Living in a segregated community? Interaction between families and service organizations supporting people with intellectual disabilities during the COVID-19 pandemic

Summary: Individuals with intellectual disabilities who might have been previously placed into segregated institutions now live independently in the community, supported by the necessary community care services. Nevertheless, social inclusion can be deemed successful only if they can positively interact with the various microsystems of the community. The disruption of social service provision due to the COVID-19 pandemic allowed us to evaluate other systems of support in the community. By adopting a bioecological perspective, qualitative methods are used to examine the interactions between people with intellectual disabilities and their social environment during the pandemic primarily based on focus group sessions with 17 social workers and 12 caregivers. Findings: Three overarching themes are identified through a thematic analysis: (1) limited social ties with the community that could provide support;(2) professional support as the main source of assistance;and (3) limited resources on how to care for people with intellectual disabilities. Applications: The results show that unilateral systems of support with limited participation of other systems lead people with intellectual disabilities to live segregated lives, even though they reside in the community. To fully realize the right of inclusion in society of all people with intellectual disabilities, further efforts are required to promote informal social care for people with intellectual disabilities. There is a need for a shared-care model that provides care in the community by the community through the establishment of neighborly relations and expansion of the social networks of people with intellectual disabilities. © The Author(s) 2023.

A co-orientation analysis of teachers' and students' perceptions of online teaching and learning in Hong Kong higher education during the COVID-19 pandemic

This study compares and contrasts teachers' and students' perceptions of online teaching and learning during the COVID-pandemic in higher education using the co-orientation model. Data were collected from 145 students and 31 teachers in two Hong Kong higher education institutions. The findings show that teachers were generally more negative about online teaching and learning than students, but such negative views should be reconsidered as students positively evaluated teachers' efforts to various degrees. It is suggested that during future online learning experiences (1) teachers and students set up expectations together to evaluate online interactions, (2) teachers should not be overly concerned about the potential embarrassment of using camera for class activities, and (3) teachers pay more attention to feedback delivery. Understanding these gaps will provide teachers with insights into more strategic communication and planning to manage the expectations and optimise the online experience for both parties.

Between paradigms: Comparing patient and parent experiences of injured adolescents treated at pediatric or adult trauma centres

Background: Injured adolescents may go to pediatric (PTC) or adult (ATC) trauma centres. Although there appears to be little difference in mortality when adolescents are managed in PTCs versus ATCs, evidence suggests differences in clinical processes (e.g., computed tomographic scanning, operative intervention). Moreover, there is little information on nonclinical outcome variation. We aimed to examine differences in nonclinical outcomes of injured adolescents admitted to the lead PTC or ATC within a regional Canadian trauma system. Method(s): After injury-related hospital admission at the PTC or ATC, adolescents (15-17 yr, inclusive) and parents completed the following: the Quality of Trauma Acute Care Patient-Reported (or Parent- Reported) Experience Measure (QTAC-PREM), examining clinical care, information delivery, education and social supports, and opioid exposure;the Pediatric Quality of Life Inventory;and the Brief Symptom Inventory, a psychological distress measure. Data were collected on clinical outcomes and processes. Descriptive bivariate analyses compared outcomes by trauma centre type. Result(s): Twenty-six ATC and 32 PTC patients have been enrolled to date. Survey response rates were 69% (patients) and 75% (parents) at the PTC and 58% (patients) and 54% (parents) at the ATC. There was a similar age and sex distribution between the 2 centres. Injury severity was higher at the ATC, reflected by greater mean lengths of stay (PTC 2.3 d [standard deviation (SD) 2.1 d], ATC 13.3 d [SD 23.7 d]), and lower mean Glasgow Coma Scale scores (PTC 15.0, ATC 13.8) at the ATC. There were also 3 critical care admissions at the ATC and none at the PTC among recruited patients. No differences were observed in patient- or parent-reported clinical care and follow-up experiences. There was also no difference in patient- or parent-reported social and educational support, although subscales were limited by visitor restrictions because of the COVID-19 pandemic, and the majority of injuries occurring during summer months when students were out of school. Parents at the ATC reported fewer opportunities to stay with or near their child compared with those at the PTC (100% v. 69.2%). Parents reported better information provision at the PTC (mean 17.3 [SD 1.3] v. 13.9 [SD 5.2], out of 18 as measured by the QTAC-PREM). Patients and parents were more likely to report receiving opioid prescriptions on discharge at the ATC (55.6% v. 14.3%). There was no difference in quality of life or psychological distress between the PTC and ATC. Conclusion(s): Injured adolescents and their parents indicated similar clinical and follow-up experiences, although parents felt better informed at the PTC and reported better opportunities to stay near their child. Parents and patients reported higher opioid exposures at the ATC. Sharing of communication, accommodation and opioid prescribing practices may allow for improved experiences and reduced opioid exposures in injured adolescents presenting to ATCs. Multivariable analyses are necessary in the future to adjust for injury severity differences..

The Mental Health Impacts of COVID-19 on PK-12 Students: A Systematic Review of Emerging Literature

The mental health impact of the coronavirus disease 2019 (COVID-19) pandemic on PK-12 youth is likely an urgent and enduring concern, yet research on this topic is still emerging. To synthesize current knowledge, the researchers conducted a systematic review of empirical studies exploring the mental health impacts of COVID-19. Five themes emerged across 104 included studies: (a) the pandemic proved widely disruptive to PK-12 youth;(b) there was a clear connection between the mental health of caregivers (e.g., parents) and children;(c) the pandemic broadly increased levels of stress, anxiety, and depression in PK-12 youth;(d) students were particularly affected on the basis of age, gender, race/ethnicity, socioeconomic status, and previous mental health or disability diagnosis;and (e) youth demonstrated negative and positive coping strategies and even saw some positive mental health outcomes during the pandemic. Implications for research, practice, and policy are discussed.

A co-orientation analysis of teachers’ and students’ perceptions of online teaching and learning in Hong Kong higher education during the COVID-19 pandemic

This study compares and contrasts teachers’ and students’ perceptions of online teaching and learning during the COVID-pandemic in higher education using the co-orientation model. Data were collected from 145 students and 31 teachers in two Hong Kong higher education institutions. The findings show that teachers were generally more negative about online teaching and learning than students, but such negative views should be reconsidered as students positively evaluated teachers’ efforts to various degrees. It is suggested that during future online learning experiences (1) teachers and students set up expectations together to evaluate online interactions, (2) teachers should not be overly concerned about the potential embarrassment of using camera for class activities, and (3) teachers pay more attention to feedback delivery. Understanding these gaps will provide teachers with insights into more strategic communication and planning to manage the expectations and optimise the online experience for both parties. © 2022 Elsevier Ltd

Airline employees’ stress amidst the COVID-19 pandemic and its job-related consequences

This study identified new stressors that airline employees encounter during the pandemic in addition to the traditional stressors. In addition, this study analyzed the effects of perceived stressors on their consequences. The magnitudes of the impacts of the stressors were different before and after the pandemic outbreak. Overall, even though airline employees showed a high perception of stressors, emotional symptoms and negative mental health effects, they also demonstrated appreciation of having a job at all amid the restructuring of airline human resources and overcame the stressors by reconciling them with job instability issues triggered by the pandemic. © 2021 Asia Pacific Tourism Association.

THE IMPACT OF THE COVID-19 PANDEMIC ON LIVER BIOMARKERS AND QUALITY OF LIFE IN PATIENTS WITH NAFLD

Background: The coronavirus disease 2019 (COVID-19) pandemic has been detrimental to those with chronic diseases, even those without infection. Management of non-alcoholic fatty liver disease (NAFLD) centers on weight management and optimization of metabolic risk factors, requiring a multi-disciplinary approach. Periods of quarantine and inactivity therefore pose limitations on lifestyle modifications and potentially impact both liver-related and health-related quality of life (HRQOL) outcomes. This study aims to identify the effects of the COVID-19 pandemic and alterations in healthcare access on patients with NAFLD. Methods: This study utilized a prospectively enrolled cohort of patients with NAFLD seen at the Innovative Center for Health and Nutrition in Gastroenterology (ICHANGE), a multidisciplinary clinic which targets treatment of obesity and related diseases in New York. Patients included had a comprehensive initial evaluation during the pre-pandemic period within six months of the first COVID-19 case at our institution (October 1, 2019 to March 3, 2020) and had follow-up with repeat laboratory data. Studied outcomes included changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), metabolic markers (hemoglobin A1c and lipids), weight and body composition. 16 patients had follow-up HRQOL data measured by the Chronic Liver Disease Questionnaire (CLDQ) and Short-Form 26 (SF-36) Health Survey. Secondary analysis compared those with at least three provider visits to those with fewer to evaluate for impact of medical care during this period. Analysis was performed using the Wilcoxon signed-rank test and the Mann-Whitney U test. This study was approved by the Institutional Review Board of Weill Cornell Medicine. Results: Of the 29 patients included patients, the mean age was 52 years and pre-pandemic body mass index 33.54 kg/m2 (Table 1). Overall, there was no significant change in weight during this period (p= 0.07), though skeletal muscle and truncal fat mass both decreased (p=0.02). Hemoglobin A1c and AST decreased upon follow-up (p=0.002 and p=0.04, respectively), though there was no significant change in ALT or lipids. There was an increase in both CLDQ and SF-36 total and composite activity and emotional scores though not to a significant degree, and was irrespective of the number of provider visits (Table 2). Conclusion: This cohort of motivated patients with NAFLD following within a resource abundant multidisciplinary clinic showed mild improvement in select biomarkers and body composition, though there was no significant improvement in the remainder of objective measures to the degree expected, which may have been limited by the COVID-19 pandemic. Though not significant in this cohort, the overall trend in improvement in HRQOL highlights the importance of ongoing targeted care within this at-risk group. (Table presented.)