ABSTRACT
The COVID-19 pandemic is hastening the shift of the world of work and study to online, remote, and flexible hours. The political science profession and its attributes of conferencing and workshopping will likely follow suit. To help direct this flow into relationships of reciprocity and scholarly co-creation, this article details the experiences of a successful online workshopping community known as the Normative Theory of Immigration Working Group (NTIWG). For the past 10 years, this voluntary association comprising 88 migration ethics scholars has been meeting routinely and exclusively online to workshop penultimate drafts of research papers. Three workshop conveners here reflect on the joys of group participation and mutual learning and listening. With the intention of smoothing the way for like-minded groups to emerge and solidify, we elaborate our group's animating values and its learned-by-doing rules for scheduling, moderating, and offering feedback online. In the spirit of collectively facing the diversity and equity challenges confronting the future of political science, we conclude by reviewing steps that we are taking to address our own challenges of inclusivity.
ABSTRACT
Introduction: The evaluation and risk stratification of patients with TIA/non-disabling ischemic stroke (TIA/NDS) arriving to the Emergency Department (ED) incurs high-cost imaging and increases ED length of stay (EDLOS). We evaluated the safety and feasibility of an ED-toOutpatient Pathway for TIA/NDS. Methods: In April 2020, we developed a risk stratification algorithm for TIA/NDS in the ED using features of the clincal presentation, limited blood tests, telemetry, and head-neck CT/CTA. Patients deemed low risk based on a 'safety checklist' were discharged with plans for expedited outpatient testing as warranted (e.g., brain MRI, echocardiogram) followed by rapid outpatient follow-up. To assess safety/feasibility of this pathway, we analyzed data of the first 101 patients prospectively enrolled through October 2020. Results: Mean age 68 years (range, 33-99);53% men;median NIHSS score 0 (range 0-3). Symptom duration was classified as <10 min (24%), 10-59 min (23%), >60 min (49%), unclear (4%). Deficits included isolated weakness (16%), isolated aphasia (15%), amaurosis fugax (6%), numbness/combined deficits/other (63%). Median ABCD2 score 3 (range 1-7). Outpatient follow-up included stroke clinic (82%), primary care (4%), not required or patient declined (6%), other hospital (1%);7% were lost to follow-up;43% had follow-up within 7 days. Imaging performed in the ED included CT/CTA only (39%), MRI/MRA only (27%), both (33%), or no imaging (1%). EDLOS was significantly less for patients when CT/CTA only was performed, as per pathway (12.8 versus 16.8 hours, p<0.05). The safety checklist was followed in 69% of patients. When the checklist was used properly, there were 0 recurrent strokes or TIAs within 90-days (versus 2 when not used correctly, p<0.05). Return rates to the ED were 8% with use of checklist and 6% without use (p=0.76). Conclusion: Our TIA/NDS pathway, implemented shortly after the outbreak of Covid-19 in the USA, significantly decreased EDLOS, and still allowed for TIA/NDS patients to be safely discharged from the ED. Acceptable risk stratification and safety is suggested by the low rates of recurrent events when the pathway was followed properly. More education is needed to ensure consistent and proper use of the pathway.