Playful Pedagogy in the Pandemic: Pivoting to Game-Based Learning

Educational technology adoption is more widespread than ever in the wake of COVID-19, as corporations have commodified student engagement in makeshift packages marketed as gamification. This book seeks to create a space for playful learning in higher education, asserting the need for a pedagogy of care and engagement as well as collaboration with students to help us reimagine education outside of prescriptive educational technology. Virtual learning has turned the course management system into the classroom, and business platforms for streaming video have become awkward substitutions for lecture and discussion. Gaming, once heralded as a potential tool for rethinking our relationship with educational technology, is now inextricably linked in our collective understanding to challenges of misogyny, white supremacy, and the circulation of misinformation. The initial promise of games-based learning seems to linger only as gamification, a form of structuring that creates mechanisms and incentives but limits opportunity for play. As higher education teeters on the brink of unprecedented crisis, this book proclaims the urgent need to find a space for playful learning and to find new inspiration in the platforms and interventions of personal gaming, and in turn restructure the corporatized, surveilling classroom of a gamified world. Through an in-depth analysis of the challenges and opportunities presented by pandemic pedagogy, this book reveals the conditions that led to the widespread failure of adoption of games-based learning and offers a model of hope for a future driven by new tools and platforms for personal, experimental game-making as intellectual inquiry. © 2023 Emily K. Johnson and Anastasia Salter.

The late onset of emotional distress in people with progressive multiple sclerosis during the COVID-19 pandemic: longitudinal findings from the CogEx study

Background: An earlier follow-up study from the CogEx rehabilitation trial showed little change in symptoms of depression, anxiety and psychological distress during the first COVID-19 lockdown compared to pre-pandemic measurements. Objective(s): Here we provide a second follow-up set of behavioral data on the CogEx sample. Method(s): Data were obtained from the CogEx study, a randomized controlled trial of exercise and cognitive rehabilitation in people with progressive MS involving 11 centres in North America and Europe. Participants completed the same COVID Impact Survey and self-report measures of depression, anxiety and MS symptoms that had been obtained during the first pandemic lockdown period. Result(s): The average time between measurements was 11.4 (SD=5.56) months. Sample size declined from 131 to 72 largely because pandemic restrictions prevented data collection from sites in Denmark and England. There were no significant differences in age, sex, EDSS, disease course and duration between those who participated in the current follow-up study (n=74) and the group that could not (n=57). One participant caught Covid in the time between assessments. Participants now took a more negative view of their mental/psychological wellbeing (p=.0001), physical wellbeing (p=.0009) and disease course (p=.005) compared to their last assessment. Depression scores increased on the HADS-depression scale (p = .01) and now exceeded the clinically significant threshold of >= 8.0 for the first time. Anxiety scores on the HADS remained unchanged. Poorer mental wellbeing was predicted by HADS depression scores (p=.012) and a secondary-progressive disease course (p=.0004). Conclusions and Relevance: A longer follow-up period revealed the later onset of clinically significant depressive symptoms on the HADS and a decline in self-perceptions of mental and physical wellbeing associated with the COVID-19 pandemic.

Examining the Efficacy and Patient Satisfaction of Telehealth in a Multidisciplinary Spine Practice

Background and/or Objectives: To investigate the efficacy and patient satisfaction with telehealth (TH) visits administered by non-surgical physicians, surgical physicians, and mid-level providers in a multidisciplinary spine practice. Design(s): Cross Sectional Study Setting: Multidisciplinary spine practice at large academic medical center Participants: 407 patients with TH appointment between June 1, 2021 and December 2, 2021 Interventions: Patients received an electronic survey developed to characterize patients' TH experiences. Main Outcome Measure(s): Respondents were surveyed on TH appointment type, type of medical provider, purpose of TH appointment, reason for TH utilization, length of time for visit, technical components to the visit, patient demographics, respondents level of satisfaction and likelihood to recommend. Result(s): 407 patients responded to survey. First time TH utilization was 48.6%. Gender utilization was higher with those who identified as female (65.6%). The largest age group utilizing TH was ages 65-74 years old (41%). Majority of respondents, 86.2%, identified as White, 8.1% identified as Black or African American and 6.6% identified as Hispanic or Latino. Medical care via TH was evenly distributed amongst all providers: 33.9% of respondents meet with a surgeon, 35.4% with non-surgical physicians, and 30.7% with a mid-level provider. A majority of visits were follow-up appointments (46.4%) new patient appointment made up 26.3% of visits 21.9% of appointments were post injection follow ups and 5.4% were for post-surgery follow up. Reasons listed for TH utilization: long distance to travel (35.9%) ease and convenience of virtual visit (23.3%) 4.4% to maintain social distancing during the COVID -19 Pandemic. 96.8% of respondents were very satisfied or satisfied with their TH visit, with 93.6% recommending TH visit to others. Conclusion(s): The study demonstrates that TH is a satisfactory and convenient option to care for patients in a multidisciplinary spine practice.

Updated results of the COVID-19 in MS global data sharing initiative validate consistent associations of anti-CD20 and other reported risk factors with severe COVID-19 outcomes

Background: As the COVID-19 pandemic continues, evidencebased clinical guidance for managing the care of people with multiple sclerosis (MS) is an ongoing concern. In recent months, data from cohorts of people with MS has indicated that certain demographic and clinical characteristics, including use of some disease- modifying therapies (DMTs), leads to worse outcomes from SARS-CoV-2 infection. The COVID-19 in MS global data sharing initiative, which now includes over 4,500 confirmed COVID- 19 cases in people with MS, gives the opportunity to corroborate previous findings with greater certainty. Methods: Clinician-reported data from 32 countries were aggregated into a dataset of 5,543 patients who had suspected or confirmed COVID-19. Demographic and clinical covariates were queried, alongside COVID-19 clinical severity outcomes. These outcomes (hospitalisation, admission to ICU, requiring artificial ventilation, and death) were assessed in patients with suspected/ confirmed COVID-19 using multilevel mixed-effects logistic regression. All models were corrected for age, sex, EDSS, and MS type. DMTs were individually compared to glatiramer acetate (GA), as well as to pooled other DMTs and natalizumab. Results: Of 5,543 patients in the clinician-reported dataset, 909 with suspected and 4,634 with confirmed COVID-19 were included in the analysis. Previous demographic findings were confirmed: male sex, older age, progressive MS, and higher disability were associated with worse outcomes from SARS-CoV-2 infection. Use of anti-CD20 DMTs (ocrelizumab and rituximab) was associated with worse COVID-19 outcomes. Compared to GA, ocrelizumab and rituximab were associated with increased risk of hospitalisation (aOR=1.61(95%CI=1.06-2.43);aOR=2.42(95%CI=1.54-3.81) and ICU admission (aOR=3.13(95%CI=1.22-8.00);aOR=4.46 (95%CI=1.64-12.09)). Rituximab was associated with increased risk of artificial ventilation (aOR=3.57(95%CI=1.38-9.20));ocrelizumab showed a positive trend (aOR=1.86(95%CI=0.76-4.55). Rituximab showed a positive trend with increased risk of death (aOR=2.74(95%CI=0.68-11.09). Associations persisted on restriction to confirmed COVID-19 cases. Conclusions: Analysing the largest international real world dataset of people with MS who have suspected or confirmed COVID- 19 confirms previous findings that male sex, older age, progressive MS, higher disability, the use of anti-CD20 medication (ocrelizumab and rituximab) are associated with worse COVID-19 outcomes.

COVID-19 in neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody disease patients in North America;COViMS registry

Introduction: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised concerns about the risks of COVID-19 in those with neuroimmunological disorders that affect the central nervous system. Risk factors associated with worse COVID-19 outcomes in MS have been identified. However, little data has been reported on how COVID-19 impacts people with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD). Objective: To assess whether the COVID-19 Infections in MS and Related Diseases (COViMS) Registry provides information on the impact of COVID-19 on people with NMOSD and MOGAD. Aims: To describe the clinical characteristics, risk factors for severe course of COVID-19, and overall COVID-19 outcomes in patients with NMOSD and MOGAD. Methods: The COViMS Registry collected data on North American patients with MS and related diseases with laboratory positive or highly suspected SARS-CoV-2 infection. De-identified data were entered into a web-based registry by health care providers. Data were analyzed using t-tests, Pearson's chi-square or Fisher's Exact tests for categorical variables. Univariate logistic regression models examined effects of risk factors and COVID-19 clinical severity. Results: As of April 1, 2021, 66 NMOSD and 15 MOGAD patients were reported in the COViMS Registry. Most NMOSD patients were laboratory positive for SARS-CoV-2 and taking rituximab at time of COVID-19 diagnosis. Most NMOSD patients were not hospitalized (66.7%[95%CI:54.0-77.8%]), while 12.1% (95%CI:5.4-22.5%) were hospitalized only, 9.1% (95%CI:3.4-18.7%) were admitted to the ICU and/or ventilated, and 12.1% (95%CI:5.4-22.5%) died. In NMOSD patients, having a comorbidity was the sole factor identified for poorer COVID-19 outcome (OR=6.3, 95%CI:1.64-24.52). Most MOGAD patients were laboratory positive for SARS-CoV-2 and almost half were taking rituximab. Among MOGAD patients, 73.3% were not hospitalized and no deaths were recorded;no factors were different between those not hospitalized versus those hospitalized, admitted to the ICU, or ventilated. Conclusion: Among the reported NMOSD patients, a high mortality rate was observed and presence of comorbid conditions were associated with worse COVID-19 outcome. MOGAD patients appear to fare better than NMOSD patients, with fewer reported with severe COVID-19 outcome and no reported deaths.

Cosplay on Demand? Instagram, OnlyFans, and the Gendered Fantrepreneur

Fan producers engaged in monetization, or what Suzanne Scott has termed “fantrepreneurs,” struggle with legal mechanisms for brand-building given the limitations of both copyright and platform moderation. These challenges have been amplified during the COVID-19 pandemic, which has fundamentally changed the way that cosplayers, or fans who dress up as characters from their favorite television shows or movies, market themselves in an increasingly online space, as opposed to their initial public platforms of conventions. Restricted by digital platforms and their various moderation and monetization methods, cosplayer fantrepreneurs have developed new, multi-platform methods for sustaining their content and community connection. One prominent platform significant to this turn is OnlyFans, which is billed as a “peer-to-peer subscription app,” and allows users to “Sign up and interact with your fans!” Through a sample analysis of 50 cosplayers, this case study considers the approaches of cosplayers on integrating OnlyFans as part of a multiplatform struggle for economic viability. When we contextualize this platform labor in the history of cosplay, we note the hypersexualized labor that has always been central to monetization in this space, and the media franchise exploitation that profits from that labor at the expense of the fan producer, demonstrating the fundamental, gendered exploitation of the trend toward a patronage economy. © The Author(s) 2021.