Who owns spiritual care, and why does it matter?

At our unique juncture in history, challenged by a global pandemic, the impact of climate change, and a polarized political landscape, more and more people are seeking mental health assistance (Mochari-Greenberger & Pande, 2021), and a larger proportion of those who seek help are describing existential or spiritual concerns (Chirico, 2021; Kondrath, 2022). Many psychologists may be experiencing themselves as insufficiently prepared to help with spiritual concerns (Vogel et al., 2013); the mission of this special section is to facilitate discourse and dissemination of resources among chaplains and psychologists to explore the interdisciplinary dynamics of spiritual care and to establish a foundation for the expansion of ethically appropriate, spiritually integrated care where needed. All of the articles presented in this special section were reviewed by both chaplains and psychologists, and often by professionals cross-trained in both fields. Our hope is that this special section will serve to increase interdisciplinary collaboration so that both chaplains and psychologists can provide appropriate services to rise to the present constellation of crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Moral injury and psychosocial functioning in health care workers during the COVID-19 pandemic.

Studies of moral injury among nonmilitary samples are scarce despite repeated calls to examine the prevalence and outcomes of moral injury among civilian frontline workers. The purpose of this study was to describe the prevalence of moral injury and to examine its association with psychosocial functioning among health care workers during the COVID-19 pandemic. We surveyed health care workers (N = 480), assessing exposure to potentially morally injurious events (PMIEs) and psychosocial functioning. Data were analyzed using latent class analysis (LCA) to explore patterns of PMIE exposure (i.e., classes) and corresponding psychosocial functioning. The minimal exposure class, who denied PMIE exposure, accounted for 22% of health care workers. The moral injury-other class included those who had witnessed PMIEs for which others were responsible and felt betrayed (26%). The moral injury-self class comprised those who felt they transgressed their own values in addition to witnessing others' transgressions and feeling betrayed (11%). The betrayal-only class included those who felt betrayed by government and community members but otherwise denied PMIE exposure (41%). Those assigned to the moral injury-self class were the most impaired on a psychosocial functioning composite, followed by those assigned to the moral injury-other and betrayal-only classes, and finally the minimal exposure class. Moral injury is prevalent and impairing for health care workers, which establishes a need for interventions with health care workers in organized care settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comparison of Sedation Requirements in Vv Ecmo Patients with Sars-Cov-2 Versus Non-Sarscov- 2 Ards

INTRODUCTION: Increased sedation and analgesia requirements have been described in patients with acute respiratory distress syndrome (ARDS) on veno-venous (VV) extracorporeal membrane oxygenation (ECMO) support due to unique pharmacokinetic challenges. The primary objective of this study was to compare analgesia and sedation requirements in adult patients with SARS-CoV-2 ARDS versus other etiologies of ARDS requiring VV-ECMO support. METHOD(S): This was a retrospective cohort study of adult patients requiring VV-ECMO for ARDS between May 2016 and July 2021. Patients were excluded if cannulated at an outside hospital for greater than 24 hours, expired within 48 hours of ECMO cannulation, or received neuromuscular blocking agents for greater than 7 consecutive days. The primary outcome of the study was the daily median dose for continuous infusion analgosedation for 7 days following ECMO cannulation. Secondary outcomes included the daily median analgosedation requirements utilizing the highest daily rate, ICU length of stay and mortality, and incidence of adjunct sedation, analgesia, and anxiolytic use while on VVECMO. RESULT(S): Of 108 patients evaluated on VV-ECMO support, 44 had non-SARS-CoV-2 ARDS and 64 had SARS-CoV-2 ARDS. The median daily dexmedetomidine requirements were significantly higher in the SARS-CoV-2 cohort (16.7 vs. 13.4 mcg/kg/day, p=0.03), while the median propofol daily requirements were significantly higher in the non- SARS-CoV-2 cohort (40.3 vs. 53.5 mg/kg/day, p < 0.01). There was no difference in daily requirements of opioids, benzodiazepines, and ketamine between groups. Patients in the SARS-CoV-2 cohort remained on greater than 2 continuous infusion agents significantly longer than the non-SARS-CoV-2 cohort (3.0 vs. 2.0 days, p=0.04). Use of non-parenteral adjunct agents was significantly higher in the SARS-CoV-2 cohort (78.1% vs. 43.2%, p< 0.01). CONCLUSION(S): Patients with ARDS on VV-ECMO support require multiple analgesic and sedative agents with higher utilization of non-parenteral adjunct agents in the SARSCoV- 2 ARDS cohort. To circumvent these challenges, ECMO centers should consider implementation of ECMO-specific analgosedation protocols to optimize patient outcomes.

ASSOCIATIONS BETWEEN COVID-19 VACCINE HESITANCY AND SOCIOSPATIAL FACTORS IN NYC TRANSIT WORKERS 50 YEARS AND OLDER

This analysis aimed to investigate how age, race/ethnicity, and geographical location contributed to vaccine hesitancy in a sample of New York City (NYC) Metropolitan Transit Authority (MTA) workers. Transport Workers Union, Local 100 members completed online surveys in August 2020 about their COVID-19 history, workplace protections and policies, fear of COVID-19 exposure, vaccination attitudes, and sociodemographic and health characteristics. We conducted univariate and bivariate analyses, followed by multivariate logistic regression, to determine the association between respondent age (younger than 50 vs. 50+) and vaccine hesitancy (willing vs. unwilling/unsure). We also produced spatial visualizations to examine these factors by participants' zip codes. Of 645 respondents, 59% were 50 years or older, 53% were non-White, and 71% expressed vaccine hesitancy. MTA workers ages 50+ were 46% less likely to be vaccine hesitant than their younger counterparts (OR 0.64;95% CI 0.42, 0.97). Compared to Whites, non-Whites (OR 3.95;95% 2.44, 6.39) and those who did not report their race (OR 3.10;95% CI 1.87, 5.12) were significantly more likely to be vaccine hesitant. Those who were not concerned about contracting COVID-19 in the community had 1.83 greater odds (95% CI 1.12, 2.98) of being vaccine hesitant than those who were concerned. Spatial visualizations revealed that the oldest respondents tended to reside in Queens. Zip codes with high vaccine hesitancy were clustered in Brooklyn, where non-White respondents tended to reside. The trends observed in COVID-19 vaccine hesitancy based on race and age persist in a population of high risk, non-healthcare essential workers.

Working every weekend: The paradox of time for insecurely employed academics

Wage theft claims against Australian universities have raised awareness of the substantial proportion of academics who are precariously employed and underpaid. The COVID-19 global pandemic has further highlighted the extent of precarity for many working in higher education. It is in this context that we situate this paper, reflecting on how time is experienced for academics in a period of growing uncertainty, and what this means for individuals who work on casual or fixed-term contracts. While previous research has examined how academics experience time, limited attention has been paid to the ways in which time is experienced by those in precarious employment. Drawing on interviews with 24 academics employed on casual or fixed-term contracts, this paper investigates differences between the experiences of time for those in the 'precariat' and those in ongoing employment. We describe social acceleration and uncertainty as inherent features of the neoliberal context of academia. This paper builds on Ylijioki and Mantyla's categories of academic time to illustrate how the paid work of precariously employed academics consists primarily of 'scheduled time'. We argue, however, that academics in short-term or casual employment also engage in substantial unpaid work or 'concealed time' in order to compete for future employment. While acknowledging the struggles associated with the acceleration of work for all academics, this paper raises significant concerns about the overwork and risk of burnout for those in precarious employment.

Global Competency Through Collaborative Online International Learning (COIL)

There is a need for college students to develop global perspectives and gain cultural awareness to become responsible global citizens. Innovative ways to create such experiences are known as Collaborative Online International Learning (COIL experiences). COIL is a voluntary partnership between professors in different countries collaborating on jointly constructed learning experiences to enhance international and intercultural understanding. The purpose of this article is to highlight a successful COIL partnership between students from SUNY Oswego in New York and The Hague University of Applied Sciences in the Netherlands during the COVID-19 pandemic. 35 students participated in the experience that served as a platform to educate students through a health educator's unique cultural lens. Benefits from the experiences regarding global outcomes showed that both US students (n=70.6%) and Holland students (n=61.1%) felt they gained the appropriate skills and knowledge to use in their future careers. 70.6% of US and 61.2% of Holland students reported that the COIL experience introduced them to a new outlook and new ways of thinking about how they relate to the world. The current COVID-19 pandemic has created an opportunity to rethink education pathways and integrate global learning in our classrooms.

The effects of loneliness and psychological flexibility on veterans' substance use and physical and mental health functioning during the COVID-19 pandemic.

During the COVID-19 pandemic, social isolation was a common experience as people were trying to keep themselves and others safe from infection. Veterans with problematic substance use are at particular risk of the consequences of social isolation. This study evaluated the nature of social interactions during the COVID-19 pandemic and the effects of loneliness and psychological flexibility on self-reported substance use and physical and mental health functioning among U.S. veterans who reported problematic substance use. Data from 409 veterans with self-reported substance use concerns were obtained via a cross-sectional online survey. Results showed that many veterans who engaged in problematic substance use during the COVID-19 pandemic reported a number of social supports during this period and frequent communication with others, but still felt lonelier during the pandemic. In regression analyses, higher levels of loneliness were associated with more negative impacts of the pandemic, greater substance use, and poorer physical and mental health functioning. Psychological flexibility demonstrated significant unique variance in explaining mental health functioning during the pandemic after accounting for loneliness, but not for substance use or physical functioning. For veterans with high levels of loneliness, high levels of psychological flexibility were associated with a lower negative impact on quality of life due to the pandemic, but for veterans with low levels of loneliness, differing levels of psychological flexibility were not significantly associated with the negative impact of COVID-19. Overall, loneliness and psychological flexibility appear to be highly associated with the negative impact of COVID-19 on veterans with problematic substance use.

Development of a Polypharmacy-Based Outreach System for Pharmacist-Led Annual Wellness Visits

Introduction: Less than 20% of Medicare beneficiaries receive an Annual Wellness Visit (AWV) each year. Employing non-physician professionals to perform AWVs is one strategy to overcome the underutilization. Previous studies suggested polypharmacy as a way to operationalize pharmacy-led AWVs. However, the effectiveness of using a simple electronic medical record (EMR) outreach to recruit patients, with a goal of addressing medication-related problems (MRPs) and impacting quality measures, has not been fully investigated yet. Research Question or Hypothesis: Do numbers of polypharmacybased outreach correlate with numbers of pharmacist-led AWV appointments within a healthcare system? Study Design: Prospective cross-sectional study using EMR records Methods: Outreach was conducted from December 2021 to February 2022 by either pharmacists or non-pharmacist team members via EMR messaging in six primary care clinics. Targeted patients were: AWVeligible Medicare beneficiaries with ≥7 medications. Patients who were ≥90 years of age, had their last primary-care visit >1 year, or 'did not have an active EMR portal were excluded. The number of scheduled AWV visits were tracked as the primary outcome, and types of interventions made were collected for the secondary objective. Spearman correlation between the number of the outreach and AWV appointments was evaluated, using JMP Pro v.16, with significance level at 0.05. Results: The number of outreaches correlated to the number of AWVs scheduled (Spearman's rho=0.83, p=0.04) and MRPs identified (Spearman's rho=0.89, p=0.02). A total of 108 AWVs were conducted with 21 medications and 114 labs ordered, 15 referrals and 38 imaging/procedure placed, 16 vaccines given, 27 care gaps addressed, and 190 MRPs identified. Reported barriers to scheduling AWVs included appointment availability and COVID-related changes in workflow. Conclusion:The number of polypharmacy-based outreaches conducted was correlated with the number of pharmacist-led AWV appointments and MRPs identified during the visits. Although pharmacists have demonstrated proficiency at conducting AWVs, additional challenges were identified to operationalize pharmacyled AWVs.

Exposure to potentially morally injurious events and mental health outcomes among frontline workers affected by the coronavirus pandemic.

OBJECTIVE: The current studies explored associations between exposure to potentially morally injurious events (PMIEs) and mental health outcomes among frontline workers affected by the coronavirus pandemic. METHOD: We administered online self-report surveys to emergency responders (N = 473) and hospital personnel (N = 854) in the Rocky Mountain region of the United States between April and June of 2020. Surveys assessed frequency and intensity of exposure to PMIEs alongside psychological and functional outcomes. RESULTS: Between 20% and 30% of frontline workers reported exposure to PMIEs of at least moderate frequency and intensity. Exposure to more intense PMIEs was associated with greater psychological symptoms (i.e., stress, depression, and anxiety) and functional impairment (i.e., professional burnout), especially among emergency responders who reported frequent exposure but also hospital workers who reported few exposures. CONCLUSION: Efforts to facilitate and maintain the well-being of the public health workforce should specifically address critical incidents encountered by frontline workers that have embedded moral and ethical challenges. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

THE IMPACT OF IBS ON SELF-REPORTED PHYSICAL AND MENTAL HEALTH DURING THE COVID PANDEMIC – A NORWEGIAN TWIN STUDY

Background: Irritable bowel syndrome (IBS) is a stress-sensitive gut-brain disorder. The outbreak of Covid-19 has influenced the level of stress and anxiety at least for some people. Individuals with IBS often report poor self-rated health (SRH), which also reflects psychological and social aspects of life and an overall sense of well-being. This populationbased twin study evaluates whether the Covid pandemic has affected self-reports of abdominal symptoms of IBS and ratings of physical (p_SRH) and mental health (m_SRH) among individuals with IBS. Further, we calculate measures of twin similarity and correlations across traits to gain insights into the importance of genetic influences. Methods: In July 2021, we invited 17138 twins from the Norwegian Twin Register to complete a questionnaire asking how the pandemic affected their health and well-being, including depression, perceived stress, loneliness, anxiety, chronic somatic and pain-related diseases. Responses were received from 9032 twins, aged 19 – 86 of whom 831 reported a positive history of IBS (Table 1). Hierarchical regression models were used to estimate the impact of IBS on p_ SRH and m_SRH during the Covid pandemic, covariates in the stepwise modeling included age, sex, education, and other chronic physical and mental health conditions. Phenotypic, intraclass and cross-twin cross-trait correlations were computed for IBS and the health measures. Results: The majority of individuals with IBS reported no changes in abdominal pain or bowel disturbance during the pandemic. Nonetheless, they did report worse perceptions of health compared to those without IBS. Further findings revealed weak but significant associations between IBS and changes in perceived stress. Age was inversely related to ratings for p_SRH and m_SRH, with younger participants reporting that their mental and physical health worsened more than older participants. IBS retained significance as a predictor of worsening m_SRH after accounting for depression and perceived stress (model 5, Table 2) [OR = 1.22 (1.00;1.50), Table 2]. The intraclass correlations for worse p_SRH and m_SRH were greater among monozygotic (MZ) than dizygotic (DZ) twins, which is consistent with genetic variance explaining some of the differences in how the pandemic has affected perceptions of health. Cross-twin cross-trait correlations between IBS and worse p_SRH were 0.15 (0.11;0.18) for MZ twins and 0.08 (0.03;0.12) for DZ twins, suggesting that common genetic factors may underlie this relationship Conclusion: Abdominal symptoms of IBS did not change during the pandemic. However, IBS was predictive of worsening of mental SRH, not confounded by depression or perceived stress. These results underscore the role of psychosocial and emotional factors for mental health in IBS during the pandemic. (Table Presented) (Table Presented) (Table Presented) (Table Presented)

“More Worthwhile than the Paycheck”: An Innovative Summer Internship in Northern Manhattan to Engage Youth in Food Justice Promotion

Purpose: Youth engagement in food justice movements to address healthy food access and nutrition-related disparities is a powerful tool for community health promotion and youth empowerment. Such opportunities are often unpaid and inaccessible to low-income youth. Launched in 2019, NewYork-Presbyterian Hospital (NYP) Youth Market is a paid 8-week summer internship in Northern Manhattan that engages youth in a community health intervention and supports their personal professional development. Methods: Youth ages 16-22 were recruited from NYP partner schools and youth programs in Washington Heights, Inwood, and the South Bronx, communities with suboptimal access to healthy food and disparately high rates of obesity and food insecurity. Interns managed their own weekly farm stand and provided nutrition education and cooking demonstrations at GrowNYC Fort Washington Greenmarket. They participated in didactics led by NYP staff and community partners on nutrition and disease, food systems, and small business management. Due to COVID-19, the 2020/2021 programs were adapted to become partially-virtual with interactive didactics on Zoom, and responded to community needs by distributing emergency food packages to food insecure families. Matched, de-identified pre-post online surveys for 2021 assessed attitudes, self-efficacy, and lessons learned via Likert scale (analyzed using Wilcoxon signed-rank test) and open-ended questions (assessed for common themes). Results: 2021 interns (n=20, median age=17, 100% self-identified as persons of color) largely aspired to careers in healthcare/public health/nutrition (65%). Youth led 21 nutrition workshops for community members;a total of 17,645 pounds of healthy food was distributed to the community via farm stand sales, emergency food distributions, donations, and redemptions of NYP fruit and vegetable prescriptions. Pre-post analysis findings (missing=1) demonstrated several statistically significant findings of improvement. Interns self-reported a median increase of one more fruit (p<0.01) and one more vegetable (p<0.01) eaten per day, but did not significantly change their sugar-sweetened beverage consumption (p=0.48). Youth expressed increased confidence (5-point scale: 1=not confident at all to 5=very confident) in their ability to share information with friends/family about healthy eating (mean pre=3.20, post=4.21, p<0.01) and information on resources for someone experiencing food insecurity (mean pre=2.40, post=4.00, p<0.001). In response to open-ended questions, interns emphasized improvement in their public-speaking/communication skills and felt enriched by mentorship from both their peers and a diverse group of professionals. They gained positive feelings of community connectedness through customer nutrition education and emergency food distributions. One intern stated, “There are so many people that don't have the key information about nutrition and how to overall live healthy lives and it's so important to acquire and spread this knowledge because it allows you to become self-reliant and more responsible with your lifestyle.” Another intern commented, “The experience is so much more worthwhile than the paycheck”. Conclusions: NYP Youth Market demonstrates a valuable model of youth engagement in paid work to promote community access to healthy food, improve their own nutrition behaviors, and develop their burgeoning health careers. Next steps include developing program enhancements, such as hands-on farming experience and strengthening the program’s mentorship component. Sources of Support: NewYork-Presbyterian Hospital Choosing Healthy & Active Lifestyles for Kids Program, partnered with GrowNYC Greenmarkets.

By the seat of our pants: the experience of small businesses in the COVID-19 pandemic, Washington State, March-October 2020

Introduction: Most US businesses are small, yet they employ almost half of the nation's workforce. Literature is limited about how small employers (those with 20-250 employees) have made decisions about operating their businesses during the COVID-19 pandemic. We sought to learn how employers made these decisions, what information sources they used, what information they wanted, and to what extent they worked with or used information from their local health department.

Interrogating the Effect of Assay Media on the Rate of Virus Inactivation of High-Touch Copper Surfaces: A Materials Science Approach

Contamination of high-touch surfaces with infected droplets of bodily secretions is a known route of virus transmission. Copper surfaces have been reported to inactivate human coronaviruses after several minutes, via the release of Cu cations. Utilization of copper alloys for high-touch surfaces can be a pivotal preemptive strategy for preventing the next pandemic. Understanding the true efficacy by which copper, and copper alloys, inactivate the virus under realistic conditions is essential for tuning intrinsic alloy features such as composition, grain orientation, and surface attributes, to optimize for antiviral function. However, virus inactivation measurements depend on the presence of an assay media (AM) solution as a carrier for the virus, and its effects on the surface properties of pure copper that regulate oxidative copper release are previously unknown. Herein, these properties and the influence of AM on the efficacy of virus inactivation occurring on the surface of pure copper are investigated. The process is uncovered by which a five-fold decrease in virus half-life is observed in simulated real-life conditions, relative to exposure to traditional AM. The investigation highlights the notion that virus inactivation on copper surfaces may be significantly more effective than previously thought. © 2022 The Authors. Advanced Materials Interfaces published by Wiley-VCH GmbH.

The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study.

As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.

Comparing disciplinary engagement in global health research across the social sciences

Objectives What did social science disciplines contribute to the study of global health before the coronavirus pandemic? This article compares the contributions of four major social science disciplines-anthropology, economics, political science, and sociology-to the study of global health. Methods We assessed disciplinary contributions through analysis of Web of Science;disciplinary annual reviews;and each discipline's top two general focus journals, complemented by literature reviews. Results Of the four disciplines, anthropology and economics have contributed relatively more in quantitative terms, although qualitative contributions have been refracted through the larger histories, methods, and theoretical concerns. Although interest in global health research has grown across the disciplines, only in anthropology has it achieved a measure of prominence in top journals. Conclusion Cross-disciplinary comparison draws out how each discipline approaches global health;which topics it studies;and the topic's centrality/marginality within the broader disciplines.

Disparities in SARS-CoV-2 Antibody Prevalence: Findings from a Citywide Serosurvey in Holyoke, Massachusetts, November 2020-January 2021

Background. Seroprevalence studies are important tools to estimate the prevalence of prior or recent SARS-CoV-2 infections. This information is critical for identifying hotspots and high-risk groups and informing public health responses to the COVID-19 pandemic. We conducted a city-level seroprevalence study in Holyoke, Massachusetts to estimate the seroprevalence of SARS-CoV-2 antibodies and risk factors for seropositivity. Methods. We invited inhabitants of 2,000 randomly sampled addresses to participate between November 5 and December 31, 2020. Participants completed questionnaires measuring sociodemographic and health characteristics, and COVID-19 exposure history, and provided dried blood spots for measurement of SARS-CoV-2 IgG and IgM antibodies. To calculate total and group seroprevalence estimates, inverse probability of response weights were constructed based on age, gender, race/ethnicity and census tract to ensure estimates represented the city's population. Results. We enrolled 280 households including 472 individuals. 328 underwent antibody testing. The citywide weighted seroprevalence of SARS-CoV-2 IgG or IgM was 13.9% (95%CI 7.8 - 21.8) compared to 9.8% based on publicly reported case counts. Seroprevalence was 16.8% (95%CI 5.7 - 28.0) among individuals identifying as Hispanic compared to 8.9% (95%CI 3.0 - 14.7) among those identifying as White. Seroprevalence was 20.7% (95%CI 2.2 - 39.2) for ages 0-19;13.8% (95%CI 5.6 - 22) for ages 20 - 44;9.6% (95%CI 0 - 20.5) for ages 45 - 59;4.8% (95%CI 0 - 10.2) for ages 60 - 84;and 42.9% (95%CI 0 - 100) for ages >85. Conclusion. The measured SARS-CoV-2 seroprevalence in Holyoke was only 13.9% during the second surge of SARS-CoV-2 in this region, far from accepted thresholds for "herd immunity" and highlighting the need for expanding vaccination. Individuals identifying as Hispanic were at high risk of prior infection. Subsequent community-level serosurveys are necessary to guide local responses to the SARSCoV-2 pandemic.