An Examination of Occupational Therapy Telehealth Service Delivery Among Novice Users During the COVID-19 Pandemic

The COVID-19 pandemic allowed for widespread implementation of telehealth as a delivery method for occupational therapy (OT) services. The purpose of this study was to investigate the perceptions of novice telehealth OT practitioners regarding telehealth as a delivery method for OT services. Quantitative data was collected through a modified version of the Telehealth Usability Questionnaire and analyzed via descriptive statistics. Qualitative data was collected by open-ended questions and analyzed via thematic analysis. OT practitioners' responses revealed four major themes: logistics of telehealth practice, role of client champions, capacity of the OT practitioner, and styles and approaches. The study revealed that OT sessions delivered via telehealth increased access to clients and continuity of services. Client champion engagement, effective coaching strategies, and practitioner flexibility supported the success of OT telehealth sessions. © 2023, University Library System, University of Pittsburgh. All rights reserved.

SARS-CoV-2 mRNA vaccination elicits robust antibody responses in children

Although children have been largely spared from coronavirus disease 2019 (COVID-19), the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) with increased transmissibility, combined with fluctuating mask mandates and school reopenings, has led to increased infections and disease among children. Thus, there is an urgent need to roll out COVID-19 vaccines to children of all ages. However, whether children respond equivalently to adults to mRNA vaccines and whether dosing will elicit optimal immunity remain unclear. Here, we aimed to deeply profile the vaccine-induced humoral immune response in 6-to 11-year-old children receiving either a pediatric (50 mu g) or adult (100 mu g) dose of the mRNA-1273 vaccine and to compare these responses to vaccinated adults, infected children, and children who experienced multisystem inflammatory syndrome in children (MIS-C). Children elicited an IgG-dominant vaccine-induced immune response, surpassing adults at a matched 100-mu g dose but more variable immunity at a 50-mu g dose. Irrespective of titer, children generated antibodies with enhanced Fc receptor binding capacity. Moreover, like adults, children generated cross-VOC humoral immunity, marked by a decline of omicron-specific receptor binding domain, but robustly preserved omicron spike protein binding. Fc receptor binding capabilities were also preserved in a dose-dependent manner. These data indicate that both the 50-and 100-mu g doses of mRNA vaccination in children elicit robust cross-VOC antibody responses and that 100-mu g doses in children result in highly preserved omicron-specific functional humoral immunity.

PREVALENCE AND CORRELATES OF SARS-CoV-2 VACCINE HESITANCY AMONG US PEOPLE WITH HIV

Background: People with HIV (PWH) have a higher risk of COVID-19 morbidity and mortality. SARS-CoV-2 vaccination is highly effective in preventing severe COVID-19, although medical mistrust may contribute to vaccine hesitancy among PWH. Method(s): PWH from 8 sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) completed the clinical assessment of patient-reported outcomes including a vaccine hesitancy instrument as part of routine care from 2/21-4/22. Participants were defined as vaccine hesitant if they had not yet received the SARS-CoV-2 vaccine and would probably or definitely not receive it. We assessed factors associated with SARS-CoV-2 vaccine hesitancy using logistic regression, and adjusted for demographics, unsuppressed viral load >200 copies/mL, calendar month and time on ART. Result(s): Overall, 3,278 PWH with a median age of 55 responded;19% were female sex at birth;93% were virally suppressed. At the time of survey, 27% reported they had not received the SARS-CoV-2 vaccine, of whom 27% (n=242;7% overall) reported vaccine hesitancy. Of these 242, 82% expressed concerns about vaccine efficacy;86% about side effects;38% reported distrust of healthcare, 53% reported concerns about vaccine contents (i.e. trackers, live virus);and 24% did not perceive risk from COVID-19. Factors associated with vaccine hesitancy included female sex (Adjusted Odds Ratio [AOR] 2.0;95% Confidence Interval (CI): 1.5-2.8;Table), Black vs. White race (AOR 1.8;95% CI: 1.3-2.5), age< 30 years (AOR 2.8;95% CI: 1.5-5.2), South/Midwest vs. Northeast region (AOR 1.7;95% CI: 1.2-2.4), years on ART (0.8;0.7-0.9) and unsuppressed viral load (AOR 2.2;95% CI: 1.4-3.5). Hesitancy decreased over time (AOR 0.9 per month;95% CI: 0.8-0.9). Vaccine side effects were the primary concern for women;vaccine contents for Black PWH and those who were unsuppressed;and lack of perceived COVID-19 risk for youth. Conclusion(s): Vaccine hesitancy was reported by approximately 7% of a U.S. multi-site cohort of PWH, and it was more prevalent among Black PWH, women, youth, those with unsuppressed viral loads, and residents of the South/ Midwest. The association between virologic non-suppression and vaccine hesitancy highlights the intertwined challenge of medical mistrust for both HIV and COVID-19. Although vaccine hesitancy decreased over time, renewed efforts will be needed to address concerns of PWH about the COVID-19 vaccine, given the ongoing need for revaccination with the evolution of the pandemic.

Viral Suppression Trajectories Destabilized after Covid-19 among Us People with Hiv

Background: Disruptions in clinical services during the COVID-19 pandemic could compromise past progress towards meeting U.S. Ending the HIV Epidemic (EHE) goals. We examined changes in the proportion with virologic suppression (VS) before and since the onset of COVID-19 in a multi-site U.S. cohort of people with HIV (PWH) using an interrupted time series design. Method(s): We assessed VS (< 200 copies/mL) trajectories 1/1/2018-1/1/2022, comparing trends before and after March 21, 2020 at 8 HIV clinics within the U.S. Center for AIDS Research Network of Integrated Clinical Systems (CNICS'). Hierarchical mixed-effects logistic regression and interrupted time series analyses examined changes in the trend (i.e., slope) of VS over time, and maximum likelihood estimation was used to account for missing VS data among those lost to follow-up (LTFU) post-COVID-19. Analyses were adjusted for demographics, site, CDC transmission group, CD4 nadir, VS, time on ART. Result(s): Data from 17,999 participants were included, providing a total of 120,918 VS assessments. Median age was 53 (interquartile range 42-61);19% were female sex at birth;the mean time on ART was 9.5 years;18% were unsuppressed at any point;17.7% were LTFU. Among the overall population, prior gains in VS slowed during COVID-19 (adjusted odds ratio [AOR] 0.93 per quarter-year;95% CI: 0.88-0.98;p=0.004;Figure). Greater impacts occurred among women (AOR 0.90;95% CI 0.81-0.99;p=0.05), persons with a history of injection drug use (PWID) (AOR 0.77 95% CI: 0.66-0.90;p=0.001), and Black PWH (AOR 0.90;95% CI: 0.84-0.96;p=0.001) in whom prior positive VS trends plateaued or began to reverse (Figure). VS remained lower among those with unstable housing (AOR 0.44;95% CI: 0.40-0.50;p< 0.001) but stayed unchanged from the pre-pandemic period. Conclusion(s): Previous gains in VS slowed during the COVID-19 pandemic among PWH in a multi-site network of U.S. HIV clinics. Known disparities in VS according to housing status remain unchanged, but VS disparities worsened for PWH who were women, PWID, or Black. Changes in VS trends could be related to socioeconomic impacts of the pandemic, insurance lapses, reduction of in-person clinic services, fear of coming to clinics, or other factors. Renewed investment in HIV public health and clinical services will be vital to achieve the U.S. EHE goals following COVID-19, with additional targeted interventions to support key populations with persistent or worsening disparities needed.

Using real-time data to improve patient no-shows and late cancellations

Background: The Cystic Fibrosis Foundation (CFF) advises that all persons with cystic fibrosis (PwCF) visit a cystic fibrosis (CF) care center every 3 months for evaluation, treatment, surveillance, counseling, and education [1]. In March 2020, our clinic went into modified operations in response to the COVID-19 pandemic, necessitating a temporary change in our ability to conduct routine face-to-face visits. Within 1 month, we operationalized virtual visits in addition to face-to-face visits. During the pandemic, staff noticed a drop in clinic attendance, and we implemented a quality improvement (QI) plan to study and address this trend. Method(s): Our QI team is a multidisciplinary group that is part of the Cystic Fibrosis Learning Network (CFLN). We defined the clinic fill rate (CFR) as the number of people seen over the number of available clinic slots. Each week, we determined the number of PwCF scheduled the following week and compared that number with no-shows and cancellations that occurred during that 7-day period. We also determined the number of PwCF scheduled 1 month ahead to compare it with weekly data. We used a key driver diagram to help focus our interventions (change ideas). Using run charts, we analyzed data each week to identify trends and variances. We used plan-do-study-act cycles and implemented initial interventions centered on publicizing CFF follow-up guidelines in town hall meetings, emails, and newsletters. We later identified PwCF who had a no-show history, and before clinics, our social worker communicated with each family (telephone or text) to remind them of the upcoming visit and identify any barriers to attending. During our study, Oregon experienced a surge in COVID-19 cases from the omicron variant, andwe overlaid our data with a graph of cases. Result(s): CFR was measured in 598 encounters over 28 weeks. CFR 1 month in advancewas 79%. In theweek before clinic, CFRwas 84%. After theweek, overall CFR was 66% (68% for face-to-face visits, 58% for virtual visits). Fifteen percent of our cancellations were COVID-related (increasing to 21% during the surge), but CFR did not change during the surge. After our intervention, those contacted in advance came to clinic 93% of the time, and our CFR improved to 74.8%. Conclusion(s): An 84% CFR, measured 1 week ahead of clinic, was dropping to an average of 66% because of late cancellations and no-shows, and widespread education about clinic attendance guidelines did not increase the rate. Having our social worker communicate directly with PwCF increased the overall CFR closer to our advance numbers, and 93% came to clinic. These communications also served as an additional patient interaction during which other social work needs were identified. Overall reduced clinic attendance may be related to the indirect impact of the pandemic and benefits of modulator therapy.We need to gather more postimplementation data and to consider different approaches to partnering with PwCF to achieve ideal follow-up.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Recent Trends and Characteristics of Genitourinary Fistulas in Rwanda

INTRODUCTION AND OBJECTIVE: Genitourinary fistulas (GU) in Rwanda have significantly increased in recent years. We previously reported an increase in the proportion of vesicouterine, vesicocervical and uterovaginal fistulas, with the majority occurring after Cesarean section. Our goal is to examine the characteristics of our the most recent cohort. METHOD(S): A cross-sectional study was conducted of women presenting for evaluation to the International Organization for Women and Development (IWOD) in Kigali, Rwanda, from 2018 to 2019, and 2022. No data was collected during years 2020 and 2021, due to the COVID-19 pandemic. Data was collected from medical records and included region of residence, surgical history, presence of fistula, and type. RESULT(S): A total of 434 women were evaluated, of these 194 (44.7%) were diagnosed with GU fistula. In 2018, fistula types were 40 (52%) vesicovaginal, 5 (6%) urethral, 5 (6%) ureterovaginal, 23 (30%) vesicoureterine or vesicocervical, and 7 (9%) juxtacervical. In 2019, the fistula types were 26 (41%) vesicovaginal, 4 (6%) urethral, 6 (10%) ureterovaginal, 17 (27%) vesicoureterine or vesicocervical, and 10 (16%) juxtacervical. In 2022, the fistula types were 33 (61%) vesicovaginal, no urethral fistula reported, 7 (13%) ureterovaginal, 8 (15%) vesicoureterine or vesicocervical, and 6 (11%) juxtacervical. CONCLUSION(S): In comparison to our prior cohort, recent data shows a stable proportion of types of fistulas. The increased number of vesicouterine, vesicocervical, and juxtacervical fistula may be higher due to increased performance of Cesarean sections.

Factors Influencing Covid-19 Risk: Insights from Molnupiravir Exposure-Response

Background: Exposure-response (E-R) models were developed for the primary endpoint of hospitalization or death in COVID-19 patients from the Phase 3 portion of the MOVe-OUT study (Clinicaltrials.gov NCT04577797). Beyond dose, these models can identify other determinants of response, highlight the relationship of virologic response with clinical outcomes, and provide a basis for differential efficacy across trials. Method(s): Logistic regression models were constructed using a multi-step process with influential covariates identified first using placebo arm data only. Subsequently the assessment of drug effect based on drug exposure was determined using placebo and molnupiravir (MOV) arm data. To validate the models, the rate of hospitalization/death was predicted for published studies of COVID-19 treatment. All work was performed using R Version 3.0 or later. Result(s): A total of 1313 participants were included in the E-R analysis, including subjects having received MOV (N=630) and placebo (N=683). Participants with missing baseline RNA or PK were excluded (79 from MOV and 16 from placebo arms). The covariates shown to be significant determinants of response were baseline viral load, baseline disease severity, age, weight, viral clade, and co-morbidities of active cancer and diabetes. Day 5 and Day 10 viral load were identified as strong on-treatment predictors of hospitalization/death, pointing to sustained high viral load as driving negative outcomes. Estimated AUC50 was 19900 nM*hr with bootstrapped 95% C.I. of (9270, 32700). In an external validation exercise based on baseline characteristics, the E-R model predicted the mean (95% CI) placebo hospitalization rates across trials of 9.3% (7.6%, 11.7%) for MOVe-OUT, 7.2% (5.3%, 9.8%) for the nirmatrelvir/ritonavir EPIC-HR trial, and 3.2% (1.9%, 5.5%) for generic MOV trials by Aurobindo and Hetero, consistent with the differing observed placebo rates in these trials. The relative reduction in hospitalization/death rate predicted with MOV treatment (relative to placebo) also varied with the above patient populations. Conclusion(s): Overall, the exposure-response results support the MOV dose of 800 mg Q12H for treatment of COVID-19. The results further support that many clinical characteristics impacted hospitalization rate beyond drug exposures which can vary widely across studies. These characteristics also influenced the magnitude of relative risk reduction achieved by MOV in the MOVe-OUT study.

A randomised controlled trial of early intervention with oral favipiravir in patients hospitalised with COVID-19 (PIONEER Trial)

Background: Oral anti-viral therapies are licensed worldwide in COVID-19 but indications and efficacy rates vary. Aims and Objectives: To evaluate the safety and efficacy of oral favipiravir in patients hospitalised with COVID-19. Method(s): We conducted a multi-centre, open-label, randomised controlled trial of oral favipiravir in patients newly hospitalised with COVID-19, in five centres worldwide. 500 participants were randomised 1:1 to receive oral favipiravir (1800 mg twice daily (BD) for one-day;800 mg BD for nine-days) plus standard care (SC), or SC alone. NCT: 04373733. Result(s): Recruitment was performed between May 2020 and May 2021, with 251 patients randomised to favipiravir and 249 to SC. There was no difference in time to recovery in all patients (HR 1 06;95% CI 0 89-1 27;n=499;p=0.52). A faster rate of recovery was observed in patients receiving favipiravir under the age of 60 years (HR 1 35;95% CI 1 06-1 72;n=247, p=0 01). A 66 % improvement in mechanical ventilation free survival was evident in patients under 60-years of age (HR 0 34;95% CI 0 13-0 85;n=247, p=0 02). A non-significant 26 % reduction in mortality was observed in patients receiving favipiravir (favipiravir: 26;SC: 34;p=0 24). No significant differences were observed in serious adverse events (SAE) between arms (favipiravir: 36 in 27 patients;SC: 33 in 27 patients). Conclusion(s): Orally administered favipiravir has a beneficial effect on recovery, and mechanical ventilation freesurvival in patients under 60-years of age, hospitalised with COVID-19. Wider evaluation of anti-viral medications and their potential treatment combinations is warranted in patients with COVID-19.

Planning, Prioritizing, and Conducting Clinical Research in the Va Learning Healthcare System during the Covid-19 Pandemic

The Veterans Affairs (VA) Cooperative Studies Program (CSP) and Clinical Science Research and Development (CSRD) are both divisions of the VA Office of Research and Development (ORD) that is responsible for the planning and conduct of clinical trials and epidemiological studies within the VA's learning healthcare system. Since the outbreak of the COVID-19 pandemic in the United States, the VA has been facing some new and evolving challenges in clinical research, especially in planning, prioritizing, and conducting new clinical research projects aimed at preventing and/or treating SARS CoV-2 infection/ COVID-19 disease. In considering clinical research projects, different stakeholders of the VA research enterprise assess needs using numerous parameters: (1) CSP and CSRD leadership: VAMC network infrastructure, financial support, available funding, and enterprise-wide impact. (2) Clinical researchers: clinical perspectives and needs, as they relate to study design and operations, in the context of an ever-evolving epidemiological picture and disease knowledgebase. (3) VA research Coordinating Center(s): the challenges that reside in aspects of trial design and planning, in an effort to account for frequent changes in the COVID-19 epidemiology, and its impact on project feasibility/participant recruitment, choice of study endpoints, safety of healthcare providers, research personnel, and study participants. Notwithstanding these evolving challenges, the VA ORD stood up the VA CoronavirUs Research and Efficacy Studies (VA CURES) network in a coordinated effort to develop a master protocol framework that could efficiently utilize the VA's clinical research infrastructure to address the COVID-19 pandemic. The VA CURES framework has been serving as the umbrella structure encompassing numerous COVID-19 clinical research activities. Both CSP and CSRD have an established clinical research infrastructure, including Coordinating Centers, a Network Of Enrollment Dedicated Sites (NODES) and over 150 VA Medical Centers across the United States, with a clear and streamlined process of submission and review of research proposals (Letters of Intent;LOI), subsequent trial planning leading up to scientific review and, once approved, conduct of research projects. In this session, we will present the VA clinical research infrastructure and share its mobilization in this pandemic. Furthermore, we will share lessons learned in conducting research in emergency situations and how the research infrastructure pivoted and adapted to fulfill its mission of providing the best healthcare to Veterans. The following four areas will be the focus of this session: the VA ORD leadership perspective: Infrastructure/support/funding/priorities;clinical research perspectives: Study design in the face of evolving epidemiological picture;trial design and planning: Protocol drafting/timelines/shifting priorities/feasibility/ VAMC networks;organizing and operationalizing the VA CURES umbrella/platform: CURES-1, and CURES-2.

Not by trees alone: centering community in urban forestry

Urban forestry and urban greening efforts are blossoming as cities and towns work to enhance their open spaces as green infrastructure that provides multiple benefits. This work has reached new urgency given the need for both high-performance landscapes that can mitigate the effects of climate change and accessible, safe greenspaces that can support community well-being during the COVID-19 pandemic. At the same time, activists, practitioners, scholars, and decision-makers--particularly those within Black, Indigenous, People of Color, and frontline communities who bear the brunt of negative impacts--are calling for the need to attend to environmental justice implications of greening efforts. Following a review of the literature, we draw upon our observations as researchers embedded in the field of urban and community forestry to offer three themes and related guiding questions that can help advance that work: (1) supporting human capacity and care (investments in people and organizations);(2) community organizing beyond the green silo (intersectional and cross-sectoral approaches);and (3) re-envisioning the functions of the urban forest (productive systems and biocultural approaches). Our perspective is inspired by the work of residents, practitioners, and decision-makers who are engaging in reflection and innovation in pursuit of "just cities" that can enhance diversity, equity, and inclusion as critical to and inseparable from sustainability and resilience. We suggest that the field of urban forestry draw upon a community forestry ethos as we center the needs, capacities, and priorities of historically marginalized communities at the heart of the work of creating more just, sustainable cities.

Antibody Response to Sars-Cov-2 Vaccination in Adolescents Following Solid Organ Transplantation

Serological responses to Covid-19 vaccines in adults post solid organ transplant are impaired [1]. We sought to measure antibodies to SARS-CoV-2 in adolescents post lung, heart, kidney-liver and kidney transplant following the vaccine rollout to 12-17 year-olds in the UK. We measured anti-spike, receptor binding domain and nucleocapsid IgG in adolescents attending our centre for routine drug monitoring after Pfizer/BioNTech BNT 162b2 was made available in autumn 2021, and collected information on prior infection from electronic records and via patient/parent recall. Samples were obtained from 42 participants, with paired samples pre and post vaccine in 14 patients. 52% had serological evidence of past exposure at baseline (fig 1). Receptor binding domain IgG was positive in all subjects at follow up, with spike IgG positive in 13/14 (p<0.001, fig 2). Individuals who had received vaccine and been infected had higher levels of spike IgG than those who had been infected and unvaccinated (p<0.05). All subjects demonstrated antibody responses to vaccine, and vaccine increases antibody levels in adolescents who have also had a SARS-CoV-2 infection in comparison to the unvaccinated. These data support an age-related relationship to antibody responses in post solid organ transplant recipients and support efforts to increase vaccine uptake in this at-risk group. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Clinical Trial Facilitators: A Novel Approach to Support the Execution of Clinical Research at the Study Site Level

In the summer of 2020, there were multiple efforts to establish safe and effective vaccines that would combat the spread of COVID-19. Efforts to eradicate the virus in the United States included Operation Warp Speed (OWS) which was a partnership between the Departments of Health and Human Services (HHS) and Defense (DOD), and the private sector, that aimed to help accelerate control of the COVID-19 pandemic by advancing development, manufacturing, and distribution of vaccines, therapeutics, and diagnostics. As the nation's largest integrated healthcare system, the US Department of Veterans Affairs (VA) was identified as a potential collaborator in several large-scale OWS Phase III clinical trial efforts designed to evaluate the safety and efficacy of various vaccines in development. Given the national (and global) importance of these trials, it was recognized that there would be a need for a coordinated, centralized effort within VA to ensure that its medical centers (sites) would be ready and able to efficiently initiate, recruit, and enroll into these OWS COVID-19 vaccine trials. To accomplish this mission, two groups within the VA Office of Research and Development (ORD) partnered to manage and provide support to these sites and facilitate their execution of these trials. The Partnered Research Program (PRP) is a division of VA ORD that is dedicated to developing partnerships that enhance Veterans' access to high-quality, multi-site clinical trials. PRP has an overall goal of establishing long-term relationships with external organizations that are committed to Veterans' health and VA's clinical research mission. The VA Cooperative Studies Program (CSP) is a clinical research infrastructure embedded within the VA healthcare system. CSP is also a division of the VA ORD and was established to provide coordination for, and enable cooperation on, multi-site clinical trials and epidemiological studies that fall within the purview of VA. Its infrastructure comprises a number of Coordinating Centers that are responsible for the planning and conduct of large multi-site clinical trials in the VA healthcare system. CSP also established a consortium of 10 VA medical centers (VAMCs) called the Network of Dedicated Enrollment Sites (NODES) that have teams (nodes) to provide site-level expertise and innovative approaches in addressing challenges to clinical trial execution. This (poster) outlines the partnership and activities undertaken by VA's PRP and CSP NODES groups to manage and support a large-scale OWS Phase III multi-site clinical trial. It focuses specifically on the determination to designate clinical trial facilitators to study sites, the important role that they played in getting this trial initiated at those sites in a timely fashion, and their work to ensure successful study enrollment.

Fit testing and comfort evaluation of prophylactic dressing use for healthcare workers under N95/P2 respirators in one health service district in Australia.

BACKGROUND: This study evaluated the use of prophylactic dressings (silicone foam, silicone tape, hydrocolloid) under N95/P2 respirators to determine which dressings fit successfully. AIM: The aim was to develop a health service protocol for one state in Australia. METHODS: Data were collected during August and September 2021 as part of the Respiratory Protection Programme on 600 health workers using three types of prophylactic dressings. Five different types of respirators were used. Participant healthcare workers rated comfort on a four-point Likert scale. RESULTS: Successful fit was achieved by 63.6% of the respirator-dressing combinations. The best-performing respirator-dressing combination was the Trident® respirator with dressing Mepilex® Lite silicone foam (90.2% pass rate). High pass rates were found in the Trident® respirator with Mepilex® Border Lite with SofSicure silicone tape (79.1%); the 3M™ 1860 respirator with Mepilex® Border Lite with SofSicure silicone tape (74%); and the BSN orange duckbill respirator with Mepilex® Lite silicone foam (69.8%). The poorest-performing combination was the BYD™ respirator with Mepilex® Border Lite with SofSicure silicone tape (25.9% pass rate). Uncorrected chi-squared tests for association revealed significant associations between dressing type and outcome (P=0.004) and respirator type and outcome (P<0.001). Most respondents (82%) found the dressing combination markedly comfortable. CONCLUSIONS: When using prophylactic dressings under N95/P2 respirators, it is necessary to perform a fit test. In this study Trident® respirators had the highest probability of successful fit, while BYD™ respirators had the lowest. Combining Trident® respirators with Mepilex® Lite dressing was optimal. Most participants reported greater comfort with the dressings under the respirators.

Pediatric Post-Acute Sequelae of SARS-CoV-2 infection

Aim: Youth who have not recovered from COVID-19 have been referred to as having Post-Acute Sequelae of SARS-CoV-2 Infection (PASC). The goal of this study was to better understand which symptoms persisted since onset of infection and how these symptoms compare to symptoms experienced by those with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Method: A sample of 19 parents who had a child with PASC were recruited using social media to fill out a questionnaire detailing symptoms at two time points. The first time point included their child's current symptoms and the second captured symptoms at initial infection. These participants were compared to a sample of 19 youth with ME/CFS. Results: Findings indicated significant decreases among several immune, neuroendocrine, pain, post-exertional malaise (PEM), and COVID-19 Centers for Disease Control and Prevention (CDC) domain symptoms from time of acute infection to time of current reporting. Fatigue remained at a high level as did several symptoms within the sleep and PEM domains. Participants with ME/CFS had overall worse symptomatology when compared to participants with PASC, especially in the neurocognitive domain. Conclusion: Most symptoms of those with PASC decline over time, but several remain at high levels, including fatigue. These findings are helpful in better understanding common symptom presentation profiles for youth with PASC and can be used to more adequately tailor diagnostic criteria and treatment strategies for youth. © 2023 IACFS/ME.

The Connection between Gardening and Outdoor Activity during the COVID-19 Pandemic and Perceptions of Hope, Hopelessness, and Levels of Stress, Anxiety, and Depression

During the past few years, Americans have experienced a wide variety of stressors, including political tensions, racial/civil unrest, and the coronavirus disease 2019 (COVID-19) pandemic. All of these have led to uncertainty within society. Chronic feelings of helplessness can lead to depression or feelings of hopelessness in those who perceive their situation as unchanging. The purpose of this study was to evaluate the impacts of gardening and outdoor activities during the COVID-19 pandemic on perceptions of hope, hopelessness, and levels of depression, stress, and anxiety. Participants of this study were recruited through online social media platforms such as Facebook and Instagram;458 participants completed the 21-item Depression Anxiety and Stress Scale inventory as well as the Hope Scale. Our data indicated that individuals who self-reported themselves as gardeners had significantly more positive scores related to levels of stress, anxiety, and depression and a sense of hope. Furthermore, gardeners had lower levels of self-reported depression, anxiety, and stress when compared with those who did not identify themselves as gardeners. The gardeners also had a more positive outlook regarding hope for the future. Additionally, a significant positive correlation was found between the number of hours spent participating in gardening and a sense of hope, and a negative correlation was found between the number of hours gardening and stress levels. Similarly, there was a significant negative correlation between the number of hours spent participating in any outdoor activity and self-reported levels of stress, anxiety, or depression;however, there was a positive correlation between the number of hours spent participating in any outdoor activity and a sense of hope. Our data suggested that more hours spent outside gardening or participating in recreational activities led to less perceived stress, anxiety, and depression and greater levels of hope for the future. © 2023, American Society for Horticultural Science. All rights reserved.

Collaborative research services: a peer-led cohort approach

PurposePrior to 2020, University of California, Los Angeles (UCLA) Library's research services spanned multiple service points. Multiple locations were staffed by Library Student Research Assistants (LSRAs) and each location was supervised independently. While efforts to increase collaboration had been underway, much of the work and services remained siloed and often duplicated training and service hours.Design/methodology/approachWith the onset of coronavirus disease 2019 (COVID-19), UCLA Library rapidly transitioned from entirely in-person to entirely online services. With multiple service points pivoting, UCLA was redundant to have multiple online desks providing Zoom appointments and that quickly became apparent. Moreover, transitioning in-person student work to remote work was paramount to providing both normal services to users and allowing LSRAs to keep jobs during a time of uncertainty and insecurity.FindingsWhile the authors' original consolidation of services and implementation of shared supervision was a result of the pandemic and primarily involved online services, the authors have maintained this shared approach and collaborative vision in returning to in-person services. For the past year, the authors have offered shared in-person (at two library locations) and online services. As subject-specific library locations begin to reopen their desks, the authors continue to identify ways to leverage shared supervision and a robust referral model for those on-site services while negotiating student staffing and the need for both general and subject-specific services.Originality/valueThe authors present a novel approach to peer-to-peer teaching and learning and research services and shared student worker supervision with services coordinated across multiple locations and disciplines within a large academic library serving a large student population.

Stability of Psychological Well-being Following a Neurological Event and in the Face of a Global Pandemic

This study examined the stability of psychological well-being in people who have experienced a neurological event resulting in focal brain damage. Evidence suggests that psychological well-being is largely stable in healthy adult populations. However, whether such stability exists in neurological patients with acquired brain lesions is an open question. Given the trait-like characteristics of psychological well-being, we hypothesized that psychological well-being would be stable in neurological patients who are in the chronic epoch of recovery (>= 3 months after the neurological event). Eighty participants (women = 40;age: M = 56, standard deviation (SD) = 13) completed the Ryff Scales of Psychological Well-Being (PWBS) twice between 2016 and 2020 (Time 1 [T1] and Time 2 [T2]). The Ryff Scales measure various facets of well-being, including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Approximately half of participants completed their T2 assessment during the COVID-19 pandemic, creating an opportunity to investigate the effects of the pandemic on the stability of psychological well-being in a neurological population that may be particularly vulnerable to reduced well-being in this context. Pearson correlations and within-sample t-tests were conducted to examine the stability of self-reported well-being over time. Test-retest correlations ranged from .71 to .87, and no significant differences in well-being emerged across the two time points. Significant correlations between T1 and T2 were also evident in the subsample of participants who completed their second assessment during the COVID-19 pandemic. These findings provide evidence that long-term psychological well-being is remarkably reliable and consistent over time in patients who have experienced a major neurological event, even when an unprecedented global event occurred between measurement epochs. Treatment implications of these findings are discussed.