Student Perceptions of Online Education during COVID-19 Lockdowns: Direct and Indirect Effects on Learning

The COVID-19 pandemic forced an abrupt transition to fully online learning in universities that typically provided campus-based teaching. We examined the learning experience of undergraduate and postgraduate students during this transition at a UK university. Qualitative surveys and interview responses revealed both direct effects of the transition to online learning and indirect effects caused by the COVID-19 induced lockdown. Direct effects related to interaction and communication altered study-related opportunities and digital tool use. In all cases, students expressed a range of views, for example, with some reporting greater opportunities and others fewer. However, there was a clear consensus that the online learning had brought greater flexibility for students. For indirect effects, students noted altered time available for study, challenges and benefits to studying at home, greater monotony and required autonomy as well as altered priorities, concerns about employment, finances and career prospects. These reflections on students' experiences of online learning can inform academics and education providers to design appropriate strategies in order to better facilitate and support students' education via fully online or blended learning approaches.

Effect of electronic adherence monitoring on adherence and outcomes in chronic conditions: A systematic review and meta-analysis.

INTRODUCTION: Electronic adherence monitoring (EAM) is increasingly used to improve adherence. However, there is limited evidence on the effect of EAM in across chronic conditions and on patient acceptability. We aimed to assess the effect of EAM on adherence and clinical outcomes, across all ages and all chronic conditions, and examine acceptability in this systematic review and meta-analysis. METHODS: A systematic search of Ovid MEDLINE, EMBASE, Social Work Abstracts, PsycINFO, International Pharmaceutical Abstracts and CINAHL databases was performed from database inception to December 31, 2020. Randomised controlled trials (RCTs) that evaluated the effect of EAM on medication adherence as part of an adherence intervention in chronic conditions were included. Study characteristics, differences in adherence and clinical outcomes between intervention and control were extracted from each study. Estimates were pooled using random-effects meta-analysis, and presented as mean differences, standardised mean differences (SMD) or risk ratios depending on the data. Differences by study-level characteristics were estimated using subgroup meta-analysis to identify intervention characteristics associated with improved adherence. Effects on adherence and clinical outcomes which could not be meta-analysed, and patient acceptability, were synthesised narratively. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed, and Risk of bias (RoB) assessed using the Cochrane Collaboration's RoB tool for RCTs. The review is registered with PROSPERO CRD42017084231. FINDINGS: Our search identified 365 studies, of which 47 studies involving 6194 patients were included. Data from 27 studies (n = 2584) were extracted for the adherence outcome. The intervention group (n = 1267) had significantly better adherence compared to control (n = 1317), (SMD = 0.93, CI:0.69 to 1.17, p<0.0001) with high heterogeneity across studies (I2 = 86%). There was a significant difference in effect according to intervention complexity (p = 0.01); EAM only improved adherence when used with a reminder and/or health provider support. Clinical outcomes were measured in 38/47 (81%) of studies; of these data from 14 studies were included in a meta-analysis of clinical outcomes for HIV, hypertension and asthma. In total, 13/47 (28%) studies assessed acceptability; patient perceptions were mixed. INTERPRETATION: Patients receiving an EAM intervention had significantly better adherence than those who did not, but improved adherence did not consistently translate into clinical benefits. Acceptability data were mixed. Further research measuring effects on clinical outcomes and patient acceptability are needed.

A Case Study Investigating Mental Wellbeing of University Academics during the COVID-19 Pandemic

COVID-19 has impacted Higher Education worldwide. While several studies have examined the effects of the pandemic on students, few have addressed its impact on academic staff. Here, we present both survey (n = 89) and interview (n = 12) data highlighting the pandemic-induced effects on academics from various disciplines and career stages. Data was collected between May and September 2020, aiming to capture and understand the immediate effects of the U.K. lockdown on the academics examining demographic and employment factors, digital abilities and confidence, and mental wellbeing. Analyses revealed that most academics were satisfied with the support they received from the university and colleagues, and they had adequate equipment and space at home to work. However, half incurred additional financial costs to maintain access to technology and many felt an altered relationship with the university. There were discrepancies in digital abilities and confidence according to employment status, age, faculty, and social identity as an academic. Teaching workload did not increase across the board, rather seniority predicted increases. Levels of wellbeing were low but were not significantly predicted by workload increase or abilities and confidence in working digitally as might have been expected. Stronger social identity as an academic may predict higher mental wellbeing with qualitative data suggesting teamwork and collegiate activities helped. Furthermore, interviewees identified several positive aspects to working remotely. These findings suggest universities should consider carefully how to support all staff to work digitally and consider flexible working post-pandemic.

Overcoming hurdles to intervention studies with autistic children with profound communication difficulties and their families.

LAY ABSTRACT: Autistic children who speak few or no words or who have an intellectual disability are the most in need of new understandings and treatments, but the most often left out of the research that can bring these benefits. Researchers perceive difficulties around compliance with instructions, testing, challenging behaviours and family stress. Although research with these children can indeed be difficult, their continuing exclusion is unethical and unacceptable. Drawing on our experiences testing a possible treatment for children with profound autism, we provide 10 practical guidelines related to (1) interacting physically, (2) combining play and testing, (3) responding to challenging behaviour, (4) finding suitable tests, (5) relationships with parents, (6) relationships with siblings, (7) involving stakeholders, (8) planning the testing times, (9) the role of the clinical supervisor and (10) recruiting and retaining participants. We hope that these guidelines will prepare and embolden other research teams to work with profoundly autistic children, ending their historical exclusion from research. These guidelines also could be useful for conducting research with children with intellectual disabilities.