Clashing Roles and Identities of EL Teachers during Emergency Remote Teaching and Learning

During Emergency Remote Teaching and Learning (ERTL) and the closure of schools due to the COVID-19 pandemic, teachers of multilingual students were positioned to adopt varied outreach methods to sustain access to education among multilingual families. Prior to ERTL, instruction in schools was socially situated as having greater institutional value relative to service-oriented tasks, yet service-related needs, including health and human services and/or access to technology increased during the physical closure of schools. EL teachers took on more service-related tasks for their MLL families and did so by assuming, negotiating and resisting particular roles;a reflexive and interactional process. Using theories of teacher positioning and language teacher identity, we examined the experiences of EL teachers in the Great Lakes Region of the US. Findings demonstrate that few EL teachers resisted roles within instruction and service during ERTL, a critical dimension of teacher identity transformation and advocacy for MLLs. As we move into recovery from the COVID-19 pandemic and into a Remote Teaching and Learning (RTL) period, implications suggest that when EL teachers' roles and identities are incongruous, resilience can be fostered informing a unique form of agency and teacher leadership;a necessary characteristic for an equity-informed education. © 2023 The Authors. TESOL Quarterly published by Wiley Periodicals LLC on behalf of TESOL International Association.

What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States.

OBJECTIVE: The ways that device-associated infection prevention practices changed during the coronavirus disease 2019 (COVID-19) pandemic remain unknown. We collected data mid-pandemic to assess the use of several infection prevention practices and for comparison with historical data. DESIGN: Repeated cross-sectional survey. SETTING: US acute-care hospitals. PARTICIPANTS: Infection preventionists. METHODS: We surveyed infection preventionists from a national random sample of 881 US acute-care hospitals in 2021 to estimate the current use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated events (VAE). We compared the 2021 results with those from surveys occurring every 4 years since 2005. RESULTS: The 2021 survey response rate was 47%; previous survey response rates ranged from 59% to 72%. Regular use of most practices to prevent CLABSI (chlorhexidine gluconate for site antisepsis, 99.0%, and maximum sterile barrier precautions, 98.7%) and VAE (semirecumbent positioning, 93.4%, and sedation vacation, 85.8%) continued to increase or plateaued in 2021. Conversely, use of several CAUTI prevention practices (portable bladder ultrasound scanner, 65.6%; catheter reminders or nurse-initiated discontinuation, 66.3%; and intermittent catheterization, 37.3%) was lower in 2021, with a significant decrease for some practices compared to 2017 (P ≤ .02 for all comparisons). In 2021, 42.1% of hospitals reported regular use of the newer external urinary collection devices for women. CONCLUSIONS: Although regular use of CLABSI and VAE preventive practices continued to increase (or plateaued), use of several CAUTI preventive practices decreased during the COVID-19 pandemic. Structural issues relating to care during the pandemic may have contributed to a decrease in device-associated infection prevention practices.

Ensuring equity in mental health and psychosocial support during the COVID-19 pandemic and beyond.

Populations affected by armed conflict and other humanitarian crises are at elevated risk for mental health problems. While the COVID-19 pandemic has had broadly deleterious effects on livelihoods, economic well-being, and population health worldwide, vulnerable groups have been disproportionately impacted by the pandemic. Providing mental health and psychosocial support (MHPSS) services during these times to vulnerable groups, especially in low- and middle-income countries and humanitarian settings, is essential. In an effort to comply with the public health response to the pandemic and mitigate COVID-19 transmission, significant implementation adaptations were made to service delivery during the pandemic. This short report describes several strategies to ensure that equity was central to these adaptations and public health responses, and provides recommendations for ensuring continuity of this progress post-pandemic. Examples and key lessons learned are given related to strategies to increase access to MHPSS services, improve meaningful stakeholder engagement, develop and support community networks, and implement community-based psychosocial support groups. They come from diverse settings of Bangladesh, Colombia, Ecuador, and Lebanon. The COVID-19 pandemic has highlighted the importance of preventing and treating MHPSS issues. It also has created opportunities for innovative programming to address overlooked problems, improve the quality of services provided, and increase focus on equity. It is vital that we use the momentum and attention generated around MHPSS services during the COVID-19 pandemic to continue to build and improve existing MHPSS services in more equitable ways for vulnerable populations.

Comparison of the Impact of COVID-19 on Veterans Affairs and Non-federal Hospitals: a Survey of Infection Prevention Specialists.

BACKGROUND: As the COVID-19 pandemic evolves, it is critical to understand characteristics that have allowed US healthcare systems, including the Veterans Affairs (VA) and non-federal hospitals, to mount an effective response in the setting of limited resources and unpredictable clinical demands generated by this system shock. OBJECTIVE: To compare the impact of and response to resource shortages to both VA and non-federal healthcare systems during the COVID-19 pandemic. DESIGN: Cross-sectional national survey administered April 2021 through May 2022. PARTICIPANTS: Lead infection preventionists from VA and non-federal hospitals across the US. MAIN MEASURES: Surveys collected hospital demographic factors along with 11 questions aimed at assessing the effectiveness of the hospital's COVID response. KEY RESULTS: The response rate was 56% (71/127) from VA and 47% (415/881) from non-federal hospitals. Compared to VA hospitals, non-federal hospitals had a larger average number of acute care (214 vs. 103 beds, p<.001) and intensive care unit (24 vs. 16, p<.001) beds. VA hospitals were more likely to report no shortages of personal protective equipment or medical supplies during the pandemic (17% vs. 9%, p=.03) and more frequently opened new units to care specifically for COVID patients (71% vs. 49%, p<.001) compared with non-federal hospitals. Non-federal hospitals more frequently experienced increased loss of staff due to resignations (76% vs. 53%, p=.001) and financial hardships stemming from the pandemic (58% vs. 7%, p<0.001). CONCLUSIONS: In our survey-based national study, lead infection preventionists noted several distinct advantages in VA versus non-federal hospitals in their ability to expand bed capacity, retain staff, mitigate supply shortages, and avoid financial hardship. While these benefits appear to be inherent to the VA's structure, non-federal hospitals can adapt their infrastructure to better weather future system shocks.

COVID-19 vaccine controversy: A cross-sectional analysis of factors associated with COVID-19 vaccine acceptance amongst emergency department patients in New York City.

Objective: Understanding variables associated with coronavirus disease 2019 (COVID-19) vaccine confidence and hesitancy may inform strategies to improve vaccine uptake in clinical settings such as the emergency department (ED). We aim to identify factors contributing to COVID-19 vaccine acceptance and to assess patient attitudes surrounding offering COVID-19 vaccines in the ED. Methods: We conducted a survey of a convenience sample of patients and patient visitors over the age 18 years, who were native English or Spanish speakers. The survey was conducted from March through August 2021 at 3 EDs in New York City. The survey was administered via an electronic format, and participants provided verbal consent. Results: Our sample size was 377. Individuals with post-graduate degrees viewed vaccines positively (Prevalence Ratio [PR], 1.63; 95% Confidence Interval [CI], 1.07-2.47).  Of the various high-risk medical conditions associated with adverse COVID-19 infection outcomes, diabetes was the only condition associated with more positive views of vaccines (PR, 1.37; CI, 1.17-1.59). Of all participants, 71.21% stated that they believed offering a COVID-19 vaccine in the ED was a good idea. Of unvaccinated participants, 21.80% stated they would get vaccinated if it were offered to them in the ED. Conclusion: EDs can serve as a safety net for vulnerable populations and can act as an access point for vaccination.

Covid-19 Prevention Behaviors in a Cooperative Extension Audience: Findings from a Nutrition Education Study

The COVID-19 pandemic has dramatically impacted the delivery of nutrition education through Cooperative Extension. This study aimed to identify a Cooperative Extension audience’s attitudes towards virus prevention behaviors, preferred sources of information regarding COVID-19, and nutrition education preferences during the pandemic. We distributed an online survey to 477 potential nutrition education participants including questions about behaviors like mask wearing, preferences for virtual nutrition lesson delivery, and attitudes towards sources of information about COVID-19. Attitudes towards mask wearing and preferred sources of information differed significantly by race, income, and age. These differences have serious implications for future outreach and program delivery © This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License

Healthcare-associated infection prevention and control practices in Israel: results of a national survey.

BACKGROUND: Healthcare-associated infection (HAI) is a common and largely preventable cause of morbidity and mortality. The COVID-19 pandemic has presented unprecedented challenges to health systems. We conducted a national survey to ascertain hospital characteristics and the use of HAI prevention measures in Israel. METHODS: We e-mailed surveys to infection prevention and control (IPC) leads of acute care hospitals in Israel. The survey included questions about the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). The survey also assessed COVID-19 impact and healthcare worker well-being. RESULTS: IPC leads from 15 of 24 invited hospitals (63%) completed the survey. Only one-third of respondents reported strong support for IPC from hospital leadership. Although several prevention practices were used by all hospitals (e.g., maximum sterile barrier precautions for CLABSI and real-time assessment of environmental cleaning for CDI), use of other practices was suboptimal-particularly for CAUTI and VAP. COVID-19 had a profound impact on Israeli hospitals, with all hospitals reporting opening of new units to care for COVID patients and most reporting moderate to extreme financial hardship. All hospitals reported highly successful plans to vaccinate all staff and felt confident that the vaccine is safe and effective. CONCLUSION: We provide a status report of the IPC characteristics and practices Israeli hospitals are currently using to prevent HAIs during the COVID-19 era. While many globally accepted IPC practices are widely implemented, opportunities to increase the use of certain IPC practices in Israeli hospitals exist.

Practic-ing culture: exploring the implications of pre-existing mobility cultures on (post-) pandemic practices in Norway, Ireland, and the United States

Issues of culture have to date been underexplored in practice-theoretical approaches to consumption. As a disruptive force affecting citizen mobility all over the world, the COVID-19 pandemic provides a unique empirical context to explore how culture and practice intersect, specifically concerning how unsettling events affect practices across different cultural and governing settings. Applying a combined mobility-culture and practice-theoretical framework, we conceptualize mobility cultures as setting-specific arrangements of practices that shape and reflect distinct, temporally unfolding, socio-material contexts. Comparing three cities with different mobility cultures in Norway, Ireland, and the United States, we combine 63 qualitative interviews with a contextual analysis of mobility settings to explore how daily urban mobilities have been transformed. We find that existing variation in mobility cultures, including bundles of place-specific mobility-related norms and infrastructures, mediate the impact of disruption, shaping how changes in modes, meanings, and performances of mobilities transpire. Notably, the analysis reveals how underlying cultures of mobility shape how practice trajectories respond and are reconfigured in a pandemic health-risk society. The article concludes by discussing the implications of the findings for understanding how culture and practice intersect and calls for further comparative culture-focused analysis in social science research on consumption. We consider how cross-cultural analysis can inform science and policy efforts focused on transitions toward low-carbon mobilities. © 2022 The Author(s). Published by Informa UK Limited trading as Taylor & Francis Group on behalf of the Environmental Policy Group, Wageningen University & Research.

Beliefs about COVID-19 prevention and preferences for virtual nutrition education for the SNAP-Ed program

Supplemental Nutrition Assistance Program Education (SNAP-Ed) staff across Louisiana distributed a survey to their network of potential program participants and partners who work with people eligible for SNAP-Ed. The survey asked participants to report their attitudes about behaviors used to slow the spread of COVID-19 and preferences for the delivery of nutrition education. Participants also reported their race, age and eligibility for the SNAP-Ed program so that researchers could assess whether attitudes and preferences differed across these categories. Of the 458 participants completing the survey, the majority were white (62%), female (91%), aged 18 to 50 (65%) and eligible for SNAP-Ed (57%). Most agreed that it was important to wash their hands (99%) and physically distance from others (95%) to avoid the coronavirus, but a smaller majority felt that it was important to wear face masks in public (79%). Attitudes toward wearing masks were significantly different across categories of race. African Americans were more concerned about the risk posed by in-person programming and more likely to report that they would prefer live virtual lessons, online quizzes and workbooks compared to white participants. Respondents over 50 were significantly more likely to say it was important to wear masks, less likely to feel uncomfortable covering their faces and more likely to prefer a written or workbook format for nutrition lessons compared to participants under 50. SNAP-Ed-eligible participants did not differ significantly from higher-income participants in their attitudes toward virus prevention behaviors but were more likely to say they would prefer online quizzes as part of virtual nutrition education. Results indicate that it may be appropriate for nutrition education conducted by the LSU AgCenter to occur in person because most potential program participants agree with COVID-19 precautions. In addition, the attitudes and preferences expressed by African American participants indicate that nutrition education for African Americans may better reach participants if it is done virtually rather than in-person.

NEUROLOGIC and IMMUNOLOGIC BIOMARKERS ASSOCIATED with POST-COVID NEUROLOGIC SYMPTOMS

Background: The biologic mechanisms underlying neurologic post-acute-sequelae of SARS-CoV-2 infection (PASC) are incompletely understood. We measured plasma markers of neuronal injury (glial fibrillary acidic protein [GFAP], neurofilament light chain [NfL]) and inflammation among a cohort of people with prior confirmed SARS-CoV-2 infection at early and late recovery following the initial illness (defined as < and > 90 days since COVID-19 onset, respectively). We hypothesized that those experiencing persistent neurologic symptoms would have elevations in these markers. Methods: The primary clinical outcome was the presence of self-reported central nervous system (CNS) PASC symptoms during the late recovery timepoint. We compared fold-changes in marker values between those with and without CNS PASC symptoms using linear mixed effects models and examined relationships between neurologic and immunologic markers using rank linear correlations. Results: Of 121 individuals, 52 reported CNS PASC symptoms. During early recovery, those who went on to report CNS PASC symptoms had elevations in GFAP (1.3-fold higher mean ratio, 95% CI 1.04-1.63, p=0.02), but not NfL (1.06-fold higher mean ratio, 95% CI 0.89-1.26, p=0.54). During late recovery, neither GFAP nor NfL levels were elevated among those with CNS PASC symptoms. Although absolute levels of NfL did not differ, those who reported CNS PASC symptoms demonstrated a stronger downward trend over time in comparison to those who did not report CNS PASC symptoms (p=0.041). Those who went on to report CNS PASC also exhibited elevations in IL-6 (48% higher during early recovery and 38% higher during late recovery), MCP-1 (19% higher during early recovery), and TNF-alpha (19% higher during early recovery and 13% higher during late recovery). GFAP and NfL correlated with levels of several immune markers during early recovery (MCP-1, IL-6, TNF-a, IFN-g);these correlations were attenuated during late recovery. Conclusion: Self-reported neurologic symptoms present approximately four months following SARS-CoV-2 infection are associated with elevations in markers of neurologic injury and inflammation at early recovery timepoints, suggesting that early injury can result in long-term disease. The correlation of GFAP and NfL with markers of systemic immune activation suggests one possible mechanism that might contribute to these symptoms. Additional work will be needed to better characterize these processes and to identify interventions to prevent or treat this condition.

Evaluation of emergency department visits for mental health complaints during the COVID-19 pandemic.

Background: The COVID-19 pandemic has resulted in over 6 million deaths worldwide as of March 2022. Adverse psychological effects on patients and the general public linked to the pandemic have been well documented. Methods: We conducted a retrospective analysis of adult emergency department (ED) encounters with diagnoses of anxiety, depression, and suicidal ideation using International Classification of Diseases, Tenth Revision (ICD-10) codes at a tertiary care hospital in New York City from March 15 through July 31, 2020 and compared it with ED encounters during the same time period in the previous 3 years (2017-2019). The relative risk (RR) of these diagnoses was calculated comparing a prepandemic sample to a pandemic sample, accounting for total volume of ED visits. Results: A total of 2816 patient encounters met the inclusion criteria. The study period in 2020 had 31.5% lower overall ED volume seen during the same time period in the previous 3 years (27,874 vs average 40,716 ED encounters). The risk of presenting with anxiety during the study period in 2020 compared to prior 3 years was 1.40 (95% confidence interval [CI] 1.21-1.63), for depression was 1.47 (95% CI 1.28-1.69), and for suicidal ideation was 1.05 (95% CI 0.90-1.23). There was an increase in admissions for depression during the pandemic period (15.2% increase, 95% CI 4.6%-25.7%). Conclusion: There was a relative increase in patients presenting to the ED with complaints of anxiety and depression during the height of the COVID-19 pandemic, while absolute numbers remained stable. Our results highlight the importance of acute care-based mental health resources and interventions to support patients during this pandemic.

Adapting Ripple Effect Mapping to a Virtual Survey Format

Community development projects continue despite the COVID-19 pandemic. Participatory evaluation of these projects is crucial. Ripple effect mapping (REM) is a participatory approach to evaluation that captures coalition and community member perspectives on program outcomes and impacts. In response to COVID-19, the Louisiana State University AgCenter Healthy Communities Initiative adapted REM for online delivery. The REM evaluation was found to be an effective way for community coalitions to reflect on outcomes and impacts and to motivate continued engagement © This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License

Priorities for addressing substance use disorder in humanitarian settings.

BACKGROUND: Populations affected by humanitarian emergencies are vulnerable to substance (alcohol and other drug) use disorders, yet treatment and prevention services are scarce. Delivering substance use disorder treatment services in humanitarian settings is hampered by limited guidance around the preparation, implementation, and evaluation of substance use disorder treatment programs. This study aims to identify and prioritize key gaps and opportunities for addressing substance use disorder in humanitarian settings. METHODS: UNODC convened a consultation meeting (n = 110) in coordination with UNHCR and WHO and administered an online survey (n = 34) to, thirteen program administrators and policymakers, eleven service providers, nine researchers, and one person with lived experience to explore best practices and challenges to addressing substance use disorder in diverse populations and contexts. Participants presented best practices for addressing substance use disorder, identified and ranked challenges and opportunities for improving the delivery of substance use disorder treatment interventions, and provided recommendations for guidelines that would facilitate the delivery of substance use disorder treatment services in humanitarian emergencies. RESULTS: Participants agreed on key principles for delivering substance use disorder treatment in humanitarian settings that centered on community engagement and building trust, integrated service delivery models, reducing stigma, considering culture and context in service delivery, and an ethical 'do no harm' approach. Specific gaps in knowledge that precluded the delivery of appropriate substance use disorder treatment include limited knowledge of the burden and patterns of substance use in humanitarian settings, the effectiveness of substance use disorder treatment services in humanitarian settings, and strategies for adapting and implementing interventions for a given population and humanitarian context. Participants emphasized the need to strengthen awareness and commitment related to the burden of substance use disorder treatment interventions among communities, practitioners, and policymakers in humanitarian settings. CONCLUSIONS: Results from this consultation process highlight existing gaps in knowledge related to the epidemiology and treatment of substance use disorders in humanitarian emergencies. Epidemiological, intervention, and implementation research as well as operational guidance are needed to fill these gaps and improve access to substance use treatment services in humanitarian settings.

Clinical outreach to older adults in the community during COVID: A description of unmet health-related needs

Background: Shelter-in-place orders and service disruptions due to the COVID-19 pandemic created a risk of unmet healthrelated needs among older adults and those with disabilities, such as the ability to obtain medications or receive healthcare. To mitigate these risks, primary care clinics performed outreach calls to identify and address unmet needs. We examined the association with unmet needs and healthcare utilization. Methods: Four primary care clinics completed outreach calls, each with differing with at-risk populations: home-based, safety-net adult, academic geriatrics and safety-net HIV. Examined needs included medication refills, medical supplies, food insecurity, and telehealth capability. Utilization included urgent care, ER visits and hospitalizations, measured 3 months prior and 3 months after the call. We also report on COVID diagnosis and death in the 3 months after the outreach call. We show descriptive statistics and will use Poisson regression models to examine associations. Results: Thus far, we analyzed 165 of 500 total outreach calls. Mean age was 84.1, with 18% of patients >95, 71% female, 40% white, 33% Asian, 12% Black, and 15% Latinx. Forty five percent had both Medicare and Medi-Cal, 33% had Medicare and supplemental insurance, and 17% had Medicare only. Comorbid conditions were frequent: 69% had hypertension, 37% had dementia, 30% had depression. Unmet needs and care utilization are presented in Table 1. Conclusion: The pandemic has disrupted health and social care among older adults. Evaluation of associations between unmet needs and use of urgent healthcare services can inform future planning during crises to better meet the needs of community dwelling older adults.

Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers' infection and psychological distress during the COVID-19 pandemic in the USA.

OBJECTIVE: The COVID-19 pandemic has been associated with significant occupational stressors and challenges for front-line healthcare workers (HCWs), including COVID-19 exposure risk. Our study sought to assess factors contributing to HCW infection and psychological distress during the COVID-19 pandemic in the USA. DESIGN: We conducted a cross sectional survey of HCWs (physicians, nurses, emergency medical technicians (EMTs), non-clinical staff) during May 2020. Participants completed a 42-item survey assessing disease transmission risk (clinical role, work environment, availability of personal protective equipment) and mental health (anxiety, depression and burn-out). SETTING: The questionnaire was disseminated over various social media platforms. 3083 respondents from 48 states, the District of Columbia and US territories accessed the survey. PARTICIPANTS: Using a convenience sample of HCWs who worked during the pandemic, 3083 respondents accessed the survey and 2040 participants completed at least 80% of the survey. PRIMARY OUTCOME: Prevalence of self-reported COVID-19 infection, in addition to burn-out, depression and anxiety symptoms. RESULTS: Participants were largely from the Northeast and Southern USA, with attending physicians (31.12%), nurses (26.80%), EMTs (13.04%) with emergency medicine department (38.30%) being the most common department and specialty represented. Twenty-nine per cent of respondents met the criteria for being a probable case due to reported COVID-19 symptoms or a positive test. HCWs in the emergency department (31.64%) were more likely to contract COVID-19 compared with HCWs in the ICU (23.17%) and inpatient settings (25.53%). HCWs that contracted COVID-19 also reported higher levels of depressive symptoms (mean diff.=0.31; 95% CI 0.16 to 0.47), anxiety symptoms (mean diff.=0.34; 95% CI 0.17 to 0.52) and burn-out (mean diff.=0.54; 95% CI 0.36 to 0.71). CONCLUSION: HCWs have experienced significant physical and psychological risk while working during the COVID-19 pandemic. These findings highlight the urgent need for increased support for provider physical and mental health well-being.