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After schools were closed in AY 2019–2020 due to the COVID-19 pandemic, teachers were expected to continue two-way communication and collaboration with their students' families without much guidance. In this study, we focus on how five teacher candidates navigated and continued their efforts of communication and collaboration with students' families and the larger community during the pandemic. Through storytelling during interviews, the five teacher candidates provided valuable insight that focused on communication during the pandemic. Findings indicated that these teacher candidates struggled with establishing professional boundaries with students' families, wrestled with the unforeseeable challenges of "being” in the homes of their students' families, and experienced a disconnect from the community. Implications of this study suggest that lessons learned during COVID-19 could transform how teacher candidates and Educator Preparation Programs (EPPs) practice future two-way communication and collaboration with students' families. © 2022 Association of Teacher Educators.
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Background. Development of robust vaccination guidelines against SARS-CoV-2 requires an understanding of the longitudinal antibody (Ab) response to vaccination and interactions with natural infection. Here, we leveraged an observational cohort study of healthcare personnel (HCP) to study the impact of prior SARS-CoV-2 infection on Ab binding and neutralization after mRNA-based vaccination over a 13 month period. Methods. From July 2020 to February 2022, HCP at an academic medical center provided blood samples biweekly for 12 weeks and monthly thereafter. First and second vaccine doses became available in mid-December 2021 and boosters were available starting in October 2021. Individuals were excluded if they did not provide any samples, if baseline serostatus was unknown, and if they received a monoclonal Ab treatment for COVID. ELISA measured total immunoglobulin (Ig) and IgG binding to SARS-CoV-2 RBD. Neutralization was measured by live virus Nanoluc SARS-CoV-2ic assay. Demographics, serostatus, and vaccinations for the total study population and the sub-sample of participants with pre- and post-vaccination antibody measurements. Results. Of 213 participants, 192 met inclusion criteria. A majority had detectable IgG levels 8 months after a second dose. Prior to vaccination, median total Ig was higher among seropositive vs. seronegative participants (3.7 vs 1.0, p< 0.001). After a first dose, the median total Ig response was two-fold higher in seropositive compared to seronegative participants (13.8 vs. 7.0, p=0.009). A similar pattern was noted with IgG binding and neutralization. After the second dose, median IgG increased to similar levels in both seropositive and seronegative participants (22.1 vs. 21.2, p=0.8). Neutralization after the second dose was slightly higher in seropositive vs. seronegative participants (log10 3.1 vs. 2.5, p=0.075). Durability of IgG responses after second dose of mRNA-based vaccination against SARS-CoV-2 IgG P/N measurements after 5 days post-V2 for the entire study cohort (incident seropositive: yellow circles, prevalent seropositive (red circles), seronegative (open circles) are shown. The solid lines represent Loess curves for incident and prevalent seropositive participants combined (orange line) and those who were seronegative (grey line). SARS-CoV-2-specific total Ig and IgG subtype responses among healthcare personnel before and after vaccination against SARS-CoV-2 with an mRNA-based vaccine. Total Ig P/N ratios at pre-vaccine, post-V1, post-vaccine 2 (post-V2), and post-booster dose (post-boost) timepoints by serostatus (seronegative: n(-), seropositive: n(+)) are shown in the left panel. For the pre-vaccine time point, the most recent antibody level prior to vaccination (for those who were vaccinated) or most recent antibody level overall (for those who were not vaccinated) is shown. For the post-vaccine time points, the first measurement after 5 days post-vaccination is included. Individuals who were infected with SARS-CoV-2 at any time after the first vaccine dose are shown as open circles with black outlines. The black numbers next to the circles indicate the number of days between vaccination and sample collection for seropositive individuals. SARS-CoV-2 specific IgG P/N ratios respectively at pre-vaccine, post-V1, post-V2, and post-boost timepoints by serostatus (seronegative: n(-), seropositive: n(+)) are shown in the right panel. One individual tested positive for SARS-CoV-2 by PCR shortly after the second vaccine dose (V2);post-V2 results were excluded for this participant. For the pre-vaccine time point, the most recent antibody level prior to vaccination (for those who were vaccinated) or most recent antibody level overall (for those who were not vaccinated) is shown. For the post-vaccine time points, the first measurement after 5 days post-vaccination is included. The dotted line is a P/N ratio of 2.4, the cut-off associated with 99.3% specificity (SARS-CoV-2 IgG-positive above the line, IgG-negative below). Individuals who were infected with SARS-CoV-2 at any t me after the first vaccine dose are shown as open circles with black outlines. The black numbers next to the circles indicate the number of days between vaccination and sample collection for seropositive individuals. SARS-CoV-2 D614G live virus neutralization among healthcare personnel by serostatus prior to vaccination. Example neutralization curves are shown in Panel A. Panel B shows the SARS-CoV-2 D614G live virus neutralization titers displayed as EC50 for seropositive (prevalent and incident) individuals and a subset of seronegative individuals. Samples for seronegative individuals were selected by matching on age and time between vaccination and sample collection to the samples from seropositive individuals. Conclusion. Antibody responses after SARS-CoV-2 vaccination persist up to 1 year with wide individual variability. Though prior infection was associated with greater Ab responses after a first dose, it did not significantly modify responses after second and third doses. Still, we observed overall slightly higher Ab levels among individuals that had a prior infection before any one of the 3 doses of vaccine. These results suggest that immunity against SARS-CoV-2 prior to vaccination has a role in initial response but does not significantly modify circulating Ab titers after multiple doses of vaccination.
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Background. Global genomic surveillance has allowed identification of SARS-CoV-2 circulating variants responsible for the COVID-19 pandemic. Statewide variant characterization can guide local public health mitigations and provide educational opportunities. We characterized statewide evolution of SARS-CoV-2 variants in Rhode Island (RI). Methods. De identified RI SARS-CoV-2 sequences since 2/2020, generated at authors, CDC and commercial laboratories, were extracted from https://www.gisaid. org. Genomic and phylogenetic analyses were conducted with available tools and custom python scripts and, after quality control, sequences were classified as variants of Concern (VOC), variants being monitored (VBM), or non-VOC/ non-VBM, per CDC definitions. Specific mutations that are characteristic of the most recent VOCs (Delta or Omicron) were explored outside of their designated lineages. Results. Of the 1.1 million RI population, 14,933 SARS-CoV-2 sequences were available between 2/2020 and 3/2022. These included 1,542 (11%) sequences from 37 non-VOC/non-VBM lineages until 2/2021, most commonly B.1.2 (21%), B.1.375 (13%), and B.1.517 (6%);2,910 (19%) sequences from 7VBM lineages between 3-6/2021, most commonly Alpha (48%), Iota (34%), and Gamma (10%);and 10,481 (70%) sequences from 2 VOC lineages, including 7,574 (72%) Delta mostly between 6/2021 and 12/2021, and 2,907 (28%) Omicron mostly between 1/2022 and 3/2022. Phylogeny showed expected clustering of local variants within regional and global sequences, and continued viral evolution over time. Further VOC evolution was observed, including 87 Delta sub-lineages, most commonly AY.103 (17%), AY.3 (15%), and AY.44 (12%);and 4 Omicron sub-lineages BA.1 (61%), BA.1.1 (32%), BA.2 (7%), and BA.3 (< 1%). Omicron-associated mutations S:del69/70, S:H655Y, or N: P13L were observed in 219 Delta sequences, and Delta-associated mutations ORF1b: G662S, N:D377Y, or M:I82T were observed in 16 Omicron sequences. Conclusion. Statewide SARS-CoV-2 genomic surveillance allows for continued characterization of locally circulating variants and monitoring of viral evolution. Such data guide public health policies, inform the local health force, and mitigate the impact of SARS-CoV-2 on public health.
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Background: The telemedicine clinic in general surgery has become widespread since the onset of the COVID-19 pandemic and has remained so following relaxation of restrictions on conventional face-to-face appointments. However, there has been significant scepticism regarding its continued utility. In particular, there is a concern that patients cannot be adequately assessed and counselled for invasive procedures, which may result in high cancellation rates on the day of procedure. The aim of this study was to assess the cancellation rate on the day of surgery for procedures booked in telemedicine clinics. Method(s): We conducted a retrospective analysis of surgical procedures booked via hepatopancreatobiliary (HPB) and general surgery telemedicine clinics from March 2020 to November 2021. From September 2020 onwards, telemedicine clinics were only run for laparoscopic cholecystectomies for benign gallbladder disease. The primary outcome was the cancellation rate of surgical cases booked from telemedicine clinics. Statistical analysis was done using JASP 0.16.2 software. Result(s): We identified 240 cases booked for surgery from telemedicine clinic. 162 patients (68%) were female;the median age of the study population was 51 (16-81). 186 (78%) patients had gallstones, 19 (8%) gallbladder polyps, 13 (5%) secondary liver tumour, 5 (2%) liver cyst, 5 (2%) pancreatic tumour, 4 (1.7%) primary liver tumour, 2 (0.8%) gallbladder tumour and 6 (2.5%) other pathologies. 225 patients (94%) underwent surgery on their first admission. Procedures included 192 cholecystectomies, 10 open segmental liver resections, 6 laparoscopic segmental liver resections, 4 distal pancreatectomies, 3 open right hepatectomies, 2 Whipple procedures, 2 laparoscopic deroofing of the liver cyst, 2 laparoscopic lymph node biopsy, 1 extended right hepatectomy, 1 left hepatectomy, 1 small bowel resection and 1 exploratory laparotomy. 15 (6%) patients had surgery cancelled on the day of surgery, 14 of those were for laparoscopic cholecystectomy, 1 for laparoscopic liver resection. Only one such cancellation was deemed avoidable as it may have been prevented by a face-to-face assessment. The majority 212 (88%) of patients were ASA class 1-2;only 28 (12%) were ASA class 3. There was no significant association between high ASA (3) and cancellation rate (Chi square test 5% vs 14% p=0.062). Conclusion(s): Telemedicine clinic in general surgery was often the only option to assess and plan operative management for newly referred patients during the COVID-19 pandemic. Our series showed that it was feasible to assess and counsel patients on the phone even for major HPB procedures with a minimal cancellation rate on the day of operation.
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The process of the development of a citizen science platform on Ocean Literacy designed and implemented during the lock down period of 2020 is described. As restrictions due to the COVID-19 health emergency did not allow researchers to organise public events and field data collection activities related to Ocean Literacy, it was decided to take advantage of this situation by building an online platform to bring Ocean Literacy issues directly into citizens' homes. The massive use of digital tools by all civic communities during this time has enabled both the implementation of this idea and rendering it effective. The pandemic control measures then provided a unique opportunity to focus citizen attention on the collection of household data and information and to highlight the more or less direct connections between citizens' lifestyles and the eco-marine system. Short questionnaires were used to ascertain and highlight citizens' household behaviours and daily attitudes during the lockdown towards water use, seafood consumption and plastic material use and disposal. Data and information were also proposed, collected and analyzed in terms of: general environmental awareness of the respondents, perception regarding their purchasing choices during this particular period, as well as any changes in lifestyles and habits during the lockdown with respect to previous periods. The collected data enabled the improvement of our knowledge on some aspects of people's domestic habits as well as their perception vs. real knowledge about the proposed environmental issues. We also realized that it is increasingly crucial for scientists to directly and extensively involve people and schools in educational and outreach activities and events as a good practice of science-society interaction. But to achieve good results there is a need to develop appropriate communication tools and effective involvement strategies to promote their widespread participation in citizen science projects.
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Background: Medical research is critical to professional advancement, and mentoring is an important means of early research engagement in medical training. In contrast to international research collaborations, research mentoring programs are often locally limited. With the COVID- 19 pandemic causing drifts to virtual classes and conferences, virtual international medical research mentoring may be viable. We hereby describe our experience with a virtual, international mentorship group for cardiovascular research. Methods: Our virtual international research mentorship group has been running since 2015. The group focuses on risk stratification and outcomes research in cardiovascular medicine and epidemiology. Mentees from any country or region in all stages of medical careers are welcomed. Considering the increasing emphasis of contemporary research on multidisciplinary healthcare and translational research, our team also includes allied healthcare professionals or students, and graduates from natural sciences (Figure 1). With our members' diverse backgrounds, we firmly adhere to the principle that all members must be given equal opportunities and treatment, regardless of their age, gender, race, nationality, sexual orientation, family background, and institution of study or practice. We make use of virtual platforms and multi-level mentoring (both senior and peer mentoring), and emphasize active participation, early leadership, open culture, accessible research support, and a distributed research workflow (i.e. an accessible-distributed model). Results: Since establishment, our group has expanded to include 63 active members from 14 countries (Figure 2), leading a total of 109 peer-reviewed original studies and reviews published. We observed no significant difficulty in communication between team members, nor conflicts due to differences in nationality or ethnicity. Most studies involve cross-country and ethnicity collaborations, and inter-disciplinary and inter-regional knowledge exchanges are frequent. Multi-level mentoring ensured mentoring quality without compromising bonding and communication. Conclusion: An accessible-distributed model of virtual international medical research collaboration and multi-level mentoring is viable, efficient, and caters to the needs of contemporary healthcare. We hope that others will build similar models and improve medical research mentoring globally. (Figure Presented).
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Introduction: Facial protective equipment (FPE) is a critical barrier to COVID-19 transmission, but compliance with FPE recommendations has historically been low, even amongst health care workers. This study analyzes factors influencing home care worker FPE compliance during the COVID-19 pandemic. Materials and Methods: Nurses and PSWs employed by VHA Home HealthCare (N=199) completed an online survey adapted from a Facial Protection Questionnaire used in previous studies from January 27 – February 10, 2021. Descriptive statistics, tests of significance, and logistic regression were conducted for each variable separated by FPE compliance. Results: This study found higher rates of FPE compliance (71%) than previously reported. Regression results suggest that participants who were not always FPE compliant (29%) were significantly more likely to have lower perceived FPE efficacy, lower knowledge of recommended FPE use, lower perception of risk at work, and higher personal barriers for face shields. Fogging of glasses or face shields from wearing a mask (74%) or face shield (71%) increased job difficulty for many participants. Conclusions: Policies and initiatives addressing perceived FPE efficacy, knowledge of recommended FPE use, perception of at-work risk, and personal barriers to FPE would be expected to significantly affect FPE compliance in the home care sector. Additionally, interventions that reduce visibility issues while wearing FPE would decrease personal barriers to FPE use.
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Introduction: Personal support workers (PSWs) are considered the backbone of homecare however their working conditions remain precarious and unregulated suggesting increased vulnerability in the face of a pandemic. The purpose of this study is to better understand the experiences of PSWs working in homecare during the COVID-19 pandemic. Methods: This qualitative descriptive study used a social constructivist approach to understand the experiences of Toronto-based PSWs working at a local homecare agency during the COVID-19 pandemic. Semi-structured virtual interviews were conducted. All transcribed interviews were coded and analyzed using the DEPICT framework. Results: 19 interviews were completed. PSWs shared a strong belief in duty to work during a health crisis and responsibility to support their vulnerable clients despite feeling vulnerable themselves to transmission and infection;the weight of pandemic anxiety was felt daily and intensely for most. PSWs described existing system challenges exacerbated by the pandemic that tested the limits of their motivations to work, emotional wellbeing and perception of organizational support. Conclusions: The COVID-19 pandemic contributed to increased occupational stress among PSWs. Longstanding system-level issues coupled with increased emotional labour has positioned this workforce at- risk for burnout indicating that health human resource issues may persist if unaddressed. Homecare organizations can implement strategies that promote and protect the mental wellbeing of PSWs while aggressively lobbying for system changes such as higher wages and better labour protections.
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COVID-19 is a worldwide public health emergency caused by SARS-CoV-2. Genomic surveillance of SARSCoV-2 emerging variants is important for pandemic monitoring and informing public health responses. Through an interstate academic-public health partnership, we established Rhode Island's capacity to sequence SARSCoV-2 genomes and created a systematic surveillance program to monitor the prevalence of SARS-CoV-2 variants in the state. We describe circulating SARSCoV-2 lineages in Rhode Island;provide a timeline for the emerging and expanding contribution of variants of concern (VOC) and variants of interest (VOI), from their first introduction to their eventual predominance over other lineages;and outline the frequent identification of known adaptively beneficial spike protein mutations that appear to have independently arisen in non-VOC/non-VOI lineages. Overall, the described Rhode Islandcentric genomic surveillance initiative provides a valuable perspective on SARS-CoV-2 in the state and contributes data of interest for future epidemiological studies and state-to-state comparisons. [ABSTRACT FROM AUTHOR] Copyright of Rhode Island Medical Journal is the property of Rhode Island Medical Society 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 abstract 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 abstract. (Copyright applies to all Abstracts.)
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The Asian community in the United States has seen an enormous uptick in discriminatory experiences since the start of the COVID-19 pandemic. Asian individuals have reported discrimination within their workplaces, in their communities, and against Asian-owned businesses. Many for-profit organizations have failed to acknowledge this surge. We argue that organizations should adopt policies to protect their Asian employees and clientele. On the basis of behavioral science research and knowledge of best practices for promoting diversity and inclusion, we suggest that organizational leaders create crisis task forces to find ways to reduce discrimination against Asian employees and that the leaders more generally reaffirm organizational commitments to diversity and inclusion, communicate those commitments to stakeholders, visibly enact expected organizational norms related to diversity and inclusion, and establish or reassess accountability systems to ensure that policies and norms are followed. © 2020, Brookings Institution Press. All rights reserved.
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COVID-19 has led to staggering numbers of people being laid off or furloughed. The way these decisions are communicated to employees can critically affect how workers receive and process the news. Specifically, if employees perceive layoff decisions as unfair, both those who are let go and those who remain may suffer untoward mental and physical effects from the layoffs, and these effects, in turn, can have negative consequences for the organization (such as reputational damage). In this article, we draw on prior research into perceptions of justice—including distributive justice (focused on how resources and burdens are allocated), procedural justice (focused on how decisions are made and implemented), and interactional justice (focused on how decisions are communicated)— to offer behaviorally based policy recommendations that organizational leaders and managers can apply to buffer some of the negative effects that layoff decisions can have on both employees and organizations. © 2020, Brookings Institution Press. All rights reserved.
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Purpose: The purpose of this paper is to present the case for examining the concept of positive risk taking (PRT) in the context of adult protection. The paper argues there is a need for empirical research to understand the application of and attitudes to PRT to explore whether the concept has moved beyond a principle to make an identifiable difference to service users. Design/methodology/approach: By investigating evidence from policy, literature and professional opinion, this paper presents the ethical tensions for professional practice in adult protection between respecting a service user’s freedom to make choices to enhance their independence while preserving safety for service users and society. This is considered in the context of risk in health and social care and the recent changes in society resulting from COVID-19. Findings: Inherent tensions are apparent in the evidence in health and social care between attitudes propounding safety first and those arguing for the benefits of risk taking. This indicates not only a need for a paradigm shift in attitudes but also a research agenda that promotes empirical studies of the implications of PRT from service user and professional perspectives. Originality/value: This paper draws attention to the relatively limited research into both professionals’ and service user’s perspectives and experiences of PRT in practice. © 2021, Emerald Publishing Limited.
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COVID-19 is a worldwide public health emergency caused by SARS-CoV-2. Genomic surveillance of SARS-CoV-2 emerging variants is important for pandemic monitoring and informing public health responses. Through an interstate academic-public health partnership, we established Rhode Island's capacity to sequence SARS-CoV-2 genomes and created a systematic surveillance program to monitor the prevalence of SARS-CoV-2 variants in the state. We describe circulating SARS-CoV-2 lineages in Rhode Island;provide a timeline for the emerging and expanding contribution of variants of concern (VOC) and variants of interest (VOI), from their first introduction to their eventual predominance over other lineages;and outline the frequent identification of known adaptively beneficial spike protein mutations that appear to have independently arisen in non-VOC/non-VOI lineages. Overall, the described Rhode Island- centric genomic surveillance initiative provides a valuable perspective on SARS-CoV-2 in the state and contributes data of interest for future epidemiological studies and state-to-state comparisons.