Trust in educational leadership in times of crisis: The superintendent-teacher union leader trust dynamic

This qualitative case study explores the role that trust plays between the superintendent and the teacher union leader of a public school district in the Northeast United States during the COVID-19 pandemic using the framework of interpersonal trust-building (Zand, 1972). Further, it uses the five facets of trust (Tschannen-Moran, 2001) to identify the leadership practices that have the greatest impact on perceptions of trust in this relationship. Specifically, this study addresses the following research question: How, if at all, does trust influence the relationships and practices of educational stakeholders during times of crisis? Based on semi-structured interviews, document reviews, and observations, findings support previous research indicating that trust develops only with the benefit of time and, once established, allows for more direct communication and more efficient and collaborative problem-solving. Data also indicate that the facet of benevolence exerts the greatest impact on perceptions of trust in the superintendent's and teacher union leader's working relationship. Finally, the accumulation of shared experiences over time help develop a shared sense of identity between the superintendent and teacher union leader, resulting in stronger perceptions of trust and a greater sense of shared purpose. This shared sense of identity may also serve as a proxy for time, allowing parties to make assumptions about the other's future behavior based on perceived group memberships, thereby jump-starting the development of trust in the relationship. Recommendations include purposefully demonstrating benevolent behaviors in order to more effectively develop trust in a relationship and, whenever possible, communicating a shared sense of identity based on common values and beliefs. These findings have implications for district and school leaders who want to more intentionally establish trusting relationships and can inform the preparation, induction, and learning of district leaders. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Trust in educational leadership in times of crisis: Trust between the superintendent and principals during COVID-19

Trust is never more important than during a crisis. For years, researchers have been studying trust in organizations and schools, focusing on the principal and teacher relationship and its impact on school climate. The literature has been less focused, however, on the superintendent and principal relationship-and the role trust plays within that relationship. Moreover, given the recency and continually evolving nature of COVID-19, there is little research about the actions superintendents and principals are taking to lead their school communities through this pandemic and even less research on how this crisis impacts the relational trust between the superintendent and the principal.The purpose of this study, therefore, is to examine how trust impacts the relationship between the superintendent and the principals in their district. Accordingly, this study will address the following research questions: 1) How do principals view their relationship with the superintendent and their schools during a crisis? and 2) What practices influence the role of trust in this relationship?To understand how principals view their relationships with their superintendent, as well as practices that influence trust, I conducted six interviews with five principals and the superintendent, and I observed a School Committee meeting where a principal presented on behalf of all principals in support of the superintendent. Principals highlighted how working for a benevolent, competent, and reliable superintendent over a long period of time helps them build trust in their superior while also leading a school during a time of crisis. Practices that appeared to build and sustain trust during the COVID-19 crisis and that support a trusting relationship between the superintendent and principals include length of time working together;perceived trust from the superintendent in the principals' competence, which led to reciprocal trust;the ability to advocate for systems-wide change;and acts of benevolence. This research emphasizes that the relationship between principals and the superintendent matters. It is essential that trust is developed between principals and the superintendent to ensure a stable working environment for staff, ultimately leading to greater consistency for students during trying times in school and beyond. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Rolosense: Mechanical detection of SARS-CoV-2 using a DNA-based motor (preprint)

Assays detecting viral infections play a significant role in limiting the spread of diseases such as SARS-CoV-2. Here we present Rolosense, a virus sensing platform that transduces the motion of synthetic DNA-based motors transporting 5-micron particles on RNA fuel chips. Motors and chips are modified with virus-binding aptamers that lead to stalling of motion. Therefore, motors perform a mechanical test of viral target and stall in the presence of whole virions which represents a unique mechanism of transduction distinct from conventional assays. Rolosense can detect SARS-CoV-2 spiked in artificial saliva and exhaled breath condensate with a sensitivity of 10^3 copies/mL and discriminates among other respiratory viruses. The assay is modular and amenable to multiplexing, as we demonstrated one-pot detection of influenza A and SARS-CoV-2. As a proof-of-concept, we show readout can be achieved using a smartphone camera in as little as 15 mins without any sample preparation steps. Taken together, mechanical detection using Rolosense can be broadly applied to any viral target and has the potential to enable rapid, low-cost, point-of-care screening of circulating viruses.

Evaluation of an Audio-Visual Novela to Improve COVID-19 Knowledge and Safe Practices Among Spanish-Speaking Individuals with Schizophrenia.

In the United States, the health and economic consequences of the COVID-19 pandemic have disproportionately affected the Latinx community. Within the Latinx community, people with schizophrenia-spectrum disorders are more susceptible to exposure to the virus. Given their increased risk of contracting and getting sick from the virus, efforts targeting the Latinx population should focus on increasing knowledge and safe practices associated with COVID-19. We developed a 10 min animated, Spanish-language audio-visual novela designed to improve knowledge, attitudes, and behaviors regarding COVID-19. Latinx adults with schizophrenia (N = 100) at a community mental health center in Los Angeles were randomly assigned to watch the novela or a non-COVID video (control group). Participants completed surveys immediately before and one month after viewing the material. One month after watching the audio-visual novela, subjects endorsed a greater likelihood of seeking a COVID-19 vaccine than control subjects. No other significant differences were observed between the two conditions. The findings of this study suggest that the presentation of health information in a relevant, engaging, and appealing manner may be useful way to improving salutary health behaviors of Latinx people with schizophrenia-spectrum disorders.

Underfunding of Psychiatric Services for the Civilly and Criminally Committed.

As illustrated by the State of Oregon, a lack of inpatient psychiatric resources for civil commitment and restoration of competency to stand trial has become an increasing problem. In California, the government of Los Angeles County has studied this problem and identified potential solutions. The proposed solutions not surprisingly involve increased resources, including additional inpatient psychiatric beds. Despite recognition of a potential solution, however, sufficient resources have not yet appeared in Los Angeles County. The study of the civil and criminal commitment systems for individuals with mental illness in Oregon and Los Angeles County reveals considerable overlap between these systems and suggests that the two systems be considered as a part of a single mental health system adversely affected by a variety of factors such as homelessness, substance use, and the COVID-19 pandemic.

System Interventions to Reduce Disparities in Covid-19 Vaccine Offer Rates

A simple strategy to reduce disparities in Covid-19 vaccination is to consistently offer the vaccine during primary care visits, a process that can be measured using standardized documentation practices.

EFFECTIVENESS OF OPT-IN VERSUS OPT-OUT TEXT MESSAGE-BASED OUTREACH FOR COLORECTAL CANCER SCREENING

Background and Aims: Reliance on in-visit, opt-in screening for colorectal cancer (CRC) may be an obstacle to screening, especially during the COVID-19 pandemic and among low income and vulnerable populations. We aim to describe and evaluate the effectiveness of a CRC screening outreach campaign in a safety-net health system testing opt-out and opt-in text message outreach followed by mailed fecal immunochemical test (FIT) kits. Methods: From November 2020 to April 2021, the outreach campaign targeted patients ages 50-75 from 11 primary care clinics within the San Francisco Health Network who had previously completed a FIT test and were overdue for CRC screening. Patients were assigned to receive a language-concordant, pre-alert text message notifying that they would be mailed a FIT kit 1) unless they opted out of receiving a kit or 2) if they opted in to receiving a kit. The primary outcome was screening participation at 3 months after outreach. Results: A total of 371 patients were assigned to receive opt-out text messages and 522 received opt-in text messages. FIT kits were mailed to 96.5% (n = 358) of the opt-out group and 19.3% (n = 101) of the opt-in group. Screening uptake at 3 months was significantly higher in the optout group than in the opt-in group (58.8% vs. 18.0%, P < 0.001;difference = 40.8%, 95% confidence interval 34.8%-46.8%). Black/African American patients had lower screening rates (33.3% in opt-out group and 9.4% in opt-in group) compared to Hispanic/Latino (53.3% in opt-out group and 26.7% in opt-in group) and Asian (66.7% in opt-out group and 26.7% in opt-in group) patients. Conclusions: During the COVID-19 pandemic, optout text messaging followed by mailed FIT kits improved population-level CRC screening rates in a safety-net health system. Tailored initiatives are needed to address low screening rates for Black/African American patients.

Phosphate-regulated expression of the SARS-CoV-2 receptor-binding domain in the diatom Phaeodactylum tricornutum for pandemic diagnostics.

The worldwide COVID-19 pandemic caused by the SARS-CoV-2 betacoronavirus has highlighted the need for a synthetic biology approach to create reliable and scalable sources of viral antigen for uses in diagnostics, therapeutics and basic biomedical research. Here, we adapt plasmid-based systems in the eukaryotic microalgae Phaeodactylum tricornutum to develop an inducible overexpression system for SARS-CoV-2 proteins. Limiting phosphate and iron in growth media induced expression of the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein from the P. tricornutum HASP1 promoter in the wild-type strain and in a histidine auxotrophic strain that alleviates the requirement for antibiotic selection of expression plasmids. The RBD was purified from whole cell extracts (algae-RBD) with yield compromised by the finding that 90-95% of expressed RBD lacked the genetically encoded C-terminal 6X-histidine tag. Constructs that lacked the TEV protease site between the RBD and C-terminal 6X-histidine tag retained the tag, increasing yield. Purified algae-RBD was found to be N-linked glycosylated by treatment with endoglycosidases, was cross-reactive with anti-RBD polyclonal antibodies, and inhibited binding of recombinant RBD purified from mammalian cell lines to the human ACE2 receptor. We also show that the algae-RBD can be used in a lateral flow assay device to detect SARS-CoV-2 specific IgG antibodies from donor serum at sensitivity equivalent to assays performed with RBD made in mammalian cell lines. Our study shows that P. tricornutum is a scalable system with minimal biocontainment requirements for the inducible production of SARS-CoV-2 or other coronavirus antigens for pandemic diagnostics.

Acrylamide fragment inhibitors that induce unprecedented conformational distortions in enterovirus 71 3C and SARS-CoV-2 main protease.

RNA viruses are critically dependent upon virally encoded proteases to cleave the viral polyproteins into functional proteins. Many of these proteases exhibit a similar fold and contain an essential catalytic cysteine, offering the opportunity to inhibit these enzymes with electrophilic small molecules. Here we describe the successful application of quantitative irreversible tethering (qIT) to identify acrylamide fragments that target the active site cysteine of the 3C protease (3Cpro) of Enterovirus 71, the causative agent of hand, foot and mouth disease in humans, altering the substrate binding region. Further, we re-purpose these hits towards the main protease (Mpro) of SARS-CoV-2 which shares the 3C-like fold and a similar active site. The hit fragments covalently link to the catalytic cysteine of Mpro to inhibit its activity. We demonstrate that targeting the active site cysteine of Mpro can have profound allosteric effects, distorting secondary structures to disrupt the active dimeric unit.

Cancer during a pandemic: A psychosocial telehealth intervention for young adults.

The SARS-II COVID-19 pandemic has posed pronounced global health threats and prompted assorted transformations in societal engagement and clinical service delivery. For cancer survivors, many of whom are immune-compromised, these pandemic-related health threats pose greater challenges, warranting extra precautions within everyday living. Young adult (YA) cancer survivors already confront many unique physical and emotional challenges specific to their demographic. Already comfortable with assorted technologies, the pandemic presented an opportunity to provide telehealth intervention that targeted social isolation and distress in an effort to facilitate healthy coping. Within this context, we created an 8-week telehealth intervention for YAs (age 18-39) comprised of 60-minute sessions with interventions derived from Acceptance and Commitment Therapy and Meaning-Centered Psychotherapy. Participants reported a reduction in anxious preoccupation, helplessness/hopelessness, and psychological inflexibility and provided rich qualitative feedback on their experiences. Findings contribute new insight for an underinvestigated population navigating the dual health threats of cancer and COVID-19, provide practice recommendations with attention to the value of qualitative data capturing in group settings, and underscore participants' preference for flexible group structure and age-related connections.

Dynamic assessment of the COVID-19 vaccine acceptance leveraging social media data.

Vaccination is the most effective way to provide long-lasting immunity against viral infection; thus, rapid assessment of vaccine acceptance is a pressing challenge for health authorities. Prior studies have applied survey techniques to investigate vaccine acceptance, but these may be slow and expensive. This study investigates 29 million vaccine-related tweets from August 8, 2020 to April 19, 2021 and proposes a social media-based approach that derives a vaccine acceptance index (VAI) to quantify Twitter users' opinions on COVID-19 vaccination. This index is calculated based on opinion classifications identified with the aid of natural language processing techniques and provides a quantitative metric to indicate the level of vaccine acceptance across different geographic scales in the U.S. The VAI is easily calculated from the number of positive and negative Tweets posted by a specific users and groups of users, it can be compiled for regions such a counties or states to provide geospatial information, and it can be tracked over time to assess changes in vaccine acceptance as related to trends in the media and politics. At the national level, it showed that the VAI moved from negative to positive in 2020 and maintained steady after January 2021. Through exploratory analysis of state- and county-level data, reliable assessments of VAI against subsequent vaccination rates could be made for counties with at least 30 users. The paper discusses information characteristics that enable consistent estimation of VAI. The findings support the use of social media to understand opinions and to offer a timely and cost-effective way to assess vaccine acceptance.

Remdesivir and Mortality in Patients With Coronavirus Disease 2019.

BACKGROUND: The impact of remdesivir (RDV) on mortality rates in coronavirus disease 2019 (COVID-19) is controversial, and the mortality effect in subgroups of baseline disease severity has been incompletely explored. The purpose of this study was to assess the association of RDV with mortality rates in patients with COVID-19. METHODS: In this retrospective cohort study we compared persons receiving RDV with those receiving best supportive care (BSC). Patients hospitalized between 28 February and 28 May 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection were included with the development of COVID-19 pneumonia on chest radiography and hypoxia requiring supplemental oxygen or oxygen saturation ≤94% with room air. The primary outcome was overall survival, assessed with time-dependent Cox proportional hazards regression and multivariable adjustment, including calendar time, baseline patient characteristics, corticosteroid use, and random effects for hospital. RESULTS: A total of 1138 patients were enrolled, including 286 who received RDV and 852 treated with BSC, 400 of whom received hydroxychloroquine. Corticosteroids were used in 20.4% of the cohort (12.6% in RDV and 23% in BSC). Comparing persons receiving RDV with those receiving BSC, the hazard ratio (95% confidence interval) for death was 0.46 (.31-.69) in the univariate model (P < .001) and 0.60 (.40-.90) in the risk-adjusted model (P = .01). In the subgroup of persons with baseline use of low-flow oxygen, the hazard ratio (95% confidence interval) for death in RDV compared with BSC was 0.63 (.39-1.00; P = .049). CONCLUSION: Treatment with RDV was associated with lower mortality rates than BSC. These findings remain the same in the subgroup with baseline use of low-flow oxygen.

Disparities in telehealth use: How should the supportive care community respond?

Telehealth use has increased in the setting of the COVID-19 pandemic. However, there are disparities in telehealth use based on age, income, race/ethnicity, low health, digital literacy, and limited English proficiency. There are multilevel barriers to telehealth use at the patient, health systems, telehealth portal, and policy levels. To ensure equity in telehealth services and to leverage these services to maximize the reach of health care services, concerted efforts are needed to design telehealth tools and workflows. It should include reimbursement for staff training, patient education, and technical support needed for telehealth use. Furthermore, ongoing monitoring and responsive modifications in the use of telehealth services are needed to promote telehealth equity.

The effect of COVID-19 on children with congenital talipes equinovarus in a tertiary service in the United Kingdom.

During the coronavirus disease 2019 (COVID-19) pandemic, many aspects of healthcare have been hindered. The primary aim of this study was to identify what the impact of COVID-19 was on the delivery of outpatient care for children with congenital talipes equinovarus deformity (CTEV) at a large tertiary hospital in the UK. This study reviewed the patients who commenced their Ponseti treatment between March and September 2020, representing the cohort who received hands-on care during the first wave of the COVID-19 pandemic. Equivalent 6-month periods were searched in 2019 and 2018 as control cohorts. This study included a total of 45 children (72 affected feet) presenting for treatment of clubfoot. Twenty-three babies were seen with CTEV in 2020. For the same time period in 2018 and 2019, 11 babies were treated each year. The distance commuted to by families was higher in 2020 compared to 2019 and 2018, although the difference did not reach statistical significance (P = 0.301). Treatment with Ponseti casting was commenced at a mean age of 52 days, with no statistically significant differences between cohorts (P = 0.758). Using strict precautions, the Ponseti service at a large tertiary hospital in the UK grew in size and successfully provided treatment for children presenting with CTEV during the first wave of the COVID-19 pandemic. This study has shown that with careful protocols in place, children with CTEV can be treated successfully during times of pandemic, thereby reducing the post-pandemic burden of older children requiring treatment.