Parents also reported their anxiety/depression, parenting self-agency, fear of recurrence, health service and psychotropic medication use, engagement in productive activities, confidence to use, and actual use of, CBT skills, and their child's quality of life. Seventy-six parents opted in; 56 commenced the trial. Cascade achieved good parent engagement and most Cascade parents were satisfied and reported benefits. Some parents expressed concerns about the time burden and the group format. Most outcomes did not differ across trial arms. Cascade parents felt more confident to use more CBT skills than peer-support and waitlisted parents, but this did not lead to more use of CBT. Cascade parents reported lower psychosocial health scores for their child than waitlisted parents. Cascade parents' health service use, psychotropic medication use, and days engaged in productive activities did not improve, despite some improvements in waitlisted parents. Our trial was difficult to implement, but participants were largely satisfied. Cascade did not improve most outcomes, possibly because many parents were functioning well pre-enrolment. We used these findings to improve Cascade and will trial the new version in future.

Hanging Out Online: Social Life During the Pandemic

In March 2020, the government of India ordered a nationwide lockdown to prevent the spread of Covid-19. This led to the shutdown of educational institutes throughout the country, restricting all activities to online mediums. The shift has affected how students engage with each other, where rather than in-person interaction, they meet through a variety of online tools. In this paper, we discuss how the normal everyday routine of ‘hanging out’ with friends has been transformed during a prolonged lockdown of over ten months and counting. We investigate the opportunities and challenges students encounter when socializing online through various online modes including video calls, communal movie watching and social media. We discuss how social interaction;in particular, hanging out with friends has been transformed through these technologies and its implications for facilitating spontaneous interaction, negotiating intimacy, mutual understanding, and accessibility to different social groups. Finally, we conclude with a discussion of how these factors impact the transition from in-person to online modes of casual social interaction. © 2021, IFIP International Federation for Information Processing.

From Mild to Wild: Reimagining Friendships and Romance in the Time of Pandemic Using Design Fiction

With the forced reboot of our lives due to the COVID-19 pandemic, our interpersonal relationships are nowhere yet everywhere. However, opportunities for initiating or maintaining friendships and romance in the physical world have dwindled. Within the context of India where multiple realities exist, the question arises - what is the future of these relationships? In this paper, we present the outcomes of a workshop looking at the future of relationships using design fiction. Participants worked in small teams to create scenarios that critically consider the future of love, friendships, and romance within the Indian context. Through the lenses of criticality, empowerment, and value creation, we examine the design scenarios and the design process including criticality of the designs, empowering experiences of the participants, and the perceived value gained from participating in such a workshop. Our findings indicate the potential of design fiction to allow participants to step out of their comfort zone into a critical stance in discussing love and intimacy. Based upon our findings, we discuss implications for design research, practice, and education. © 2021 Owner/Author.