"She Looks Like Me": Putting High-Quality Multicultural Literature in Children's Hands During COVID-19

Amid the COVID-19 pandemic, children, families, and educators faced unprecedented challenges that disproportionally impacted racially/ethnically diverse, low-income communities due to long-standing health system, socioeconomic, and educational inequities. With closures of schools, libraries, and child-care centers, many children were disconnected from the community and did not have access to books. Parents' and educators' concerns centered around children falling behind academically and socially. Therefore, in partnership with an afterschool center, we purchased and distributed 410 highquality, multicultural books to children and families. Case study design explored: (1) how this access to multicultural books influenced the CARC children's home-based literacy experiences and their responses to the texts;and (2) the challenges of parents/caregivers in supporting their child's literacy needs during a global crisis. We described how we selected highquality multicultural literature book sets. We identified three themes: (1) enjoyment, appreciation, and learning;(2) relevance of multicultural literature to children's lives and identities;(3) difficulties during the COVID-19 pandemic. Through this collaboration, we increased access to multicultural books for children living in a low-socioeconomic and African American community. Our book distribution project positively impacted the children and families in this underserved community.

Nursing in the time of COVID-19: exploring nurse preparedness early in a global pandemic

Objective: To obtain Australian nurses' perspectives regarding COVID-19 preparedness early in the pandemic. Background: In March 2020 Australia experienced a rise in COVID-19 cases and was bracing itself for the worst, having witnessed China, Europe and America's earlier exposure to the outbreak. On 14 March 2020 an Australian nurse set up a Facebook page called " Nursing in the time of COVID- 19: A clinical forum" allowing colleagues to share information about COVID-19. This presented an ideal opportunity to survey nurses' preparedness for the pandemic. Study design and methods: Anonymous web-based survey disseminated between 9 April-4 May 2020 via the Facebook page. Results: A total of 214 nurses responded to the survey of whom 85% were direct care clinical staff and 29 (13.5%) had cared for a COVID-19 patient. Prevalent feelings regarding COVID-19 were anxious, overwhelmed, vulnerable, engaged and interested. The strongest sources of information regarding COVID-19 were published academic articles, WHO/ CDC and similar authorities, employer leaflets/ guidance and Facebook. The strongest needs/expectations identified by the respondents were education and information, access to mental health counselling, provision of additional health workers to support nurses, and supplemental pay rise. Respondents identified work-related training specific to COVID-19, revision of skills and competencies and upskilling to do tasks previously not familiar to the participant of particular benefit. Nurses who had cared for COVID-19 patients expressed a stronger interest in receiving a supplemental pay rise for risk exposure, a stronger sense that they and their employer were ready to care for COVID-19 patients yet expressed less appreciation for mental health counselling compared to nurses who had not yet cared for COVID-19 patients. Discussion: The perspectives of Australian nurses are generally similar to nurses in other countries. However, we report some variations between nurses who have and have not cared for COVID-19 patients. We identify the levels of concern as well as those supportive actions that are most appreciated by nurses responding to COVID-19 specifically, these same findings could be applied to other major events generally. Conclusion: The timing of this survey allowed us to explore the perspectives of Australian nurses during the early pandemic vulnerability period without the benefit of hindsight. Despite thinking the Australian experience was going to be worse than it was, Australian nurses showed relative confidence in their own and their employers' readiness and this was most obvious in nurses who had cared for COVID-19 patients. What is already known about the topic? Nurses around the world have voiced anxiety and concern about the COVID-19 pandemic and the impact it may have on them personally and professionally. Nurses have access to informal networks, social media, media, employer guidelines and other professional and academic sources of information to stay informed and up-to-date with current information on COVID-19 that may help to allay their concerns. What this paper adds The perspectives of Australian nurses early in the development of the COVID-19 pandemic in relation to how prepared they felt at the time and where they were obtaining information to help guide their thinking and their practice. A synopsis of the role and benefits of a social media platform to allow nurses to share thoughts, articles of interest and experiences of COVID-19. Opinions vary based on whether a nurse had already cared for a COVID-19 patient or not.

Health Insurance and Duration of Symptoms Prior to Emergency Department Visit: An Analysis of 19,850 Patients With Suspected COVID-19

Study Objectives: The COVID-19 pandemic has emphasized disparities in health outcomes across social and economic strata. The mechanisms of this relationship are poorly understood, but the length of time patients exhibit symptoms prior to getting tested for COVID-19 increases the opportunity for community transmission. We hypothesized that there is a relationship between insurance coverage and the duration of COVID-19 symptoms prior to seeking care at the emergency department (ED). Methods: A national, multi-institution (n=45 sites) registry collected information on ED visits in which patients were tested for suspected COVID-19. Demographics and clinical characteristics were summarized for the total cohort. Insurance was categorized into private (private or commercial), public (Medicare, Medicaid, or dual-eligible), worker’s compensation or unknown, or no health insurance. Negative binomial regression was used to analyze both the unadjusted and adjusted relationship between insurance and the time from symptom onset to ED presentation. Adjustments included age, sex, race, ethnicity, medical history, smoking status, drug use, and number of COVID symptoms. Results: Baseline demographic and clinical characteristics of included patients (n=19,850) are displayed in Table 1. The average time from symptom onset to ED presentation among patients with suspected COVID-19 was 5.4 days. In unadjusted analysis, patients with private insurance had significantly longer time of symptom onset prior to ED presentation than patients with public insurance (5.6 vs. 5.3 days, p=0.007). After multivariate adjustment, increased duration of symptoms prior to ED presentation was significantly associated with private insurance [rate ratio (RR) 1.07, 95% confidence interval (CI): 1.03 – 1.10] and no health insurance (RR 1.06, 95% CI: 1.07 – 1.13) compared to public insurance (Figure 1). Patients residing in states with Medicaid expansion were not independently associated with the increased time to ED presentation (RR 1.03, 95% CI: 1.00 – 1.07). Conclusion: Patients with private insurance or no insurance waited significantly longer to present to the ED. The extended duration of symptoms prior to presentation increases the opportunities for community transmission. The results from this study can be used by health systems to target the patients at increased risk for delayed ED presentation. [Formula presented]

Where evidence-based policy meets research impact

This paper explores the territory between the evidence-based policymaking (EBPM) agenda and the research impact agenda. Although these two related agendas are typically considered in isolation, this paper provides an analysis dedicated to how they interact. It begins with a discussion outlining the origins of research impact and the use of evidence in policymaking. This is followed by an overview of the Australian policy context that shapes academic research and its impact. We argue that although the relationship between EBPM and research impact can be viewed as a symbiotic one, there are some tensions that arise in practice. Such difficulties can be further exacerbated when using research to inform policy in times of crisis, as illustrated by governing during the COVID-19 pandemic. The insights provided contribute to our understanding of impact and are of value to policymakers and academic researchers as they help clarify the changing context within which they operate.

Abstract No. 138 Going virtual has become a reality: interventional radiology programs adapt to COVID-19 times

Purpose: To describe the reaction of interventional radiology (IR) residency programs to COVID-19 by way of social media, virtual sub-internship and virtual open house opportunities for applicants Materials and Methods: A list of integrated IR residencies was obtained from ERAS, identifying 89 programs. Twitter, Instagram, and Facebook presence of each program was reviewed between September 9 and 13, 2020. Social media accounts were assigned to programs only if “interventional” or “IR” was included in the account username or description. Shared diagnostic radiology/IR accounts were included only if the above criteria were met. Date of creation of social media accounts and virtual sub-internship and open house opportunities offered to students were recorded. VSAS was reviewed for virtual opportunities. Each program’s date of initial accreditation was obtained from ACGME. Results: Of the 89 programs, 61 (68%) had a social media presence and 107 total social media accounts were identified. All programs with social media presence had been accredited for at least two years. Social media characteristics of programs are profiled in the Table. Three programs (3%) offered virtual sub-internships on VSAS, and no sub-internship opportunities were identified on any social media accounts. Twelve programs had updated their websites to reflect changes in protocol due to COVID-19. Conclusions: COVID-19 has altered the way we conduct business within graduate medical education. Given the ubiquitous restrictions in place pertaining to sub-internships and visitations, social media has become a cornerstone of recruitment and knowledge for residency programs and prospective applicants alike. Individuals and institutions have potential to engage with those outside their normal scope owing to increased social media outreach and efforts. Perhaps this shift toward digital engagement will persist and have lasting impact. [Formula presented]