The intersection of environmental justice, climate change, community, and the ecology of life

This book examines and encourages the increasing involvement of those in the social sciences, including social work, as well as everyday citizens, with environmental injustices that affect the natural ecology, community health, and physical and mental health of marginalized communities. The authors draw on their diverse experiences in research, practice, and education to suggest interdisciplinary strategies for addressing environmental justice, climate change, and ecological destruction on both a local and global scale. This insightful work presents models for action, practice, and education, including field learning, with examples of how programs and schools have integrated and infused environmental justice content across their curricula. Environmental and ecological impacts on local communities as well as the whole ecology of life are examined. Models for engaging civic dialogue, addressing structural oppression, and employing other interdisciplinary responses to environmental injustices are provided. Topics explored among the chapters include: Water, Air, and Land: The Foundation for Life, Food, and Society;Human Health and Well-Being in Times of Global Environmental Crisis;Power and Politics: Protection, Rebuilding, and Justice;Pathways to Change: Community and Environmental Transformation;Decolonizing Nature: The Potential of Nature to Heal;The Intersection of Environmental Justice, Climate Change, Community, and the Ecology of Life equips readers to identify the impact of the global environmental crisis in their own communities. Emphasizing the need for immediate action on ecological, climate, and environmental justice issues, this forward-thinking book assists social science professionals, educators, researchers, and other concerned individuals with the knowledge needed for creating meaningful interdisciplinary responses in their communities as they take action within a rapidly changing context. © Springer Nature Switzerland AG 2021. All rights reserved.

COVID-19 and Complete Heart Block in a Vaccinated Adult

Introduction: Complete heart block (CHB) in association with Covid-19 is uncommon and has been described primarily in the pre-vaccine time period. In the setting of acute Covid-19 infection, decision to treat CHB with permanent pacemaker (PPM) is often uncertain as the CHB may resolve or persist. We present a case of reversible CHB and Covid-19 infection in a vaccinated healthy 28- year-old. Case: A healthy 28-year-old female presented after syncope. She had been vaccinated three times against Covid-19 with Pfizer-BioNTech mRNA vaccine with her third dose four months prior. She had known Covid-19 exposure and developed sore throat three days prior to presenting with syncope. She had no other symptoms. Physical exam was remarkable only for bradycardia. Labs showed positive Covid-19 PCR test and elevated troponin of 0.396 ng/mL. Complete blood counts, metabolic panel, ESR and CRP were normal. Lyme IgM and IgG were negative by Western blot. ECG showed CHB with a rate of 35 beats per minute (Figure 1A). Echocardiogram showed no abnormalities. The patient remained in CHB for 24 hours, at which point PPM was implanted after shared-decision making. Post-PPM ECG showed AV-paced rhythm (Figure 1B). At follow up, PPM interrogation showed that she transitioned to sinus rhythm with right bundle branch block (RBBB) followed by a return to normal sinus rhythm without RBBB 5 days after implantation (Figure 1C). Cardiac MRI two months after PPM implantation showed no abnormalities. Discussion(s): This was a case of Covid-19 associated myocardial injury with CHB in a fullyvaccinated, healthy adult treated with PPM. Despite vaccination, this patient experienced myocardial and conduction system involvement during acute Covid-19 infection. Myocardial injury along with this ECG progression suggested that there was transient inflammation of the myocardial septum resulting in CHB. It may be reasonable to delay PPM implantation in cases of CHB and Covid-19 infection as the CHB may be transient.

Novel Enhancement of Checkpoint Inhibition Using Pulsing Radiotherapy with Concurrent and Adjuvant CPI for LAHNSCC in Elderly Patients Considered Ineligible for Curative Intent Therapy

Elderly patients with NON-METASTATIC HNSCC represent an unmet and growing need population that would benefit for more novel, less toxic approaches. With the success of immunotherapy in metastatic LAHNSCC, understanding how to best utilize palliative radiotherapy (RT) with immunotherapy remains a challenge. We sought to combine a pulsing RT strategy (QUAD shot x 3) directed only to gross LAHNSCC non-metastatic, to enhance response to immunotherapy. 25 pts (16 males/9 females), median age of 82, were seen in our HN-MDC and determined to be ineligible for curative intent treatment. 23 were evaluable for this analysis. Pts were treated with the QUAD shot regimen (3,7 Gy x 4 BID) x 3 (TD 44.4 Gy) spaced 3 weeks apart with inclusion of an approved CPI at the discretion of the Medical Oncologist. ERT was directed to ONLY Gross disease, determined by clinical and diagnostic PET/CT scan. CPI was administered in the majority of patients AFTER the 1st QUAD shot within the 1st five days. CPI continued until assessment of response, or AE/tolerance or POD. Sites treated included oropharynx (43%), LA/or recurrent cutaneous SCC (30%), Nasopharynx (8%), OC (8%) and Larynx (4%). AJCC 8th edition stage included Stage 1 (4%), stage II (8%), stage III (8%) and stage IVa-c (56%). The median cycles of CPI were 5 (range: 2-24). The median Follow-up time was 5 months, (range 3-36). 16/23pts (70%) achieved a cCR at the completion of their QUAD regimen +CPI, while 1 pt achieved a cCR after 2 Quad shots. 2 pts were not evaluable due to death from intercurrent disease or covid after completion of the QUAD regimen. The overall infield LRC control rate was 65%. The infield LC and RC rates were 65% and 71% respectively. The regional failure rate in the untreated elective neck was only 8% (2/21). 2 patients died immediately after completing radiation from Covid and FTT. Of the patients treated for LA-cSCC, the infield and out of field LRC was 100% and 100% respectively. 3 pts developed distant failure. 2/3 experienced Local and/or regional failure as well. QUAD regimen was well tolerated when combined with CPI, with only 1/23 pts requiring treatment interruption and admission for FTT, but completed therapy. Gr 3 mucositis occurred in 1 patient on the lower lip that resolved. Gr 1 fatigue, xerostomia, and anorexia were noted in 1 patient. Gr 3/ 4 IMAR's were observed in 3 patients and included infusion reaction, colitis, and fatigue/FTT and were discontinued. 4 pts (23%) required post QUAD PEG's unrelated to radiation toxicity and due to POD or intercurrent illness. This represents the first reported experience utilizing a pulsing radiotherapy approach in elderly patients with LAHNSCC combined with a CPI unable to undergo conventional radiotherapy. The regimen was well tolerated with surprisingly low local/regional toxicity and very encouraging response rates. The low failure rate observed in the untreated neck was encouraging and reduces toxicity. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science 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.)

Epitope Mapping of SARS-CoV-2 Spike Protein Reveals Distinguishable Antibody Binding Activity of Vaccinated and Infected Individuals. (preprint)

A multitude of studies have attempted to characterize the antibody response of individuals to the SARS-CoV-2 virus on a linear peptide level by utilizing peptide microarrays. These studies have helped to identify epitopes that have potential to be used for diagnostic tests to identify infected individuals, however the immunological responses of individuals who have received the currently available mRNA vaccines have not been characterized. We aimed to identify linear peptides of the SARS-CoV-2 spike protein that elicited high IgA or IgG binding activity and compare the immunoreactivity of infected individuals to those who received recommended doses of either the Moderna mRNA-1273 or Pfizer BNT162b2 vaccines by utilizing peptide microarrays. Our results revealed peptide epitopes of significant IgG binding among recently infected individuals, many of which are located near functional domains implicated in the high infectivity of SARS-CoV-2. Vaccinated individuals were found to have less intense antibody binding activity than those acutely infected, yet novel markers of IgG binding were identified in the vaccinated group.

Conducting a pediatric randomized clinical trial during a pandemic: A shift to virtual procedures

Purpose of Study Prior to the COVID-19 pandemic, we initiated a randomized clinical trial for childhood obesity. The trial consented 131 and randomized 104;6-12 year old patients who reside in rural regions in 4 member states (DE, NE, SC, and WV) of the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) Approximately 6 weeks into the 10-week recruitment period, the trial was forced to pause all study activity due to the COVID-19 pandemic. This pause necessitated a substantial revision in recruitment and study methods to using virtual procedures. This descriptive paper outlines ways to recruit and manage clinical trial participants using technology to obtain informed consent, obtain height and weight measurements by video, and maintain participant engagement throughout the duration of the trial. Methods Used We reviewed multiple data sources to describe the transition to virtual study procedures. These include research electronic data capture (REDCap) surveys conducted both during the pause and at the completion of the study to identify readiness for each site to conduct virtual recruitment and other study procedures as well as at the end of the study to identify issues that each site encountered during the virtual phase of the project. We also reviewed meeting notes and study enrollment figures. Summary of Results The IRB approved study changes allowed for variability between clinical sites in terms of virtual communication platforms and methods for participant consent and height/weight assessment. Identified advantages of the study included ability to conduct visits during all times of the day or evening, and reduced travel requirements. Challenges included poor Internet reliability in some rural areas;additional participant contacts for consent and eligibility screening;shipping delays of materials;reliance on family to perform height and weight measures;increased costs for materials and shipping. Despite the added challenges, all sites were able to meet the study enrollment objectives. Flexibility was key in implementation of virtual procedures given the variations in site resources. Conclusions While each study site had certain challenges unique to their location during the pandemic, we also identified several common issues with the transition to remote procedures. Lessons learned from this study can assist other study groups in navigating challenges, especially when recruiting and implementing studies with a difficult to reach rural and underserved populations or during challenging events like the pandemic.

A Strategy to Detect Emerging Non-Delta SARS-CoV-2 Variants with a Monoclonal Antibody Specific for the N501 Spike Residue.

Efforts to control SARS-CoV-2 have been challenged by the emergence of variant strains that have important implications for clinical and epidemiological decision making. Four variants of concern (VOCs) have been designated by the Centers for Disease Control and Prevention (CDC), namely, B.1.617.2 (delta), B.1.1.7 (alpha), B.1.351 (beta), and P.1 (gamma), although the last three have been downgraded to variants being monitored (VBMs). VOCs and VBMs have shown increased transmissibility and/or disease severity, resistance to convalescent SARS-CoV-2 immunity and antibody therapeutics, and the potential to evade diagnostic detection. Methods are needed for point-of-care (POC) testing to rapidly identify these variants, protect vulnerable populations, and improve surveillance. Antigen-detection rapid diagnostic tests (Ag-RDTs) are ideal for POC use, but Ag-RDTs that recognize specific variants have not yet been implemented. Here, we describe a mAb (2E8) that is specific for the SARS-CoV-2 spike protein N501 residue. The 2E8 mAb can distinguish the delta VOC from variants with the N501Y meta-signature, which is characterized by convergent mutations that contribute to increased virulence and evasion of host immunity. Among the N501Y-containing mutants formerly designated as VOCs (alpha, beta, and gamma), a previously described mAb, CB6, can distinguish beta from alpha and gamma. When used in a sandwich ELISA, these mAbs sort these important SARS-CoV-2 variants into three diagnostic categories, namely, (1) delta, (2) alpha or gamma, and (3) beta. As delta is currently the predominant variant globally, they will be useful for POC testing to identify N501Y meta-signature variants, protect individuals in high-risk settings, and help detect epidemiological shifts among SARS-CoV-2 variants.

Teachers’ Orchestration Needs During the Shift to Remote Learning

Transitioning from in-person to remote instruction has forced teachers to navigate unexpected constraints while providing meaningful learning experiences for their students. This transition has drastically changed how teachers orchestrate learning for their students. To explore these unique orchestration challenges, we used needs finding and validation activities to explore middle school teachers’ emergent needs and constraints during the unplanned shift to remote instruction. Our findings highlight the need for informative, real-time tools, issues with workload and burnout, and concerns with students feeling disconnected. The contribution of this work includes insights from the early stages of our design process and reflections on how we might support teachers during remote learning and in navigating future emergency shifts. © 2021, Springer Nature Switzerland AG.

A Prolegomenon to Refiguring the Neoliberal University: Reading with Early Christian Traditions of Compassion in the Throes of a Pandemic

Discussion here will follow the surfacing of compassion as a defining reaction to crisis events throughout history, including (like the present moment) those marked by plagues and disease. Drawing on the discipline of Theology and Religion, selected cultural histories of compassion within biblical traditions, in particular within a parabolic story of compassion, ‘The Good Samaritan’, will be explored. It will be argued that in Covid-19 compassion has once again emerged as a critical value and as such, has the power and traction to challenge and critique neoliberal models which too often privilege the competitive individual, over a caring and communal collective. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

China's higher education governance during COVID: a mixed-methods study of policy analysis and student perspectives

Purpose This study analyzed Chinese higher education (HE) governance policies during the first four months of the 2020 COVID-19 pandemic, providing insight into HE management, policymaking and governance. This study also illuminates Chinese student experiences and real-time policy impact, providing insight into the effectiveness of HE crisis management. Design/methodology/approach Using frameworks of real-time policy evaluation, this paper analyzed theoretical and realized policy impacts through the theoretical framing of temporality. Using real-time evaluation methods, this paper first identified HE policy priorities and then used a mixed-methods approach of "policy as discourse" analysis and a quantitative survey from Chinese HE students to assess the theoretical and realized impact of policies. Findings An analysis of HE policies identified three priorities: pastoral care, graduate employment and ideological education. Discourse analysis revealed each priority of HE policies was intrinsically linked to mitigating societal, economic and political consequences of the epidemic. Survey data revealed the perceived effectiveness of policies mirrored China's top-down government structure. Additionally, students expressed strong support in the central government's crisis management, despite relatively little realized policy impact. Originality/value This paper presents a timely review of HE governance during a global pandemic by offering a snapshot of HE crisis management and contributing to the literature surrounding China's ongoing HE centralization. This paper also provides unique insight into HE's role in state development, variations between prescriptive and realized policy impact and the "crisis as opportunity" paradox in a contemporary setting.

Canada's multi-jurisdictional COVID-19 public health response - January to may 2020

In late January 2020, the first COVID-19 case was reported in Canada. By March 5, 2020, community spread of the virus was identified and by May 26, 2020, close to 86,000 patients had COVID-19 and 6,566 had died. As COVID-19 cases increased, provincial and territorial governments announced states of public health emergency between March 13 and 20, 2020. This paper examines Canada's public health response to the COVID-19 pandemic during the first four months (January to May 2020) by overviewing the actions undertaken by the federal (national) and regional (provincial/territorial) governments. Canada's jurisdictional public health structures, public health responses, technological and research endeavours, and public opinion on the pandemic measures are described. As the pandemic unravelled, the federal and provincial/territorial governments unrolled a series of stringent public health interventions and restrictions, including physical distancing and gathering size restrictions;closures of borders, schools, and non-essential businesses and services;cancellations of non-essential medical services;and limitations on visitors in hospital and long-term care facilities. In late May 2020, there was a gradual decrease in the daily numbers of new COVID-19 cases seen across most jurisdictions, which has led the provinces and territories to prepare phased re-opening. Overall, the COVID-19 pandemic in Canada and the substantial amount of formative health and policy-related data being created provide an insight on how to improve responses and better prepare for future health emergencies.

Conducting cross-cultural qualitative interviews with mainland Chinese participants during COVID: Lessons from the field

The COVID-19 global pandemic has had a significant impact on researchers as the normal and expected difficulties of research are exacerbated as education and our way of life has drastically changed. This research note is a reflective narrative of the author’s experience transitioning from face-to-face to online interviews in light of social distancing and global travel restrictions. Through a descriptive analysis, this article details the numerous ethical, logistical, practical, and cultural issues the author confronted in preparation for qualitative cross-cultural online interview research through personal reflections, current events, and existing literature. The aim of this article is to highlight personal experience to better inform future research and encourage flexibility and reflexivity in research. It is hoped that this article can be of use to further develop cross-cultural qualitative methodology and expand upon the emerging field of literature surrounding videoconferencing qualitative research. © The Author(s) 2020.