Disconnected during disruption: Energy insecurity of Indigenous Australian prepay customers during the COVID-19 pandemic

Energy policy measures aimed at mitigating the impacts of energy insecurity during the first years of the COVID-19 pandemic, such as moratoriums on disconnection from electricity, were widespread. In Australia, early pandemic safeguards against electricity disconnection were successful in temporarily protecting most people. However, their application was uneven. For remote-living Indigenous community residents, who are required by policy or elect to use prepay metering and are known to experience frequent ‘self-disconnection', energy insecurity continued as the impacts of the pandemic accrued. The risks associated with the regular de-energization of prepay households have long been overlooked by government reporting and this contributed to a lack of visibility of energy insecurity and available protections for this group during the pandemic response. In contrast to the rest of Australia, energy insecurity in the form of disconnections remained unrelentingly high or worsened for prepay households during this time. COVID-19 magnifies pre-existing health and socio-economic inequities. There is a need to pay closer attention to the rationales and impacts of energy policy exceptionalism if we are to mitigate the potential for compounding impacts of energy insecurity among specific groups, such as Indigenous Australian prepay customers, including during times of crisis. © 2023 The Authors

Know-Nothing Nihilism: Pandemic and the Scandal of White Evangelicalism

White evangelical habits of mind and idolatrous allegiances propped up a devastatingly irresponsible political administration;I argue that the COVID-19 pandemic should be viewed as an apocalypse: "a catastrophic revelation"-in this case, of Christian responsibility refused. I engage the works of Christian historians Mark Noll and Kristin Kobes Du Mez to interrogate how evangelical habits of mind and heart have nurtured anti-intellectualism, credulousness, and the uncritical adoption of neoliberal economic individualism before turning to a constructive Christian realist call for "nasty" (honest, embodied) thinking and genuine repentance which draws from Andrew DeCort's Bonhoeffer scholarship.

Sustained Alleviation and Resolution of Targeted COVID-19 Symptoms with Nirmatrelvir/Ritonavir versus Placebo

Background. Nirmatrelvir with ritonavir (nirmatrelvir/r) is an oral antiviral COVID-19 treatment. We report its efficacy to shorten time to sustained alleviation and resolution of COVID-19 signs/symptoms in nonhospitalized adults with COVID-19 at high risk of severe disease as of primary completion data cut (11 Dec 2021). Methods. In this phase 2/3 double-blind study, eligible adults with confirmed SARS-CoV-2 and <= 5 days (d) of symptoms were randomized 1:1 to nirmatrelvir/r 300 mg/100 mg or placebo (PBO) every 12 hrs for 5 d. Pts logged presence and severity (on 3- or 4-point scales) of prespecified COVID-19 signs/symptoms daily Day 1 (predose) through 28. Times to sustained alleviation and resolution of all targeted signs/ symptoms were assessed, summarized with Kaplan-Meier curves, and compared by treatment by log-rank test. Individual signs/symptoms were compared with descriptive analyses. Results. From Jul-Dec 2021, 2246 pts enrolled;2085 pts (nirmatrelvir/r, n=1039;PBO, n=1046) met criteria for the mITT1 population (<= 5 d of symptom onset, did not/not expected to receive an mAb). More pts achieved sustained alleviation or sustained resolution with nirmatrelvir/r. Shorter median times to sustained alleviation/ resolution were observed with nirmatrelvir/r (13/16 d) vs PBO (15/19 d;Fig 1 & 2). Also, a shorter median time to sustained alleviation was seen in pts treated <= 3 d of symptoms with nirmatrelvir/r (12 d) vs PBO (15 d). The most common symptoms were cough, muscle/body aches, and headache in both groups. The median time to sustained alleviation of cough and headache was 2 d less with nirmatrelvir/r vs PBO. The median time to sustained resolution of muscle aches and shortness of breath was 3 d and 4 d less with nirmatrelvir/r. The proportion of pts with severe signs/symptoms in the nirmatrelvir/r vs PBO group was significantly higher at baseline, but significantly lower after treatment, showing nirmatrelvir/r significantly reduced symptom severity through Day 28 (Fig 3). Pts who were seronegative vs seropositive or had high vs low viral load at baseline achieved faster times to sustained alleviation with nirmatrelvir/r vs PBO. Conclusion. Nirmatrelvir/r treatment reduced duration and severity of COVID-19 symptoms vs PBO in pts at high risk of progressing to severe disease. NCT04960202.

Impact of Genetic Testing in Nephrology: A Family's Experience with Dent Disease 2

Diagnosis of a genetic kidney disease can enhance treatment/management, allow patient/family counseling, and enable patient referral to specialists or clinical trials. Here we present a case study describing the use of a >380 gene panel associated with kidney diseases (The RenasightTM test, Natera, Inc.) to diagnose Dent disease 2 in a patient and their family members. A 41-year-old male was referred to Nephrology for evaluation of elevated SCr (4.6 mg/dL) and proteinuria. The patient’s medical history was unremarkable except for glaucoma in infancy. A renal biopsy identified glomerulomegaly. Genetic testing identified a likely pathogenic, hemizygous, frame-shift variant (c.311del;p.Cys104Phefs*2) in exon 5 of OCRL, an X-linked gene, which is associated with Dent disease 2. This genetic diagnosis prompted changes to the patient’s treatment plan, including patient counseling and preparation for renal replacement therapy (RRT). The patient’s 46-year-old brother was hospitalized due to COVID-19 symptoms with a SCr of 19.1 mg/dL. Due to limited medical history, it was unclear if he was presenting with acute kidney injury or chronic kidney disease. Although there was no evidence of nephrolithiasis or renal tubular acidosis typically associated with Dent disease 2, the family history prompted genetic testing that confirmed the presence of the familial variant in this patient. These genetic findings prevented delay in treatment, namely, initiation of RRT. Given the X-linked inheritance of Dent disease 2, the patients’ mother is an obligate carrier of the p.Cys104Phefs*2 variant in OCRL. Therefore, the third brother is an appropriate candidate for genetic testing due to his 50% chance of inheriting the familial variant. In this family, identification of an OCRL variant via broad panel renal genetic testing impacted patient counseling, management, and family testing. Notably, without genetic testing for the proband, his brother’s condition may have gone undiagnosed due to the atypical presentation, demonstrating the variability of OCRL-related conditions. Genetic testing can enable accurate disease diagnosis in individuals with an atypical presentation, syndromic kidney disease and/or a family history.

Presentation and Variability of APOL1-Related Kidney Disease

Inheritance of the APOL1 G1 or G2 risk alleles in the homozygous or compound heterozygous state, are associated with a ~7-30X increased risk of development of chronic kidney disease (CKD), and with collapsing glomerulopathies in individuals with viral infections including COVID-19 or HIV. Identification of APOL1 high risk genotypes (HRG) can impact patient treatment, prognosis and kidney donor selection. Approximately 13% of African Americans (AA) have an APOL1 HRG, indicating genetic testing in this population can identify those at-risk for CKD development, leading to appropriate patient counseling and management. Here we sought to understand the clinical presentation and variability among patients with APOL1 HRGs, following the implementation of genetic testing for kidney disease with a broad panel at a Louisiana Nephrology clinic. Clinical genetic testing of patient samples was performed using a >380 kidney gene panel (the RenasightTM test, Natera, Inc.) A retrospective review of clinical data for individuals positive for an APOL1 HRG (G1/G1, G2/G2, G1/G2) was performed. We identified 12 patients that were positive for an APOL1 HRG, with all genotypes represented: G1/G1 (n=8), G1/G2 (n=3), and G2/G2 (n=1). Among this cohort, 100% (12/12) were of AA descent. At the time of testing 91% (11/12) of the patients were diagnosed with CKD or ESRD with proteinuria. Biopsy confirmed focal segmental glomerulosclerosis (FSGS) in two patients and collapsing glomerulopathy in one patient. The most common comorbidities among this cohort were hypertension (9/12) and diabetes mellitus (2/12). Four patients had a history of infection with COVID-19 (n=3) or HIV (n=1), three of whom had renal involvement (acute kidney injury or CKD and proteinuria). Use of a broad kidney gene panel enabled the identification of APOL1 HRGs in individuals for which hypertension or diabetes may have otherwise been attributed as the primary cause of CKD. APOL1 HRGs could also provide context for the renal involvement seen in the patients with COVID-19 or HIV infection. Broad panel genetic testing provides an accessible tool for nephrology clinics to help identify individuals at risk for positivity for an APOL1 HRG, including those of AA descent with hypertensive, proteinuric CKD.

Losing the elearning safety net: Teaching an MBA class without an educational technician

The forced transition caused by the safety lockdowns associated with the COVID-19 pandemic imposed “emergency eLearning” on many university faculty members. This transition had many facets including moving away from face-to-face instruction to fully online and hybrid or blended forms of eLearning. For programs that were already leveraging blended teaching, using simultaneous synchronous and asynchronous teaching in the same classroom, the major change was the loss of an educational technician to operate and monitor the technology used for these hybrid teaching models. This paper outlines some of the changes required to navigate this transition and the positive and negative consequences associated with this forced move to eLearning. © 15th International Conference e-Learning, EL 2021 - Held at the 15th Multi-Conference on Computer Science and Information Systems, MCCSIS 2021. All rights reserved.

Emergency elearning during a pandemic: Tales of a forced transition

This paper explores the impact on faculty and students of the forced transition to eLearning caused by the COVID-19 pandemic. A review of the literature on eLearning modalities and the issues involved in transitioning from face-to-face instruction is followed by a series of reports on the experiences of 10 faculty in making the change from traditional instruction to various modalities of eLearning. The methodology employed is an adaptation of the grounded theory approach used in sociology. The results indicate that the primary advantages to the transition to eLearning were the flexibility afforded both faculty and students and the ability to continue delivering quality instruction during the pandemic. The primary negatives were the difficulty in engaging students in the new delivery modalities and the significant challenges involved in proctoring exams. Prior experience with online and blended learning on the part of the faculty and students made the transition smoother. © 15th International Conference e-Learning, EL 2021 - Held at the 15th Multi-Conference on Computer Science and Information Systems, MCCSIS 2021. All rights reserved.

Towards a theology of Covid: providence and lament in past, present, and future trauma narratives

The aim of this article is to juxtapose contemporary and historical perspectives in order to offer new theological insight into COVID-19, particularly regarding the church's pastoral response to the trauma it has left in its wake. Narratives of the experience of trauma in the early modern period will be compared to the work of twenty-first century theologians and current theological debate about COVID-19. Providence and lament are highlighted as key themes for comparison. Whilst accepting the limitations of doing theology via a historical perspective, the results of this juxtaposition suggest the possible outlines of a theological response to COVID-19 which takes the unfolding consequences of the virus as its stimulus. The past-present comparison will highlight the need for theologians to develop a more confident and direct theology of providence and a fuller theological rationale for lament, whilst moving away from therapeutic models which promote passivity and acceptance. A theology of Covid suggests the inclusion of language which embraces the need for positive change in the light of the inequalities exposed by the pandemic, whilst engaging with sorrow, grief, and loss.

Extension Professionals' Information Use, Protective Behaviors, and Work-Life Stress During the COVID-19 Pandemic

In the context of the COVID-19 pandemic, we asked Extension professionals about sources used to inform their work, means used to inform clientele, and management of their own health and well-being. Survey data revealed that Extension professionals sought information from trusted sources and that large majorities were involved in disseminating online information to clientele. Extension professionals felt well supported, were prepared to address the pandemic's challenges, and were practicing recommended health behaviors. However, respondents reported high levels of stress and difficulty balancing professional and personal needs. Recommendations focus on collaborative opportunities for Extension as well as professional development and other resources for Extension personnel.

Take my breath away: Transformations in the practices of relatedness and intimacy through Australia’s 2019–2020 convergent crises

This article eschews the singularity of much disaster, crisis and catastrophe research to focus on the complex dynamics of convergent crises. It examines the prolonged crises of a summer of bushfire and COVID-19 which converged in Eurobodalla Shire on the south coast of New South Wales (NSW), Australia, in 2019–2020. We focus on air and breathing on the one hand and kinship and the social organisation of survival and recovery on the other. During Australia’s summer of bushfires, thick smoke rendered air, airways and breathing a challenge, leaving people open to reflection as well as to struggle. Bushfire smoke created ‘aware breath-ers’. It was aware breathers who were then to experience the invisible and separating threat of COVID-19. These convergent crises impacted the ‘mutuality of being’ of kinship (after Mar-shall Sahlins) and the social organisation of survival. Whereas the bushfires in Eurobodalla drew on grandparent-families in survival, the social distancing and lockdown of COVID-19 has cleaved these multi-household families asunder, at least for now. COVID-19 has also made plain how the mingling of breath is a new index of intimacy. © Berghahn Books and the Association for Anthropology in Action.