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Introduction: Overweight and obesity in youth with serious emotional disturbance (SED) is exceedingly common. In 2015 the AHA called attention to mental illnesses in youth as important risk conditions for early CVD and the need for transformational change in management of overweight and obesity in this group. Our objective was to test a 12-month, innovative healthy weight intervention in youth with SED.Hypothesis: The active intervention is more effective than control in decreasing BMI Z-score compared at 12 m. Method(s): We conducted a two-arm randomized trial in 2 outpatient pediatric mental health settings in 112 youth, ages 8-18 yrs. The active intervention group was offered 12m of in-person and virtual individual weight management sessions led by health coaches who provided guidance on improving diet and increasing physical activity, and engaged parents. Result(s): At baseline, mean (SD) age was 13.0 (2.7) yrs with 46% ages 8-12 and 54% 13-18;55% were male, 46% Black, 39% had household income less than $50K/yr and 31% lived in a single-parent household. Primary diagnoses were ADHD (41%), major depression (23%), and anxiety (23%). Mean BMI Z-score (SD) was 2.0(0.4), BMI 30.4 (6.4) kg/m2.Mean(SD) psychotropic medications were 2.1(1.4).At 12m, 111 (99%) had a follow-up weight;42 were collected after the onset of the COVID pandemic). The intervention group compared to the control group had 0.15 decrease in BMI Z-Score (95% CI 0.26 to 0.04), p<0.007) between baseline and 12 m (Figure) and a 1.43 kg/m2 decrease in BMI (95% CI 2.43, 0.42, p<0.006). Estimated net effect on BMI Z-score for intervention vs. control was enhanced during the pandemic but not statistically different from net effects pre-pandemic (p=0.06). Conclusion(s): A weight control intervention designed for children with SED decreased BMI Z-score substantially over 12 months, including during the COVID-19 pandemic. These results provide empirical evidence in support of weight control programs in a population at high risk for early development of CVD risk factors.
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The 2022 Beijing Winter Olympics took place when American public opinion about China was already predominantly negative as media reports had a lot of highlights of human rights violations happening in China. Besides, earlier, the global image of China was undermined by the COVID-19 pandemic. In this study, we explored whether American public opinion about the Olympics and China can be influenced by images of the Olympics shared in the media. Findings from the 2 × 2 between-subject experimental design suggest that the opinions about the Olympics can be predicted by people's beliefs about China's role in the global pandemic. In addition to that, our findings suggest that pre-existing opinions and feelings held by most of the population can mitigate the effects of visual primes. © The Author(s) 2023.
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Higher education (HE) students experience rates of depression and anxiety substantially higher than those found in the general population. Many psychological approaches to improving wellbeing and developing student resilience have been adopted by HE administrators and educators, especially during the Covid-19 pandemic. This article aims to review literature regarding integration of resilience and wellbeing in HE. A subsequent aim is to scope toward developing foundations for an emerging discipline specific concept–designer resilience. A literature scoping review is applied to chart various conceptual, theoretical and operational applications of resilience and wellbeing in HE. Twenty-seven (27) articles are identified and analysed. The scoping review finds that two general approaches to implementing resilience and wellbeing training exist in HE. First, articles reacting to a decline in student mental health and remedying this decline through general extra-curricular resilience or wellbeing programmes. Second, articles opting for a curricula and discipline-specific approach by establishing why resilience will be needed by future graduates before developing and testing new learning experiences. The presence of cognitive flexibility, storytelling, reframing and reflection lie at the core of the practice of resilience and design and therefore offer preliminary opportunities to develop ‘designer resilience' training. Future research opportunities are identified throughout the article. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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Introduction: Liver transplantation (LT) is the second most common solid organ transplantation, however, less than 10% of global transplantation needs are achieved. Low- and middle- income countries (LMIC's) are the most affected. A university- based Center for Global Surgery and our LT team joined efforts in 2017 to create an international alliance for clinical care and academic endeavors. Here we describe our experience establishing a LT mentoring group within an academic Center for Global Surgery. Method(s): This is a retrospective observational study. We evaluated the number of clinical, research and educational activities that our program did with LMICs from 2009 to 2022. Surgeries, patient evaluation, and follow-up were done in a multidisciplinary fashion with protocols from our LT program in partnership with LMIC's teams and via telehealth. Most educational and research activities were done online. Result(s): We performed 15 surgeries in pediatric and adult patients, including cadaveric, living donor LT, portosystemic shunts, and resections, and evaluated 27 patients from LMIC's. We have submitted 2 articles, presented 5 s, and obtained 1 grant. Our group received support to sponsor 1 research scholar per year and we had 15 bilateral exchange visits and organized 27 online multidisciplinary education sessions in collaboration with centers from LMIC'S. Conclusion(s): Our data shows that global transplant efforts with a multidisciplinary model can have clinical and academic impact. It is feasible to partner and mentor LT programs in LMICs through telehealth and exchange programs. Funding of these efforts remains challenging, and COVID-19 has limited academic and clinical activities.
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Background: Two million adults and children die each year of liver disease. Liver transplantation (LT) is the second most common solid organ transplantation, however, less than 10% of global transplantation needs are achieved. Low- and Middle-income Countries (LMIC's) are the most affected. A University based Center for Global Surgery and our LT team, started collaborations with counterparts in LMIC's over a decade ago and joined efforts in 2017 to create an international alliance that allows clinical care, education and research endeavors. We aim to describe our experience establishing a LT mentoring group within an academic Center for Global Surgery. Methods: This is a retrospective observational study. We evaluated the number of clinical, research and educational activities that our program did in collaboration with LMIC's for more than a decade (2009 -2022).Surgeries, patient evaluation and follow-up were done in a multidisciplinary fashion with protocols and guidelines from our LT program in partnership with LMIC's LT teams and via telehealth. Most educational and research activities were done online. Results: We performed 15 surgeries in pediatric and adult patients, including cadaveric and living donor LT, portosystemic shunts and resections and evaluated 27 patients from LMIC's. We published 1 article, presented 5 s and obtained 1 grant. Our group received support to sponsor one research scholar per year and we had 15 bilateral exchange visits and organized 27 online multidisciplinary education sessions in collaboration with centers from LMIC'S. Conclusions: Our data shows that global efforts with a multidisciplinary model supported by international societies can have clinical and academic impact. It is feasible to partner and mentor the academic and clinical development of LT programs in LMIC's through telehealth and exchange programs. Funding of these efforts remains challenging, and COVID-19 has limited academic and clinical activities.
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Introduction: The AbC-19™ lateral flow immunoassay (LFIA) performance was evaluated on plasma samples from a SARS-CoV-2 vaccination cohort, WHO international standards for anti-SARS-CoV-2 IgG (human), individuals ≥2 weeks from infection of RT-PCR confirmed SARS-CoV-2 genetic variants, as well as microorganism serology. Methods: Pre-vaccination to three weeks post-booster samples were collected from a cohort of 111 patients (including clinically extremely vulnerable patients) from Northern Ireland. All patients received Oxford-AstraZeneca COVID-19 vaccination for the first and second dose, and Pfizer-BioNTech for the third (first booster). WHO international standards, 15 samples from 2 variants of concern (Delta and Omicron) and cross-reactivity with plasma samples from other microorganism infections were also assessed on AbC-19™. Results: All 80 (100%) participants sampled post-booster had high positive IgG responses, compared to 38/95 (40%) participants at 6 months post-first vaccination. WHO standard results correlated with information from corresponding biological data sheets, and antibodies to all genetic variants were detected by LFIA. No cross-reactivity was found with exception of one (of five) Dengue virus samples. Conclusion: These findings suggest BNT162b2 booster vaccination enhanced humoral immunity to SARS-CoV-2 from pre-booster levels, and that this antibody response was detectable by the LFIA. In combination with cross-reactivity, standards and genetic variant results would suggest LFIA may be a cost-effective measure to assess SARS-CoV-2 antibody status.
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Higher education (HE) students experience rates of depression and anxiety substantially higher than those found in the general population. Many psychological approaches to improving wellbeing and developing student resilience have been adopted by HE administrators and educators, especially during the Covid-19 pandemic. This article aims to review literature regarding integration of resilience and wellbeing in HE. A subsequent aim is to scope toward developing foundations for an emerging discipline specific concept - designer resilience. A literature scoping review is applied to chart various conceptual, theoretical and operational applications of resilience and wellbeing in HE. Twenty-seven (27) articles are identified and analysed. The scoping review finds that two general approaches to implementing resilience and wellbeing training exist in HE. First, articles reacting to a decline in student mental health and remedying this decline through general extra-curricular resilience or wellbeing programmes. Second, articles opting for a curricula and discipline-specific approach by establishing why resilience will be needed by future graduates before developing and testing new learning experiences. The presence of cognitive flexibility, storytelling, reframing and reflection lie at the core of the practice of resilience and design and therefore offer preliminary opportunities to develop 'designer resilience' training. Future research opportunities are identified throughout the article.
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A novel human recombinant antibody for prophylactic treatment against SARS-CoV-2 was formulated in a nasal solution comprising chitosan as mucoadhesive polymer. Two levels of protein concentration have been assessed and formulations loaded into Aptar VP3 nasal pump. The formulations produced showed values of pH (6.2- 6.3) and osmolality (414 and 421 mosm/kg) suitable to prevent precipitation of the antibody in the final solution and for nasal administration. Assay of the protein after formulation manufacturing showed a lower dimeric fraction than the reference standard and hydrodynamic diameter of the final formulations was also comparable to the unprocessed antibody solution (10 nm). Zeta-potential values were higher than 25mV, indicating colloidal stability against aggregation due to charge stabilization for the formulations obtained. Spray performance did not evidence any difference between protein levels in the final formulations when combined with VP3 nasal pump. Particularly, droplet size distribution (mean volume diameter of 55.13 lm for the low dose formulation and 57.21 lm for the high dose), spray pattern and plume geometry resulted to be applicable for nasal delivery. Finally, for both solutions sprayed antibody content was within 75-125% of the target delivered dose with a very low variability on ten consecutive shots (5%). Future studies will assess the formulations stability under refrigerated and ambient storage conditions of the combination product and of the antibody comprised in the formulation,whereas in vivo studieswill define pharmacokinetics and pharmacodynamics profile of these final formulations. Key Message: The possibility to deliver to the nose a novel human antibody for prophylactic treatment against SARS-CoV-2 employing Aptar VP3 pump was assessed. Spray performance of the formulations manufactured was characterized and no protein agglomeration was observed in the formulations and after spraying, indicating favourable results in applying this system for delivery of antibodies to the nose.
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The COVID-19 pandemic prompted school closures across the United States, removing important social support sources for many LGBTQ youths. The current research examines the collective coping of young LGBTQ people (majority transgender/nonbinary) who participated in the first known virtual camp program for pandemic-affected youths. In Study 1, in-depth, semistructured interviews with 15 youths (aged 14–20) revealed youths used the virtual camp space to develop unique support networks, maintain connections with trusted individuals, dwell where LGBTQ identity is celebrated, find grounding through synchrony, and fill unscheduled time. In Study 2, 41 participants in a second virtual camp session (aged 12–19) were longitudinally surveyed. Findings demonstrated youths experienced reduced depressive symptoms, and new friendships made through virtual camp influenced self-esteem. Results across both studies indicate the importance of tailored virtual spaces in facilitating social connections, providing a sense of safety and belonging, and addressing LGBTQ youths’ mental health during a collective crisis. © 2022 (Traci Kristin Gillig, Jared Macary, and Ron Price). Licensed under the Creative Commons Attribution Non-commercial No Derivatives (by-nc-nd). Available at http://ijoc.org.
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This article presents empirical findings and recommendations from a survey of 100 industrial design engineering students from the Faculty of Industrial Design Engineering at Delft University of Technology, the Netherlands. The article adopts a self-deterministic motivation lens to present findings from a qualitative survey (N=100 respondents) and two member check workshops with design students and educators regarding motivations to study during COVID-19 restrictions. We identify that COVID-19 lockdown measures compromise three psychological prerequisites for motivation: ‘relatedness’, ‘autonomy’ and ‘competency’. We find that resilient students who have a sense of ‘purpose’ remain highly motivated. The article reveals creative approaches students are applying to build and sustain motivation during the COVID-19 pandemic. The article contributes recommendations for educators and administrators to promote student motivation in pandemic and post-pandemic higher education. This article contributes novel insights regarding how students in particular are remaining motivated to study during COVID-19. © 2021 Intellect Ltd Article. English language.
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Background : Coronavirus disease 19 (COVID-19) is associated with an increased risk of venous thromboembolism (VTE). Aims : To assess the effectiveness of outpatient thromboprophylaxis in patients with COVID-19. Methods : Consecutive patients hospitalized for SARS from March to May, 2020 were selected. Descriptive statistics, chi-square and t -tests were used to compare COVID-19 and non-COVID-19 patients. Results : The Newcastle upon Tyne Hospital NHS Foundation Trust is a large UK-based teaching hospital. All individuals admitted with COVID-19 were offered outpatient thromboprophylaxis (rivaroxaban 10 mg daily for 28 days) on discharge. Electronic medical records were reviewed for all admissions between 1st April and 15th May 2020, and for up to six months following discharge. Thromboprophylaxis was offered to those not at increased bleeding risk (see Figure 1). The study compares two groups, those individuals who received outpatient thromboprophylaxis (thromboprophylaxis) and those who did not (no thromboprophylaxis). Statistical analysis was performed using Fisher's exact test for categorical data and unpaired t test for continuous data. Data were collected from 179 medical inpatients with COVID-19, of these, 98 were eligible for thromboprophylaxis (Figure 1). The thromboprophylaxis group included 57 (58%) individuals and the no thromboprophylaxis 41 (42%). All medical records were reviewed at 3 and 6 months but all VTE and bleeding events occurred within the 3 months following discharge (see Figure 2). At 3-month follow up there was no difference in the rate of VTE events between the groups (thromboprophylaxis, 1;no thromboprophylaxis, 1;P = 1.00). All VTE events occurred between stopping thromboprophylaxis (at 28 days) and before the 3-month point. The use of thromboprophylaxis was not associated with an increased risk of major bleeding (thromboprophylaxis, 1;no thromboprophylaxis, 0;P = 1.00). The single bleeding event in the thromboprophylaxis group was an intracranial bleed following trauma and occurred two months after stopping the thromboprophylaxis. Conclusions : Extended thromboprophylaxis was not associated with an increased risk of major bleeding. No VTE events occurred whilst an individual was taking thromboprophylaxis. Further work is needed to investigate the optimum duration of thromboprophylaxis.
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Background : COVID-19 is associated with a higher risk of venous thromboembolism (VTE). There is no consensus on the optimum dose of thromboprophylaxis. Aims : To assess the effectiveness of weight-based thromboprophylaxis dosing. Methods : This is a retrospective cohort study of all medical patients at a large UK-based teaching hospital, between April 1st and 15th May 2020. Electronic medical records were reviewed. People who were PCR positive for SARS-CoV-2 (COVID-19 positive) received a weight-based thromboprophylactic dose of enoxaparin (Table 1). Those PCR negative for SARS-CoV-2 (COVID-19 negative) received a standard dose (enoxaparin 40 mg daily). Chi square and Fisher's exact test were used for categorical variables, unpaired t test for continuous. Results : 569 cases (179 COVID-19 positive, 390 COVID-19 negative) were identified. The COVID-19 positive group had a significantly higher average age, a similar proportion of males and a greater average weight (Table 2). 86% of the COVID-19 positive group received the correct thromboprophylaxis dose for their weight. Most receiving an incorrect dose weighed >100 kg (54%) and received a lower dose than recommended. The incidence of new VTE was similar in the COVID-19 positive group (12, 7%) compared to those in the COVID-19 negative (16, 4%, P = 0.18). Most VTE events were proven radiologically apart from two COVID-19 positive patients diagnosed by clinical suspicion alone. Eight cases (67%) of VTE in patients with COVID-19 were pulmonary thrombosis, compared to twelve (75%) in patients without ( P = 0.69). Two cases of VTE occurred in the COVID-19 positive group whilst they were therapeutically anticoagulated compared to none in the COVID-19 negative group. Two major bleeding episodes occurred in the COVID-19 positive group and one in the COVID-19 negative ( P = 0.23). Conclusions : There was a similar incidence of VTE in medical patients with COVID-19 compared to those without. Weight-based thromboprophylaxis was not associated with an increased rate of bleeding.
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Positive student wellbeing is intrinsically connected to positive learning outcomes. Students learn more when they feel well, and the way we shape education influences the way students feel. The COVID-19 crisis has forced us to radically change our design education and is having a large impact on student wellbeing and learning. While some students manage well to adapt to the new circumstances, others struggle and face challenges such as risk of burnout, lack of motivation, and social isolation. In this paper we describe how we approached this challenge by applying methods and principles from strategic human-centred design and systems thinking. The strategic design approach included researching values and patterns in student and staff experiences. The systems approach meant that we saw the university as a complex adaptive system, which focused our activities on connecting staff and students who were and are running multiple creative experiments to promote student wellbeing. This approach is strategic because it supports continuous design and implementation of initiatives to promote wellbeing. While this is work in progress, we here present a number of design principles that we developed through this work that enable future designs that promote student wellbeing in (pandemic) higher education. © 2021 Universidade do Vale do Rio dos Sinos. All rights reserved.