COLLEGIAL LEARNING DURING THE PANDEMIC: REALIZED ACTIVITIES AND LESSONS LEARNT

The CDIO initiative, through its twelve standards, provides a well-structured platform for creating optimal teaching and learning opportunities. While most of the standards focus on students and their learning process, two standards focus on the teachers. While standard 9 centers on enhancing faculty competence in personal and interpersonal skills, product, process, system, and service building skills, as well as disciplinary fundamentals, standard 10 centers on enhancing faculty competence through integrated learning experiences, in using active and experiential learning methods, and in assessing student learning. Recent CDIO papers have indicated that standard 10 is one of the least researched standards. This paper addresses a challenge that many universities have faced during the pandemic outbreak in the spring of 2020;how to identify and share positive and negative experiences acquired by teachers during the rapid transition from campus to digital education. The paper outlines how standard 10 has been applied on a group level among the teachers at the School of Engineering at Jönköping University. The objective is to demonstrate how a scientifically founded group and collegial learning perspective could increase the focus on standard 10 and its importance to the CDIO platform. The Covid-19 outbreak led to a transition of pertinent teaching forms and the teachers' pedagogical mindset. The urgent question to many higher education teachers was how to swiftly adapt teaching and learning to the new situation. Hence, the pandemic forced an abrupt transition from campus to online activities, something that affected most teachers. To support this transition, the role of the pedagogical development group (PED) changed from inviting experts to share knowledge, to the group members themselves becoming experts through building competence within digital education. The barriers and difficulties in the transition from campus to online education were identified, and best practices, as well as pedagogical experiences, were shared among the teachers through learning activities, such as online seminars with a particular focus on online teaching and assessment. This also led to the identification of new topics for competence development. Student engagement and online examination forms were identified as primary areas for further competence development, and a team activity was initiated based on previous pedagogical research. This resulted in an increase in the awareness of choosing adequate examination forms to optimize student engagement within a course. Future possible directions within collegial learning at the School of Engineering are also outlined. © CDIO 2022.All rights reserved.

Peeking Behind the Curtains Exploring Death and the Body through Patchwork Ethnography

Patchwork ethnography is a viable methodological and theoretical approach. Fieldwork can be accessible, achievable and accommodating of both personal and professional circumstances and responsibilities of the researcher, and external factors such as living within a COVID-19 world. In this article, we explain patchwork ethnography and showcase how the methodology was implemented during the first author's PhD fieldwork conducted in 2020– 2021 relating to peeking behind the physical and metaphorical curtains of the death industry to understand the handling, management and conceptualisation of the dead human body in Adelaide, South Australia. We demonstrate how field sites were constructed and discuss the methodological tools utilised to produce an ethnographic experience. We also question the ongoing viability of notions of ‘traditional' fieldwork practices. © The Author(s).

Opioid Overdoses During the 2020 COVID-19 Pandemic

Introduction: The opioid epidemic is a major public health concern in the United States. In 2020 the COVID-19 pandemic changed the delivery of healthcare and majorly impacted mental health. While some research has been performed to investigate the impact of the COVID-19 pandemic on the opioid epidemic, further examination is warranted.We hope to add to the literature utilizing a large and unique population including a high percentage of underrepresented patients (including a large Hispanic population), urban and rural centers, and in multiple western states. Objective(s): The objective of this study was to investigate the impact of the COVID-19 pandemic on the incidence of opioid overdoses in a multi-center health network and to investigate the demographics of these patients. Method(s): A retrospective chart review was done to identify patients who presented to the emergency department (ED) or were admitted for opioid overdose between January 2016 - December 2020 within a multi-center health network. Opioid overdose was identified via ICD-10 codes. Opioid overdoses from January 2019 - December 2019 (prepandemic) were compared to January 2020 - December 2020 (first year of pandemic). Demographic data including sex, age, race/ethnicity, and fatal vs. non-fatal opioid overdoses were collected. Temporal trends and comparison between pre-pandemic and pandemic were evaluated. Students t-test or Mann-Whitney test and Chi-Square or Fisher Exact test were used to compare continuous and categorical variables respectively. Poisson regression was used to compare the overdose incidences between groups. Result(s): Of the 19,722 patients included, the mean age was 52 years and 51% were female. The aggregate incidence of opioid overdose was 9.2 per 1000 patients admitted or seen in the ED. It was higher in males compared to females (10.3 vs 8.3 per 1000 patients admitted or seen in the ED, P < 0.001). White individuals (10.5) had the highest incidence, followed by Native Americans (9.2), Black individuals (7.8) and Hispanic individuals (7.0) had the lowest incidence of opioid overdoses per 1000 patients. There was a significant increase in the incidence of opioid overdose from 2016 to 2020 (6.1 vs. 6.51 per 1000 patients, P = 0.004). Of those with an opioid overdose, a decline was noted in females from 2016-2019 (57%, n = 2,139 to 46%, n = 1,810, P < 0.001). The number of total opioid overdose deaths increased from 16% in 2016 to 29% in 2020. There was a 9% increase in the incidence of opioid overdose from pre-pandemic to during the pandemic. During the pandemic, the opioid overdose patients were younger (mean +/- SD, 49.6 +/- 20.1 vs 51.2 +/- 20.8 years, P = 0.0009) and consisted of significantly more males (54% vs 46%, P = 0.020). There was no significant difference by race during the pandemic compared to pre-pandemic. Opioid overdose deaths were significantly higher during the pandemic (1.7% vs 2.7%, P = 0.002). Conclusion(s): The incidence of opioid overdose presenting to the ED or admitted as an inpatient is higher in males and White individuals and lowest in Hispanic individuals. During the pandemic, there was an increase in the incidence of opioid overdoses and opioid overdose deaths. Patients were younger and more often male. This information is important to understanding healthcare disparities and the impact of COVID-19 on the opioid epidemic.

Randomized controlled trial (RCT) of symptom screening with targeted early palliative care (STEP) versus usual care in patients with advanced cancer

Background: To direct limited specialized palliative care resources to patients in greatest need, we developed STEP (Symptom screening with Targeted Early Palliative care). STEP entails symptom screening (ESAS-r) at each oncology clinic visit and triggered alerts (for moderate-high physical and psychological symptoms) to a nurse who calls the patient to offer a palliative care clinic (PCC) visit. We conducted a phase III RCT to assess the impact of STEP versus usual care on quality of life and other patient-reported outcomes (PROs). Methods: Adults with advanced cancer were recruited from medical oncology clinics at the Princess Margaret Cancer Centre, Toronto, Canada. Consenting patients with oncologist-assessed ECOG 0-2 and estimated survival of 6-36 months were enrolled and block randomized (stratified by tumour site and symptom severity) to STEP or usual care. Participants completed measures of quality of life (FACT-G7), depression (PHQ-9), symptom control (ESASr-CS), and satisfaction with care (FAMCARE-P16) at baseline, 2, 4 and 6 months. The primary outcome was FACT-G7 at 6 months, with a planned sample size of 261/arm. Results: From 8/2019 to 3/2020, 69 patients were enrolled: 33 randomized to STEP and 36 to usual care. The trial was then halted permanently due to the COVID-19 pandemic, owing to substantial changes to elements of STEP (shift to virtual symptom screening and palliative care) and usual care (shift to virtual oncology care). Median age was 64 years (range 25-87) and 62% (43/69) were women;study arms were balanced at baseline except gender, with more women randomized to STEP. Within the STEP arm, 20 (61%) participants triggered a nurse's call to offer a PCC visit, of whom 13 attended the clinic at least once. All outcomes tended to be better in the STEP arm compared to usual care, particularly depression and satisfaction with care at 6 months;however, results were not statistically significant (Table). Conclusions: STEP holds promise for improving quality of life and other PROs in patients with advanced cancer and effectively directing early palliative care towards those who need it most. In response to the pandemic, an online version of STEP has been developed and a further trial is in progress.

Novel SARS-CoV-2 variants induce higher toxicity in cardiovascular cells

Objective: SARS-CoV-2 causes the coronavirus disease 2019 (COVID-19) and has spawned a global health crisis. Virus infection can lead to elevated markers of cardiac injury and inflammation associated with a higher risk of mortality. However, it is so far unclear whether cardiovascular damage is caused by direct virus infection or is mainly secondary due to inflammation. Recently, additional novel SARS-CoV-2 variants have emerged accounting for more than 70% of all cases in Germany. To what extend these variants differ from the original strain in their pathology remains to be elucidated. Here, we investigated the effect of the novel SARS-CoV-2 variants on cardiovascular cells. Results: To study whether cardiovascular cells are permissive for SARSCoV-2, we inoculated human iPS-derived cardiomyocytes and endothelial cells from five different origins, including umbilical vein endothelial cells, coronary artery endothelial cells (HCAEC), cardiac and lung microvascular endothelial cells, or pulmonary arterial cells, in vitro with SARS-CoV-2 isolates (G614 (original strain), B.1.1.7 (British variant), B.1.351 (South African variant) and P.1 (Brazilian variant)). While the original virus strain infected iPS-cardiomyocytes and induced cell toxicity 96h post infection (290±10 cells vs. 130±10 cells;p=0.00045), preliminary data suggest a more severe infection by the novel variants. To what extend the response to the novel variants differ from the original strain is currently investigated by phosphoproteom analysis. Of the five endothelial cells studied, only human coronary artery EC took up the original virus strain, without showing viral replication and cell toxicity. Spike protein was only detected in the perinuclear region and was co-localized with calnexin-positive endosomes, which was accompanied by elevated ER-stress marker genes, such as EDEM1 (1.5±0.2-fold change;p=0.04). Infection with the novel SARS-CoV-2 variants resulted in significant higher levels of viral spike compared to the current strain. Surprisingly, viral up-take was also seen in other endothelial cell types (e.g. HUVEC). Although no viral replication was observed (850±158 viral RNA copies at day 0 vs. 197±43 viral RNA copies at day 3;p=0.01), the British SARS-CoV-2 variant B.1.1.7 reduced endothelial cell numbers (0.63±0.03-fold change;p=0.0001). Conclusion: Endothelial cells and cardiomyocytes showed a distinct response to SARS-CoV-2. Whereas cardiomyocytes were permissively infected, endothelial cells took up the virus, but were resistant to viral replication. However, both cell types showed signs of increased toxicity induced by the British SARS-CoV-2 variant. These data suggest that cardiac complications observed in COVID-19 patients might at least in part be based on direct infection of cardiovascular cells. The more severe cytotoxic effects of the novel variants implicate that patients infected with the new variants should be even more closely monitored.

A New Reality: The Role of Simulated Learning Activities in Postgraduate Psychology Training Programs

In training to become a registered psychologist in Australia, as with many other countries, there is a requirement for students to attend placements, where they work with clients in an apprenticeship model under the guidance of qualified supervisors. In the context of COVID-19, tertiary sector psychology educators responsible for facilitating these placements, which typically require face-to-face client work, have been challenged to arrange or maintain practica. During the pandemic, across Australia, most placements have been affected through cancellation, postponement, or modification (e.g., using telehealth, supported by the Australian Federal Government). In this paper we describe a collaborative initiative by members of the psychology profession across 15 providers of Australian postgraduate professional training programs. The initiative aimed to identify ways in which to develop and innovate psychological placement offerings, specifically using simulation-based learning. Although simulation-based learning in psychology training programs in Australia is a widely employed pedagogy for the scaffolding of theory into psychological practice, there is paucity of clear and comprehensive guidelines for the use of simulation to both optimize competency-based training and ensure public and student safety. The overarching aim of the group, and the focus of this paper, is to provide standardized guidelines for the inclusion of simulation-based learning in psychology training in Australia both during and post-COVID 19. Such guidelines may be equally valuable for psychology training programs globally.

Assessment of state socioeconomic and demographic disparities on coronavirus-2019 mortality during the exponential increase period in the US

Background: To assess the effect of population-based age, race, gender, ethnicity, settlement type, health coverage and poverty on coronavirus disease-19 (COVID-19) death rate during the exponential increase period. Methods: The study involved ecological analysis of publicly available COVID-19 cases and deaths data for January-May 2020. Using Boltzmann fitting of COVID-19 cases and deaths, the inflection time, duration and rate of the exponential increase period were computed. The associations of COVID-19 deaths rate with COVID-19 cases rate and population estimates of race, ethnicity, age, gender, living in urban settlements, uninsured and poverty levels were assessed using multivariate regression analysis. Results: The exponential increase period lasted on average 49.2 and 43.6 for COVID-19 cases and deaths, respectively. The corresponding rates during the same period were 55.8±7.5 and 3.3±0.6 per 1,000,000 per day. Both the duration and rate of the COVID-19 cases during the exponential increase period increased as the percent and race and ethnic minorities, male and elderly increased. An increase of 69% (95% CI: -6 to 144) and 51% (95% CI: -33 to 134) of COVID-19 rate for an interquartile range increase in the percentage of older than 45 years and minorities was computed. Gender, settlement type, health insurance and poverty were also positively associated with COVID-19 death rate during the exponential increase period. Conclusions: The study highlighted that race/ethnicity and socioeconomic status may modify the relationship between COVID-19 disease and mortality. © 2021 AME Publishing Company. All rights reserved.

Food systems resilience through dialogue: localizing a food systems approach in pandemic response

Community and international development practitioners are increasingly adopting a food systems approach to research, planning, and intervention. This paper examines such an approach as part of the COVID-19 response of the Food Systems Dialogues (FSDs), a global effort facilitating multistakeholder interchange to build support for food systems transformations. The FSDs' pandemic response involved redesigning the in-person global dialogue process for online delivery in localized settings. This paper documents how the online FSDs in New York's Hudson Valley allowed local systems actors to share their experience mid-shock, as the system responded to the pandemic, and revealed FSDs' ability to quickly adopt a systems orientation and thus take the first steps toward transforming food systems. It also highlights where new research is needed in food systems approaches to development.

Proteinase K treatment in absence of RNA isolation classical procedures is a quick and cheaper alternative for SARS-CoV-2 molecular detection.

The World Health Organization (WHO) has declared a pandemic of COVID-19, the disease caused by the recently described SARS-CoV-2. The relevance and importance of mass diagnosis in order to find the asymptomatic individuals is widely recognized as a mandatory tool to reinforce the control measures for monitoring virus circulation and reduce the spreading of SARS-CoV-2. Here, we described quickness and cheaper strategies of direct RT-qPCR (in the absence of RNA isolation) and compared the results to those obtained using standard RNA isolation procedure. The tests varied using pure, diluted samples, combined with Proteinase K (PK) or Lysis Buffer. Our findings showed consistently that PK pre-treated samples in the absence of RNA extraction procedures presents similar results to those obtained by standard RNA isolation procedures. On average, 16 samples extracted with the MagMAX™ CORE Kit, take around 2 h, costing an average of USD 5, the pre-treatment of samples using PK, on the other hand, would cut the value to less than USD 0.30 and reduce the time of procedure in more than 1 ½ hours. The present study suggests the use of PK treatment instead of RNA isolation in order to reduce costs and time in processing samples for molecular diagnosis of SARS-CoV-2.

[Pneumocystis pneumonia and HIV infection in two patients suspected with COVID-19]

Pneumocystis pneumonia (PCP) in undiagnosed HIV-positive individuals and COVID-19 patients share many of the same clinical features. This case report describes two patients admitted to hospital during the COVID-19 pandemic. Both suffered from dyspnoea, dry cough and fever, showed signs of underlying illness and had severe hypoxia, elevated lactate dehydrogenase levels and lymfocytopenia. COVID-19 was suspected despite several negative tests. Both patients tested positive for PCP and HIV. In cases with unexplained interstitial pneumonia, PCP and underlying immunodeficiency should be suspected, and an HIV-test should be performed.