Long-term airborne measurements of pollutants over the UK, including during the COVID-19 pandemic, to support air quality model development and evaluation

The ability of regional air quality models to skilfully represent pollutant distributions throughout the atmospheric column is important to enabling their skilful prediction at the surface. This provides a requirement for model evaluation at elevated altitudes, though observation datasets available for this purpose are limited. This is particularly true of those offering sampling over extended time periods. To address this requirement and support evaluation of regional air quality models such as the UK Met Offices Air Quality in the Unified Model AQUM), a long-term, quality assured, dataset of the three-dimensional distribution of key pollutants has been collected over the southern United Kingdom from June 2019 to April 2022. This sampling period encompasses operations during the global COVID-19 pandemic, and as such the dataset serves an additional application in providing a unique resource with which to explore changes in atmospheric composition associated with reduced emissions during this period. Measurements were collected using the Met Office Atmospheric Survey Aircraft MOASA), a Cessna-421 instrumented for this project to measure gaseous nitrogen dioxide, ozone, sulphur dioxide and fine mode (PM2.5) aerosol. This paper provides a technical introduction to the MOASA measurement platform, flight strategies and instrumentation. The MOASA air quality dataset includes 63 flight sorties (totalling over 150 hours of sampling), the data from which are openly available for use. Example case studies using data from these sorties are presented, which include an analysis of the spatial scales of measured pollutant variability, initial work to evaluate performance of the AQUM regional air quality model, and an introduction to the vertical structure of pollutants observed during repeated flight patterns over Greater London, including during the COVID-19 impacted period. [ABSTRACT FROM AUTHOR] Copyright of Atmospheric Measurement Techniques Discussions is the property of Copernicus Gesellschaft mbH 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Access to Medications Is a Health Care Right: Filling Prescriptions Should Not Be a Luxury.

In the summer of 2022, my daughter came down with an ear infection after suffering from several different upper respiratory infections that followed an initial infection of COVID-19. Her cough had been ongoing for about six to eight weeks after her COVID-19 infection had resolved. At this juncture, her primary care physician prescribed an inhaler. While this would eventually prove to be ineffective, this was the last-line treatment before a referral to the Ear Nose and Throat physician and a subsequent tonsillectomy and adenoidectomy. But, before that chapter of the journey began, I entered the retail pharmacy where I have always filled my prescriptions for my children. Re-imbursement for the inhaler was denied by my insurance. The out-of-pocket cost would be $250.

Did New York City Diabetes Prevention Programs Suffer or Succeed during COVID-Pandemic Lockdowns?

Pandemic restrictions may have affected in-person health education such as the CDC's Diabetes Prevention Program (DPP) . We interviewed staff from New York City (NYC) DPPs to a) document if/how DPPs adapted and served participants during pandemic lockdowns, and b) identify successes and challenges to operating remotely. Interviewees were lifestyle coaches and DPP coordinators representing a public hospital, a national weight loss program, a healthcare center, a community based organization, a health insurance company, a faith-based DPP, and a network of federally qualified health centers. DPPs served participants in Manhattan, Brooklyn, Queens, and the Bronx. Zoom interviews (1hr) were recorded and transcribed. Interviewees received a $50 gift card.DPP host organizations continued to provide DPP services during the pandemic and experienced a number of successes and challenges (Table) . NYC DPPs suffered greatly during COVID-lockdowns and limits on social gathering because they and their participants were unprepared for virtual classes. However, most were successful due to resilient, dedicated, and extraordinarily creative staff. The pandemic highlighted opportunities for successful virtual DPPs in the urban setting, and the need for more robust funding mechanisms, staff support, and technical assistance to ensure sustainability and scalability of the DPP.

Treatment escalation plans and DNACPR decisions within general surgery during COVID-19 pandemic

BackgroundThe COVID-19 pandemic has caused unprecedented pressures on hospital which has prompted early treatment escalation discussions. BMA guidance states that effective communication regarding DNACPRs should occur in a timely manner.1 Consideration should also be given to patients’ preferences and ample opportunity for discussions.2 However, from anecdotal evidence in an acute hospital, these conversations have not happened within general surgery. Previously, the main barriers to these discussions were having unresolved feelings around death and inadequate training.3 Many barriers to these discussions lie with doctors, we aimed to assess whether discussions were occurring, whether they were clear and accessible and to understand any barriers to discussions.MethodsCross-sectional quantitative data collection of patients admitted to an acute general surgical ward was undertaken between Nov’ 20 to March 21’. Treatment escalation and DNACPR decisions were identified from patient notes. This included time elapsed from admission, what was discussed, and by whom. A qualitative survey was sent to senior surgeons to explore ideas and any barriers to these discussions.ResultsThe study included 43 patients. 12/43 (28%) had treatment escalation discussions, with 8/12 (67%) being about DNACPR. Half of these decisions were made by ITU Outreach 4/8 (50%), none by senior surgeons. The average time elapsed from admission to a decision was 18.9 days. 35 senior surgeons were surveyed with a response rate of 14%. 4/5 (80%) thought treatment escalation options should only be discussed in patients who might deteriorate, with time pressures and fear of frightening patients as the main barriers cited.ConclusionMost patients did not have a treatment escalation plan. To address one of the main barriers identified, we have created a sticker with clear prompts for treatment escalation decisions to be placed in the clerking booklet. Further work is required to understand other barriers involved.ReferencesBritish Medical Assosciation, Resuscitation Council (UK), Royal College of Nursing. Decisions relating to cardiopulmonary resuscitation: a joint statement from the british medical association, the resuscitation council (UK) and the royal college of nursing. J Med Ethics 2001;27(5):310–6.Pitcher D, Fritz Z, Wang M, Spiller JA. Emergency care and resuscitation plans. Vol. 356, BMJ (Online). BMJ Publishing Group;2017.Chittenden EH, Clark ST, Pantilat SZ. Discussing resuscitation preferences with patients: challenges and rewards. J Hosp Med 2006 Jul 1;1(4):231–40.

THE ASPIRE STUDY 1. A MIDWIFERY-LED RESEARCH RESPONSE TO COVID-19 AND BEYOND

This is the first article in a series reflecting on the role of research midwives in the ASPIRE (Achieving Safe and Personalised maternity care In Response to Epidemics) study. In this article we introduce ASPIRE and provide an overview of the study. We also reflect on what makes ASPIRE uniquely midwifery-led within the National Institute for Health Research (NIHR) Portfolio and the role of research midwives within recruitment sites. We hope this article, and those that follow in the series, written by ASPIRE research midwives, will serve as a roadmap to inspire the next chapter of midwifery research in England.

Enhancing Vocational Training in the Post-COVID Era through Mobile Mixed Reality

COVID-19 and the resulting restrictions have had a massive impact on engineering education, particularly vocational and practical aspects of training. In this study, we present a novel mixed reality (MR) tool to simulate and guide learners through a simple fault diagnosis task of a three-phase power supply. The tool was created as a web-based application that could be accessed from budget smartphones in order to cover the majority of users. Comparisons were made between novices using MR guidance and those with more experience in the task who did not have additional guidance, finding that the novices outperformed the experts across all metrics measured. This indicates that MR could be a valuable tool to supplement traditional vocational learning methods, particularly at a time when physical access to equipment and facilities is scarce. MR has applications across the engineering industry, but the target task of a three-phase power supply was chosen as it has particular relevance to the offshore wind industry, which faces a shortage of skilled engineers and technicians in the coming years.

Health anxiety, coping mechanisms and COVID-19: An Indian community sample at week 1 of lockdown

It is critical to gain an understanding of the impact of the COVID 19 pandemic and the associated lockdown restrictions on the psychological, social and behavioural functioning of the general public, in order to inform public health promotion and future health service resource allocation. This cross-sectional study, completed during week 1 of lockdown in India, reports on data from 234 participants using an online survey. Data regarding health anxiety, coping mechanisms and locus of control was collected. Structural equation modelling was used to assess the relationship between locus of control, coping mechanisms, health anxiety and age. Age related differences in both locus of control and coping strategies were found. Younger people experienced more health-related anxiety and were more likely to engage with social media as a coping mechanism. Mindfulness-based strategies may reduce health anxiety by increasing tolerance of uncertainty experienced during the COVID 19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Remote Clinics During Coronavirus Disease 2019: Lessons for a Sustainable Future.

Background The coronavirus disease 2019 (COVID-19) pandemic has led to a focus on non-face-to-face (NF2F) orthopedic clinics. In this study, our aim was to establish whether NF2F clinics are sustainable according to the "triple bottom line" framework by taking into account the impact on patients, the planet, and the financial cost. Methodology This retrospective cohort study was carried out at a large district general hospital with 261 patients identified as having undergone face-to-face (F2F) or NF2F orthopedic consultations (April 2020). These patients were contacted by telephone to establish their experience, mode of transport, and preference for future consultations. Data were also collected relating to environmental and financial costs to the patient and the trust. Results The final analysis included 180 (69%) patients: 42% had an F2F consultation and 58% NF2F consultation. There was no significant difference between each group in terms of convenience, ease of communication, subjective patient safety, or overall satisfaction rating (p > 0.05). Overall, 80% of NF2F patients would be happy with virtual consultations in the future. The mean journey distance was 18.6 miles leading to a reduction in total carbon emissions of 563.9 kgCO2e (66%), equating to 2,106 miles in a medium-sized car. The hospital visit carbon cost (heating, lighting, and waste generation) was reduced by 3,967 kgCO2e (58%). The financial cost (petrol and parking) was also reduced by an average of £8.96 per person. Conclusions NF2F consultations are aligned to the National Health Service's "Long Term Plan": (i) delivering high patient satisfaction with equivalent outcomes as F2F consultations; (ii) reducing carbon emissions from transportation and hospital running; and (iii) becoming cheaper.

Health anxiety, coping mechanisms and COVID 19: An Indian community sample at week 1 of lockdown.

It is critical to gain an understanding of the impact of the COVID 19 pandemic and the associated lockdown restrictions on the psychological, social and behavioural functioning of the general public, in order to inform public health promotion and future health service resource allocation. This cross-sectional study, completed during week 1 of lockdown in India, reports on data from 234 participants using an online survey. Data regarding health anxiety, coping mechanisms and locus of control was collected. Structural equation modelling was used to assess the relationship between locus of control, coping mechanisms, health anxiety and age. Age related differences in both locus of control and coping strategies were found. Younger people experienced more health-related anxiety and were more likely to engage with social media as a coping mechanism. Mindfulness-based strategies may reduce health anxiety by increasing tolerance of uncertainty experienced during the COVID 19 pandemic.

Mobilising a workforce to combat COVID-19: An account, reflections, and lessons learned.

With the declaration of coronavirus 2019 (COVID-19) as a pandemic, intensive care units across the globe began to prepare for large numbers of patients. For many years, UK Intensive Care Units (ICUs) have been at high capacity, while facing staffing shortages. In order to prepare for the predicted increased work caring for large numbers with COVID-19, staff were redeployed from other clinical areas to help. Many of these staff had no previous ICU experience. In this article, we share our experiences redeploying medical staff from an extensive range of backgrounds, and how we utilised those staff to maximise use of their existing skills, together with reflections from a variety of redeployed staff members.