IMPACT OF INTERGENERATIONAL SERVICE LEARNING ON PSYCHOLOGICAL DISTRESS FOR HOMEBOUND OLDER ADULTS DURING COVID

More than 2 million of older adults are homebound and 5 million need help leaving their homes. They often experience social isolation, food insecurity, and lack of connection to community resources, which for many has intensified since the pandemic. To date, home-based services for those aging in place are lacking. Using newly available data, this study examined the benefits of an intergenerational home-based service learning program in reducing psychological distress for a community-based sample of 190 homebound older adults during the COVID-19 pandemic. Multivariate regression analyses were conducted to examine the association of living in one's own home, disability status, presence of child and spousal caregivers, and length of services from the program with psychological distress. Findings indicated that length of service with the intergenerational in-home support program was associated with lower psychological distress (β = -0.16, p < 0.05). Having a child as a caregiver was associated with lower psychological distress (β = -0.15, p < 0.05). Poor health status was associated with higher levels of psychological distress (β = 0.16, p < 0.05). Living in one's own home, having a spouse as a caregiver, disability status, and having a long-term medical condition were not associated with psychological distress in the analysis. Results from this study suggest that intergenerational in-home support services can help reduce psychological distress for homebound older adults. Policies and practice can support a pipeline of geriatric health professionals through innovative service learning models to benefit older adults, caregivers, and students.

A District General Hospital (DGH) EBUS Service: a different model

Dorset County Hospital set up its EBUS service in February 2020. The Respiratory consultant undertook 2 training courses and then undertook a period of direct EBUS training at Southampton General Hospital. The service continued throughout the COVID 19 pandemic. We have undertaken 45 cases between Feb 2020 and Aug 2021. 3/45 were non diagnostic. All cancer cases provided enough tissue for molecular studies. 1 case was abandoned due to desaturation once the vocal cords were anaesthetised, but there have been no other complications. Previously all of our EBUS cases had to be sent to Poole or Bournemouth Hospitals (now University Hospitals Dorset) meaning our patients had to travel. There is no real local provision for staging EBUS in Dorset. We do not have funding for Rapid OnSite Evaluation (ROSE) so the 2 Lung CNS and Advanced Nurse Practitioner make the slides in the endoscopy room, after training from the biomedical scientists. This approach has been supported by our Histopathologist. Now the ANP and endoscopy nurses will often operate the needle, due to only having 1 trained consultant and 1 junior Respiratory registrar. Using the nurses to undertake the needling has not been associated with a drop off in diagnostic yield and has allowed the service to be more robust/ We have 2 EBUS scopes, which have both been funded through charitable funding. It is possible to run a diagnostic EBUS service under sedation at a DGH, utilising the endoscopy staff and Lung CNS to take and process the samples. It is important to be creative with service models when recruitment is challenging.

PRE-PANDEMIC CIRCADIAN PHASE PREDICTS PANDEMIC SLEEP, DEPRESSION, AND ALCOHOL USE AMONG ADOLESCENTS

Growing evidence links later circadian rhythm timing during adolescence to worse sleep, more symptoms of depression, and greater alcohol involvement, perhaps due to circadian misalignment and sleep restriction imposed by early school start times. School schedules shifted later during the initial phase of the COVID-19 pandemic, which hypothetically should reduce circadian misalignment and sleep restriction for adolescents with later circadian timing, and thus may mitigate any problems with sleep, depression, and alcohol. Here we used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing, relative to those with earlier circadian timing, showed improved sleep, depressive symptoms, and alcohol involvement. We studied 42 high school juniors and seniors reporting alcohol use (aged 16-18;27 female participants), assessing circadian phase via the dim light melatonin onset (DLMO) during pre-pandemic conditions, and then following them over four remote assessments every 3 months during the pandemic. Sleep characteristics were assessed via the Munich Chronotype Questionnaire, depressive symptoms were assessed via the Quick Inventory of Depressive Symptomatology, and alcohol use was assessed via a 90-day Timeline Followback. Mixed-effect models focused on the pre-pandemic baseline, COVID baseline (Apr/ May 2020), and COVID-9-mo (Jan/Feb 2021) timepoints, and covaried for age, time between prepandemic and COVID baselines, and whether or not individuals were currently in school or working. In the pre-pandemic period, compared with those with earlier circadian timing, individuals with later circadian timing (later DLMO) got relatively less sleep (shorter total sleep time) on school nights. During the pandemic, earlier and later groups no longer differed on school night sleep. Over the course of the pandemic, compared with the earlier group, individuals with later circadian timing also reported larger increases in alcohol use (number of drinks, drinking days, and maximum drinks). Individuals with later circadian timing reported relatively greater depressive symptoms both pre-pandemic and 9-months into the pandemic. While individuals with later circadian timing benefitted in terms of more school night sleep during the pandemic, this did not translate to mitigating depression or alcohol use. These findings suggest that later circadian timing may contribute to risk for depression and alcohol use over and above effects due to insufficient sleep.

PRE-PANDEMIC CIRCADIAN PHASE PREDICTS PANDEMIC SLEEP, DEPRESSION, AND ALCOHOL USE AMONG ADOLESCENTS

Introduction: Growing evidence links later circadian timing during adolescence to worse sleep, more severe depression, and greater alcohol involvement, perhaps due to circadian misalignment and sleep restriction imposed by early school start times. School schedules initially shifted later during the COVID-19 pandemic, which hypothetically should reduce circadian misalignment and sleep restriction for adolescents with later circadian timing, and thus may mitigate any problems with sleep, depression, and alcohol. Here we used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing, relative to those with earlier circadian timing, showed improved sleep, depressive symptoms, and alcohol involvement. Methods: We studied 42 high school students reporting alcohol use (aged 16-18;27 female participants), assessing circadian phase via the dim light melatonin onset (DLMO) during prepandemic conditions, and then following them over four remote assessments every 3 months during the pandemic. Sleep characteristics were assessed via the Munich Chronotype Questionnaire, depressive symptoms were assessed via the Quick Inventory of Depressive Symptomatology, and alcohol use was assessed via a 90-day Timeline Followback. Mixed-effect models focused on the pre-pandemic baseline, COVID baseline (Apr/May 2020), and COVID-9-mo (Jan/Feb 2021) timepoints, and covaried for age, time between pre-pandemic and COVID baselines, and current school/work status. Results: In the pre-pandemic period, compared to those with earlier circadian timing, individuals with later circadian timing (later DLMO) got relatively less sleep (shorter total sleep time) on school nights. During the pandemic, earlier and later groups no longer differed on school night sleep. Over the course of the pandemic, compared to the earlier group, individuals with later circadian timing also reported larger increases in alcohol use (number of drinks, drinking days, and maximum drinks). Individuals with later circadian timing reported relatively greater depressive symptoms both pre-pandemic and 9-months into the pandemic. Conclusion: While individuals with later circadian timing benefitted in terms of more school night sleep during the pandemic, this did not translate to mitigating depression or alcohol use. These findings suggest that later circadian timing may contribute to risk for depression and alcohol use over and above effects due to insufficient sleep.

Longitudinal Evaluation of Neuro-PASC Symptoms

Objective: A longitudinal study (NeuCovid) was created at UC San Diego to compare the long-term neurological outcomes of SARS-CoV-2 infection in two cohorts, patients with and without prior neurologic disease. Background: While cross-sectional analyses have demonstrated the prevalence of neurological symptoms in the Post-Acute Sequelae of SARS-CoV-2 infection (PASC), the evolution of these symptoms over time has not yet been well-described. Design/Methods: Participants with neurological symptoms post-acute infection with SARS-CoV-2 were recruited. Team members conducted assessments including a detailed SARS-CoV-2 infection history, neurologic review of systems (scored on 10-point severity scale), neurologic exam, MoCA exam, and self-reported neuropsychiatric questionnaires, at baseline (conducted after acute infection resolved) and at 3-,6-, and 12-month follow-ups. As appropriate, participants were referred for imaging and neuropsychological testing. We report 6-month data, but 12-month data will be available in 2022. Results: 61 participants (69% female, mean age 50.2 years) were enrolled, 18 with prior known neurological disease. Acute COVID-19 disease severity was largely described as mild (44.4%) or moderate (48.1%). To date, 27 participants (74% female, mean age 52.6 years) completed baseline and 6-month follow-up visits. At baseline, the most common symptoms included fatigue (85.2%), headaches (74.1%), memory impairment (59.3%), insomnia (55.6%), and decreased concentration (48.1%). Complete symptom resolution was reported in 33.3% at 6-month follow-up. In the remaining participants at 6 months, persistent memory impairment (68.8%), decreased concentration (61.5%), fatigue (52.2%), insomnia (46.7%), and headache (45.0%) were reported. Average severity score decreased for fatigue (69.4%), headache (64.3%), insomnia (51.3%), decreased concentration (47.6%), and memory impairment (38.6%). Average MoCA scores improved from baseline (n=19, 26.4 to 28.0). Conclusions: Early in neuro-PASC, fatigue and headache were the most common reported symptoms. At 6-month follow-up, memory impairment and decreased concentration were most prominent. Only a third of participants had complete resolution of neuro-PASC symptoms at 6 months.

Gender Inequality in Paid and Unpaid Work During Covid-19 Times

We employ real-time household data to study the impact of the pandemic lockdown on paid and unpaid work in Spain. We document large employment losses that affected more severely low-skilled workers and to some extent college educated women. We show that the pandemic resulted in an increase in the gender gap in total hours worked, including paid and unpaid work. This is due to the smaller decrease in paid work hours among women that was not compensated by a smaller increase in unpaid work. We also examine the impact of the lockdown on within-household specialization patterns. We find that while men slightly increased their participation in home production, the burden continued to be borne by women, irrespective of their labor market situation. This evidence suggests that traditional explanations cannot account for the unequal distribution of the domestic workload. Additional analysis supports gender norms as a plausible explanation for our findings.

Message From the Editors to Our Reviewers

Neurology(R) manuscript submissions continue to increase every year;mid-2020 saw a large influx of manuscripts related to complications of coronavirus disease 2019 (COVID-19), many of which went through an expedited peer-review process. The journal received 4301 new and 691 revised manuscripts between April 1, 2020, and September 30, 2020 (compared to 3336 new and 597 revised manuscripts during the same period in 2019). We received 7158 peer reviews (compared to 4455 during the same period in 2019) evaluating these papers.

Procedural Patchwork: Community-Focused Generative Design for Quilting

We are developing quilt design generation software for Code Crafters workshops, which aim to broaden public awareness of computational thinking and build links between computer science and quilting. The software generates quilt designs, which will be manipulated and modified by workshop participants. Due to COVID, our workshops will be conducted remotely, so the software has been designed to increase the sense of community by providing opportunities for the types of social interactions that take place in colocated quilting workshops. © 2021 Owner/Author.

What the Flock?: Fostering collaborative Active Breaks for Online Education

The sudden transition to online education due to the COVID-19 pandemic created a lack of informal embodied social interactions between children. To address this, we developed What The Flock?, an online game for Active Breaks for children in primary and elementary school. Children collaboratively create migratory bird flock formations by controlling a bird character through bodily movement captured by their webcam. A calibration process allows each child to define the thresholds of movements to control their bird. Each player also controls the volume of a sound track, resulting in a unique song for every instance of game play. © 2021 Owner/Author.

Essential workers: A multiplayer game for enacting patterns of social interdependency in a pandemic

In order to understand a pandemic like the COVID-19 crisis of 2020, we have to keep in mind larger patterns (e.g., information visualizations such as charts), and individual perspectives (e.g., interviews). However, it is challenging to connect these larger patterns with lived experiences. In this work-in-progress paper, we argue that interactive digital experiences such as games have the potential to bridge this gap by allowing players to explore the pandemic at multiple levels of abstraction. We present Essential Workers: an online multiplayer game which situates players as one of four workers?Nurse, Grocery Worker, Office Worker, or Delivery Driver?who face difficult dilemmas as they live through three weeks of rising infection during the COVID-19 pandemic. Through a core cooperative game mechanic, Essential Workers seeks to tie the constraints and choices of the individual to the health of their communities, and to simulate some of the interdependencies that keep our communities functional during the pandemic. We aim to illustrate our approach to key challenges commonly faced by designers seeking to model the entanglements of the individual and society. © 2020 ACM.