Increases in adolescent firearm injuries were associated with school closures during COVID-19.

BACKGROUND: Mitigation measures, including school closures, were enacted to protect the public during the COVID-19 pandemic. However, the negative effects of mitigation measures are not fully known. Adolescents are uniquely vulnerable to policy changes since many depend on schools for physical, mental, and/or nutritional support.  This study explores the statistical relationships between school closures and adolescent firearm injuries (AFI) during the pandemic. METHODS: Data were drawn from a collaborative registry of 4 trauma centers in Atlanta, GA (2 adult and 2 pediatric). Firearm injuries affecting adolescents aged 11-21 years from 1/1/2016 to 6/30/2021 were evaluated. Local economic and COVID data were obtained from the Bureau of Labor Statistics and the Georgia Department of Health. Linear models of AFI were created based on COVID cases, school closure, unemployment, and wage changes. RESULTS: There were 1,330 AFI at Atlanta trauma centers during the study period, 1,130 of whom resided in the 10 metro counties. A significant spike in injuries was observed during Spring 2020. A season-adjusted time series of AFI was found to be non- stationary (p = 0.60). After adjustment for unemployment, seasonal variation, wage changes, county baseline injury rate, and county-level COVID incidence, each additional day of unplanned school closure in Atlanta was associated with 0.69 (95% CI 0.34- 1.04, p < 0.001) additional AFIs across the city. CONCLUSION: AFI increased during the COVID pandemic. This rise in violence is statistically attributable in part to school closures after adjustment for COVID cases, unemployment, and seasonal variation. These findings reinforce the need to consider the direct implications on public health and adolescent safety when implementing public policy.

Nutrition and behavior change: a review of recent literature.

PURPOSE OF REVIEW: The current article will highlight recent trends and novel approaches to behavior change strategies in nutrition. Physicians, nurses, and other healthcare professionals play key roles in counseling patients on lifestyle change, which is critical for patients with chronic conditions. Nutrition science continues to advance, and new approaches to behavior change are needed for successful implementation at the individual and population level. RECENT FINDINGS: The solutions to obstacles around healthful eating patterns are varied, population-dependent, and require a multipronged approach. One area of focus is the language around behavior change, ensuring it is clear and emphasizes its multifactorial nature. For young adults, the careful use of video games and social media may be essential. For older adults, altering food consistency and ensuring proper nutrient intake are crucial factors. Vulnerable populations remain susceptible to malnutrition and need special attention. Despite significant advances in managing and treating diseases, there are still gaps in nutrition counseling and behavior change efforts. SUMMARY: Every age and stage of life needs a focus on healthful foods, and nutrition counseling at each stage has its unique nuances. Careful attention to the language of change and the phrasing used in counseling is vital for educating, connecting with, and empowering patients to change. Changing healthcare operations and provider behavior around nutrition counseling is a part of the solution to the worldwide problem of unhealthy eating patterns and practices.

WholeheartedMD: Medical Students Embracing Vulnerability and Finding Fulfillment.

INTRODUCTION: Medical Students experience high levels of stress throughout their four years. When the COVID-19 pandemic exacerbated this, there was a need for programming and this created an opportunity to provide a whole person, lifestyle medicine approach to enhance medical student wellbeing. METHODS: Two student leaders and one faculty member created a 12-week program that addressed the 6 pillars of lifestyle medicine as well as positive psychology. The program was offered to all first year students, and within 12 hours the roster was full with 15 students. The program was held weekly by Zoom for 1-2 hours. RESULTS: Attendance was high each week with full participation from everyone present. In the post program evaluation form, conducted one year after completion of the program, 100% of respondents reported they would recommend this group to another medical student, 71% reported they used tools learned from the group at least weekly. Participants noted that growth mindset, gratitude, mindfulness, priorities, and relationship building were the most used well-being strategies learned in the program. CONCLUSION: An intervention that is based on the 6 pillars of lifestyle medicine and positive psychology and presented by Zoom is feasible in medical school and well accepted by medical students.

Policy Point-Counterpoint: Can Colleges and Universities Maintain High Quality Connections with Students through Virtual Platforms?

The need to more deeply and creatively assess educational modalities has been amplified with the unexpected emergence of a global pandemic. In spring 2020, institutions of higher education quickly shifted to online formats with little time for pause to consider the pedagogies that were implemented as they more or less survival strategies. Entering into the 2020-21 academic year, institutions now must take responsibility for considering and implementing mechanisms for maintaining educational quality and students' connections to their professors and campus communities;in addition to deeply assessing health of the campus community. Preparation for distance education course delivery has likely been enhanced as many college students now have experience with utilizing online platforms, and faculty have developed a wider range of skills to deliver and facilitate high quality courses through technologically rich, remote formats.