Back and neck problems as well as disadvantageous ergonomic behavior patterns in university students: Concomitants of the pandemic?

Background: As a part of the coronavirus disease 2019 (COVID-19) lockdown measures, universities converted courses to digital formats, leading to remote studying. It is unclear how these measures affect university students in terms of musculoskeletal problems (i.e., neck and back pain), e.g., by non-ergonomically equipped home offices or reduced physical activity. Material(s) and Method(s): Students from Osnabruck University weresurveyed via fully standardized online questionnaires from early March to mid-April 2022 (6 weeks) about neck and back problems, movement behavior in home offices, and personal information. Result(s): Of 447 students who clicked on the link, 378 students (80.4% female, mean age: 24.1 +/- 4.2 years) answered the questionnaire (response rate: 84.6%). 299 (79.1%) students suffered from neck pain and 294 (77.8%) from back pain during the pandemic. 206 (54.4%) students generally used ergonomic furniture, 83 (22.0%) used ergonomic sitting furniture, 57 (15.1%) used a standing desk, and 212 (56.1%) used aids for a more comfortable use of laptops in home office. 203 (53.7%) students took movement breaks in home office, 207 (54.8%) worked out regularly, and 65 (17.2%) moved regularly in the fresh air. Conclusion(s): The present study found a high rate of neck and back pain amongst university students. Measures are needed to prevent neck and back pain in this group, considering that increased physical activity and enhanced home office equipment might be beneficial.Copyright © 2022 Elsevier GmbH

ONLINE PARTICIPATORY TOOLS IN CLASSROOM AND RESEARCH SETTINGS

Collaborative engagement in research and education often involves the need for a shared workspace among participants. With improved web-based technologies, and limitations to in-person interactions presented by the COVID-19 pandemic, educators and researchers need to adapt their methods and tools to support meaningful engagement. We reflect on our experiences and iterative experiments navigating these challenges in the domains of design education and design research. As design educators, our team utilized various online platforms including video conferencing, whiteboards, spreadsheets, surveys, and polling tools, to support teaching and student collaboration. As design researchers working in the domain of maternal healthcare, we borrowed from our experiences in the classroom and applied some of these tools to our research with patient and clinician stakeholders, to support data collection and research team collaboration. In this paper, we elaborate on these experiences by drawing from examples across our teaching and research activities to share key strengths, challenges, and considerations of the online workspaces, with a particular focus on online whiteboards. We compare the two settings and reflect on barriers and facilitators of online engagement specific to these. Lastly, we suggest recommendations for designing online activities and selecting appropriate online tools based on the objective, contextual needs, and the affordances of tools and activities. Our findings may support decisions of educators, designers, and researchers in planning for online engagement. © Proceedings of the 24th International Conference on Engineering and Product Design Education: Disrupt, Innovate, Regenerate and Transform, E and PDE 2022. All rights reserved.

The NSW Telestroke Service: A cross-agency collaboration to implement and sustain a virtual care hyperacute stroke service at 23 regional and rural hospitals

Background: The $21.7 million NSW Telestroke Service was a 2019 NSW Government election commitment. Implementation of the service is a collaboration between South Eastern Sydney Local Health District, the NSW Agency for Clinical Innovation, eHealth NSW and the NSW Ministry of Health. Between March 2020 and June 2022, the telestroke service launched at 23 sites across regional and rural NSW, providing access to specialist stroke physicians for rapid assessment, diagnosis and treatment through virtual care. The service has treated over 2200 patients with a reperfusion rate for acute ischaemic stroke patients of 34%. Aim(s): To understand the factors driving the successful implementation of a major project led by multiple health organisations in a complex environment. Interrogating and documenting the success factors will help NSW Health agencies implement similar large-scale, complex projects. Method(s): The implementation team adopted a reflective approach to draw out key lessons during the implementation at each site. Lessons learnt discussions were held at a local and program-wide level, focusing on areas including resourcing, leadership, education and training, and sustainability. Result(s): Key elements of successful implementation highlighted by the reflective lessons learnt approach include: * Division of responsibility that reflected the strengths of each partner agency * Clear implementation roadmap including comprehensive implementation and training packages * Flexibility to adapt the implementation approach based on contextual factors and intervening events * Strong executive support at each partner agency * Upfront focus on sustainability to identify and mitigate issues early on The telestroke service was implemented by the target schedule, despite the significant impacts caused by the COVID-19 pandemic and natural disasters. The service was a finalist in the 2021 NSW Premier's Awards. Conclusion(s): The implementation of telestroke can offer insights for partner agencies into the key factors driving success of transformative projects to improve access to healthcare.

Local Extension of a Solitary Extra Medullary Nasal Plasmacytoma into the Orbit

Aim Extramedullary plasmacytoma are rare neoplasms, which mainly occur in the head and neck, the most common site being the nasal cavity or septum. Patients may present with epistaxis, nasal obstruction, or rhinorrhoea. Extension into the orbit is rare but can lead to visual disturbances. Method This case report pertains to a 69-year-old female patient who initially presented with a 6-week history of recurrent sinusitis, with left sided cheek pain and diplopia. Results A CT and MRI scan was performed, which showed opacification of the left maxillary, ethmoid and sphenoid sinuses with bony destruction of the medial and anterior maxillary walls and into the anterior soft tissues. The mass was completely obstructing the left nasal cavity extending into the inferomedial orbit. Staging CT scans also showed nodal disease in the neck. Biopsy with histology was positive for CD138, with diffuse proliferation of plasma cells of varying maturity and atypia. Additionally, mono IgG kappa was also positive as was CD45 suggestive of a lymphoid neoplasm. Bone marrow biopsy and PET scan confirmed there was no systemic involvement. Radiotherapy was initiated after the patient recovered from COVID -19. A repeat MRI scan 6 weeks post radiotherapy showed a partial response with reduction in the size of the tumour, resolution of the intra-orbital extension and disappearance of paraprotein. Conclusions This case report illustrates need for earlier consideration of EMP diagnostically to reduce the risk of conversion of the plasmacytoma to multiple myeloma, which is a known possibility and to ensure minimal delay in the commencement of treatment.

Bilateral diaphragmatic dysfunction: A cause of persistent dyspnea in patients with post-acute sequelae of SARS-CoV-2

Persistent shortness of breath is one of the most common concerns reported by patients with post-acute sequelae of SARS-CoV-2. Here, we present a case of bilateral diaphragmatic paralysis as a cause shortness of breath that developed after SARS-CoV-2 infection. A middle-aged gentleman with history of sleep apnea and body mass index 27.9 kg/m2 presented to our post-COVID clinic with 3 months of dyspnea and orthopnea after contracting SARS-CoV-2 in November 2020. During acute infection, he was hospitalized for hypoxemia, which improved with steroids and supplemental oxygen. At 3 months, he continued to report dyspnea and orthopnea. On examination, he had tachycardia and increased respiratory rate with paradoxical respiratory abdominal movement. Chest imaging showed elevated bilateral hemidiaphragms without any parenchymal lung disease. Pulmonary function test revealed severe ventilatory defect with restrictive lung disease. He was diagnosed with bilateral diaphragmatic dysfunction which was confirmed by absence of evoked potentials in diaphragm after phrenic nerve stimulation bilaterally. He was advised to use continuous positive airway pressure machine to assist with breathing at night. At his last follow-up (1-year post-infection), he was symptomatically improving without specific interventions.

Problem-Solving in a Pandemic: How the Creation of a New Workflow Improved the Quality and Timeliness of Remote Core Descriptions

The COVID-19 pandemic limited global travel and access to core facilities. However, by adopting an innovative remote core description workflow, potential delays to an important reservoir characterisation study were avoided and mitigated. Over c.1700ft of middle Miocene core from an Onshore well in Abu Dhabi was described using high-resolution core photos, CT scans and CCA data. Detailed (1:20ft scale) descriptions of heterogeneous, mixed lithology sediments from a gas reservoir were produced. The aim when developing the workflow was not to try and replicate the process of in-person core description, but to create a workflow that could be executed remotely, whilst maintaining technical standards. Ideally, we wanted to find a solution that also had the potential to improve the overall quality of core description, by integrating more data from the onset. The workflow used a matrix to generate a confidence score for the description of each cored interval. Factors such as core condition were considered, which highly influences the extractable core information. The confidence score was used to make decisions, such as whether an in-person review of the core was necessary, especially where core condition was below a reasonable threshold. This helped prioritise cored intervals for review, ensuring time in the core store was focused, and allowed accuracy and reliability of the remote description to be assessed. The 4-phase workflow is summarised as: 1. Image extraction of white light (WL), ultraviolet (UV) and computed tomography (CT) core images. 2. Digital chart creation, core-to-log shifts and sample selection: a.Wireline data, CCA data and core images loaded b.Core images used to determine core-to-log shifts c.Thin section, SEM and XRD samples selected 3. Remote core description: a.Conducted using all core imagery, CCA and wireline data b.Thin section, SEM and XRD data were used to refine the description when they became available c.A confidence score was given to each cored interval 4. QC and finalization: a.Using the results from phase 3, a selection of cored intervals for in-person review was made. Intervals included those with a poor match between remote description and petrographic data, or areas with a low confidence score. b.Following the review, charts were finalised and quality-checked for data export Using this workflow, ensured work on an important study could continue during the pandemic. Such an approach has continued value for future studies as it increases efficiency and accounts for more data to be considered in core description prior to viewing the core in-person;it has been used on recent studies with great success. Another benefit to this approach is that less time in the core store is required, reducing potential HSE risks and helping to manage core store availability in busy facilities. © Copyright 2021, Society of Petroleum Engineers

Will Online Learning Become a New Norm in Higher Education?

The Covid-19 pandemic has been seen by some as the event that will finally make online delivery become a dominant mode in universities. This study reports the preferences of students for online teaching, collaboration, and assessment using survey data gathered after a lengthy period of full online delivery and at a time when students were free to choose conventional, online and hybrid approaches to learning, collaboration and assessment. Most previous research has explored student preferences with respect to specific courses or at the institutional level, but the present study examines students' preferences with respect to their discipline: arts, science and technology, business, hospitality and mathematics. Analyses revealed that students prefer conventional lectures providing that recordings are made available online, but that students prefer small group teaching, collaborative work, assessment, support and other activities to be delivered conventionally. These preferences were broadly similar across students drawn from the different discipline areas, but there was also some variation between the disciplines. Overall the findings suggest that students prefer conventional on-campus teaching, learning and assessment to full online delivery. © 2021 ACM.

What are the most important unanswered research questions on rapid review methodology? A James Lind Alliance research methodology Priority Setting Partnership: the Priority III study protocol

Background: The value of rapid reviews in informing health care decisions is more evident since the onset of the coronavirus disease 2019 (COVID-19) pandemic. While systematic reviews can be completed rapidly, rapid reviews are usually a type of evidence synthesis in which components of the systematic review process may be simplified or omitted to produce information more efficiently within constraints of time, expertise, funding or any combination thereof. There is an absence of high-quality evidence underpinning some decisions about how we plan, do and share rapid reviews. We will conduct a modified James Lind Alliance Priority Setting Partnership to determine the top 10 unanswered research questions about how we plan, do and share rapid reviews in collaboration with patients, public, reviewers, researchers, clinicians, policymakers and funders.

Improving vitamin D content in pork meat by UV bio-enrichment

Given the marked variation in seasonally-induced cutaneous synthesis, habitually low dietary vitamin D intakes (2–4μg/day) and the generally low uptake of supplementation at the population level, identification of alternative food-based strategies are urgently warranted. Bio-enrichment is a growing area of research, with particular interest in the use of fortified animal feed and/or UV exposure to naturally increase vitamin D content in meat(2). Since meat contributes the highest percentage to total vitamin D intake(3), enriched pork meat may offer a plausible vehicle for bio-enrichment. In Study 1, UVB exposure significantly increased serum 25(OH)D3 concentrations in the pigs (mid and endpoint, p < 0.05) but did not alter total vitamin D activity, vitamin D3 nor 25(OH)D3 concentration in pork meat compared to control (p > 0.05).

Vitamin D bio-enrichment of pork may offer a food-based strategy to increase vitamin D intakes in the UK population

Hypovitaminosis D is prevalent worldwide, with many failing to achieve the recommended nutrient intake (RNI) for vitamin D (10- 20μg/d)(1). Moreover, the COVID-19 pandemic has re-emphasised the need to avoid vitamin D deficiency to help maintain immune function(2) and the urgent need for food-based strategies to help address this(3). The aims of the current study were to 1) determine any changes to vitamin D intake and status over a 9-year period, and 2) apply dietary modelling to predict the impact of vitamin D bio-enrichment of pork and pork products on population intakes in the UK. Data from the National Diet and Nutrition Survey (NDNS) Rolling Programme Year 1-9 (2008/09-2016/17) were analysed using SPSS to determine nationally representative mean vitamin D intakes and 25(OH)D concentrations [a robust biomarker of vitamin D status]. Subgroup analysis investigating variance in sex, age and season was conducted. Informed by previous studies(4), four theoretical dietary modelling scenarios of vitamin D pork bio-enrichment were analysed (vitamin D content + 50/100/150/200% vs standard). Vitamin D intake in the UK population has not changed significantly from 2008 to 2017 yet, over the same period significant gender difference (M 2.66 ± 1.99μg/d and F 2.30 ± 1.66μg/d, p < 0.05) and seasonal variation in the mean 25(OH)D concentrations were evident. In 2016/17, across all age groups, 13.2% were considered insufficient (25(OH)D <25nmol/L). Across the whole group, theoretical modelling demonstrated an increase of 4.9, 10.1, 15.0 and 19.8% in daily vitamin D intake when vitamin D concentrations in bio-enriched pork were elevated by 50, 100, 150 and 200%, respectively. Based on the 200% modelling scenario, a greater relative change was observed in males (22.6%) compared to females (17.8%), and although older adults (65+ years) had significantly greater vitamin D intakes compared to other age categories (3.28 ± 2.27μg/day), this age group observed the smallest relative increase from the dietary modelling scenarios (14.3%). The greatest relative change was observed amongst 11-18-year olds, where 200% vitamin D bio- enrichment of pork and pork products would result in a 25.2% increase in mean daily vitamin D intakes. Vitamin D intakes have remained stable in the UK across almost a decade, and current results confirm that strategies are required to help the population achieve the RNI for vitamin D. These findings align with Irish data and provides incentive to pursue bio-enrichment practices. Specifically, bio-enrichment of pork meat provides a proof of concept, demonstrating that animal-based strategies may offer an important contribution to help to improve the vitamin D intakes of the UK population, particularly adolescents.

How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey.

The effects of COVID-19 have the potential to impact on the management of chronic diseases including osteoporosis. A global survey has demonstrated that these impacts include an increase in telemedicine consultations, delays in DXA scanning, interruptions in the supply of medications and reductions in parenteral medication delivery. INTRODUCTION: The COVID-19 pandemic has had profound effects on the health of the global population both directly, via the sequelae of the infection, and indirectly, including the relative neglect of chronic disease management. Together the International Osteoporosis Foundation and National Osteoporosis Foundation sought to ascertain the impact on osteoporosis management. METHODS: Questionnaires were electronically circulated to a sample of members of both learned bodies and included information regarding the location and specialty of respondents, current extent of face to face consultations, alterations in osteoporosis risk assessment, telemedicine experience, alterations to medication ascertainment and delivery and electronic health record (EHR) utilisation. Responses were collected, quantitative data analysed, and qualitative data assessed for recurring themes. RESULTS: Responses were received from 209 healthcare workers from 53 countries, including 28% from Europe, 24% from North America, 19% from the Asia Pacific region, 17% from the Middle East and 12% from Latin America. Most respondents were physicians (85%) with physician assistants, physical therapists and nurses/nurse practitioners represented in the sample. The main three specialties represented included rheumatology (40%), endocrinology (22%) and orthopaedics (15%). In terms of the type of patient contact, 33% of respondents conducted telephone consultations and 21% video consultations. Bone mineral density assessment by dual-energy X-ray absorptiometry (DXA) usage was affected with only 29% able to obtain a scan as recommended. The majority of clinicians (60%) had systems in place to identify patients receiving parenteral medication, and 43% of clinicians reported difficulty in arranging appropriate osteoporosis medications during the COVID-19 crisis. CONCLUSIONS: To conclude through surveying a global sample of osteoporosis healthcare professionals, we have observed an increase in telemedicine consultations, delays in DXA scanning, interrupted supply of medications and reductions in parenteral medication delivery.