Social Cognition Approaches to Understanding and Changing COVID-19 Preventive Behaviors

Until pharmacological measures are rolled out on a global scale, reducing the transmission of COVID-19 and preventing future outbreaks require the continued promotion of behaviors known to effectively limit the spread of infections (e.g., physical distancing, hand hygiene practices). The success of such behavioral measures, however, relies on widespread compliance, highlighting the importance of theory-and evidence-based behavior change interventions targeting COVID-19 preventive behaviors. Theories of social cognition have recently been applied to COVID-19 preventive behaviors to identify the key modifiable determinants of behavior that can be targeted by strategies or techniques in interventions. The identification of key modifiable determinants of COVID-19 preventive behaviors permits the matching of evidence-based behavior change strategies or techniques proposed to affect change in the targeted determinants. The goal of this chapter is to provide an overview of the social cognition literature and interventions targeting key psychological constructs as means to adopt and maintain COVID-19 preventive behaviors. The chapter also provides example materials used in behavior change interventions based on social cognition theory, which may have application across a broad range of COVID-19 preventive behaviors. First, the chapter provides an overview of social cognition theories that have been used to explain and predict health and social behavior and how behavior change occurs. Next, the emerging research evidence of potentially modifiable social cognition determinants of COVID-19 preventive behaviors are reviewed. Finally, a step-by-step example of how interventionists might develop a theory-based intervention targeting change in an important COVID-19 preventive behavior is provided. The chapter concludes with a summary of some key challenges and future directions in moving forward behavior change research in this area. Overall, this chapter provides information useful to the design and development of effective behavior change interventions targeting the adoption and maintenance of COVID-19 preventive behaviors which are relevant to current and future pandemic contexts. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Non-trauma uses of viscoelastic hemostatic assays in critical care: A narrative review and primer for pharmacists

Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are point-of-care viscoelastic tests of whole blood that provide real-time analyses of coagulation. TEG and ROTEM are often used to guide blood product administration in the trauma and surgical settings. These tests are increasingly being explored for their use in other disease states encountered in critically ill patients and in the management of antithrombotic medications. As the medication experts, pharmacists should be familiar with how to interpret and apply viscoelastic tests to disease state and medication management. The purpose of this narrative review is to provide a primer for pharmacists on viscoelastic tests and their interpretation and to explore non-trauma indications for viscoelastic testing in critical care. Literature evaluating the use of TEG and ROTEM for patients with acute and chronic liver disease, ischemic and hemorrhagic stroke, myocardial infarction, cardiac arrest, coronavirus disease 2019, and extracorporeal membrane oxygenation are described. Current applications of viscoelastic tests by pharmacists and potential future roles of critical care pharmacists in expanding the use of viscoelastic tests are summarized.Copyright © 2023 The Authors. JACCP: Journal of the American College of Clinical Pharmacy published by Wiley Periodicals LLC on behalf of Pharmacotherapy Publications, Inc.

The pandemic within systemic injustice: Intersectional cultural dimensions of women's aging, health, and case stories of COVID-19

This book chapter delves into the intersectional cultural dimensions of COVID-19 and explores how pandemics expose and amplify past and current health inequities and disparities for minoritized women. In this chapter, the authors question how gender reflects and intersects with health determinants of oppressed and privileged identities to produce disparate health outcomes, affecting discourse, ideologies, and women's activity as they age. Additionally, issues of racism, classism, ageism, and other "isms" are examined to understand the challenges faced by aging women as they strive to stay healthy. The chapter concludes with case story narratives of women diagnosed with COVID-19, showing the virus' effect on marginalized women aging within a stratified society. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

Narrowing awarding gaps: the contributory role of policy and assessment type

Awarding gaps between various groups of students persist across the Higher Education sector, yet the responses designed to address the contributors remain localised. The sudden spread of COVID-19 led to various responses across the University sector creating an unprecedented natural experiment and offering the opportunity to compare outcomes from these measures with prior cohorts. This study seeks to investigate the effects of two COVID-19 interventions on students' performance in the Business and Management discipline at a UK university. The specific COVID-19 measures considered here are the move to online assessments and the new grade policy to ensure the pandemic did not affect students' outcomes adversely. We use a Kernel Propensity Score and a Quantile Difference in Differences models to estimate the treatment effect of the two COVID interventions on the treated group, namely term two students' performances of the academic year 2019/20. Our results indicate that the effects of both COVID interventions supported the outcomes of international students, thereby narrowing the awarding gap. Findings suggest firstly that institutional policies adopted in crises should seek to address potential adverse effects on student outcomes for the period of disruption, indicating that significant care should be taken in their drafting. The policy, in this case, was found to have achieved its aim. Secondly, the move to new modes of assessment combined with detailed briefings from faculty may have served to uncover aspects of the hidden curriculum for this group, contributing to a narrowing of awarding gaps between different groups of students.

Marginal Artery of Drummond Pseudoaneurysm Masquerading as Fistulous Tract Resulting in Recurrent Lower Gastrointestinal Bleeding

Introduction: The mortality rate of patients hospitalized with a lower gastrointestinal bleed has been reported at 1.1% in the United States from 2005 to 2014. Pseudoaneurysms, typically associated with pancreatitis, have been described in case reports as a rare condition with a small subset presenting as gastrointestinal bleeding. Our study describes a rare case of recurrent lower gastrointestinal bleeding diagnosed as a pseudoaneurysm by endoscopy and angiography. Case Description/Methods: A 38-year-old male presented to our facility from a long-term care facility with hematochezia and blood clots per gastrostomy-jejunostomy. He had recently been hospitalized for severe coronavirus disease 2019 with a complicated hospital course in the intensive care unit including necrotizing pancreatitis with an abdominal drain, multiple secondary infections, tracheostomy, and percutaneous endoscopic gastrostomy-jejunostomy. On previous hospitalization, he was found to have a small pseudoaneurysm of the gastroduodenal artery and received embolization of the gastroduodenal and gastroepiploic arteries at that time. During transport to our hospital, he was noted to have tachycardia, hypotension requiring norepinephrine, and was transfused one unit of red blood cells. Hemoglobin at this time was 7.5 g/dl after transfusion. Esophagogastroduodenoscopy was completed and showed a gastrojejunostomy tube in the expected location but was noted to be tight to the mucosa, which was pale in appearance. Flexible sigmoidoscopy revealed localized areas of edematous and erythematous mucosa with some associated oozing throughout the sigmoid colon. Repeat evaluation was completed one week later due to recurrent hematochezia. Colonoscopy was performed with identification of an apparent fistulous tract in the sigmoid colon located at 35 cm. Computed tomography angiography localized a pseudoaneurysm arising from the marginal artery of Drummond just proximal to its anastomosis with the ascending branch of the left colic artery and was successfully embolized. Discussion(s): Pseudoaneurysms, such as the one described in this case, have been shown to be associated with pancreatitis and can result if a pseudocyst involves adjacent vasculature. Gastrointestinal bleeding is a rare presentation of this condition. However, this case highlights the importance of repeat colonoscopy and angiography in the setting of a lower gastrointestinal bleed of unknown etiology.

COVID-19 impacts on lung cancer diagnosis, management and timeliness in Victoria, Australia: A population based observational study

Objectives : To describe impact of COVID-19 on lung cancer incidence, stage at diagnosis, treatment utilisation and timeliness of care in Victoria, Australia. Design : Retrospective study using population wide Victorian Cancer Registry data and clinical data from the Victorian Lung Cancer Registry, comparing data pre-COVID (2019 and Q1 of 2020) with the COVID era (April 2020-31/12/2020). Setting and participants : Population wide data on lung cancer diagnoses diagnosed in 2019 and 2020 in Victoria, and 4485 cases with additional clinical data. Result(s): Compared In the COVID-era, 177 fewer males (-12%) and 4 fewer females (-0.3%) were diagnosed with lung cancer. Stage at diagnoses for NSCLC was higher on average in Q2 2020 and was similar to the pre-COVID distribution in Q2 and Q4. No changes were detected in the stage distribution for SCLC. The proportion of patients whose time from referral to diagnosis was >=28 d decreased with increasing volume of referrals but was higher in the COVID era (74.6%) compared with the pre-COVID era (67.5%), not caused by a decrease in volume. The proportion of patients receiving any anti-cancer treatment reduced slightly from 84% in the pre-COVID era to 81% in the COVID era ( p = 0.022). Time from diagnosis to treatment (>=14 d;37.3% of patients on average) was not associated with volume of new diagnoses, nor did change in the COVID-era ( p = 0.13). The proportion of NSCLC patients who received guideline concordance treatment did not differ between pre-COVID (83.1%) and the COVID era (81.7%;p = 0.31).

Pathogenesis of encephalopathy and delirium: neocortical neuronal membrane potential and action potential firing are changed by coronavirus-associated cytokines

Introduction: Encephalopathy and delirium are common following coronavirus infection [1], and the associated neuroinflammation often results in long-term behavioral and cognitive impairment. Neurovirulent cytokines (NVC) are strongly implicated in the pathogenesis of coronavirus encephalopathy [2]. We hypothesized that characterizing the abnormal signaling in NVC exposed neurons will enable us to identify targets to treat encephalopathy and prevent its downstream effects. Method(s): We incubated primary mouse neocortical cultures in NVC known to be increased in coronavirus encephalopathy (TNF-alpha, IL-1beta, IL-6, IL-12 and IL-15). Using whole-cell patch clamp methods, we tested how neuronal function was impacted by 22-28-h exposure to NVC. Result(s): We found that NVC depolarized the resting membrane potential (RMP), reduced the firing threshold of neocortical neurons, and increased baseline spontaneous action potential (AP) firing. NVC altered the sensitivity (or input-output properties) of single neurons to changes in their microenvironment. Specifically, decreasing external Ca2+ and Mg2+ from physiological to low (1.1-0.2 mM) levels increased evoked AP firing in control, but not following exposure to NVC. AP firing threshold and spontaneous firing rates returned to control levels 1 h after NVC wash-out. However, the RMP and attenuated sensitivity of evoked APs to changes in the microenvironment remained persistently abnormal suggesting two distinct mechanisms were at play. Interestingly, hyperpolarizing the RMP reversed this altered response. Conclusion(s): Sustained exposure to NVC reversibly depolarizes neocortical neuronal RMP, altering excitability and the ability of neurons to respond to microenvironment changes. By characterizing the pathogenesis of the underlying changes in neuronal function in our model of coronavirus encephalopathy we will identify intervenable drug targets.

Exploring the Experiences of Latinx Immigrant Families who are Undocumented during the COVID-19 Pandemic through an Ecosystemic Perspective

Latinx families in the United States who are undocumented face challenges that worsened during the COVID-19 pandemic and negatively impacted child development and well-being. The purposes of this paper are to present this community's experiences from an ecosystemic perspective and provide guidelines and implications for child welfare professionals. This paper urges child welfare professionals to develop models and initiatives that alleviate effects of barriers to access care and services experienced by this community.

Human Resource Considerations for Supporting Employees with Neurological Disorders: Multiple Sclerosis and Spinal Cord Injury

It is important for human resource (HR) teams to have the ability to appropriately identify and support the transition-to-work accommodation needs of employees with neurological disabilities as they return to work post-coronavirus disease-2019 (COVID-19) pandemic. This chapter discusses the potential biopsychological areas of consideration for human resource teams to focus their support on employees with spinal cord injury (SCI) or multiple sclerosis (MS), whose experience of work or the symptoms of these conditions have been affected by the COVID-19 pandemic and its resulting lockdowns. Potential short-term and long-term considerations in a post-COVID-19 workplace that focus on health-related work accommodations are discussed. The resulting effectiveness or success of such transition-to-work outcomes that focus on employees with neurological disorders (ewNDs) are suggested to be better evaluated by human resource teams using the lens of employee organizational commitment as it impacts employee retention. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Increasing global mindset through collaborative online international learning (COIL): internationalizing the undergraduate international business class

Purpose: This study aims to provide a case example of two partner institutions and business faculty who creatively used a collaborative online international learning (COIL) experience during the height of the COVID-19 pandemic and transition to online learning to internationalize an undergraduate business class and use existing technology to offer a case study project to further students' global mindset. Design/methodology/approach: Using open-ended qualitative comments from an American college and a Peruvian university, researchers uncovered key themes from a virtual COIL-based learning experience offered as part of an international business class. Findings: Student end-of-course evaluation comments from both countries validated the success of the learning experience and value of working together with other students and faculty in a virtual setting. Research limitations/implications: Areas for future research are provided to extend these initial exploratory findings. However, the implications are clear that the methodology is also appropriate in nonpandemic situations and can quickly bring a global mindset to remote corners of the globe and ensure all students experience the "virtual” study abroad, even when there are travel limitations or budget restrictions for students or the institutions. Practical implications: The implementation detail provided can be easily replicated by other institutions with a global mindset and internationalization goals. Social implications: The proliferation of COIL-based experiences will impact how study abroad experiences are defined and offered in the future. Originality/value: While researchers have documented COIL experiences in the academic literature, their use during the COVID-19 pandemic, as often the only solution for on-going internationalization, has not been thoroughly studied or documented. In addition, the class activities further used team-based international workplace pedagogy, authentic engagement and technology. © 2023, Emerald Publishing Limited.

Beliefs about vaccination and relation to COVID-19 vaccination side-effects in asthma patients

Background: Clinical trials of COVID-19 vaccination provide evidence of side effects in the placebo group, consistent with some side effects reporting being a nocebo effect (Amanzio M, et al. Lancet Reg Health Eur 2022;12:100253) Aim: To investigate whether side effects of COVID-19 vaccination are associated with negative beliefs about vaccination. Method(s): European patients with severe asthma (SHARP network) completed a questionnaire (May-June 2021) about their vaccination status, the Vaccination Attitudes EXamination (VAX) Scale, a measure of vaccination hesitancy related to four different types of belief, and if vaccinated whether they experienced side effects (none, mild, severe). Result(s): 660 patients from 12 European countries participated, of whom 497 had at least a first vaccination and also completed the VAX questions and side effects. Of these patients, those reporting severe side effects (5.7%) compared to those with mild (48.2%) or no side effects (43.8%) had significantly (p = 0.001, ANOVA) more mistrust of vaccine efficacy, more concerns about future effects and more concerns about profiteering but not significantly more preference for natural immunity (Fig 1). Conclusion(s): People with severe asthma who have negative beliefs about vaccination are more likely to report severe side effects to COVID-19 vaccination. Consistent with the nocebo effect, negative beliefs create negative expectations and side effects. (Figure Presented).

Impact assessment culture in the European Union. Time for something new?

Current approaches and cultures for the economic evaluations of environmental and health policies may suffer from excessive reliance on a standard neoclassic economic toolbox that neglects alternative perspectives. This may prematurely limit the spectrum of available policy options. Here we show how the inclusion of neglected currents of thought such as non-Ricardian economics, bioeconomics and a set of qualitative-quantitative methods from post-normal science leads to richer perspectives for a more inclusive uses of quantitative evidence, and opens the analysis to more possible futures. We also present some case studies in the energy, water, health and climate domains that highlight the point in a practical context for a more policy-oriented audience. We situate our analysis in the context of recent calls in the EU for the inclusion of more perspectives from the social sciences and the humanities in environmental assessment works.Copyright © 2023 The Authors

Humoral immune responses to COVID-19 vaccines are reduced in patients with severe asthma

Background: Patients with severe asthma (SA) may be at higher risk of severe COVID-19 (C-19) illness. C-19 vaccines aim to reduce number and severity of infections. Patients with SA are often treated with maintenance oral corticosteroids (mOCS) and/or biologics (mAb)- it is unknown if vaccines will generate the same protective responses in patients with SA on such therapies. Aim(s): To compare magnitude and range of post-vaccination (PV) antibody responses (IgG) in patients with SA on mAb, mOCS or high-dose inhaled corticosteroids (ICS) with healthy controls (HC) without asthma. Method(s): The Virtus finger-prick quantitative C-19 antibody test was used to detect IgG levels 16-24 weeks post second-dose of the C-19 vaccine (123 AstraZeneca, 56 Pfizer, 5 Moderna). IgG>0.2AU was considered positive with range: very high >1.25AU, high 0.751-1.25AU, medium 0.401-0.75AU and low 0.201-0.4AU. SA was defined as per ATS/ERS criteria. Result(s): PV IgG results were obtained from 127 patients with SA (84 mAb, 13 mOCS and 46 ICS) and 57 HC. After adjusting for age, significantly fewer people with SA compared to HC had a positive PV IgG result (81% vs 95% p=0.016). Lower median IgG levels were seen in patients on mOCS (0.40AU) compared to HC (1.24AU) (p=0.051). Patients on mAb had high or very high IgG levels (omalizumab n=25, 0.80AU;mepolizumab n=25, 1.07AU;benralizumab n=34, 1.11AU). Conclusion(s): Overall, a higher proportion of patients with SA had a negative PV IgG level after receiving 2 doses of a C-19 vaccine. This was mainly seen in patients on mOCS while mAb use was associated with high levels of humoral antibody response. These results reinforce the need for booster vaccines in SA, especially in those on mOCS.

Ad hoc government payments impact on non-real estate farm debt

Purpose: The authors examined the impact of the Market Facilitation Program (MFP) and Coronavirus Food Assistance Program (CFAP) payments to United States agricultural producers on non-real estate agricultural loans. Design/methodology/approach: The authors used quarterly, state-level commercial bank data from 2016–2020 to estimate dynamic panel models. Findings: The authors found MFP and CFAP payments not associated with the percentage of non-real estate agricultural loans with payments over 90 days late. However, these payments associated with the percentage of non-real estate agricultural loans with payments between 30 and 89 days late. The available data utilized cannot consider when producers received the actual payment and what they specifically did with those funds. Originality/value: The contribution of this study is for US policymakers and agricultural lenders. The findings could be helpful in designing and implementing future ad hoc payment programs and provide an understanding of potential shortcomings of the current safety net for agricultural producers in the Farm Bill. Additionally, findings can assist agricultural lenders in predicting the impact of ad hoc payments on their distressed loan portfolios. © 2022, Charles Martinez, Christopher N. Boyer, Tun-Hsiang Yu, S. Aaron Smith and Adam Rabinowitz.

Anxiety, stress, and depression in Australian pregnant women during the COVID-19 pandemic: A cross sectional study.

BACKGROUND: The COVID-19 pandemic necessitated rapid responses by health services to suppress transmission of the virus. AIM: This study aimed to investigate predictors of anxiety, stress and depression in Australian pregnant women during the COVID-19 pandemic including continuity of carer and the role of social support. METHODS: Women aged 18 years and over in their third trimester of pregnancy were invited to complete an online survey between July 2020 and January 2021. The survey included validated tools for anxiety, stress, and depression. Regression modelling was used to identify associations between a range of factors including continuity of carer, and mental health measures. FINDINGS: 1668 women completed the survey. One quarter screened positive for depression, 19% for moderate or higher range anxiety, and 15.5% for stress. The most significant contribution to higher anxiety, stress, and depression scores was a pre-existing mental health condition, followed by financial strain and a current complex pregnancy. Protective factors included age, social support, and parity. DISCUSSION: Maternity care strategies to reduce COVID-19 transmission restricted women's access to their customary pregnancy supports and increased their psychological morbidity. CONCLUSION: Factors associated with anxiety, stress and depression scores during the COVID-19 pandemic were identified. Maternity care during the pandemic compromised pregnant women's support systems.

Augmented Reality as a Digital Tool to Support All Learners in Inquiry-Based Learning Lessons

This article presents a conceptual understanding of how the powerful digital tool of augmented reality (AR) can be used for enhancing inquiry-based learning lessons (IBLLs). With an increased reliance on technology following the COVID-19 pan-demic, reduced teacher preparation time, and a need to provide students with alternative student-centered lessons, we provide a simplified understanding of the often-complex nature of IBLLs using experiential learning theory (ELT). Further, we highlight the immersive qualities within AR, pair AR with the simplified foundation, provide examples within the research, and offer further applications available to current practitioners. © Holder: Adam Carreon & Sean Smith.

A Privacy Paradox? Impact of Privacy Concerns on Willingness to Disclose COVID-19 Health Status in the United States

Privacy concerns around sharing personal health information are frequently cited as hindering COVID-19 contact tracing app adoption. We conducted a nationally representative survey of 304 adults in the United States to investigate their attitudes towards sharing two types of COVID-19 health status (COVID-19 Diagnosis, Exposure to COVID-19) with three different audiences (Anyone, Frequent Contacts, Occasional Contacts). Using the Internet User's Information Privacy Concern (IUIPC) scale, we were able to identify the effect of different types of privacy concerns on sharing this information with various audiences. We found that privacy concerns around data Collection predicted lower willingness to share either type of health status to all of these audiences. However, desire for Control and for Awareness of data practices increased willingness to share health information with certain audiences. We discuss the implications of our findings. © 2022 Owner/Author.

Ad hoc government payments impact on non-real estate farm debt

Purpose>The authors examined the impact of the Market Facilitation Program (MFP) and Coronavirus Food Assistance Program (CFAP) payments to United States agricultural producers on non-real estate agricultural loans.Design/methodology/approach>The authors used quarterly, state-level commercial bank data from 2016–2020 to estimate dynamic panel models.Findings>The authors found MFP and CFAP payments not associated with the percentage of non-real estate agricultural loans with payments over 90 days late. However, these payments associated with the percentage of non-real estate agricultural loans with payments between 30 and 89 days late. The available data utilized cannot consider when producers received the actual payment and what they specifically did with those funds.Originality/value>The contribution of this study is for US policymakers and agricultural lenders. The findings could be helpful in designing and implementing future ad hoc payment programs and provide an understanding of potential shortcomings of the current safety net for agricultural producers in the Farm Bill. Additionally, findings can assist agricultural lenders in predicting the impact of ad hoc payments on their distressed loan portfolios.

Where There Is No Paediatric Intensivist: Building Critical Care Capacity and Implementing a Pandemic Response Team in Guyana

BACKGROUND AND AIM: Building formal Paediatric Critical Care Medicine (PCCM)capacity provides a significant opportunity for meaningful impact on quality of life and mortality rates in Low Middle Income Countries (LMICs). In a global pandemic, it becomes even more essential to provide critical care to this vulnerable population.To meet the challenges of developing PCCM in Guyana, we utilized a student centered, Micro-Modular Fellowship (MMF) strategy which utilized standardised curricula (PFCCS, PALS, NRP, etc.), bespoke courses (Ventilation, POCUS, etc.), open source simulation, and teleconferenced lectures from PICUs around the world. Training the Trainer, Psychological Safety and High Yield Pedagogy, were key components in optimising both PCCM program sustainability and clinical outcomes in Guyana. METHOD(S): Didactics were immediately reinforced by student driven, case based simulations which often drew from grand rounds and were conducted in an environment in which psychological safety, continuous feedback dynamic process improvement, and High Performance Teamwork were constantly emphasized. RESULT(S): Our multidisciplinary team was able to build and sustain the first paediatric critical care unit in Guyana. Since 2018, over five hundred children have benefited from the establishment of this unit. In addition, our established strategy also resulted in rapid capacity building and mobilisation of a Paediatric COVID 19 response team to the 2020 pandemic surge in Guyana. CONCLUSION(S): Our High Yield Pedagogy approach optimised rapid knowledge acquisition and lasting translation into paediatric critical care medicine practiceacross multiple practice milieus in Guyana.It may provide a useful model for building sustainable PCCM capacity in other LMICs.