On the Margins: Exploring Minority News Media Representations of Women during the COVID-19 Pandemic

The COVID-19 pandemic has had a disproportionately negative affect on women, especially women from minoritized groups. Minority news media are an important information source for these groups, when it comes to providing alternative views, and health related information. Whilst the poor representation of women in COVID-19 related mainstream news coverage is acknowledged, little is known regarding the representation of women in digital minority news content, during the pandemic and beyond. Considering this gap, we examine how women have been represented within a diverse corpus of minority news, and explore how these representations serve to bridge between different social groups. Critically analyzing the representation of these marginalized groups offers a lens through which we can better understand the function of minority news media in a democracy. Using critical discourse analysis, this study examines three online minority newspapers and one podcast from the US. Findings show that women are covered in an inclusive and empowering way, containing perspectives and concerns unique to the minority group, strengthening identities, platforming community-specific issues, communicating a call to action, and promoting intersectional solidarity. These representations also reveal the complex tensions between counterhegemonic and dominant publics which minority news media sources constantly negotiate through their content.

Achieving results in challenging times: how hardwired improvement practices increased student performance post-COVID

Student learning loss during the Covid-19 Pandemic became an issue nationally. When school systems were thrown into hybrid and virtual learning environments, some schools still saw success due to their culture and hard-wired improvement practices. This article will illustrate how those practices at one particular school led to an actual improvement in learning during the pandemic.

Shoulder Injury Related to Vaccine Administration.

Background: Shoulder injury related to vaccine administration (SIRVA) is a recognized complication and possible source of morbidity associated with incorrectly administered intramuscular deltoid vaccinations. As this site is commonly used for intramuscular injection, both clinicians and vaccine administrators should be familiar with SIRVA to minimize risk and monitor for its clinical presentation. Case Report: A 49-year-old male presented with shoulder pain that began 1 day after intramuscular administration of an influenza vaccine and point tenderness near the site of injection. Magnetic resonance imaging of the shoulder demonstrated focal osseous edema in the humeral head related to suboptimal needle placement. Conclusion: Based on the combination of history, physical examination findings, and imaging findings, the diagnosis of SIRVA was made with confidence in this clinical scenario.

A Public Health Laboratory Information System in Support of Health Emergencies: The Nebraska Public Health Laboratory COVID-19 Experience.

OBJECTIVES: Public health laboratories (PHLs) are essential components of US Public Health Service operations. The health information technology that supports PHLs is central to effective and efficient laboratory operations and overall public health response to infectious disease management. This analysis presents key information on how the Nebraska Public Health Laboratory (NPHL) information technology system evolved to meet the demands of the COVID-19 pandemic. MATERIALS AND METHODS: COVID-19 presented numerous, unforeseen information technology system challenges. The most notable challenges requiring changes to NPHL software systems and capability were improving efficiency of the laboratory operation due to high-volume testing, responding daily to demands for timely data for analysis by partner systems, interfacing with multiple testing (equipment) platforms, and supporting community-based specimen collection programs. RESULTS: Improvements to the NPHL information technology system enabled NPHL to perform >121 000 SARS-CoV-2 polymerase chain reaction tests from March 2020 through January 2022 at a sustainable rate of 2000 SARS-CoV-2 tests per day, with no increase in laboratory staffing. Electronic reporting of 62 000 rapid antigen tests eliminated paper reporting and extended testing services throughout the state. Collection of COVID-19 symptom data before specimen collection enabled NPHL to make data-driven decisions to perform pool testing and conserve testing kits when supplies were low. PRACTICE IMPLICATIONS: NPHL information technology applications proved essential for managing health care provider workload, prioritizing the use of scarce testing supplies, and managing Nebraska's overall pandemic response. The NPHL experience provides useful examples of a highly capable information technology system and suggests areas for additional attention in the PHL environment, including a focus on end users, collaboration with various partners, and investment in information technology.

Innate Immune Training with Bacterial Extracts Enhances Lung Macrophage Recruitment to Protect from Betacoronavirus Infection.

Training of the innate immune system with orally ingested bacterial extracts was demonstrated to have beneficial effects on infection clearance and disease outcome. The aim of our study was to identify cellular and molecular processes responsible for these immunological benefits. We used a murine coronavirus (MCoV) A59 mouse model treated with the immune activating bacterial extract Broncho-Vaxom (BV) OM-85. Tissue samples were analysed with qPCR, RNA sequencing, histology, and flow cytometry. After BV OM-85 treatment, interstitial macrophages accumulated in lung tissue leading to a faster response of type I interferon (IFN) signalling after MCoV infection resulting in overall lung tissue protection. Moreover, RNA sequencing showed that lung tissue from mice receiving BV OM-85 resembled an intermediate stage between healthy and viral infected lung tissue at day 4, indicating a faster return to normal tissue homoeostasis. The pharmacologic effect was mimicked by adoptively transferring naive lung macrophages into lungs from recipient mice before virus infection. The beneficial effect of BV OM-85 was abolished when inhibiting initial type I IFN signalling. Overall, our data suggest that BV OM-85 enhances lung macrophages allowing for a faster IFN response towards a viral challenge as part of the oral-induced innate immune system training.

Travel Times to Facilities Offering Oral Medication Therapy for COVID-19.

This quality improvement study evaluates access to oral COVID-19 therapeutics within communities in the 48 contiguous states and the District of Columbia.

Prevalence of Chronic Diseases, Depression, and Stress Among US Childcare Professionals During the COVID-19 Pandemic.

INTRODUCTION: Given their central role in supporting children's development, childcare professionals' overall physical and mental health is important. We evaluated the prevalence of chronic diseases, depression, and stress levels during the COVID-19 pandemic among US childcare professionals. METHODS: Data were obtained from US childcare professionals (N = 81,682) through an online survey from May 22, 2020, through June 8, 2020. We used multivariable logistic and linear regression models to assess the association of sociodemographic characteristics with 4 physical health conditions (asthma, heart disease, diabetes, and obesity), depression, and stress weighted to national representativeness. RESULTS: For physical health conditions, 14.3% (n = 11,717) reported moderate to severe asthma, 6.5% (n = 5,317) diabetes, 4.9% (n = 3,971) heart disease, and 19.8% (n = 16,207) obesity. For mental health, 45.7% (n = 37,376) screened positive for depression and 66.5% (n = 54,381) reported moderate to high stress levels. Race, ethnicity, and sex/gender disparities were found for physical health conditions but not mental health of childcare professionals during the COVID-19 pandemic. CONCLUSION: Our findings highlighted that childcare professionals' depression rates during the pandemic were higher than before the pandemic, and depression, stress, and asthma rates were higher than rates among US adults overall during the pandemic. Given the essential work childcare professionals provided during the pandemic, policy makers and public health officials should consider what can be done to support their physical and mental health.

Navigating the digital divide: providing services to people with serious mental illness in a community setting during COVID-19

Community mental healthcare around the world has been strained as people need more help and experience more barriers to access due to COVID-19. The rapid shift to telehealth services necessitated by the pandemic has made these difficulties even more pronounced. While this transition presented challenges for nearly every healthcare system, it has proven especially difficult for low resource settings such as community health centers. This article is a critical observational study of the care transformation of a state-funded safety net psychiatric system responding to the clinical needs of patients during the COVID-19 pandemic. By discussing the challenges, opportunities, and creative solutions for staff and patients, the article highlights the new importance of technology and adaptability in clinical care and outlines clear recommendations to ensure vulnerable populations do not fall into the “digital divide.”

Relationship between the use of nonpharmaceutical interventions and COVID-19 vaccination among U.S. child care providers: A prospective cohort study.

BACKGROUND: The relationship between the use of nonpharmaceutical interventions and COVID-19 vaccination among U.S. child care providers remains unknown. If unvaccinated child care providers are also less likely to employ nonpharmaceutical interventions, then a vaccine mandate across child care programs may have larger health and safety benefits. METHODS: To assess and quantify the relationship between the use of nonpharmaceutical interventions and COVID-19 vaccination among U.S. child care providers, we conducted a prospective cohort study of child care providers (N = 20,013) from all 50 states, the District of Columbia, and Puerto Rico. Child care providers were asked to complete a self-administered email survey in May-June 2020 assessing the use of nonpharmaceutical interventions (predictors) and a follow-up survey in May-June 2021 assessing COVID-19 vaccination (outcome). Nonpharmaceutical interventions were dichotomized as personal mitigation measures (e.g., masking, social distancing, handwashing) and classroom mitigation measures (e.g., temperature checks of staff/children, symptom screening for staff/children, cohorting). RESULTS: For each unendorsed personal mitigation measure during 2020, the likelihood of vaccination in 2021 decreased by 7% (Risk Ratio = 0.93 [95% CI 0.93 - 0.95]). No significant association was found between classroom mitigation measures and child care provider vaccination (Risk Ratio = 1.01 [95% CI 1.00-1.01]). CONCLUSIONS: Child care providers who used fewer personal mitigation measures were also less likely to get vaccinated for COVID-19 as an alternative form of protection. The combined nonadherence to multiple types of preventative health behaviors, that is, both nonpharmaceutical interventions and vaccination, among some child care providers may support a role for mandatory vaccination to achieve pandemic control.

Prevalence of Chronic Diseases, Depression, and Stress among U.S. Child Care Professionals during the COVID-19 Pandemic (preprint)

Importance: There is no published national research reporting child care professionals' physical health, depression, or stress during the COVID-19 pandemic. Given their central role in supporting children's development, child care professionals' overall physical and mental health is important. Objectives: To evaluate the prevalence of chronic diseases, depression, and stress levels during the COVID-19 pandemic among U.S. child care professionals. Design: In this large-scale national survey, data were collected through an online survey from May 22, 2020 to June 8, 2020. We analyzed the association of sociodemographic characteristics with four physical health conditions (asthma, heart disease, diabetes, and obesity), depression, and stress weighted to national representativeness. Sociodemographic characteristics included race, ethnicity, age, gender, medical insurance status, and child care type. Setting: Center- and home-based child care. Participants: Child care professionals (n = 81,682) from all U.S. states and the District of Columbia. Results: Mean age was 42.1 years (standard deviation = 14.1); 96.0% (n = 78,725) were female, 2.5% (n = 2,033) were male, and 0.3% (n = 225) were non-binary. For physical health conditions, 14.3% (n = 11,717) reported moderate to severe asthma, 6.5% (n = 5,317) diabetes, 4.9% (n = 3,971) heart disease, and 19.8% (n = 16,207) being obese. Regarding mental health, 45.7% (n = 37,376) screened positive for depression and 66.5% (n = 54,381) reported moderate to high stress levels. Race, ethnicity, and gender disparities were evidenced for physical health conditions of child care professionals, but not for mental health during the pandemic. Conclusions and Relevance: Our findings highlight that child care professionals' depression rates during the pandemic were much higher than before the pandemic, and depression, stress and asthma rates were higher than U.S. adult depression rates during the pandemic. Given the essential work child care professionals provide during the pandemic, policy makers and public health officials should consider what can be done to support the physical and mental health of child care professionals.

Quantitative and Functional Assessment of the Influence of Routinely Used Cryopreservation Media on Mononuclear Leukocytes for Medical Research.

Quantitative and functional analysis of mononuclear leukocyte populations is an invaluable tool to understand the role of the immune system in the pathogenesis of a disease. Cryopreservation of mononuclear cells (MNCs) is routinely used to guarantee similar experimental conditions. Immune cells react differently to cryopreservation, and populations and functions of immune cells change during the process of freeze-thawing. To allow for a setup that preserves cell number and function optimally, we tested four different cryopreservation media. MNCs from 15 human individuals were analyzed. Before freezing and after thawing, the distribution of leukocytes was quantified by flow cytometry. Cultured cells were stimulated using lipopolysaccharide, and their immune response was quantified by flow cytometry, quantitative polymerase chain reaction (qPCR), and enzyme-linked immunosorbent assay (ELISA). Ultimately, the performance of the cryopreservation media was ranked. Cell recovery and viability were different between the media. Cryopreservation led to changes in the relative number of monocytes, T cells, B cells, and their subsets. The inflammatory response of MNCs was altered by cryopreservation, enhancing the basal production of inflammatory cytokines. Different cryopreservation media induce biases, which needs to be considered when designing a study relying on cryopreservation. Here, we provide an overview of four different cryopreservation media for choosing the optimal medium for a specific task.

Memory advocate peers: Piloting a sustainable, replicable, volunteer peer mentor program to support individuals newly diagnosed with dementia and their care partners

BACKGROUND: Alzheimer's disease and related dementias (ADRD) have an enormous impact on persons living with dementia and their care partners. Care partners of people with dementia are more likely to have depression, anxiety, and be isolated, heightened by events like the COVID-19 pandemic. Connecting individuals to research has been challenging, especially in diverse populations who are disproportionately impacted by ADRD and health and socioeconomic inequities. The Memory Advocate Peers (MAP) Program aims to address these challenges by building and piloting a sustainable, replicable, volunteer peer mentor program to support individuals newly diagnosed with dementia and their care partners, and help to connect them to services. METHOD: The MAP program has been developed and is led by people living with dementia, care partners, community-based experts in dementia care, and healthcare leaders. The program will give people with dementia and care partners the opportunity to share experiences with a volunteer advocate who has lived experience with dementia, obtain valuable education about how to live well with dementia, connect to community services, and access clinical trials or other research opportunities. Partnerships have been established with New York University-affiliated neurologists to identify and refer newly diagnosed patients to the program, and with the leading local research programs. RESULT: MAP will recruit and train up to 25 advocates to provide twelve months of post-diagnostic support to 50 clients and care partners (where applicable), with a focus on under-represented communities. A research study is embedded within the program to evaluate feasibility, as well as participant quality of life, health resource use, impact on psychological wellbeing, and value of research participation. CONCLUSION: This pilot will be critical in understanding the impact peer-to-peer mentorship can have for both the individual with ADRD and the care partner. It will also be critical to develop best practices to recruit, train and support volunteers serving as these peer advocates. Results from the pilot will be used to improve the program prior to expansion to other regions. © 2021 the Alzheimer's Association.

Association of Child Masking With COVID-19-Related Closures in US Childcare Programs.

Importance: It is not known how effective child masking is in childcare settings in preventing the transmission of SARS-CoV-2. This question is critical to inform health policy and safe childcare practices. Objective: To assess the association between masking children 2 years and older and subsequent childcare closure because of COVID-19. Design, Setting, and Participants: A prospective, 1-year, longitudinal electronic survey study of 6654 childcare professionals at home- and center-based childcare programs in all 50 states was conducted at baseline (May 22 to June 8, 2020) and follow-up (May 26 to June 23, 2021). Using a generalized linear model (log-binomial model) with robust SEs, this study evaluated the association between childcare program closure because of a confirmed or suspected COVID-19 case in either children or staff during the study period and child masking in both early adoption (endorsed at baseline) and continued masking (endorsed at baseline and follow-up), while controlling for physical distancing, other risk mitigation strategies, and program and community characteristics. Exposures: Child masking in childcare programs as reported by childcare professionals at baseline and both baseline and follow-up. Main Outcomes and Measures: Childcare program closure because of a suspected or confirmed COVID-19 case in either children or staff as reported in the May 26 to June 23, 2021, end survey. Results: This survey study of 6654 childcare professionals (mean [SD] age, 46.9 [11.3] years; 750 [11.3%] were African American, 57 [0.9%] American Indian/Alaska Native, 158 [2.4%] Asian, 860 [12.9%] Hispanic, 135 [2.0%] multiracial [anyone who selected >1 race on the survey], 18 [0.3%] Native Hawaiian/Pacific Islander, and 5020 [75.4%] White) found that early adoption (baseline) of child masking was associated with a 13% lower risk of childcare program closure because of a COVID-19 case (adjusted relative risk, 0.87; 95% CI, 0.77-0.99), and continued masking for 1 year was associated with a 14% lower risk (adjusted relative risk, 0.86; 95% CI, 0.74-1.00). Conclusions and Relevance: This survey study of childcare professionals suggests that masking young children is associated with fewer childcare program closures, enabling in-person education. This finding has important public health policy implications for families that rely on childcare to sustain employment.

Putting food systems thinking into practice: Integrating agricultural sectors into a multi-level analytical framework

In the wake of the United Nations Food Systems Summit - the first of its kind - practitioners need to capture the concept of the food system and learn how the process of transformation that they engage in contributes to food system outcomes or risk operating in silos. With that aim, we focus on sector analysis, interpreting changes in sector performance as food system outcomes. This makes food systems thinking more actionable. We share an application of the integrated framework in a particular case: rapid assessments of the impact of COVID-19 on the functioning of the horticulture, sesame, and seed sectors across seven low- and middle-income countries. We highlight lessons learned from applying the multi-level integrated framework for putting food systems thinking into practice.

Mental Health during Covid-19 Pandemic-Observations among Head Neck Cancer Patients

Objective In crisis as Covid-19 pandemic the individual coping has a special importance for each tumor patient in order to overcome their specific burdens. Material and methods We have measured mental health data of patients with head and neck cancer in two projects - WHO-5, SpREUK, distress thermometer of burdens. Before pandemic we included 113 patients, during 1st wave we registered 84 patients, and 86 patients took part during 2nd wave. Results During the first lockdown we have seen a decreasing trend of disease burden. The patients reported significant improved life satisfaction and increased search, trust, and reflections. During 2 nd wave those developments were still seen, but in reduced amount. The generally not very high scoring religious trust was significantly reduced during the 2nd lockdown. Conclusions Tumor patients are able to overcome crisis situations by their individual coping strategies. Spiritual care could support these resources.

COVID-19 Vaccine Uptake Among US Child Care Providers.

OBJECTIVES: Ensuring high coronavirus disease-2019 (COVID-19) vaccine uptake among US child care providers is crucial to mitigating the public health implications of child-staff and staff-child transmission of severe acute respiratory syndrome coronavirus 2; however, the vaccination rate among this group was previously unknown. METHODS: To characterize vaccine uptake among US child care providers, we conducted a multistate cross-sectional survey of the child care workforce. Providers were identified through various national databases and state registries. A link to the survey was sent via e-mail between May 26 and June 23, 2021. A 37.8% response yielded 21 663 respondents, with 20 013 satisfying inclusion criteria. RESULTS: Overall COVID-19 vaccine uptake among US child care providers (78.2%, 90% confidence interval: 77.5% to 78.9%) was higher than the US general adult population (65%). Vaccination rates varied between states from 53.5% to 89.4%. Vaccine uptake among respondents differed significantly (P < .01) based on respondent age (70.0% for ages 25-34, 91.6% for ages 75-84), race (70.0% for Black or African Americans, 92.5% for Asian Americans), annual household income (70.8% for <$35 000, 85.1% for >$75 000), and child care setting (73.0% for home-based, 79.7% for center-based). CONCLUSIONS: COVID-19 vaccine uptake among US child care providers was higher than the general US adult population. Those who were younger, lower income, Black or African American, resided in states either in the Mountain West or the South, and/or worked in home-based child care programs reported the lowest rates of vaccination. State public health leaders and lawmakers should prioritize these subgroups to realize the largest gains in vaccine uptake among providers.

Are German endoscopy units prepared for the COVID-19 pandemic? A nationwide survey

Background and aims The COVID-19 pandemic challenges health care systems worldwide. In this situation, guidelines for health care professionals in endoscopy units with increased risk of infection by COVID-19 from inhalation of airborne droplets, conjunctival contact and feces are urgently needed. Recently, the European Society of Gastrointestinal Endoscopy (ESGE) and the German Respiratory Society (DGP) issued recommendations. However, real-world data on the conditions and requirements of endoscopy units to adhere to this guidance are missing. Methods We conducted an internet-based survey among German endoscopy units from all levels of care from April 1s t to 7t h , 2020. The survey comprised 33 questions and was distributed electronically by the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the DGP. Results In total, 656 endoscopy units completed the survey. Overall, 253 endoscopy units (39%) cancelled less than 40% of their procedures. Of note, private practices cancelled fewer than 40% of their procedures in 46% compared to 34% in hospital-based units. Complete separation of high-risk and COVID-19 positive patients was achieved in only 20% of the units. Procedural measures were well adopted, with 91% of the units systematically identifying patients at risk and 85% using risk-adapted personal protective equipment (PPE). For the future, shortages in PPE (81%) and/or staff (69%) and relevant financial losses (77%) were expected. Conclusion Concise definitions of non-urgent, elective interventions and endoscopic surveillance strategies are needed to better guide endoscopic activity and cancellations of interventions. In the short term, a lack of PPE can constitute considerable impairment of endoscopy units' operability and patient outcomes.

Rapid assessments of the impact of COVID-19 on the availability of quality seed to farmers: Advocating immediate practical, remedial and preventative action

Rapid assessments of the impacts of the COVID-19 crisis on the seed sector were conducted by a coalition of partners in Ethiopia, Myanmar, Nigeria, and Uganda in May and June 2020. The method was rapid, iterative, inclusive and valuable in revealing threats to the availability and timely access of farmers to quality seed and to food, nutrition and income security, and in advocating for remedial and preventative action. Via mobile application and web survey, and focus group discussions on virtual conferencing platforms a panel of 36 or more local experts operating particularly in formal seed systems in each country identified potential disruptions to activities in the seed sector and recommended immediate practical action to ensure continuity in performance. Recommendations, and the stakeholders best positioned to propel their action, were proposed to and approved by senior leadership in the sector. The entire process from survey to publication of a seed alert in each iteration was completed within two weeks. Due to the highly seasonal nature of agriculture, and recognition that activities are time-bound, quick turnaround on assessments was essential. Dashboards indicated where impact was felt the hardest, also showing how dynamic the situation was. Countries were at different stages in their agricultural seasons, which made the data highly contextual, but also interesting for getting a glimpse into the future. Lessons were offered from one country to another. Reduced mobility was the root cause of many disruptions in supplying seed to farmers. Disruptions caused seed and related industry to operate at reduced capacity. The cost of transactions and doing business during these times may have increased the scarcity and price of inputs beyond what farmers can recover. Sales of quality seed in formal markets were perceived to decline due to delays in distribution, weakened promotion efforts and fewer farmers present. Farmers are less likely to benefit from investments in crop improvement for more seasons to come due to delays in the development and release of new varieties. Social distancing prevents stakeholders from meeting to exchange goods, services and information, but the sector is gradually getting up to speed with information technology. For all concerns, practical options were offered and often implemented. The pandemic has exacerbated structural weaknesses in the organization of the seed sector, for which reforms are not only justified, but overdue.