Rethinking Visual Arts–Based Methods of Knowledge Generation and Exchange in and beyond the Pandemic

This inaugural special issue of ‘Beyond the Text’ brings together a collection of visual arts (animation, creative and fine art, film, photographs, and zines) produced by children, young people, families, artists, and academics as part of co-created research during the 2020–2021 coronavirus pandemic. Our aim, in making these pieces available in this new publication format, is to illustrate the potential of visual arts as a form of co-creation and knowledge exchange which can transcend the challenges of researching ‘at a distance’, enable participants and co-researchers to share their stories, and support different ways of knowing for academic, policy, and public audiences. This is not to suggest that such methods offer transparent windows into participants’ worlds. As the reflections from the contributing authors consider, visual arts outputs leave room for audience interpretations, making them vulnerable to alternative readings, generating challenges and opportunities about how much it is possible to know about another and what is ethical to share. It is to these issues of ethics, representation, and voice that this special issue attends, reflecting on the possibilities of arts-based approaches for knowledge generation and exchange in and beyond the coronavirus pandemic.

Seeing as an Act of Hearing: Making Visible Children’s Experiences of the COVID-19 Pandemic Through Participatory Animation

‘Our Voices’ is an animation co-created with children aged 9–11 during the 2020–2021 global pandemic. A short, stop-start animation of children’s visual, audio and textual representations of their experiences offers a visceral account of the pandemic in England from their perspectives. In making available the animation in this inaugural issue of ‘Beyond the Text’, we have two key aims. The first is to enable children, who have been barely seen and little heard during the pandemic, to voice their experiences in accordance with their aspirations. The second is to reflect upon the process of transforming creative data made by and with children into an animation that is representative of children’s diverse experiences and acknowledges their contributions in ways which enable audiences to engage through ‘seeing’. Accordingly, our accompanying text explores how, through a feminist ethics of care, we sought to co-produce an animation with children which delivers key messages from them and acknowledges their role as co-researchers while maintaining their anonymity. In describing our methodological and ethical practices, we aspire to make visible the relational, dialogic processes inherent in co-production, offering viewers a way of seeing the complexity of children’s experiences through the multi-layered affordances of participatory animation.

The dietary impact of the COVID-19 pandemic.

The COVID-19 pandemic led to significant changes in people's budgets, the opportunity cost of their time, and where they can purchase and consume food. We use novel data on food and non-alcoholic drink purchases from stores, takeaways, restaurants and other outlets to estimate the impact of the pandemic on the diets of a large, representative panel of British households. We find that a substantial and persistent increase in calories consumed at home more than offset reductions in calories eaten out. Households increased total calories relative to pre-pandemic by 280 per adult per day from March to July 2020, and by 150 from July to the end of 2020. Although quantity increased, there was little change in diet quality over the pandemic. All socioeconomic groups increased their calorie intake, with the largest rises for the highest SES households and the smallest for retired ones. We estimate that the changes could increase the proportion of adults who are overweight by at least five percentage points, two years after the pandemic onset.

MERS-CoV ORF4b employs an unusual binding mechanism to target IMPα and block innate immunity.

The MERS coronavirus (MERS-CoV) is a highly pathogenic, emerging virus that produces accessory proteins to antagonize the host innate immune response. The MERS-CoV ORF4b protein has been shown to bind preferentially to the nuclear import adapter IMPα3 in infected cells, thereby inhibiting NF-κB-dependent innate immune responses. Here, we report high-resolution structures of ORF4b bound to two distinct IMPα family members. Each exhibit highly similar binding mechanisms that, in both cases, lack a prototypical Lys bound at their P2 site. Mutations within the NLS region dramatically alter the mechanism of binding, which reverts to the canonical P2 Lys binding mechanism. Mutational studies confirm that the novel binding mechanism is important for its nuclear import, IMPα interaction, and inhibition of innate immune signaling pathways. In parallel, we determined structures of the nuclear binding domain of NF-κB component p50 bound to both IMPα2 and α3, demonstrating that p50 overlaps with the ORF4b binding sites, suggesting a basis for inhibition. Our results provide a detailed structural basis that explains how a virus can target the IMPα nuclear import adapter to impair immunity, and illustrate how small mutations in ORF4b, like those found in closely related coronaviruses such as HKU5, change the IMPα binding mechanism.

Developing a novel one-day paediatric assessment and stabilisation (PAS) course for front line healthcare workers in Lusaka, Zambia

BackgroundA large proportion of front-line paediatric healthcare in Zambia is delivered by staff with no specialist paediatric training, and training this group could significantly reduce preventable child deaths. In 2019–2020, the Tropical Health and Education Trust undertook a 6-month paediatric capacity building project in Lusaka, Zambia, funded by Health Education England.ObjectivesThe aim of the project was to improve paediatric skills of front-line healthcare workers.MethodsThree volunteers were recruited (2 paediatric registrars and 1 programme and evaluation consultant) to work with first (district) level hospitals in Lusaka. A needs analysis found that there was an under-utilisation of the structured approach to the recognition and stabilisation of unwell children on the front line.The initial suggestion of embedding the Emergency Triage and Treatment (ETAT) course was not an option due to insufficient resources and funding for a five-day course. The volunteers worked with local and international colleagues to design a one-day alternative based on local data, priorities and available resources. The Paediatric Assessment and Stabilisation (PAS) course is based on national Zambia Paediatric Association and international protocols (including ETAT, APLS and WHO).A ‘teach the teacher’ approach was used with instructors nominated from four first level hospitals and University Teaching Hospital (the local tertiary referral hospital). Two half-day sessions were held to train instructors on course teaching methods, and encourage them to be local ‘PAS Champions’ to embed their new knowledge and skills amongst their own hospital teams post-course.The pilot was funded by Lusaka Provincial Health Office, with participants recruited from the same four first level hospitals as the instructors. The course was delivered in small groups using Peyton’s four stage approach and simulation. A simulation test scenario was used at the end of the course to ensure credibility. Impact of the course was measured using a Likert scale questionnaire to assess participant confidence in managing critically ill children before and after the course.ResultsThe pilot ran four separate PAS courses. These were attended by 91 participants (including clinical officers, medical officers and nurses) of which 88 passed. Pre and post course questionnaires showed participant confidence scores increased by 19% in assessment of unwell children, and by 22% in treatment of unwell children. Free text by participants showed a positive impact on individual clinical practice. 25 instructors were trained to teach on the PAS course, as well as 2 course directors and 1 course administrator. Instructors also fed back that critically unwell children were more effectively managed within their facilities after the course. Ownership of the course was handed back to the ZPA and Ministry of Health at the end of the pilot. Unfortunately, the COVID-19 pandemic prevented any further impact analysis, and any further PAS courses were put on hold.ConclusionsAt a time where national resources are limited to fund internationally recognised paediatric courses (e.g. ETAT), it is hoped that the structured approach learned on the PAS course can benefit front line paediatric care in Zambia at present, and become an effective ‘stepping-stone’ to these courses.

Video counselling and psychotherapy: A critical commentary on the evidence base

Pre‐pandemic research has suggested that video counselling is as effective as face‐to‐face practice. However, the mass migration of therapy to the online video domain as a result of the COVID‐19 pandemic makes it essential to interrogate the evidence base. This paper provides a critical commentary on how video therapy is defined/labelled, the current evidence about whether video therapy is effective, and whether the working alliance and therapeutic relationship functions differently in video counselling. The paper concludes that while the evidence to date is promising, it is limited in quantity and applicability and hence generalisability. Lack of evidence is not evidence that video therapy is ineffective, but the large gaps in understanding highlight the importance, both ethically and empirically, of further research in this area. [ABSTRACT FROM AUTHOR] Copyright of Counselling & Psychotherapy Research is the property of Wiley-Blackwell 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.)

Preparing for a pandemic: spending dynamics and panic buying during the COVID-19 first wave.

In times of heightened uncertainty, consumers face incentives to build up precautionary stocks of essential supplies. We study consumer spending dynamics during one such time, the first infection wave of the COVID-19 pandemic, using household scanner data covering fast-moving consumer goods in the United Kingdom. We document large increases in demand for storable products, such as food staples and household supplies, in the days before lockdown. Households in all socio-economic groups exhibit unusually high demand pre-lockdown, but there is a clear gradient, with the largest demand spikes for wealthier households. Although stories of people purchasing extreme amounts received a lot of attention, higher aggregate demand was mainly driven by more households than usual choosing to buy storable products, with only small increases in average quantities bought on a given trip. Temporary limits on the number of units per transaction, introduced following the demand spike, are therefore unlikely to lead to the avoidance of stock-outs.

Environmental hygiene, knowledge and cleaning practice: a phenomenological study of nurses and midwives during COVID-19.

BACKGROUND: Environmental cleanliness is a fundamental tenet in nursing and midwifery but often overshadowed in practice. This study explored nurses' and midwives' knowledge and experiences of infection prevention and control (IPC) processes and cleaning, and perceptions about workplace risk-management during COVID-19. METHODS: Six registered and enrolled nurses (one with dual midwife qualifications) were recruited. In-depth telephone interviews were analyzed using Colaizzi's phenomenological method. RESULTS: Four major themes were identified: Striving towards environmental cleanliness; Knowledge and learning feeds good practice; There's always doubt in the back of your mind; and COVID has cracked it wide open. These articulate the nurses' and midwives' experiences and knowledge of IPC, particularly during COVID-19. DISCUSSION: The findings emphasize the dynamic, interdependent nature of clinical (time, staff knowledge and compliance, work processes, hospital design) and organizational contexts and environmental cleanliness, which must be constantly maintained. COVID-19 opened up critical insights regarding poor past practices and lack of IPC compliance. CONCLUSIONS: COVID-19 has highlighted the criticality of environmental cleanliness within clinical and community settings. Evidence-based, experiential learning is important for nurses and midwives at all career stages, but provides only one solution. Clinician-led hospital design may also reduce the spread of infection; thus, promoting better patient care.