Teleclinics for the management of diabetes in pregnancy during COVID-19-maternal satisfaction and pregnancy outcomes.

AIMS: Diabetes in pregnancy (DiP) rates are increasing worldwide. Pasifika, Indian and Maori peoples have high rates of DiP any improvements in clinical care may be beneficial for these populations. During COVID-19 lockdowns, the DiP service in Counties Manukau Health (CMH) South Auckland switched from face-to-face appointments to teleclinics. This study aims to: determine satisfaction of pregnant people with teleclinics for DiP; compare clinical outcomes and attendance for those receiving care through teleclinics versus standard care; and compare rates of clinic attendance between face-to-face and teleclinic appointments. METHODS: A standardised questionnaire was completed by those who had attended a teleclinic. The primary outcome was a high score (4-5/5) for satisfaction and future use. A separate, retrospective study of clinical outcomes, and the number of appointments scheduled/attended were compared between all DiP patients who were scheduled an appointment during lockdown, and all of those who were scheduled appointments the year prior. RESULTS: Of the thirty-five participants who completed the survey (response rate 37%), 89% scored the clinic highly for satisfaction and future use. There were 179 patients scheduled to clinic during the period where teleclinics were the default model of care, and 187 patients scheduled to clinic the year prior. No differences in clinical outcomes were observed. Those receiving care during lockdown were offered more appointments, although attendance rates did not differ. CONCLUSION: Teleclinics for DiP are acceptable to the people we surveyed, but should be developed further so they better support the needs of those using them.

Perception of online teacher self-efficacy: A multi-state study of nursing faculty pivoting courses during COVID 19.

BACKGROUND: COVID-19 forced many colleges and schools of nursing to abruptly pivot face-to-face learning to online formats. Online teaching is not new, but some faculty have not taught in a virtual environment and rapidly transitioning courses online was challenging. It is not known if teacher self-efficacy was impacted by these circumstances. OBJECTIVES: We aimed to assess online teacher self-efficacy of nursing faculty who transitioned at least one-face-to face course to an online format. We hypothesized that faculty with previous online teaching experience and greater self-rated instructional support would demonstrate higher online teacher self-efficacy scores compared to faculty who had little or no online teaching experience or reported less satisfaction with instructional support. DESIGN: A cross-sectional, descriptive design was used. SETTING: Faculty from ten universities across the United States were recruited. PARTICIPANTS: Nursing faculty (N = 84) who transitioned at least one face-to-face course to an online format during COVID-19 were included in the study. METHODS: Participants completed the 32-item Michigan Nurse Educators Sense of Efficacy for Online Teaching (MNESEOT) instrument and a demographic questionnaire which included items about prior online teaching experience and instructional support. RESULTS: Participants scored overall teacher self-efficacy high (75th percentile). "Computer skills" were scored highest while "student engagement" scored lowest. Prior online teaching was a predictor of higher online teacher self-efficacy; however, instructional support was not a predictor of higher online teacher self-efficacy. CONCLUSION: Nursing faculty reported a high level of online teacher self-efficacy during an abrupt pivot from face-to-face teaching to a virtual format. Pre-emptive opportunities to teach online can build self-efficacy for novice faculty. Faculty and students will benefit from improving student engagement skills, especially during isolating and overwhelming events such as the COVID-19 pandemic.

Individual-specific functional epigenomics reveals genetic determinants of adverse metabolic effects of glucocorticoids.

Glucocorticoids (GCs) are widely used as anti-inflammatory drugs, but their long-term use has severe metabolic side effects. Here, by treating multiple individual adipose stem cell-derived adipocytes and induced pluripotent stem cell-derived hepatocytes with the potent GC dexamethasone (Dex), we uncovered cell-type-specific and individual-specific GC-dependent transcriptomes and glucocorticoid receptor (GR) cistromes. Individual-specific GR binding could be traced to single-nucleotide polymorphisms (SNPs) that altered the binding motifs of GR or its cooperating factors. We also discovered another set of genetic variants that modulated Dex response through affecting chromatin accessibility or chromatin architecture. Several SNPs that altered Dex-regulated GR binding and gene expression controlled Dex-driven metabolic perturbations. Remarkably, these genetic variations were highly associated with increases in serum glucose, lipids, and body mass in subjects on GC therapy. Knowledge of the genetic variants that predispose individuals to metabolic side effects allows for a precision medicine approach to the use of clinically relevant GCs.

Transitioning to Teaching Online During the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic many nursing educators have been required to abruptly convert to an online delivery model. Faculty need resources and support to transition face to face courses into an online format. PURPOSE: The purpose of this article is to highlight nursing faculty perceptions of the effectiveness of resources, support, and methodologies for online teaching during the COVID-19 Pandemic. METHODS: A cross-sectional descriptive survey design was used to collect data about nursing faculty resources, support and methodologies used to transition at least one undergraduate or graduate degree nursing course to an online format during the COVID-19 pandemic. RESULTS: Eighty-four faculty who taught in ten university colleges of nursing used varied teaching methodologies in online courses, but included some consistent methods such as websites and web based tools. The student engagement strategies that faculty were most satisfied with were journal writing and projects. Most faculty reported having information technology support and access to instructional design resources. CONCLUSION: Nursing faculty were resourceful, adaptive, and willing to use both novel and existing resources and methodologies to meet their teaching objectives and engage students. They were also, overall, satisfied with the administrative support they received from their respective institutions. Many of these resources, methodologies, and supports will continue to be used by faculty as likely more programs and courses will continue to be managed online.

A Multicenter Study of Student Engagement and Satisfaction in Online Programs.

BACKGROUND: Students who are more satisfied and engaged in online courses have better learning experiences and outcomes. METHOD: Survey data were collected during a 4-month period in 2019. The research team created a survey to collect demographic information and assess student satisfaction. Student engagement was measured using the 19-item Online Student Engagement Scale. RESULTS: Overall student engagement and satisfaction scores in online programs were moderately high. Generation Z participants and students from PhD programs were the most satisfied and engaged in their programs. CONCLUSION: Students who are more engaged in online coursework are more satisfied and thus are more likely to remain and successfully complete their respective programs. [J Nurs Educ. 2021;60(5):259-264.].