Comparing introductory undergraduate physics learning and behavior before and after the COVID-19 pandemic

This study examines high school preparation measures [ACT/SAT scores, high school grade point average (HSGPA), and conceptual physics pretest scores], in-class behavior measures (homework submission rates and lecture attendance rates), and in-class achievement measures (homework and test averages) for the last two fully face-to-face prepandemic and the first two fully face-to-face postpandemic semesters of an introductory calculus-based electricity and magnetism class. This class was offered at a large eastern land grant university in the United States. The total number of students for the four semesters was 1033. While some significant differences were measured (higher postpandemic HSGPA, lower postpandemic conceptual pretest scores, higher postpandemic homework average (fall semesters only), and lower postpandemic lecture attendance (spring semesters only), none were larger than a small effect. As such, student achievement, attendance rates, and assignment completion rates were largely unchanged after the pandemic.

Nirmatrelvir and Molnupiravir Coadministration Modifies Preclinical Viral Exposure

Background: Implementation of vaccination programmes has had a transformational impact on control of the SARS-CoV-2 pandemic, but the need for effective antiviral drugs remains. Molnupiravir (MPV) targets viral RNA polymerase inhibiting replication via lethal mutagenesis and nirmatrelvir (NTV) is a protease inhibitor boosted with ritonavir when given clinically. This study aimed to assess the virological efficacy of NTV and MPV individually and in combination against the SARS-CoV-2 BA.1 Omicron variant in a K18-hACE2 mouse model. Method(s): K18-hACE2 mice were inoculated intranasally with 103 PFU of SARSCoV-2 BA.1 Omicron (B.1.1.529). After 24 hours, mice were orally dosed q12H, as outlined in Figure 1. At 2, 3, and 4-days post infection mice were sacrificed, and lung samples harvested. Animals were weighed and monitored daily throughout. Subsequently, viral replication in the lung was quantified using qRT-PCR to measure total (N-gene) and sub-genomic (E-gene) viral RNA. Data were normalized to 18S for quantitation. Viral exposures expressed as Areas Under viral load Curves (AUCs) were calculated by the trapezoidal method using mean values at each timepoint. Separate studies in Syrian golden hamsters using individual drugs were also conducted, and total serum IgG was measured by ELISA at 4-days post infection. Result(s): Mice gained weight in all groups post-treatment, with no significant difference between groups. A reduction in lung viral exposure was evident in all treatment groups compared to the vehicle control dosed mice (Figure 1). Coadministration of NTV with MPV displayed a trend towards lower lung viral exposure compared to the vehicle control with ~40-and ~45-fold reduction in AUC for N-and SgE-gene assays, respectively. Dosed individually, NTV and MPV reduced viral exposure 5.7-and 7.7-fold for the N-gene assay, respectively. Differences in total serum IgG concentrations were evident between vehicle and NTV-(34-fold reduction, P=0.018), and MPV-(4.2-fold reduction, P=0.053) treated hamsters. Conclusion(s): These data show virological efficacy of NTV and MPV against the SARS-CoV-2 BA.1 Omicron variant. The combination of NTV and MPV demonstrated a lower viral RNA exposure in the lung than either drug alone, albeit not statistically significant. Initial data indicate potential immune alterations in NTV and MPV dosed hamsters. Studies to clarify the utility of NTV/ MPV combinations and further characterize the impact of antiviral therapy on IgG are warranted.

NAFAMOSTAT AS NASAL CHEMOPROPHYLAXIS FOR SARS-CoV-2 IN HAMSTERS

Background: Chemoprophylaxis is a critical tool for many infectious diseases, and in COVID-19 may have particular benefit for vulnerable patients that do not maximally benefit from vaccination. Nafamostat inhibits TMPRSS2, which catalyses a critical cell entry pathway for SARS-CoV-2. This study sought to assess efficacy of intranasal nafamostat against airborne transmission of SARSCoV-2 in Syrian Golden hamsters. Method(s): Male hamsters were intranasally administered water or 5 mg/kg nafamostat in water twice daily for 5 days (sentinels). One day after treatment initiation, sentinels were co-housed with an untreated hamster that was intranasally inoculated with 1 x 104 PFU of Wuhan SARS-CoV-2 (donor). Sentinels were separated from the donor by a perforated divider, allowing airflow between zones but not contact. Hamsters were weighed and throat-swabbed throughout. At day 4, all animals were culled, and lung and nasal turbinates were harvested. N-RNA was quantified relative to 18S-RNA by qPCR. A 2-way ANOVA with Bonferroni correction was applied to compare weight changes in the nafamostat group to those in controls. An unpaired t-test was used to compare viral RNA in lung and nasal turbinate between groups. Result(s): SARS-CoV-2 viral RNA was significantly lower in the nasal turbinates of nafamostat-treated hamsters compared to water-treated controls (P = 0.012;Figure 1). Within the lung, SARS-CoV-2 RNA was undetectable in the nafamostat-treated hamsters, but was detectable in the water-treated controls. Viral RNA was undetectable in the swabs of the nafamostat-treated hamsters at all timepoints, but was quantifiable in the water-treated control group from day 3. Body weight of the nafamostat-treated hamsters was significantly lower (P = < 0.001) than in the water-treated animals throughout. SARS-CoV-2 viral RNA was detectable in the donor hamsters lung, nasal turbinate and swab samples confirming validity of the experiment. Conclusion(s): This study demonstrated a protective effect of intranasal nafamostat against airborne SARS-CoV-2 transmission in Syrian golden hamsters. A phase IIa study of intravenously administered nafamostat yielded no evidence of clinical efficacy in hospitalised patients, but further investigation of intranasally administered nafamostat in a prophylactic setting may be warranted.

Detection of SARS-CoV-2 RNA in wastewater and comparison to COVID-19 cases in two sewersheds, North Carolina, USA

Wastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be useful for monitoring population-wide coronavirus disease 2019 (COVID-19) infections, especially given asymptomatic infections and limitations in diagnostic testing. We aimed to detect SARS-CoV-2 RNA in wastewater and compare viral concentrations to COVID-19 case numbers in the respective counties and sewersheds. Influent 24-hour composite wastewater samples were collected from July to December 2020 from two municipal wastewater treatment plants serving different population sizes in Orange and Chatham Counties in North Carolina. After a concentration step via HA filtration, SARS-CoV-2 RNA was detected and quantified by reverse transcription droplet digital polymerise chain reaction (RT-ddPCR) and quantitative PCR (RT-qPCR), targeting the N1 and N2 nucleocapsid genes. SARS-CoV-2 RNA was detected by RT-ddPCR in 100 % (24/24) and 79 % (19/24) of influent wastewater samples from the larger and smaller plants, respectively. In comparison, viral RNA was detected by RT-qPCR in 41.7 % (10/24) and 8.3 % (2/24) of samples from the larger and smaller plants, respectively. Positivity rates and method agreement further increased for the RT-qPCR assay when samples with positive signals below the limit of detection were counted as positive. The wastewater data from the larger plant generally correlated (square similar to 0.5, p < 0.05) with, and even anticipated, the trends in reported COVID-19 cases, with a notable spike in measured viral RNA preceding a spike in cases when students returned to a college campus in the Orange County sewershed. Correlations were generally higher when using estimates of sewershed-level case data rather than county-level data. This work supports use of wastewater surveillance for tracking COVID-19 disease trends, especially in identifying spikes in cases. Wastewater-based epidemiology can be a valuable resource for tracking disease trends, allocating resources, and evaluating policy in the fight against current and future pandemics.

Science, Medicine, and Cytology: A Pilot Program of the ASC Diversity Equity and Inclusion (DEI) Committee

Introduction: The percentage of pathology trainees who are underrepresented minorities is low. The DEI committee established a Science, Medicine, and Cytology summer pilot program to improve exposure to cytopathology focusing on DEI. Material(s) and Method(s): An online course was developed during the Covid-19 pandemic targeting underrepresented minorities at the high school and college level, and consisted of several didactic sessions, presenting the most common procedures involving cytologists, including fine-needle aspiration, rapid onsite evaluation, and smearing techniques. Interviews of cytopathologists were also included. Participants were surveyed for their demographic information and for an evaluation of the course. Result(s): 23 participants completed the survey (Table 1). The highest level of education was high school 16 (70%), college 6 (26%), and other 1 (4%). Self-identified demographics included 2 (9%) Hispanic, 9 (36%) Asian/Asian American, 2 (8%) Black / Black American, 6 (24%) White/Caucasian, 2 (8%) African, 1 (4%) Muslim American and 1 (4%) Sudanese. Household highest level of education was high school 2 (9%), some college 1 (4%), completed college 9 (39%), completed graduate program 9 (39%), 2 (9%) preferred not to answer. 14 (61%) participants have a family member in healthcare. The program met expectations for 20 (87%). The program format was effective and appropriate for their level of education for 23 (100%). The content helpful for 22 (96%). 13 (57%) considered healthcare as a potential career. 5 (22%) considered cytology as a career (Table 2). Conclusion(s): Evaluations were excellent, generating awareness of medicine and cytopathology. Individuals with families in healthcare were overrepresented, as there were barriers in reaching underrepresented minorities. The population that signed up was influenced by our ability offer the course online. Expansion to a wider audience would increase the number of attendees. (Table Presented).

FXR INHIBITION AS A NEW STRATEGY AGAINST COVID19 T Brevini1, M Maes2, GJ Webb3, CD Fuchs4, G Buescher5

Introduction: Vaccines revolutionised the management of COVID19. Nevertheless, they lack efficacy in high-risk or vulnerable groups (e.g., immunosuppressed patients), who may not mount an appropriate immune response. Monoclonal antibodies represent the gold-standard agents for such cases;but they are limited by availability, need for parenteral administration and the risk for viral escape because of spike protein mutations. Therefore, there is a pressing need for new prophylactic agents less prone to resistance.The viral receptor ACE2 represents an ideal target as it is essential for viral entry and transmission and because being a host protein it is not affected by viral mutations. However, the regulation of ACE2 remains elusive, due to the lack of appropriatein vitromodels. Cholangiocytes show one of the highest ACE2 expression levels in the body, representing an ideal platform for these studies. Here, we use cholangiocyte organoids as proof-of-principleto identify that the bile acid receptor FXR regulates ACE2 expression and SARS-CoV-2 infectionin vitro. We validate these findings in lung and gut organoids, animal models, human organs perfusedex situand patient cohorts. Aims & Methods: 1. Identify pathways controlling the transcriptional regulation of ACE2 2. Identify drugs modulating these pathways as novel prophylactic and therapeutic agents for COVID19. Organoids were propagated using established protocols. Marker expression was assessed using single-cell RNA sequencing, QPCR, and immunofluorescence. FXR binding on DNA was assessed with chromatin immunoprecipitation. SARS-CoV-2 was isolated from bronchoalveolar lavage of a COVID19 patient. Syrian golden hamsters were infected via direct inoculation and QPCR on oral swab, nasal turbinate and lung samples was used to measure SARS-CoV-2 infection. Human livers and lungs not used for transplantation were perfusedex-situusing normothermic perfusion. Nasopharyngeal swabs were used to measure ACE2 expression in nasal epithelial cells of healthy individuals taking UDCA at the standard therapeutic dose of 15 mg/kg/day. Patient registry data were compared using propensity score matching for sex, age, diabetes, NAFLD and Child- Turcotte-Pugh score. Result(s): We identified that FXR directly regulates ACE2 transcription in cholangiocyte organoids, while FXR inhibition with the approved drug ursodeoxycholic acid (UDCA), reduced ACE2 expression and SARS-CoV-2 infectionin vitro. We confirmed this mechanism in organoids from other COVID19-affected tissues, including the respiratory and intestinal systems. We validated our findingsin vivoin Syrian golden hamsters, showing that treatment with UDCA downregulates ACE2 and prevents SARS-CoV-2 infection. We confirmed that UDCA reduces ACE2 and SARS-CoV-2 infection in human lungs and livers perfusedex-situ. We performed a clinical study demonstrating that UDCA lowers ACE2 levels in the nasal epithelium of 6 healthy volunteers. Finally, we identified a correlation between UDCA and better clinical outcomes (hospitalisation, ICU admission and death) in COVID19 patients receiving UDCA for cholestatic diseases using the COVID-Hep and SECURELiver registry data. Conclusion(s): We identified FXR as a novel regulator of ACE2 expression. Using a bench-to-bedside approach combining in vitroand in vivomodels, exsituperfused human organs and clinical data we showed that FXR inhibition prevents or reduces SARS-CoV-2 infection and identified UDCA as an approved, cost-effective drug which could be repurposed for COVID19, paving the road for future clinical trials.

Improving cystic fibrosis-related diabetes annual screening in adults with cystic fibrosis

Background: Cystic fibrosis (CF)-related diabetes (CFRD) is associated with decline in lung function and nutritional status. Cystic Fibrosis Foundation (CFF) guidelines recommend annual CFRD screening in patients starting at age 10. A review of our adult program data showed a decline in screening during 2020. We identified barriers, in addition to the COVID pandemic, that contributed to a decline in adherence. In July 2020, our clinic moved to a new location and began offering morning visits. After a quality improvement review, we began offering annual oral glucose tolerance testing (OGTT) within a routine clinic visit along with annual routine labs. Our objective was to use this multidisciplinary approach to increase OGTT screening to 50% within the first year of moving to our new location. Method(s): The CFF Patient Registry was used to compile a list of our nondiabetic patients overdue for annual OGTT. The list was reviewed during our multidisciplinary preclinic conference to identify patients who needed testing. Each patient was re-educated during clinic, and barriers to testing identified through patient interview and questionnaires. Common barriers to testing adherencewere length of testing time, time missed from work, COVID concerns, and needle phobia. The nurse and nurse coordinators made follow-up appointments, incorporating OGTT into next clinic appointment to increase adherence. Patients received phone call reminders for these appointments and the fasting criteria for testing. Result(s): CFF Registry Report data showed a decline in OGTT screening from 26% in 2019 to 21% in 2020.We identified 76 eligible patients who needed OGTT in 2021. Patient interviews were conducted during clinic visits and barriers identified. We offered routine clinic appointments in conjunction with lab appointments to increase screening adherence. We were able to capture seven patients in the first 6 months and 14 in the second 6 months, increasing our OGTT screening rate to 28%. Conclusion(s): Using a multimodal approach in a multidisciplinary team,we increased our OGTT annual screening rate by 7 percentage points. The ability to incorporate recommended screening into routine clinic visits supported adherence and patient satisfaction. Limitations to OGTT screening include continued COVID concerns and transportation to clinic.We plan to continue this quality improvement approach to increase adherence to 50% within this next year by continued consolidation of lab work and OGTT with visits and assisting patients with scheduling lab appointments and transportation to the clinic Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

The Conundrum of How Pornography Impacts Public Health

001.0001 Online ISBN: 9780190075507 Print ISBN: 9780190075477 Ptomography and Public Health is a scholarly work by Emily Rothman, ScD, professor of community health sciences, Boston University School of Public Health that explores the relationship between pornography and a range of public health issues including interpersonal violence and aggression, healthy sexuality, and body image, among other topics. While these proclamations do not have much direct impact, in a post-COVID-19 and post-Roe v. Wade world, the role of state and federal government in limiting or expanding public health powers should put the public health community on high alert. Several US Supreme Court decisions in this area between 1957 and 2002 allowed for widespread dissemination of sexual material in part because various legal "tests" to define obscenity were so subjective.

A novel PA-led urgent care model for medical oncology patients at a large academic cancer center

Background: Oncology patients are high users of the emergency department (ED), which often results in hospital admissions for management of cancer symptoms or cancer treatment toxicities. Interventions such as urgent care (UC) models can decrease such visits, and help improve patient management, health care utilization, and patient experience. Sunnybrook Health Sciences Centre, a large tertiary care hospital in Toronto, Canada has a high volume of medical oncology ED visits (average 4 per day) with about 50% admitted for management. Method(s): A novel physician-assistant (PA) led and physician supervised UC model was developed to assist in medical oncology patient phone triage, assessment, and management of cancer or treatment related issues that would otherwise have been sent to the ED by the oncology team. There were two phases: 1) due to COVID, the patients were managed in a dedicated stream primarily using space and nursing in the ED, 2) a dedicated UC clinic with nursing support was opened for these patients. Result(s): In phase 1, there were 424 referrals over 24 months;84% would have otherwise been sent through the usual ED process. 26% of patients were managed with PA navigation outside the UC program in other hospital settings. Of the 204 patients formally treated in the UC stream, 67.7% were discharged home. At 48 hours, 89% of discharged patients were stable or improved;this was 80% at 14 days, and 17.3% came back to the ED or were admitted within 14 days of the UC visit. In phase 2, there have so far been 214 referrals over 5 months;83.6% would have otherwise been sent to the ED. Of the patients who were assessed, 77.9% were discharged home. Outcomes of these patients are being collected. The top 3 patient issues managed during both phases were: fever, pain, and dyspnea. Fifteen patient telephone surveys were completed, and 93.3% were either satisfied or highly satisfied with their UC experience. Conclusion(s): A novel PAled triage and management model for urgent medical oncology patient issues was found in initial phase to be feasible and effective with streamlined care through the ED. Once a dedicated UC clinic was opened, referral volumes increased, and a high rate of ED diversion, patient discharge, and effective care was continued. Patients were also highly satisfied. Several ongoing process and outcome measures are being evaluated to help expand the scope and impact of this resource.

Science, Medicine, and Cytology: A Pilot Program of the ASC Diversity Equity and Inclusion (DEI) Committee

Introduction: The percentage of pathology trainees who are underrepresented minorities is low. The DEI committee established a "Science, Medicine, and Cytology" summer pilot program to improve exposure to cytopathology focusing on DEI. Material(s) and Method(s): An online course was developed during the Covid-19 pandemic targeting underrepresented minorities at the high school and college level, and consisted of several didactic sessions, presenting the most common procedures involving cytologists, including fine-needle aspiration, rapid onsite evaluation, and smearing techniques. Interviews of cytopathologists were also included. Participants were surveyed for their demographic information and for an evaluation of the course. Result(s): 23 participants completed the survey (Table 1). The highest level of education was high school 16 (70%), college 6 (26%), and other 1 (4%). Self-identified demographics included 2 (9%) Hispanic, 9 (36%) Asian/Asian American, 2 (8%) Black /Black American, 6 (24%) White/Caucasian, 2 (8%) African, 1 (4%) Muslim American and 1 (4%) Sudanese. Household highest level of education was high school 2 (9%), some college 1 (4%), completed college 9 (39%), completed graduate program 9 (39%), 2 (9%) preferred not to answer. 14 (61%) participants have a family member in healthcare. The program met expectations for 20 (87%). The program format was effective and appropriate for their level of education for 23 (100%). The content helpful for 22 (96%). 13 (57%) considered healthcare as a potential career. 5 (22%) considered cytology as a career (Table 2). Conclusion(s): Evaluations were excellent, generating awareness of medicine and cytopathology. Individuals with families in healthcare were overrepresented, as there were barriers in reaching underrepresented minorities. The population that signed up was influenced by our ability offer the course online. Expansion to a wider audience would increase the number of attendees. [Formula presented] [Formula presented] [Formula presented] Copyright © 2022

PEG placements during the COVID-19 pandemic An audit of the procedures performed by a single consultant operator at a tertiary teaching hospital

PEG feeding provides a valuable nutritional access for patients with a functional gastrointestinal tract. The aim of this project was to audit all the PEG procedures performed by a single consultant operator during the Covid-19 pandemic including the indications, outcomes and complications. All the procedure reports were accessed to identify the patients, indications and immediate outcomes. For every patient, all the letters from all specialties were accessed for the dates following the procedure through the clinical records platforms to identify any later complications. A total of 92 procedures were performed between 15/3/2020 and 31/4/2021 in a total of 84 patients. Lists were operating at less than half capacity compared to pre Covid-19. 65 were planned PEG insertions, 17 were planned removals, and 10 were planned replacements. 5 of the procedures were for PEG-J insertion or replacement. The main indication was Head and Neck Ca in 59/92 procedures followed by CVA 9/92, chronic nausea/vomiting/gastroparesis in 6/92, dysphagia with or without aspiration risk in 4/92, MND in 4/92, CNS tumour post-op (pineal gland) in 2/92, cerebral palsy in 1/92, multiple sclerosis in 1/92, neurodegenerative disorder in 1/92, neuromuscular disorder in 1/92, chronic pancreatitis in 1/92, cystic fibrosis in 1/92, depression with poor oral intake in 1/92 and learning difficulties in 1/92. 83/92 procedures were completed successfully. 2 procedures had a failed intubation, 1 because of a subglottal stricture. The rest of the abandoned procedures were due to patient distress (2/92), high oesophageal stricture (1/92), failed cannulation (1/92), body habitus (1/92), stomach not translluminated and patient desaturation (1/92). One of the planned replacements failed because of a buried bumper. In two patients there was a small leak around the PEG site, 1 identified in the endoscopy room, 1 a few weeks later but both were managed conservatively and the PEG was kept in place. No other complications identified. From October 2020 the consistent use of Corflo PEGs reduced the service demands as these can be easily removed in the community. Lists during the COVID-19 pandemic were significantly impacted, especially UGI procedures, as these are aerosol generating procedures. The vast majority of the procedures are completed successfully and there are no significant complications. Most failed procedures are due to patient related factors such as tolerance and anatomical factors. The use of PEGs that can be removed in the community avoiding further endoscopic procedures is a valuable tool especially in this pandemic and early post-pandemic setting.

Association Between the COVID-19 Pandemic and Insurance-Based Disparities in Mortality After Major Surgery Among US Adults.

Importance: The COVID-19 pandemic caused significant disruptions in surgical care. Whether these disruptions disproportionately impacted economically disadvantaged individuals is unknown. Objective: To evaluate the association between the COVID-19 pandemic and mortality after major surgery among patients with Medicaid insurance or without insurance compared with patients with commercial insurance. Design, Setting, and Participants: This cross-sectional study used data from the Vizient Clinical Database for patients who underwent major surgery at hospitals in the US between January 1, 2018, and May 31, 2020. Exposures: The hospital proportion of patients with COVID-19 during the first wave of COVID-19 cases between March 1 and May 31, 2020, stratified as low (≤5.0%), medium (5.1%-10.0%), high (10.1%-25.0%), and very high (>25.0%). Main Outcomes and Measures: The main outcome was inpatient mortality. The association between mortality after surgery and payer status as a function of the proportion of hospitalized patients with COVID-19 was evaluated with a quasi-experimental triple-difference approach using logistic regression. Results: Among 2 950 147 adults undergoing inpatient surgery (1 550 752 female [52.6%]) at 677 hospitals, the primary payer was Medicare (1 427 791 [48.4%]), followed by commercial insurance (1 000 068 [33.9%]), Medicaid (321 600 [10.9%]), other payer (140 959 [4.8%]), and no insurance (59 729 [2.0%]). Mortality rates increased more for patients undergoing surgery during the first wave of the pandemic in hospitals with a high COVID-19 burden (adjusted odds ratio [AOR], 1.13; 95% CI, 1.03-1.24; P = .01) and a very high COVID-19 burden (AOR, 1.38; 95% CI, 1.24-1.53; P < .001) compared with patients in hospitals with a low COVID-19 burden. Overall, patients with Medicaid had 29% higher odds of death (AOR, 1.29; 95% CI, 1.22-1.36; P < .001) and patients without insurance had 75% higher odds of death (AOR, 1.75; 95% CI, 1.55-1.98; P < .001) compared with patients with commercial insurance. However, mortality rates for surgical patients with Medicaid insurance (AOR, 1.03; 95% CI, 0.82-1.30; P = .79) or without insurance (AOR, 0.85; 95% CI, 0.47-1.54; P = .60) did not increase more than for patients with commercial insurance in hospitals with a high COVID-19 burden compared with hospitals with a low COVID-19 burden. These findings were similar in hospitals with very high COVID-19 burdens. Conclusions and Relevance: In this cross-sectional study, the first wave of the COVID-19 pandemic was associated with a higher risk of mortality after surgery in hospitals with more than 25.0% of patients with COVID-19. However, the pandemic was not associated with greater increases in mortality among patients with no insurance or patients with Medicaid compared with patients with commercial insurance in hospitals with a very high COVID-19 burden.

Community, Risk Assessment, Prevention and Control: Black American College Student's Information Seeking on COVID-19.

BACKGROUND: Despite the disproportionate impact of the novel coronavirus on Black Americans, there is little research that centres Black college students' information behaviours during the pandemic. OBJECTIVE: The objective of this study is to identify information needs, resources and use regarding the novel coronavirus pandemic among Black American college students. METHODS: This is a quantitative study among 389 college students in the USA. Data were collected using an online crowdsourced survey instrument. Descriptive and inferential statistics were used to analyse data through SPSS. RESULTS: The most salient information needs related to Covid-19 symptoms, personal protective equipment, vulnerable populations, and risk assessment; however, students also wanted information on Covid-19's impact on the Black community. There were no statistically significant gender differences in students' information seeking, resources or use with one exception; male students believed the internet alone could provide all relevant information about the coronavirus in comparison to female students. Barriers related to the volume of information, information fluidity and determining the quality of information. CONCLUSION: Colleges and universities can play a critical role in information dissemination during crisis events. Students need critical information literacy skills that intersect with everyday information needs, particularly health literacy.

Association Between the COVID-19 Pandemic and Disparities in Access to Major Surgery in the US.

Importance: Racial minority groups account for 70% of excess deaths not related to COVID-19. Understanding the association of the Centers for Medicare & Medicaid Services' (CMS's) moratorium delaying nonessential operations with racial disparities will help shape future pandemic responses. Objective: To evaluate the association of the CMS's moratorium on elective operations during the first wave of the COVID-19 pandemic among Black individuals, Asian individuals, and individuals of other races compared with White individuals. Design, Setting, and Participants: This cross-sectional study assessed a 719-hospital retrospective cohort of 3 470 905 adult inpatient hospitalizations for major surgery between January 1, 2018, and October 31, 2020. Exposure: The first wave of COVID-19 infections between March 1, 2020, and May 31, 2020. Main Outcomes and Measures: The main outcome was the association between changes in monthly elective surgical case volumes and the first wave of COVID-19 infections as a function of patient race, evaluated using negative binomial regression analysis. Results: Among 3 470 905 adults (1 823 816 female [52.5%]) with inpatient hospitalizations for major surgery, 70 752 (2.0%) were Asian, 453 428 (13.1%) were Black, 2 696 929 (77.7%) were White, and 249 796 (7.2%) were individuals of other races. The number of monthly elective cases during the first wave was 49% (incident rate ratio [IRR], 0.49; 95% CI, 0.486-0.492; P < .001) compared with the baseline period. The relative reduction in unadjusted elective surgery cases for Black (unadjusted IRR, 0.99; 95% CI, 0.97-1.01; P = .36), Asian (unadjusted IRR, 1.08; 95% CI, 1.03-1.14; P = .001), and other race individuals (unadjusted IRR, 0.97; 95% CI, 0.95-1.00; P = .05) during the surge period compared with the baseline period was very close to the change in cases for White individuals. After adjustment for age, sex, comorbidities, and surgical procedure, there was still no evidence that the first wave of the pandemic was associated with disparities in access to elective surgery. Conclusions and Relevance: In this cross-sectional study, the CMS's moratorium on nonessential operations was associated with a 51% reduction in elective operations. It was not associated with greater reductions in operations for racial minority individuals than for White individuals. This evidence suggests that the early response to the pandemic did not increase disparities in access to surgical care.

Perceived Risk, Optimistic Bias, and United Action: A socio-ecological examination of COVID-19 prevention behaviors among sexual minority men.

Sexual minority men (SMM) disproportionately experience psychosocial risk factors and comorbid health concerns (e.g., HIV infection) that increase their vulnerability to COVID-19 infection and distress. The current study applied a socioecological approach to the Health Belief model to understand associations among perceived risk, optimistic bias (a perceived lower risk relative to similar others), united action (perceived community capacity for collective action) and COVID-19 behavioral prevention strategies among COVID-19-negative adult cisgender SMM. Participants (n = 859), recruited via a geo-location-based dating app in May 2020, completed an online survey. Results indicated significant interactions between perceived risk and optimistic bias on social distancing (B = -.03, p < .05), and between perceived risk and united action on number of preventive precautions (B = -.01, p < .01) and number of casual sex partners (B= -.20, p < .05). At low and average levels of perceived risk, socioecological constructs were positively associated with behavioral prevention strategies. At average levels of perceived risk and above, united action was negatively associated with number of casual sex partners, demonstrating evidence of the interaction between perception of interpersonal and community factors and perceptions of one's own risk. These findings may help to inform how to mobilize increased engagement in COVID-19 behavioral prevention strategies among cisgender SMM.

Building Resilience and Attachment in Vulnerable Adolescents (BRAVA): Piloting a Virtual Adaptation of a Brief Group Intervention for Adolescents With Mild-to-Moderate Suicidal Ideation and Their Caregivers

Objectives: Suicidal ideation (SI) is common in adolescents and increases the risk of completed suicide. Due to the COVID-19 pandemic, healthcare providers rapidly shifted to providing telehealth and virtual options for clients. Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a group intervention designed for adolescents and their caregivers to reduce adolescent SI. The objective of this study was to adapt BRAVA for virtual delivery and evaluate the feasibility of this adaptation. Methods: We conducted an 8-week open trial between October and December 2020. Twelve participants (6 adolescents and 6 primary caregivers) were recruited from a pediatric hospital in Eastern Ontario. Through Zoom, adolescents and caregivers completed an intake assessment together, 6 weekly BRAVA group sessions separately, and an exit assessment together 1-week post-BRAVA. The primary adolescent outcome variable was the Suicidal Ideation Questionnaire Junior (SIQ-JR). Data were analyzed in IBM SPSS v.27. Pre-post comparisons on the SIQ-JR were done with a 2-tailed t test for matched pairs. Results: The study uptake rate was 42.9% of the eligible participants. There were no study dropouts. Adolescent (Mean [M] age = 15.3 years;SD age = 1.0;66.7% female) and caregiver attendance rates for BRAVA group sessions were high (median = 6). Overall group satisfaction scores were high for adolescents (M = 4.2;SD = 0.8) and their caregivers (M = 4.2;SD = 0.7). Most youth (83.4%) and caregivers (66.7%) reported that the virtual process worked well. Whereas all caregivers (100%) agreed they would participate in a virtual group session again, youth responses were more variable (50% agree, 33.3% neutral, 16.7% disagree). Adolescent SI decreased after completing the intervention (M pretreatment [tx] = 50.7, SD pretreatment [tx] = 16.7;M post-tx = 29.7, SD post-tx = 20.4;t = 5.7;95% CI, 11.52-30.5;p = 0.002). Conclusions: Study results indicate that the virtual delivery of BRAVA is feasible. Study uptake was good, retention was complete, and satisfaction was high for adolescents and their caregivers. Importantly, initial results suggest that this adaptation of BRAVA may help reduce SI in adolescents. Feedback from participants will inform further changes to improve the adaptation of BRAVA for use in a planned RCT. S, ADOL, FT