Spatiotemporal characteristics of ozone and the formation sensitivity over the Fenwei Plain.

High surface ozone (O3) levels affect human and environmental health. The Fenwei Plain (FWP), one of the critical regions for China's "Blue Sky Protection Campaign", has reported severe O3 pollution. This study investigates the spatiotemporal properties and the causes of O3 pollution over the FWP using high-resolution data from the TROPOspheric Monitoring Instrument (TROPOMI) from 2019 to 2021. This study characterizes spatial and temporal variations in O3 concentration by linking O3 columns and surface monitoring using a trained deep forest machine learning model. O3 concentrations in summer were 2-3 times higher than those found in winter due to higher temperatures and greater solar irradiation. The spatial distributions of O3 correlate with the solar radiation showing decreased trends from the northeastern to the southwestern FWP, with the highest O3 values in Shanxi Province and the lowest in Shaanxi Province. For urban areas, croplands and grasslands, the O3 photochemistry in summer is NOx-limited or in the transitional regime, while it is VOC-limited in winter and other seasons. Reducing NOx emissions would be effective for decreasing O3 levels in summer, while VOC reductions are necessary for winter. The annual cycle in vegetated areas included both NOx-limited and transitional regimes, indicating the importance of NOx controls to protect ecosystems. The O3 response to limiting precursors shown here is of importance for optimizing control strategies and is illustrated by emission changes during the 2020 COVID-19 outbreak.

Structural Competence and Equity-Minded Interprofessional Education: A Common Reading Approach to Learning

As a result of the COVID-19 pandemic and the Black Lives Matter movement, leaders in the field of interprofessional (IP) education have encouraged faculty to explore online adaptations to curriculum and examine strategies that enhance students' structural competence. Structural competence is broadly defined as the ability to understand how oppression, governmental policies, and environmental inputs impact the health and well-being of an individual. With these changes in mind, a team of IP health science faculty developed two online curricular activities guided by the "common reading” book, Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Sheri Fink. This article describes the development and findings of a mixed-methods evaluation of the two IP learning activities: (a) The Interprofessional Common Reading Experience (IPCRE) and (b) The IPCRE follow-up. The activities engaged over 250 students across multiple health professions (i.e., social work, nursing, athletic training, speech-language pathology, nutrition, and public health) attending three different universities. Our findings contribute to a greater understanding of how to develop online IP activities and curricular innovations that help to train equity-minded and anti-racist practitioners. © 2023 by the authors.

An exploratory investigation into the factors related to EdTech use among Kenyan girls

This paper contributes to the scarce literature on factors affecting EdTech use in households. These factors were considered through exploratory mixed-methods analyses of cross-sectional data on Kenyan girls and caregivers, captured during the COVID-19 pandemic. Quantitative analysis of the child dataset (n = 544) suggested the importance of both structural factors—such as technology hardware availability—and non-structural factors—including caregiver permission. Findings were supported by a thematic analysis of interview data from girls' caregivers (n = 58), which emphasised the role they play in girls' use of EdTech. Interviews also highlighted numerous caregiver concerns with EdTech, related to the relevance and rigour of educational content, the possibility of children accessing age-inappropriate material and child health (especially eyesight). Policy makers could alleviate these concerns by providing guidance on EdTech use and clearly signalling their approval of verified initiatives. Practitioner notes What is already known about this topic EdTech can benefit girls' education, yet there are various barriers to it being used. Existing research shows clearly that EdTech use can be impeded by structural factors (eg, hardware ownership). However, we find insufficient empirical evidence on the role of non-structural or behavioural factors. What this paper adds This paper addresses this gap, using a mixed-methods approach to explore the influence of 33 different measures (including non-structural factors) that could affect the number of hours girls spend using EdTech at home. Findings from a quantitative sample of girls (n = 544) and a qualitative sample of girls' caregivers (n = 58) highlighted the importance of non-structural factors, especially caregiver permission. The variable most strongly associated with girls' EdTech usage in our selected quantitative model concerned whether this was sanctioned by their caregivers. Our qualitative data suggested why caregiver permission to use EdTech might be withheld: caregivers emphasised perceived concerns about the risks and rigour of EdTech. Implications for practice and/or policy Our findings suggest the viability of policy interventions that provide EdTech guidance to caregivers. Caregivers uncertain about EdTech could be reassured of the appropriateness of verified initiatives, while those already convinced might be aided in their attempts to support EdTech learning. Such guidance could provide a low-cost means of further exploiting the benefits that household EdTech learning can provide. © 2023 The Authors. British Journal of Educational Technology published by John Wiley & Sons Ltd on behalf of British Educational Research Association.

Longitudinal lung function assessment of patients hospitalised with COVID-19 using 1H and 129Xe lung MRI

Introduction: The progression of pathophysiological pulmonary changes in patients following acute COVID-19 is not well established. Method(s): Patients hospitalised with COVID-19 pneumonia without signs of ILD, had MRI exams at a median of 6 (n=9), 12 (n=9), 25 (n=7), and 52 (n=3) weeks. MRI sequences included: dynamic contrast enhanced (DCE) lung perfusion,129 Xe diffusion weighted (DW-MRI), 129Xe ventilation and 129Xe 3D dissolved phase imaging. Result(s): 9 patients (age 56+/-9 years;7 male;1 required treatment in an ICU) were recruited. Median RBC:TP was abnormally low at all visits compared to reference age and sex matched data. An individual's RBC:TP was significantly and positively associated with an increase in their pulmonary blood volume (p=0.026). For patients with 52 week data available, one showed a continued increase in RBC:TP, 2 patients maintained a low RBC:TP (Figure 1). Ventilation defect percentage, and ventilation heterogeneity significantly decreased at 25 weeks compared to 6 129 129 129 weeks (p=0.010 and p=0.048). DW-MRI was normal at all visits. Dissolved phase xenon imaging showed RBC:TP significantly increased at 12 and 25 weeks compared to 6 weeks (p=0.048). Conclusion(s): In patients recovering after COVID-19, poor gas transfer is reflected by impaired xenon transfer, which improves alongside pulmonary blood volume.

Longitudinal 129xe and 1h Lung Mri Assessment of Lung Structure, Ventilation, Perfusion, and Gas Transfer Following Hospitalization with Covid-19

The long-term effects of coronavirus disease 2019 (COVID- 19) pneumonia on the lungs and pulmonary circulation require further characterization. We assessed progression of pathophysiological pulmonary changes during 1 year of follow-up of patients who had been hospitalized because of COVID-19. After discharge, recruited patients had up to four MRI examinations at a median of 6 (n=9), 12 (n=9), 25 (n=7) and 52 (n=3) weeks. Lung MRI examinations included: ultra-short echo time (UTE), dynamic contrastenhanced (DCE) lung perfusion, 129Xe diffusion weighted (DW-MRI), 129Xe ventilation and 129Xe 3D dissolved phase imaging. Nine patients (age 56 +/-9 years;six male) were recruited. Ventilation defect percentage and whole lung coefficient of variation of lung ventilation decreased significantly at 25 weeks (visit 3) compared with visit 1 at 6 weeks (p=0.010 and p=0.048). The UTE imaging indicated no evidence of lung scarring, and DW-MRI indicated normal lung microstructure across all visits. Dissolved phase xenon imaging showed that RBC:TP increased significantly at visits 2 and 3 compared with visit 1 (p=0.048). Median RBC:TP was abnormally low at all visits compared with reference age- and sex-matched data. An individual's RBC:TP was associated significantly and positively with an increase in their pulmonary blood volume (p=0.026). For patients with 52-week data available, one showed a continued improvement in RBC:TP;however, two of the patients maintained a low RBC:TP. In patients recovering from COVID-19, xenon gas transfer improves alongside pulmonary blood volume. Further work is needed to establish the proportion of post-COVID-19 patients who have longer-term impairment in xenon transfer and to correlate changes in lung MRI parameters with symptoms, lung function tests and other imaging modalities. Persistent impairment of xenon transfer might represent a physiological mechanism underlying ongoing symptoms in some patients and might indicate damage to the pulmonary microcirculation.

Online Supportive Conversations and Reflection Sessions (OSCaRS): A Feasibility Pilot with Care Home Staff during the Pandemic

Care homes care for people with complex needs, supporting them to the end of life and are now being seen as the 'de facto' hospice. Reflective debriefing for care home staff has been found to help support staff and provide an educative and communicative function when a resident dies. Pre-COVID-19, one of the authors had been conducting reflective debriefings face-to-face with care home staff but when COVID-19 struck, face-to-face sessions were impossible. An online format was developed with the aim of providing emotional support and practice-based learning in relation to death and dying through reflection. This study assessed the acceptability and feasibility of delivering online supportive conversations and reflective sessions (OSCaRS) on palliative and end of life care to care home staff during the pandemic. A mixed methods study design was undertaken in April to September 2020. Qualitative data comprised of digital recordings of sessions and semi-structured interviews with OSCaRS participants, managers and session facilitators. An online survey was sent to all staff and had a response rate of 12%. Eleven OSCaRS were conducted over ten weeks. Thirty-four staff members attended one or more sessions. Three overarching themes were identified from the data: pressures of working in a pandemic, practicalities of delivering online support and, practice development opportunities. Engaging care home staff in online structured supportive conversations and reflections in relation to death and dying is acceptable, feasible and valuable for providing support with the pressures of working in a pandemic. There is value for OSCaRS to continue as online sessions as they provide care home staff access to practice-based learning and support from professionals and allows specialists based in a range of settings to in-reach into care homes in an efficient way. Future implementation must consider the availability of sufficient devices with cameras to aid participation, timing and frequency of sessions to accommodate staff workflows, the engagement and support of managers and post-session support. © 2022 Lucy Johnston, Jo Hockley, Julie Watson & Susan D. Shenkin. This Open Access article is distributed under the terms of the Creative Commons Attribution Attribution-Non-Commercial No Derivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is unaltered.

Social cohesion and self-governance arrangements among small-scale fisheries in Puerto Rico

In small-scale fisheries that suffer from weak formal governance, fishers use a variety of institutional strategies to self-govern. These self-governance arrangements may or may not be forms of collective action, yet they rely on informal institutions (such as norms of reciprocity) in generating social cohesion among users so that common rules can be agreed upon. Social network perspectives have been used to understand the cohesiveness of fishers operating with different gear types or in different communities, yet less is known about how social cohesion differs between fishers that operate through formal cooperative arrangements, such as fishing associations, and independent fishers who operate solely at the community level through informal cooperation. Using mixed methods, we compared the social cohesion of commercial fishers arising from information-sharing and work-support networks in four fishing communities of north-eastern Puerto Rico, as they coped with prolonged hurricane recovery and the COVID-19 pandemic. A series of exponential random graph models (ERGMs) were applied to untangle the drivers of cohesion emerging from fisher's information-sharing patterns. Fisher's communication was driven not just by operating at the same landing site or using the same primary gear type, but also by choosing to organize their fishing under the same self-governance arrangement. Specifically, fishers that were members of fishing associations mostly communicated among themselves, while independent fishers talked across arrangements, indicating the role of fishing associations in fostering social cohesion. However, associated fishers were less likely to receive information than independent fishers, suggesting the need for targeted communication strategies within each group. Moreover, independent fishers had more work support ties and a greater diversity of supporting actors across the supply chain, suggesting their need for higher levels of linking social capital. Multiple social factors explained whether fishers choose to be members of fishing associations or remain independent, including trust in leaders and agreement on membership rules. These findings highlight the importance of knowing the cohesiveness of cooperation networks among small-scale fishers.

Incidence of colorectal cancer in the 30-49-years age group in the Geelong region: A pilot study

Background and Aim: Colorectal cancer (CRC) accounts for a significant proportion of cancer-related illness and mortality in Australia. A review of national cancer data published by the Australian Institute of Health and Welfare found that CRC was the second most diagnosed cancer in Australia, with a total of 16 398 cases across all ages in 2019. There were 1305 cases in the 30-49-years age group, accounting for 7.9% of all cases diagnosed.1 The Australian National Bowel Cancer Screening Program has reduced the overall disease burden of CRC in people aged 50-75 years.2 Despite the reduction in this age group, there is an ongoing rise in rates of CRC in the younger population of people aged under 50 years.3 In response to these emerging data, in 2018 the American Cancer Society lowered the recommended screening age for average-risk adults from 50 to 45 years of age.4 In Australia, The Rotary Bowelscan program offers a fecal occult blood test to individuals of all ages. This has the potential to detect occult bleeding in younger asymptomatic patients, allowing early investigation with colonoscopy. This study was designed to observe the incidence of CRC and high-grade dysplasia (HGD) in the 30-49-years age group at Barwon Health (Geelong region). A secondary aim was to establish if the COVID-19 pandemic (starting in 2020) affected these presentations, compared with a pre-COVID-19 year (2019). The stage of disease at diagnosis and survival were also observed where available. Method(s): We performed a retrospective cohort study of patients aged 30-49 years who had undergone a colonoscopy and subsequent diagnosis of HGD or CRC at Barwon Health between January 2019 and December 2020. Clinical and histopathological data collected included indication for colonoscopy, age, sex, and histology of biopsy or resection specimens. Stage of disease and survival of the patient up to 1 year after colonoscopy were recorded where available. Patients with known hereditary CRC syndrome or a previous diagnosis of CRC were excluded from the study. Result(s): A total of 1063 patients aged 30-49 years underwent a colonoscopy at Barwon Health between January 2019 and December 2020. In 2019, 651 colonoscopies were performed, compared with 412 in 2020. Of those undergoing colonoscopies in this period, 15 (nine in 2019, six in 2020) were diagnosed with HGD or CRC. Of the patients diagnosed in 2019, five were diagnosed with adenocarcinoma, and four with HGD. Thus, the overall incidence of CRC or HGD in the 30-49-years age group was 1.4% in 2019 (95% CI, 0.3-2.6%). In 2020, one patient was diagnosed with adenocarcinoma, three patients were diagnosed with HGD, and two were diagnosed with a neuroendocrine tumor. Therefore, the incidence of HGD or CRC was 1.5% for this age group in 2020 (95% CI, 0.4-2.3%). There was no statistically significant difference between the 2 years (1.4% vs 1.5%, P = 0.921). Of all eight patients diagnosed with CRC (adenocarcinoma and neuroendocrine), 62.5% were female, and the median age at diagnosis was 42.5 years. Of those diagnosed with HGD, 71.4% were female, and the median age at diagnosis was 37 years. One patient diagnosed with CRC had metastatic disease at the time of diagnosis, with three other patients (including both patients with neuroendocrine tumors) having evidence of nodal involvement. The remaining four patients had T1-3N0-XM0-X disease at diagnosis. Survival 1 year after diagnosis of HGD or CRC was documented for 12 patients, with the survival status of the remaining three patients not able to be ascertained. The patient with metastatic CRC at diagnosis died 14 months after colonoscopy. The other 11 patients were alive at 12 months after colonoscopy. Conclusion(s): CRC is a devastating diagnosis for patients, particularly those in arguably the most productive period of their lives, between 30 and 49 years of age. The incidence of CRC or HGD at Barwon Health in the 30-49-years age group was 1.4% in 2019 and 1.5% in 2020, with no statistically significant difference between a normal and a pandemic year. Thi compares with the national incidence of 1.3% in 2020 for the same age group.1.

A Mixed Methods Evaluation of an Integrated Primary and Behavioral Health Training Program for Counseling Students

Behavioral health provider shortages continue to grow in the United States, with the need for related services increasing as the SARS-COVID-19 pandemic persists. The implementation of integrated primary and behavioral healthcare (IPBH) practices represents one viable approach to leverage existing resources and maximize the potential for client outcomes;however, best practices for counselors within an IPBH paradigm remain unclear. We report the findings of a mixed method evaluation of an IPBH training program with 45 (36 females;9 males;M age = 31.65) professional counseling students who predominately identified with ethnic minority identities (55%), urban residences (66%), and disadvantaged backgrounds (44%). We detected statistically and practically significant changes in self-efficacy (p = .01, d =.55) and interprofessional valuing and socialization (p <.01, d =.76), but mixed findings for variables associated with multicultural competence. Stakeholder interviews and document analysis identified four key facilitators (Financial Support;Facilitated Engagement;Witnessing Collaboration;Holistic Representation of Clients and Client Care) and four barriers (Awareness Raising and Recruitment;Logistics and Coordination;Inconsistent Culture of IPBH;Momentum Maintenance) to program success. © 2022 Association for Assessment and Research in Counseling (AARC).

Assistive Technology/Augmentative & Alternative Communication Implementation: School to Home during COVID-19

This explanatory sequential mixed-methods study sought to describe the implementation process of AT/AAC from school to home during the COVID-19 pandemic, including the extent to which AT/AAC was used, how AT/AAC was used, and what, if any, support the school systems provided. A researcher-designed survey was completed by 104 special educators and 45 parents. Seventeen follow-up interviews were conducted with educators and parent participants. Results of the study demonstrated the importance of clear communication, explicit expectations and procedures for AT/AAC use, and collaboration among stakeholders if AT/AAC implementation is to be as effective as possible. © ATIA 2022.

Chloroquine/ hydroxychloroquine prevention of coronavirus disease (COVID-19) in the healthcare setting;protocol for a placebo-controlled prophylaxis study (COPCOV)

There is no proven preventative therapy or vaccine against COVID-19. Theinfection has spread rapidly and there has already been a substantial adverse impact on the global economy. Healthcare workers have been affected disproportionately in the continuing pandemic. Significant infection rates in this critical group have resulted in a breakdown of health services in some countries. Chloroquine, and the closely related hydroxychloroquine, are safe and well tolerated medications which can be given for years without adverse effects. Chloroquine and hydroxychloroquine have significant antiviral activity against SARS-CoV-2, and despite the lack of benefit of hydroxychloroquine treatment in patients hospitalised with severe COVID-19, these drugs could still work in prevention. The emerging infection paradigm of an early viral peak, and late inflammation where there is benefit from corticosteroids. If these direct actiing antivirals are to work, they have the best chance given either early in infection infection occurs. We describe the study protocol for multi-centre, multi-country randomised, double blind, placebo controlled trial to answer the question can chloroquine/ hydroxychloroquine prevent COVID-19. 40,000 participants working in healthcare facilities or involved in the management of COVID-19 will be randomised 1:1 to receive chloroquine/ hydroxychloroquine or matched placebo as daily prophylaxis for three months. The primary objective is the prevention of symptomatic, virological or serologically proven coronavirus disease (COVID-19). The study could detect a 23% reduction from an incidence of 3% in the placebo group for either drug with 80% power. Secondary objectives are to determine ifchloroquine/hydroxychloroquine prophylaxis attenuates severity, prevents asymptomaticCOVID-19 and symptomatic acute respiratory infections of another aetiology (non-SARS-CoV-2). © 2020. Schilling WH et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The effectiveness of hand hygiene interventions for preventing transmission or acquisition of viral infections in the community: Findings from a systematic review

Introduction: The World Health Organization recommends improving hand hygiene (HH) practices of the general public as one aspect of controlling the transmission of novel coronaviruses and influenza virus epidemics or pandemics. Objectives: To systematically review the evidence on the effectiveness of HH interventions for preventing transmission or acquisition of viral infections in the community. Methods: PubMed, MEDLINE, CINAHL and Web of Science databases were searched for empirical studies published between 2002-May 2020, on HH in the general public and acquisition or transmission of novel coronavirus infections or influenza. Study selection, data extraction and quality assessment were conducted by one reviewer, with all decisions checked by another. We conducted a sub-set analysis of intervention studies included in this review, by calculating the effect estimates. Results: The review identified four intervention studies, all of which used cluster randomised designs evaluating the effectiveness of HH education paired with provision of HH products or hand washing with soap and water (HW) against influenza transmission or acquisition amongst the populations of schoolchildren (n = 2) or the general public (n = 2). Three indicated a protective effect of HH interventions (Figure);yet, this effect was significant for only one school-based intervention, which consisted of the provision of HH education and performing HW twice a day (OR: 0.64;95% CI 0.51, 0.80). However, the risk of bias of this study was assessed as unclear;whereas the remaining three studies were assessed as high risk. Conclusion: There is some limited evidence demonstrating that hand hygiene interventions were effective in preventing influenza in school children. Thus, whilst provision of HH education to school children will be beneficial from a public health perspective, it's impact on influenza transmission is unclear. Research is needed to evaluate the effectiveness of HH interventions for prevention of respiratory infections, including SARS-CoV-2, amongst more diverse groups of the general public populations.

Development of a Formative Assessment Rubric for Peer Evaluation of Teaching (FARPET) and Pilot Use in Veterinary Online Teaching.

Peer evaluation of teaching (PET) serves an important role as a component of faculty development in the medical education field. With the emergence of COVID-19, the authors recognized the need for a flexible tool that could be used for a variety of lecture formats, including virtual instruction, and that could provide a framework for consistent and meaningful PET feedback. This teaching tip describes the creation and pilot use of a PET rubric, which includes six fixed core items (lesson structure, content organization, audiovisual facilitation, concept development, enthusiasm, and relevance) and items to be assessed separately for asynchronous lectures (cognitive engagement-asynchronous) and synchronous lectures (cognitive engagement-synchronous, discourse quality, collaborative learning, and check for understanding). The instrument packet comprises the rubric, instructions for use, definitions, and examples of each item, plus three training videos for users to compare with authors' consensus training scores; these serve as frame-of-reference training. The instrument was piloted among veterinary educators, and feedback was sought in a focus group setting. The instrument was well received, and training and use required a minimum time commitment. Inter-rater reliability within 1 Likert scale point (adjacent agreement) was assessed for each of the training videos, and consistency of scoring was demonstrated between focus group members using percent agreement (0.82, 0.85, 0.88) and between focus members and the authors' consensus training scores (all videos: 0.91). This instrument may serve as a helpful resource for institutions looking for a framework for PET. We intend to continually adjust the instrument in response to feedback from wider use.

The WHO guideline on drugs to prevent COVID-19: small numbers- big conclusions

The World Health Organization living guideline on drugs to prevent COVID-19 has recently advised that ongoing trials evaluating hydroxychloroquine in chemoprophylaxis should stop. The WHO guideline cites "high certainty" evidence from randomised controlled trials (RCTs) that hydroxychloroquine prophylaxis does not reduce mortality and does not reduce hospital admission, and "moderate certainty" evidence of poor tolerability because of a significantly increased rate of adverse events leading to drug discontinuation. Yet there is no such evidence. In the three pre-exposure chemoprophylaxis RCTs evaluated in the guideline there were no deaths and only two COVID-19-related hospital admissions, and there was a mistake in the analysis of the number of discontinuations (after correction there is no longer a statistically significant difference between those taking the drug and the controls). Guidelines on the prevention and treatment of COVID-19 should be based on sufficient verified evidence, understanding of the disease process, sound statistical analysis and interpretation, and an appreciation of global needs.

COVID-19 Consumer Health Information Needs Improvement to Be Readable and Actionable by High-Risk Populations

Health communicators help promote recommended health behaviors by providing accurate, actionable health information that is easy to read and understand. The COVID-19 public health crisis presents a special challenge to clear health communication because some populations most affected by the virus are also at risk for limited health literacy. We collected 28 consumer COVID-19 materials from the internet using popular search engines. We then assessed the materials for readability, understandability, and actionability using validated tools. Aggregate results suggest that the sample of materials was difficult to read and lacked a number of recommended features that promote a readers' ability to understand and act upon the information. We present these findings, their implications for health equity, and their limitations and then suggest ways to improve future health communication about time-sensitive infectious diseases.

Precision silver nitrate cautery of the posterior nasal cavity.

BACKGROUND: This technical note describes a novel method of cauterising the posterior nasal cavity through the use of a plastic straw and silver nitrate. OBJECTIVE: This technique aims to prevent unwanted damage to surrounding nasal mucosa. METHODS: Once the nasal cavity has been prepared for cauterisation, the silver nitrate stick is navigated to the bleeding point covered by the plastic straw. The silver nitrate stick is then advanced onto the bleeding point allowing precise cauterisation of the nasal mucosa, without effecting surrounding healthy mucosa.

Online supportive conversations &reflection sessions [oscars] with carehome staff following a resident's death: Improving coping mechanisms, teamcohesion and communication

Introduction COVID-19 Trauma Guidance suggests opportunities for structured,time-limited discussions about challenging experiences should beoffered. It is unknown if such discussions can be effectivelydelivered online by palliative care specialists to support care home(CH) staff in relation to death/dying. Funded by Scotland's ChiefScientist Office COVID-19 “rapid research” fund, online OSCaRS isbeing piloted. Methods Fortnightly OSCaRS delivered to small groups of CH staff via asecure online platform in three local CHs over 10 weeks. Sessionsare digitally recorded. The shortened version of the Chesneycoping self-efficacy questionnaire is completed by all staffpre/post. Additional post-study questions asked of OSCaRSparticipants and in-depth staff interviews will be undertaken (n = 10). Thematic analysis of the recorded sessions and interviews willbe undertaken and related to the staff questionnaire and context of each CH. Results New learning on the feasibility and acceptability of providingOSCaRS to frontline staff. The benefit of OSCaRS to CH staff copingmechanisms, team cohesion and communicaton with relativesduring the COVID-19 pandemic will be presented. Initial results show that OSCaRS are feasible, valued by all care home staff and support staff in coping with the challenges of COVID-19/. Key Conclusions The analysis will inform future practice, and an ImplementationGuide for OSCaRS in CHs will be produced. Key learning on thepotential for online support in relation to death/dying during thepandemic and beyond will contribute to future education, trainingand staff wellbeing resources. It will also inform the role of suchsessions in developing individual coping mechanisms and teamworking alongside communication with relatives duringlockdown.

Surveillance and testing for Middle East respiratory syndrome coronavirus (MERS-COV), Saudi Arabia, 2016-2019

Objectives: Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe respiratory illness. The majority of cases worldwide have been reported by Saudi Arabia. Clinicians and health authorities in Saudi Arabia are required to report all suspected MERS-CoV cases to the Health Electronic Surveillance Network (HESN), a national electronic surveillance platform. We aimed to describe trends in MERS-CoV surveillance and laboratory testing in Saudi Arabia over a three-year period. Method(s): Demographic information and laboratory results were collected for all suspected MERS-CoV cases reported to HESN between 1 March 2016 and 20 March 2019. Demographic and laboratory data of suspected and confirmed cases was analyzed. Data were stratified by local Health Affairs Directorate (HAD) and population estimates obtained from the Ministry of Health. Result(s): During the study period, 200 937 suspected MERS-CoV cases were reported to HESN. MERS-CoV was detected in 698 (0.3%;0.7 per 100 000 population per year). The majority of suspected cases were male (54.3%) and Saudi nationals (72.8%). Among the confirmed cases, 517 (74.1%) were male, 501 (71.8%) were Saudi nationals, and the median age was 54 years (interquartile range: 40 years-65 years). No MERS-CoV cases were identified among Hajj pilgrims. Percent positivity varied by region, with the highest percentage in Hafer Al- Baten HAD (1.2%), followed by Najran HAD (1.1%). Conclusion(s): Saudi Arabia continues to perform extensive surveillance for MERS-CoV, with an average of ~5400 suspected cases identified and tested per month. Continued surveillance is needed to better understand transmission and to monitor testing practices.