Epidemiology of Primary and Recurrent Healthcare-Associated and Community-Associated Pediatric Clostridioides difficile Infection in Canada, 2015-2020.

Clostridioides difficile infection (CDI) among children remains a concerning cause of morbidity in hospital settings. We present epidemiological and molecular trends in healthcare- and community-associated CDI among children in Canadian inpatient and outpatient settings, including those who experienced recurrent infections.

Teaching virtual job interview skills to college students with IDD using literacy-based behavioral interventions

College students with intellectual and developmental disabilities (IDD) face challenges searching for jobs, often lacking communication and social skills needed during formal interviews. The COVID-19 pandemic complicates interviews, forcing students to search online and attend virtual interviews. This study used a multiple probe design across participants to examine the acquisition of literacy-based behavioral interventions (LBBIs) on virtual job interviews. Using a video conference platform, students answered interview questions from researchers acting as employers. LBBIs were customized, incorporating students' input. Results indicated that LBBIs were effective for teaching and maintaining virtual job interview skills, and across novel employers. The findings have implications for using LBBIs to teach virtual job interview skills to students with IDD, and for researchers including these students in remote instruction. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Effects of remote audio coaching during workplace conversations for college students with intellectual disability

College students with intellectual disability (ID) face many challenges while maintaining employment. These challenges encompass both social and behavioral tribulations. Increasing social skills at work is a significant goal for practitioners and educators of adults with ID. Coaching strategies such as Covert Audio Coaching (CAC) and Remote Audio Coaching (RAC) have proven effective in teaching students with ID various employment related skills.The purpose of this study was to determine if RAC would increase on-topic workplace communication skills for college students with ID.This study used a multiple probe design to test the effects of RAC on teaching communication skills in the workplace. In this study, college students logged onto a Zoom call to speak with a co-worker about an employment topic while the interventionist used RAC to coach the student through the conversation.The results of this study demonstrated that the RAC intervention was effective in increasing on-topic exchanges between college students with ID and their co-workers.The COVID-19 pandemic has shifted the workplace to virtual settings for training and work tasks. RAC can be used as an employment support for adults with ID while minimizing in person contact. Limitations and implications of this study were further described at the end of the article. [ FROM AUTHOR] Copyright of Journal of Vocational Rehabilitation is the property of IOS Press 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.)

Speak out, stay safe: Including children with special educational needs and disabilities in an evaluation of an abuse prevention programme

This paper reports on the evaluation of an integrated violence and abuse prevention programme for children aged 5–11, focusing on children with special educational needs and disabilities (SEND). The Speak Out Stay Safe (SOSS) programme was delivered in mainstream primary schools across the UK. A small-scale study of children with SEND nested within the larger evaluation captured their understandings of abuse and harm and readiness to seek help. A specially adapted survey was completed by 76 children with SEND (aged 6–7 and 9–10) at baseline (31 intervention;45 comparison schools), 12 in intervention schools post-programme and 37 (four intervention;33 comparison schools) six months post-baseline. Qualitative data was captured through 16 teacher interviews. Whilst this nested study was compromised by the COVID-19 pandemic, it provides important evidence that with appropriate adaptations, a survey approach to investigating the learning of children with SEND can be effective. Findings indicate that awareness of abuse and help seeking strategies may improve over time, whilst interview data suggests that adapting the programme to be inclusive of those children may have a better effect. However, a much larger sample of children with SEND is required to confidently measure the effects of such programmes for this population. © 2023 The Authors. Child Abuse Review published by Association of Child Protection Professionals and John Wiley & Sons Ltd.

Promoting Physical Activity in Rural Communities During COVID-19 with Exercise is Medicine ® on Campus

Apply It!: By reading this article, the health and fitness professional will: • Recognize the urgency for widespread promotion and implementation of physical activity during the COVID-19 pandemic • Learn how Exercise is Medicine On Campus (EIM-OC) can be used to promote physical activity in the surrounding communities, especially those in rural areas • Explore strategies for promoting, adapting, and facilitating physical activity during the pandemic and beyond • Consider collaborating with an EIM-OC program to improve community health

Going viral: A systematic review exploring the impact of COVID- 19 on medical student education in urology

Introduction & Objectives: During the COVID-19 pandemic, medical students across the globe were temporarily dismissed from clinical placements. In the field of urology, prevocational exposure is closely linked to medical students' interest in pursuing urology as a career and their confidence in dealing with urological conditions post-graduation. This systemic review evaluates the emerging educational interventions to improve urological knowledge and urology exposure among medical students in the context of a global pandemic. Method(s): A modified PRISMA (Preferred Reporting Items for Systematic Review and Meta- Analyses) search was conducted using MEDLINE and EMBASE were searched with keywords related to urology education, medical education, and medical students. The inclusion criteria were all English language articles in peer-reviewed publications from January 2020- current. Full-text articles were retrieved, evaluated, and included in the final analysis. Result(s): In total, 1255 records were identified through the initial literature search, and 21 full-text articles were reviewed for eligibility. Eight studies met the selection criteria and were included in this review. Most studies were conducted in the United States. All studies utilised online learning platforms or videoconferencing applications as part of their interventions. All studies implemented a combination of interventions, including case-based learning, didactic lectures, and online discussion boards. All studies reported at least one positive finding on Kirkpatrick level 1 or 2. (See table 1 for complete data extraction). Conclusion(s): A wide variety of effective educational interventions has been implemented since 2020 to ensure adequate urology education for medical students. The pandemic largely drove the broad adoption of online learning, and these online resources should be incorporated into pre-existing Australian and New Zealand urology curricula post- COVID, given their effectiveness and popularity among medical students internationally. There was, however, a lack of educational outcomes assessed at higher Kirkpatrick levels. A robust methodology and a larger sample size are needed for future studies.

Undetected Fetal Growth Restriction During the Coronavirus Disease 2019 (COVID-19) Pandemic.

This was a retrospective cohort study of patients who delivered singleton, small-for-gestational-age (SGA) neonates between April and June 2019, before the coronavirus disease 2019 (COVID-19) pandemic (pre-COVID-19), and between April and July 2020, during the pandemic (COVID-19 epoch). The primary outcome was the rate of undetected antenatal fetal growth restriction (FGR) in the two periods. A total of 268 patients met inclusion criteria. Patients who delivered small-for-gestational-age neonates during the COVID-19 epoch were significantly more likely to have undetected FGR compared with those who delivered pre-COVID-19 (70.1% vs 58.1%, P =.04). Patients who delivered SGA neonates during the COVID-19 epoch had more telehealth visits but fewer in-person prenatal visits, recorded fundal height measurements, and growth ultrasonograms. As telemedicine continues to be incorporated into prenatal care, these data may lend further support toward self-assessment of fundal height or routine third-trimester growth ultrasonograms to identify fetal growth abnormalities.

Development of psycho-oncology telehealth recommendations: A Delphi consensus study

Aim: The COVID-19 pandemic triggered rapid implementation of telehealth (telephone and videoconference) in Australia. Psycho-oncology clinicians report a need for greater guidance on adapting in person psycho-oncology therapies to telehealth. We aimed to establish consensus on elements of psycho-oncology therapy that can be adapted for telehealth for inclusion in an educational resource incorporating clinical practice recommendations. Method(s): Draft recommendations were developed based on existing literature, reviews and guidelines. These were refined using a co-design process involving expert consultation (n = 13) with psychooncology clinicians and researchers. This process identified some uncertainty around key recommendations. A two round Delphi consensus process was conducted to confirm the relative importance and therapeutic appropriateness of content for inclusion in clinical practice recommendations. Participants included psycho-oncology clinicians with telehealth experience. Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as>80%of respondents scoringwithin two points on the Likert scale. Result(s): The co-design approach identified key topics for inclusion in the recommendations: (1) preparation for telehealth (e.g., privacy, security, technical considerations);(2) clinical and cultural considerations (e.g., safety considerations, therapeutic alliance, vulnerable/ underserved communities);(3) adaptations to therapeutic assessment and intervention;(4) specific client considerations (e.g., clients in palliative care). 32 clinicians participated in Delphi Round 1, where thirteen recommendations were presented and consensus reached for nine. Recommendations where consensus was not reached were re-presented in Round 2.We will present the consensus recommendations based on the Delphi. Conclusion and clinical implication: The clinical practice recommendations will provide a robust expert-endorsed educational resource to guide psycho-oncology clinicians tailoring their practice to telehealth. This will support delivery of evidence-based treatments to people living with cancer, increasing the sustainability of, and confidence in, psycho-oncology telehealth.

Happiness in pre-pandemic Europe: correlates of individual happiness prior to Covid.

OBJECTIVE: To identify levels and key correlates of happiness across Europe in 2018, prior to the Covid-19 pandemic. METHODS: We used data from the European Social Survey to determine levels of happiness in individuals (n = 49,419) from 29 European countries and identify associations between happiness and age, gender, satisfaction with income, employment status, community trust, satisfaction with health, satisfaction with democracy, religious belief and country of residence. RESULTS: In 2018, self-rated happiness varied significantly across the 29 European countries, with individuals in Denmark reporting the highest levels of happiness (8.38 out of 10) and individuals in Bulgaria reporting the lowest (5.55). Ireland ranked 11th (7.7). Happiness had significant, independent associations with younger age, satisfaction with health, satisfaction with household income, community trust, satisfaction with democracy and religious belief. These factors accounted for 25.4% of the variance in happiness between individuals, and, once they were taken into account, country of residence was no longer significantly associated with happiness. CONCLUSIONS: Self-rated happiness varied significantly across pre-pandemic. At individual level, happiness was more closely associated with certain variables than with country of residence. It is likely that the Covid-19 pandemic had significant impacts on some or all of these variables. This highlights the importance of further analysis of correlates of happiness in Europe over future years, when detailed happiness data from during and after the pandemic become available.

Adrienne Kennedy's Mom, How Did You Meet the Beatles?

Adrienne Kennedy and Adam P. Kennedy wrote Mom, How Did You Meet the Beatles? in 2008. The play details in sweeping narration the manipulation of Adrienne Kennedy by the National Theatre of the 1960s. The Forward Theatre Production, directed by Baron Kelly, utilized "the pause" in the text to underscore the interior world of the character's emotional state. This short article talks about how the play was received by the viewers as the theatre was beginning to transition out of the pandemic.

Using Mnemonics, Remote Coaching, and the Range-Bound Changing Criterion Design to Teach College Students with IDD to Make Employment Decisions

Adults with intellectual and developmental disability (IDD) increasingly are accessing inclusive college programs to gain academic and employment preparation for future community living. Decision-making and self-determination are two inter-related skills taught in these programs. In this study, we investigated an intervention that combined remote audio coaching (RAC) and a mnemonic strategy to teach employment decision- making skills to three college students with IDD. We evaluated the intervention using the range-bound changing criterion design to assess students' stepwise progress. All students substantially increased their employment decision-making skills, generalized those skills to a novel job coach who was not part of the intervention, and maintained the skills after the intervention was removed. We discuss implications of the procedures and results of this decision-making intervention, as well as the goodness-of-fit of the experimental design for evaluating controlled, gradual skill increases.

Trends in Clostridioides difficile infection rates in Canadian hospitals during the coronavirus disease 2019 (COVID-19) pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has placed significant burden on healthcare systems. We compared Clostridioides difficile infection (CDI) epidemiology before and during the pandemic across 71 hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Using an interrupted time series analysis, we showed that CDI rates significantly increased during the COVID-19 pandemic.

Presentation skills in the virtual meeting era - an analysis of #EAU21

Introduction & Objectives: The COVID pandemic has rapidly catapulted scientific conferences into a virtual or hybrid format. The format of traditional scientific communication has abruptly changed from physical presentations at conferences, to virtual pre-recorded contributions and participations. We assessed the quality of presentation skills at a major urology conference, the European Association of Urology Annual Meeting (#EAU21), to identify areas for improvement. Methods: Using the EAU Urosource Resource Centre, we reviewed ondemand sessions posted from the #EAU21 virtual meeting, focusing on Plenary, Industry, Poster, Semi-live and Specialty sessions. Using a predefined matrix based on industry experts, a panel of reviewers rated presentations using quality criteria including camera angle, audio quality, virtual content optimised for virtual viewers which was assessed on both laptop and iphone to replicate typical viewer experiences. Levels of quality were defined from Level I (minimum standard), to Level 3 (excellent). Results: We reviewed 138 on-demand sessions (7 plenary, 44 poster, 11 industry, 9 semi-live, 67 specialty) posted from #EAU21. Of 2068 virtual appearances assessed, 1710 (82.7%) failed to meet the minimum defined quality standard of Level 1, with camera violations being the most common offence (91.7% of time). Of those who attained level 1 standards, 39/358 (10.8%) reached Level 2, out of which only 4 (10.3%) presentations met level 3 standards. Deficiencies in audio and content presentation domains were equally common (55.9% and 55.1%, respectively) in those with level 1 standards who did not reach level 2, while video elements were less common (51.5%). There was high inter-observer agreement in the scoring (87-91.3%). Even after excluding professional studio recordings provided by EAU, there was a consistent trend of chairpersons and moderators outperforming presenters in terms of level 1 standards (31.6% vs 13.7%, p<0.001). The only exception was seen in the industry sessions where more presenters met level 1 standards (48.1% vs 30.8%, p = 0.29). Qualitative analyses revealed a wide range of styles used including the interesting use of automated voiceover narrations seen only in poster sessions (1.2%) which could overcome language barriers. In the presentations that met level 3 standards, the use of professional video and audio editing tools was evident and helped optimised the delivery of the scientific content for viewers. Conclusions: A high proportion of virtual presentations did not achieve a reasonable minimum standard for scientific communication during the virtual #EAU21 meeting. Simple technical measures can significantly improve the quality of virtual presentations and ensure a better viewer experience. Further training will help the scientific community communicate more effectively in the virtual and hybrid meeting era.

mSOFA Scores Associated with the Development of Pneumothorax, Pneumomediastinum and Subcutaneous Emphysema in Critically Ill Covid-19 Patient

Introduction: COVID-19 is a well-known cause of severe ARDS (acute respiratory distress syndrome), however recent data suggests that COVID-19 could represent a unique form of lung injury that places patients at increased risk of various uncommon complications such as pneumothorax, pneumomediastinum and subcutaneous emphysema. Studies so far have reported an increased incidence of barotrauma in intubated COVID-19 patients with unclear predictors. Our study aims to identify the different variables associated with development of pneumothorax, pneumomediastinum and subcutaneous emphysema in critically ill COVID-19 patients. Methods: We examined patients admitted to the intensive care unit from March 2020 to Feb 2021 at a large tertiary care center in Detroit, Michigan. We identified a total of 25 patients with COVID-19 ARDS requiring mechanical ventilation who developed pneumothorax, 12 who developed pneumomediastinum and 7 with subcutaneous emphysema. We compared those to 66 patients admitted with COVID-19 ARDS also requiring mechanical ventilation who did not develop any of these complications. The mean age of patients in our subject group was 61.81 years compared to a mean of 69.05 years in the control group. Male patients accounted for 58.33% of the subject group and 60.61% in the control group. Results: we detected a statistically significant difference in the modified Sequential Organ Failure Assessment Score (mSOFA) between the patients who developed these complications compared to those who did not (p<0.0001), with score being surprisingly lower in the group who developed the complication as opposed to those who did not (median mSOFA in subjects 3.5, n=32 vs median mSOFA in controls 11, n=66). Analysis of the subgroups of the mSOFA score revealed no statistically significant difference in the PF ratio (p=0.1995), platelet counts (p=0.065) and total bilirubin (p=0.4403). However, MAP was noted to be significantly lower in the control group than in the subject group accounting for a higher mSOFA score (p=0.0031). Similarly, creatinine was noted to be higher in the control group (p<0.0001) compared to the subject group. Discussion: In viewing our baseline patient characteristics we found a statistically significant difference (p<0.0001) in the rate of baseline chronic kidney disease between our subjects and control patients, with control patients having 100% baseline CKD and subjects having 19.4% baseline CKD. This could account for the higher mSOFA scores in controls. Conclusion: mSOFA did not predict the development of pneumothorax, pneumomediastinum or subcutaneous emphysema in patients admitted with COVID-19 ARDS requiring mechanical ventilation.

SARS-CoV-2 infection results in immune responses in the respiratory tract and peripheral blood that suggest mechanisms of disease severity.

Respiratory tract infection with SARS-CoV-2 results in varying immunopathology underlying COVID-19. We examine cellular, humoral and cytokine responses covering 382 immune components in longitudinal blood and respiratory samples from hospitalized COVID-19 patients. SARS-CoV-2-specific IgM, IgG, IgA are detected in respiratory tract and blood, however, receptor-binding domain (RBD)-specific IgM and IgG seroconversion is enhanced in respiratory specimens. SARS-CoV-2 neutralization activity in respiratory samples correlates with RBD-specific IgM and IgG levels. Cytokines/chemokines vary between respiratory samples and plasma, indicating that inflammation should be assessed in respiratory specimens to understand immunopathology. IFN-α2 and IL-12p70 in endotracheal aspirate and neutralization in sputum negatively correlate with duration of hospital stay. Diverse immune subsets are detected in respiratory samples, dominated by neutrophils. Importantly, dexamethasone treatment does not affect humoral responses in blood of COVID-19 patients. Our study unveils differential immune responses between respiratory samples and blood, and shows how drug therapy affects immune responses during COVID-19.

Predictors and Outcomes for COVID-19 Re-Admissions in the Anticipate Cohort.

Aims To describe readmissions of hospitalised patients with COVID-19, define predictors of readmission and explore the long term outcomes using the SF-12 score compared to patients who were not readmitted and those not hospitalised. Methods A single centre retrospective in North Inner-City Dublin. Recruitment was done through a COVID follow up clinic. Predictors of readmission and SF-12 scores at two timepoints post follow up at median 3 months and 12 months. Results Seventy (45%) participants were admitted, with a median age of 49.5 years (IQR 41.3-56.9), 36(51%) of whom were female. Unscheduled readmissions at ≤30 days in COVID-19 patients were 9(12.9%) and length of stay was four days (IQR 2-5). Readmissions were due to ongoing symptoms(n=9(64.3%)) or new complications(n=5(35.7%)). Mechanical ventilation and having symptoms of nausea and vomiting on index admission were predictive of readmission. (p=0.002). SF-12 scores at one year of readmitted patients were not different to patients who were never admitted at median one year follow up, p=.089. Conclusions Most readmissions were of short duration. Early follow up of patients post MV or who had nausea and vomiting on index admission should be prioritised. Wellbeing of readmitted patients was not different to those never hospitalised, at one year.