ABSTRACT
Conspiracy theorists' unpopular opinions likely make them more apprehensive about interactions with others, frustrating their need to belong. Therefore, they may be susceptible to believing misinformation because evidence that others share their beliefs provides "social proof” that they can expect interactions with others to be positive and rewarding. The present research examined whether alternatively fulfilling the need for social connection through romantic relationships could protect conspiracy theorists against COVID-19 misinformation. In a 3-week daily diary study (N = 555), experimental participants implicitly learned to associate their romantic partners with positive experiences (by repeatedly pairing their partner with highly positive and approachable stimuli, McNulty et al., 2017). We then assessed how much participants trusted individuals they might normally distrust, as a manipulation check, and how much participants tuned their daily personal beliefs and behavior to match the U.S. public's daily susceptibility to COVID-19 misinformation. Participants high on conspiratorial thinking trusted fellow community members more in the experimental than control condition. Participants high on conspiratorial thinking in the experimental condition were also less likely to treat the U.S. public's greater daily susceptibility to COVID-19 misinformation as proof that they could discount the virus. The present findings suggest that rewarding romantic connections might be leveraged to limit conspiracy theorists' susceptibility to believing public skepticism about COVID-19. © 2023 The Authors
ABSTRACT
People who believe they are invulnerable to infectious diseases often fail to protect themselves against the disease threats that others pose to them. The current paper hypothesizes that social pain-the experience of feeling interpersonally hurt or rejected-can sensitize the behavioral-immune system by giving people added reason to see others as worthy of protecting themselves against. We obtained four daily diary samples involving 2,794 participants who reported how hurt/rejected they felt by those they knew, how personally concerned they were about the spread of illness/COVID-19, and how vigilantly they engaged in self-protective behaviors to safeguard their health each day. An integrative data analysis revealed robust evidence that people who believed they were invulnerable to infectious disease engaged in more concerted efforts to protect themselves against the greater daily risk of contracting COVID-19 when being in acute social pain gave them added reason to see others as harmful to them.
ABSTRACT
Although the isolated threat of disease often motivates people to avoid others, people need the help and cooperation of others to protect themselves against pandemic disease threats. Therefore, the fear of contracting a highly contagious virus like COVID-19 should motivate people to believe that they can in fact count on the help and cooperation of others for protection. Trusting in others provides the basis to anticipate their cooperation. Therefore, we expected a greater daily threat of contracting COVID-19 to motivate people to trust more in others, providing needed assurance that others would keep them safe from harm. We obtained 4 daily diary samples involving 2794 participants who provided in excess of 18,000 daily observations within the first three months of the COVID-19 pandemic. Each day, we tracked (1) disease threat, captured daily by personal concerns about COVID-19 and infection totals in the nearest most populous city, and (2) trust in others, captured daily by expressions of trust in intimates, collective caregivers (e.g., President, Congress), and strangers. Participants in two samples completed 2-month follow-ups. Integrative analyses of the daily diaries revealed that people trusted more in intimates and collective caregivers on days they had greater (vs. less) reason to be concerned about COVID-19. Further integrative analyses of the follow-up data revealed that participants who were initially more likely to trust in others on days when COVID-19 cases in nearby communities spread more rapidly later reported greater confidence that others would keep them safe from harm. That is, they evidenced greater physical, interpersonal, and collective security in social connection than participants who were initially less likely to defensively trust in others on such occasions. The present findings suggest that ecological threats may dynamically motivate people to trust others more than they otherwise would, providing optimism that collectively-faced crises may motivate social cooperation when it is most needed. © 2022
ABSTRACT
Chronic lung allograft dysfunction (CLAD) is the leading long-term cause of poor outcomes after transplant and manifests by fibrotic remodeling of small airways and/or pleuroparenchymal fibroelastosis. This study evaluated the effect of pirfenidone on spirometric and radiographic progression in patients with CLAD. We performed a single-center, 6-month, randomized, placebo-controlled trial of pirfenidone on patients with CLAD. Treatment allocation was stratified by CLAD phenotype. The primary spirometric outcome measures were change FEV1 and FVC relative to post-transplant baseline values, and the primary radiographic outcome was small airways disease, quantified as percentage of lung volume via parametric response mapping analysis of CT scans (PRMfSAD). Linear mixed models were used to evaluate treatment effect of the longitudinal outcome measures. We enrolled 24 patients, 13 of whom received pirfenidone (the study was terminated prior to reaching target enrollment of 60 patients due to the COVID pandemic). The pirfenidone and placebo groups were similar with regards to age, pre-transplant diagnosis, lung function, and CLAD phenotypes. There was no significant difference between the pirfenidone vs. placebo groups with regards to expected change in FEV1 (-3.1 vs. -3.7, p =0.90, Figure Panel A), FVC (-2.5 vs. -4.6, p =0.63, Figure Panel B), or PRMfSAD (+3.7 vs. -0.6, p =0.28). Subgroup analysis found that pirfenidone attenuated the spirometric decline among female patients, but there was no difference in treatment effect with regards to age, pre-transplant diagnosis, or CLAD phenotype. Tolerance of study drug and adverse events did not differ between groups, although the rate of grade 2 or higher adverse events was higher in the placebo vs. pirfenidone group (13 vs. 7, p =0.001). Pirfenidone did not attenuate spirometric or radiographic decline in a single-center randomized trial of CLAD patients, but had an acceptable tolerance and side effect profile. [ 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.)
ABSTRACT
Background: The technological advances in electrocardiography have been substantially accelerated due to COVID-19. Furthermore, the progress in the (ECG) became possible with the introduction of integrated circuitry and wireless technologies for communication of mobile and cloud computing and of a variety of novel materials for ECG sensors. There are a number of wearables which are able to capture, monitor, record and/or remotely transmit ECG signals. Some of these devices enable non-invasive capture and storage of ECGs over a longer time period when compared to standard Holter recorders, or to acquire the ECG on demand but without the need for wet electrodes attached to the skin. Method(s): The objective of this study is to validate the ECG performance of the HeartKey Vital Signs Monitor (VSM) Watch, a dry electrode wrist wearable, against a wet electrode system whilst inducing motion noise reflective of a real-life use case. Data from each recording device was compared with the criterion in each stage of the protocol through a comparison of heart rate (HR) data. A beat rejection analysis was performed to provide insight into the degree of high frequency noise in ECG recorded from the HeartKey VSM Watch. Data from a HeartKey Reference Wrist Worn Device validation was used to compare the HeartKey VSM Watch to another wrist-based ECG wearable device. Result(s): Bland Altman analysis showed that the VSM Watch, when using HeartKey technology, had an overall mean absolute HR difference of 0.74, 1.21 and 0.80 bpm from the criterion device during the sitting, walking and standing stage respectively and within the +/-10% or +/- 5 bpm range as is recommended by ANSI EC13. ECG from the HeartKey VSM Watch had a higher beat rejection rate (8.5% vs ~0%), due to excessive high frequency noise, during the non-motion and motion-based protocol when compared to the HeartKey Chest Module. Conclusion(s): This study suggests that the HeartKey VSM Watch demonstrates medical grade HR performance when processing Lead I, dry electrode ECG data during both non-motion and motion-based testing. Further ECG signal chain development may be required to allow full usability of HeartKey Health and Wellness algorithms in a diverse population, particularly those with high skin wrist impedance. Copyright © 2022
ABSTRACT
This chapter addresses the uncanny effects of computer screen horror films during the pandemic by focusing on the British horror movie Host (2020), an independent 56-minute film directed by Rob Savage during the first wave of the COVID-19 pandemic. The horror genre typically enables a kind of identificatory catharsis while also providing its viewership with the comfort of knowingly indulging in fiction. And yet, Host unsettles this very comfort and conceit. This essay argues that Host’s originality—and its uncanny horror—owes less to its content than to its visual form. The film’s unrelenting and unbroken point of view via the Zoom interface frames the entire film through a medium become all too familiar during the pandemic. This familiarity almost guilelessly interpellates the viewer as a hapless participant in the murderous mayhem that unfolds both onscreen and, by extension, in a pandemic present marked by existential threat and mass death. © 2022 selection and editorial matter, Irene Gammel and Jason Wang;individual chapters, the contributors.
ABSTRACT
In the UK, approximately 3 million people are malnourished or at risk of malnutrition. Malnutrition is a major public health issue with costs the NHS over £19 billion per year in England alone. We know 93% of malnutrition happens in peoples own homes, 5% in care homes and 2% in hospital. It is also understood that 30% of inpatients are at higher risk of becoming malnourished in hospital. 1 As many departments, demand for dietetic services has outweighed capacity, in part due to improved rates of nutritional risk screening across the organisation. The Trust uses an internal validated nutritional screening tool but community partners largely use MUST (Malnutrition Universal Screening Tool). Within our Dietetic team, we identified a number of treatment strategies needed to ensure timely care, patient empowerment and patient safety with a focus on improved nutrition to help recovery across organisational boundaries from the acute admission and into primary care. Patients who are identified as malnourished or at very high risk of malnutrition, have specialist requirements should have immediate referral to a dietitian. Oral nutritional supplements are now prescribed appropriately whilst in hospital and post discharge in line with national and local guidelines. 4 Communication between different healthcare professionals and settings is essential for the seamless delivery of care2 and hospital teams discharging patients with an identified risk of malnutrition should communicate this in writing to primary care teams3. As a team, we decided to encompass nutrition and dysphagia scores as an inpatient on discharge letters. This was be achieved by working closely with the pharmacy, Speech and Language, catering, nursing and medical teams to develop and implement a clear process for all adult inpatients to improve ward based nutritional care and appropriate prescribing, based on their individual risk of malnutrition. We have developed and implemented a discharge process that provides patients with a nutrition pack (malnutrition pathway leaflets, cover letter +/- Care Homes information) +/- nutritional supplements on discharge. The process was developed with local CCGs, GPs, PCN Pharmacists and community dietetic services. Outcomes measured include;appropriate prescribing, access to snacks and supplements, clinical outcomes including length of stay (LOS), readmission rates and timely access to first line advice. Baseline audit information revealed only 8% of inpatients received the a first line nutrition leaflet, this has increased to 13% just 6 weeks post implementation, patient first line snacks has increased to 5 different categories as choice available has increased. Oral nutritional support (ONS) is now solely prescribed using the agreed ONS pathway. Early indications suggest a direct improvement in patient care and choice. References 1. Brothern A, Simmonds N, Stroud M.2010. Malnutrition Matters: Meeting Quality Standards in Nutritional Care. A report on behalf BAPEN Quality Group 2. ‘A Guide to Managing Adult Malnutrition in the Community’ Last accessed from: on 02.07.2021 3. ‘Pathway for using ONS in the Management of Malnutrition’ Last accessed from:https://www.malnutritionpathway.co.uk/library/ons_pathway.pdf on 29.06.2021 4. ‘Nutritional considerations for primary care teams managing patients with or recovering from COVID-19’ BDA and optimising nutritional prescribing last accessed :. 02.07.21
ABSTRACT
In April 2020, with the realisation that dietetic practice had to change when covering critical care units, a group of specialist dietitians led the development of a hand held digital dietetic record that could be safely use within the critical care unit avoiding the use of paper and it being transferred off the COVID critical care unit. Being digital enabled remote working, decreased footfall and increased safety for patients and staff. This was the first step in a journey that saw the transformation from a paper based system to one that is entirely digital across all dietetic areas within inpatient and outpatient settings and in both in adults and paediatrics by the end of 2020. Together with the introduction of video patient consultations, video conferencing applications and electronic prescribing, our approach to provide dietetic intervention has changed dramatically. It has enabled a dietetic service to embrace remote working which has been helpful during periods of self-isolation e.g. virtual;ward rounds, group sessions, 1:1 education, interviews, training and development. Collaborative working included the newly developed “digital dietetic group” and the “H Digital” trust group and DXC technologies to develop a clinical data capture (CDC) form. The clinical basis followed the layout as advised in the Model and Process for Nutrition and Dietetic Practice1 to ensure that data capture was relevant and followed a standard process. The purpose of the Model and Process is to describe, through six steps, the consistent process dietitians follow in any dietetic intervention. It articulates the specific skills, knowledge and critical reasoning that dietitians deploy, and the environmental factors that influence the practice of dietetics. This does not take away dietitians’ autonomy. Instead, it enables a consistent approach to dietetic care, with the service user at the centre. This completed form was available as a complete ‘dietetic’ digital record. A key objective within the Organisation’s Digital Strategy and it will reduce risks by enhancing clinical effectiveness and patient safety. The wider multi-professional team found dietetic digital records invaluable, to be able to access 24/7 allowing for continuity of care when unable to speak directly to the dietetic team this included alternative feeding regimens and clinical reasoning that subsequently influenced treatment decisions and allowed for patient care out of hours. This led onto working with trust digital team on electronic prescriptions for oral nutritional support and enteral feeds, digital patient lists (for caseloads), digital design of food and fluid charts for the organisation. The enhancement in clinical safety and patient care where is it required has been phenomenal and an exciting journey we are keen to share. The design will enable dietetic outcomes to be collected directly from digital record. References 1. BDA Model and Process 2020 last accessed;https://www.bda.uk.com/uploads/assets/1aa9b067-a1c1-4eec-a1318fdc258e0ebb/2020-Model-and-Process-for-Nutrition-and-Dietetic-Practice.pdf on 2.7.2021
ABSTRACT
People who believe they are invulnerable to infectious diseases often fail to protect themselves against the disease threats that others pose to them. The current paper hypothesizes that social pain—the experience of feeling interpersonally hurt or rejected—can sensitize the behavioral-immune system by giving people added reason to see others as worthy of protecting themselves against. We obtained four daily diary samples involving 2,794 participants who reported how hurt/rejected they felt by those they knew, how personally concerned they were about the spread of illness/COVID-19, and how vigilantly they engaged in self-protective behaviors to safeguard their health each day. An integrative data analysis revealed robust evidence that people who believed they were invulnerable to infectious disease engaged in more concerted efforts to protect themselves against the greater daily risk of contracting COVID-19 when being in acute social pain gave them added reason to see others as harmful to them. © The Author(s) 2022.
ABSTRACT
Play Therapy has been delivered in schools for over 25 years and it has proven to be an effective environment for facilitating such services. When the COVID-19 pandemic happened, play therapists were required to think flexibly about how best to continue meeting their clients and continue to deliver the service. As a result, telemental play therapy in schools became more popular. Telemental health has been used in schools for a number of years, but telemental play therapy has been used limitedly. For telemental play therapy to be effective, it requires careful consideration. This chapter will explore some of the issues associated with setting up the telemental play therapy in a school and working with school staff to support the child’s process. © 2022 selection and editorial matter, Jessica Stone individual chapters, the contributors.
ABSTRACT
Background: Hereditary angioedema (HAE) is a genetic disease characterized by recurrent episodes of angioedema that has been shown to be exacerbated during times of stress or anxiety. Recent market research has shown that patients with HAE have reported an increase in monthly HAE attack rates due to stress of the COVID-19 pandemic [pre-COVID: 1.5 attacks/3-months vs. during COVID: 4.4 attacks/3-months]. 1 To better understand the impact of berotralstat on HAE attack rates during COVID-19, this analysis evaluated monthly HAE attack rates in patients enrolled in the ongoing APeX-S trial (NCT03472040). Method: Patients with HAE Type 1 or 2 were centrally allocated to receive either open-label berotralstat 150 or 110mg. Safety and long-term effectiveness of berotralstat were evaluated. This post hoc analysis included patients that were on berotralstat 150mg for the entire period from September 1, 2019 to June 30, 2020. Mean pre-COVID monthly HAE attack rates were reported from September 1, 2019 to February 29, 2020. Mean monthly HAE attack rates during COVID were reported from March 1, 2020 to June 30, 2020. Results: In September 2019 patients treated with berotralstat 150mg ( n = 73) had a mean (±SD) attack rate of 0.7 (±0.92) attacks/ month. Pre-COVID attack rates remained consistent through February 2020 with mean attack rates <1 attack/month. At the start of the COVID pandemic, in March 2020, mean (±SD) attack rates were 0.8 (±1.15) attacks/month. Mean monthly attack rates remained <1 attack/month from March to June 2020. Similar results were observed with median attack rates. In September 2019 the median attack rate was 0.0 attacks/month. Pre-COVID attack rates remained consistent through February 2020 with median attack rates of ≤1 attack/month. From March to June 2020 median attack rates were 0.0 attacks/month. In September 2019 the mean rate of ondemand medication use was 0.7 (±1.12) doses/month. This rate remained generally consistent throughout the pre-COVID and COVID months [February 2020: 0.6 (±1.10) doses/month;June 2020: 0.6 (±1.03) doses/month]. Conclusion: Monthly HAE attack rates, pre-COVID and during COVID, remained consistently low for berotralstat-treated patients, demonstrating that patients receiving once-daily oral berotralstat maintained low attack rates during times of high stress.
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This paper creatively re-thinks Masked Masterpieces, a COVID-19 public art fundraising initiative for financially at-risk students, organized by Stellenbosch University (SU) and underwritten by donors. The project features five portraits by famous South African artists, re-purposed with protective masks, and installed in large-scale reproductions around Stellenbosch town. In the paper, Masked Masterpieces serves as a generative critical prompt: not for a simplistic ‘unmasking,’ but for a female scholar’s process of thinking through ‘the fold,’ an ‘en/folding’ engagement that turns and returns, erratically reviewing difficult, overlapping subjects linked to masking and mastery. In exploring both the substance and the shape of my thought process, I draw loose inspiration from innovations in mixed-materials structural design, where ‘folded surfaces … respond to spatial inquiries by transforming not into aggregates of fragments but into catalytically interconnected elements’ (Vyzoviti and Sotiriou 524). © 2021 University of the Witwatersrand.
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Like many sectors, tissue viability services have been affected by and had to learn lessons from the COVID-19 pandemic. The pandemic has had an impact on service delivery and patient communication, and there has been some debate over whether this will permanently change the ways in which care is delivered. A group of specialist nurses and academics working in wound care met online via Zoom on 15th June 2021 to discuss how care has evolved since the start of the pandemic, and what this might look like as we move forward. This builds on a previous discussion that took place one year earlier (18th June 2020), in which a similar group discussed the challenges of delivering care at the height of the pandemic, which was published in Wounds UK in September 2020 (Fletcher et al, 2020).
ABSTRACT
Background: Faith-based organisations (FBO) contribute substantially to healthcare in low- and middle-income countries (LMIC). WHO worked with FBOs to define the primary care approach in the Alma-Ata Declaration and promotes FBO contributions to care underpinned by values of compassion and altruism, particularly for marginalised communities. Indian and Nepalese FBOs provide palliative care (PC) alongside other services, developing appropriate evidence-based models for remote rural areas and excluded urban groups. Covid-19 poses substantial challenges for FBO services. Initially, lockdown affected more than Covid-19 itself. Patients with advanced illness were unable to access care, supply chains (e.g. for morphine) were disrupted and communities faced hunger because of interrupted food supplies. With cases rising new challenges are emerging. Exploring and recording FBO responses enables good palliative care to be identified. This can inform practice in Covid-19 and future pandemics in LMIC nationally and internationally. Aims: To gain strategic understanding of PC provision by FBO in India and Nepal during the Covid-19 pandemic including: (a) Effects of Covid-19 on patients and families with PC needs. (b) FBO preparedness for responding to the crisis. (c) Impact of the pandemic on PC provision, including challenges and solutions that strengthen PC interventions. Methods: Mixed-method survey of PC provision by FBOs using: provider questionnaires, key informant interviews (KII), and patient questionnaires sent to all FBOs identified as providing PC. Questionnaire results will allow important findings to be explored in depth though KII. Results: The study began with an expert advisory group of senior PC clinicians reviewing the questionnaires and interview schedules. Field work will be completed by October 2020. Conclusions: Understanding FBO responses and strategies for PC during Covid-19 can enable appropriate public health strategies for LMIC to be defined.
ABSTRACT
Background: Since the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most of the focus has been on the respiratory failure caused by the resulting disease, COVID-19. However, the effects of COVID-19 in the kidney are increasingly recognized. Acute kidney injury (AKI) has been identified with varying prevalence around the world with higher rates (37-46%) reported in the USA. It is debatable whether AKI is an indirect consequence of systemic inflammation or a consequence of viral renal cell infection and tropism. We hypothesize that SARSCoV- 2 directly infects kidney tissue and increases the risk of developing AKI, worsening prognosis of COVID-19 patients. Methods: We studied 88 COVID-19 patients admitted to the Henry Ford Hospital, Detroit after April 15, 2020. Demographics were: mean age 60, 71% African American, 55% male. We quantified viral copies by RT-PCR (S and N genes) in urine sediments from 52 PCR-confirmed COVID-19 patients. We performed immunofluorescence for Membrane and Spike viral proteins in two COVID-19 biopsies. Results: The prevalence of AKI was 72%, with 32% of patients admitted to the ICU. The overall mortality rate was 14%, with no deaths in non-AKI patients. Viral proteins M and S were detected in the glomerulus, parietal cells and tubules of COVID-19 patients. In some tubules, positive SARS-CoV-2 overlapped with ACE2, the receptor for viral entry. Virus was detected in 61% of urine sediments, with 6-fold greater viral load in AKIpatient urines (copies/ng RNA: AKI, 7422±1338 vs No-AKI: 1523 ± 404;p<0.05, n=52). The highest viral loads were detected three weeks post-AKI at 11,374±2248 copies/ng RNA (p<0.01). Among COVID-19 AKI-patients who died, the urine viral load exceeded 8000 copies/ng RNA. Above this threshold, the mortality rate was 55%. Conclusions: Our data support that direct viral renal cell infection occurs in COVID-19 AKI patients with urinary viral genome detection. Greater urinary viral loads portend increased mortality. Urinary viral detection can facilitate management and treatment of COVID-19 and improve outcomes. Future research should focus on studying whether urine contains infective virus or sheds non-infective genomic fragments.
ABSTRACT
Written in late March 2020 in the early days of the U.S. coronavirus outbreak, this essay represents a contingent reflection on the American pandemic response, mourning in anticipation of what would soon surely unfold. I argue that the State's long-standing sacrificial economies have in this moment culminated in a suicidal State. The term is Foucault's, appearing in a controversial lecture on biopolitics, Nazism, and "biological racism." Despite Foucault's problematic treatment of rac-ism, I suggest that some aspects of this discourse might nevertheless be apropos in our context. The U.S. pandemic response is racism's suicidal State legacy writ large: An extension and retooling of historically racist infrastructures deployed (once again, again) in racialized domains (as more recent reports evidence), but in this moment also across biosocial inequities and vulnerabilities marked by differential fungibilities other than race. © 2020 Penn State University Press. All rights reserved.