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With the COVID-19 pandemic, efforts focusing on student engagement in science, technology, engineering, and math (STEM) courses have shifted towards engagement in online instruction, resulting in a need for increased understanding of how instructors adapt active learning from in person instruction to online learning. Active learning occurs in many different formats across different classrooms. Despite these broadly different formats, a common thread across all active learning is that using it in classrooms results in greater student engagement as compared to passive listening to lectures. Educational researchers have found that active learning has a positive impact on student outcomes, especially for underrepresented students in STEM.The research outlined in this paper seeks to understand how instructors are adapting from in person courses and the strategies they use to engage students in online STEM courses. To do this, we interviewed 20 instructors who were using active learning in teaching an online STEM course about the strategies they were using to engage their students in online activities. We coded these interviews using a grounded theory approach. After several rounds of coding, we found six overarching themes about how instructors viewed active learning in their online classrooms: Instructor Emotion, Instructor Strategy, Instructor Goal, Active Learning Example, Instructor Barrier, and Student Behavior. This paper focuses on the instructor strategy theme and its 55 individual codes. © 2022 IEEE.
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BACKGROUND: Transplant patients have poor outcomes in coronavirus-disease 2019 (COVID-19). The pandemic's effects on rural patients' overall care experience, attitudes to telemedicine, and vaccination are poorly understood. METHODS: We administered a cross-sectional survey to adult kidney transplant recipients in central Pennsylvania across four clinical sites between March 29, 2021 and June 2, 2021. We assessed the pandemic's impact on care access, telemedicine experience, attitudes toward preventive measures, vaccination, and variation by sociodemographic variables. RESULTS: Survey completion rate was 51% (303/594). Of these, 52.8% were rural residents. The most common impact was use of telemedicine (79.2%). Predominant barriers to telemedicine were lack of video devices (10.9%), perceived complexity (5.6%), and technical issues (5.3%). On a 0-10 Likert scale, the mean positive impression for telemedicine was 7.7; lower for patients with telephone-only versus video visits (7.0 vs. 8.2; p < .001), and age ≥60 years (7.4 vs. 8.1; p = .01) on univariate analyses. Time/travel savings were commonly identified (115/241, 47.7%) best parts of telemedicine and lack of personal connection (70/166, 42.2%) the worst. Only 68.9% had received any dose of COVID vaccination. The vaccinated group members were older (58.4 vs. 53.5 years; p = .007), and less likely rural (47.8% vs. 65.2%; p = .005). Common themes associated with vaccine hesitancy included concerns about safety (27/59, 46%), perceived lack of data (19/59, 32%), and distrust (17/59, 29%). At least one misconception about the vaccines or COVID-19 was quoted by 29% of vaccine-hesitant patients. CONCLUSIONS: Among respondents, the pandemic significantly impacted healthcare experience, especially in older patients in underserved communities. COVID-19 vaccination rate was relatively low, driven by misconceptions and lack of trust.
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Most studies on the novel COVID-19 pandemic have focused mainly on human health, food systems, and employment with limited studies on how farmers implement sustainable agricultural practices (SAPs) in response to the pandemic. This study examines how perceptions of COVID-19 shocks influence the adoption of SAPs among smallholder farmers in Ghana. We find that perceptions of COVID-19 shocks influence the probability and intensity of SAPs adoption. Secondly, households who anticipated COVID-19 shocks recorded heterogeneity effects in the combinations (complementarity and substitutability) of SAPs. Farmers who anticipated an increase in input prices and loss of income due to COVID-19 recorded the highest complementarity association between pesticide and zero tillage while farmers who expected limited market access reported the highest complementarity between mixed cropping and mulching. Farmers who projected a decrease in output prices complements pesticides with mixed cropping. The findings suggest that understanding the heterogeneity effects in the combinations of SAPs due to COVID-19 shocks is critical to effectively design, target and disseminate sustainable intensification programs in a post-pandemic period.
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COVID-19 , Pesticides , Agriculture , COVID-19/epidemiology , Farmers , Ghana , Humans , PandemicsABSTRACT
This study provides new evidence on the determining factors of cropland allocation decisions within the context of the COVID-19 pandemic by using the seemingly unrelated regression (SUR) model on 309 farm households. The results reveal that socio-economic, production, institutional, and political factors significantly influence the choice and size of cropland allocation decisions among legumes and cereals. Beyond these factors, we find that COVID-19 education increases land area allocated to staples while perception of disruptive effect of COVID-19 on agriculture positively correlates with the area under commercial crop (soybean) production. The implications of the results are discussed.
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Background: High-risk smoldering multiple myeloma (HR-SMM) is associated with a greater risk of progression to symptomatic disease, suggesting the need for early, efficacious therapeutic interventions to improve outcomes. The ongoing, randomized Phase 3 ITHACA study (NCT04270409) is evaluating efficacy and safety of the anti-CD38 monoclonal antibody isatuximab (Isa) in combination with lenalidomide (R) and dexamethasone (d) (Isa-Rd) vs Rd in patients (pts) with HR-SMM. We report here preliminary results from the safety run-in part of this trial. Methods: The primary objective was to confirm the recommended dose of Isa in combination with Rd. Pts were eligible if diagnosed with SMM within 5 years and HR-SMM defined by the Mayo ‘20-2-20’ and/or updated PETHEMA model criteria. Minimal residual disease and imaging by MRI and low-dose whole-body CT/PET-CT will be assessed at fixed time points. Results: As of April 12, 2021, 23 pts (median age, 63 [28–85] years;median time from initial diagnosis, 1.14 [0.1–5.2] years) had received Isa 10 mg/kg once weekly then biweekly (QW-Q2W) in combination with Rd. The median number of cycles was 7 (range, 4–10) and median duration of treatment exposure was 29.7 (range, 16.0–38.0) weeks. Two pts met the Mayo clinical model criteria, 13 pts the PETHEMA model criteria, and 8 pts both models’ criteria for HR-SMM. No pt presented with focal lesions at baseline. Seven (30.4%) pts developed 8 grade ≥3 non-hematologic treatment-emergent adverse events (TEAEs): COVID-19 pneumonia, insomnia (2 each), papular rash, muscle spasm, retinal detachment and hyperglycemia (1 each);no pt experienced a grade 5 TEAE and no pt discontinued treatment due to a TEAE. Serious TEAEs were COVID-19 pneumonia (n=2, grade ≥3) and pneumonia, musculoskeletal chest pain and pyrexia (n=1 each, grade <3). The most common, mostly grade 1–2 TEAEs were insomnia (39%) and constipation, headache, and peripheral edema (22% each). Infusion reactions were reported in 2 pts (8.7%) (grade 2, infusion day 1/cycle 1). By laboratory results, no grade 3–4 anemia or thrombocytopenia was observed;grade 3 neutropenia was reported in 5 pts (21.7%), with no grade 4. Isa exposure and CD38 receptor occupancy were in accordance with other MM studies, reaching target saturation in bone marrow plasma cells. The overall response rate was 86.9%;21.7%, 17.4%, and 4.3% of pts have so far achieved very good partial response (VGPR), complete response (CR) and stringent CR (sCR), respectively. Conclusions: Addition of Isa 10 mg/kg QW-Q2W to Rd was associated with a favorable safety profile in pts with HR-SMM, which compares well with Rd literature data in the same patient population. Isa-Rd has shown encouraging preliminary efficacy (21.7% sCR/CR and 43.4% ≥VGPR rates) in pts with HR-SMM. These results confirm the recommended dose of Isa for the randomized part of the Phase 3 ITHACA study, which will further evaluate efficacy and safety of Isa-Rd in HR-SMM. Funding: Sanofi.
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IntroductionDistance from a transplant centre may present a barrier to liver transplant referrals and transplant recipients report disliking travel for long-term follow-up. A liver transplant outreach service based at Manchester Royal Infirmary (MRI) was established collaboratively between the MRI and a transplant centre in Sept 2019. We report the outcomes from this service.MethodsThe service runs one day/month and includes post-transplant reviews, transplant assessment triage clinic and a ‘working lunch’ complex case meeting. Baseline transplant assessment + listing data between April 2017- March 2019 for chronic liver disease indications were collected and compared with those between Sept 2019-Dec 2020, in addition to other service activity data.ResultsIn the 24 month period in 2017-19 there were 11 chronic liver disease (CLD), excluding HCC, transplant assessments from the MRI. Only 8 were assessed as outpatients. Median referral UKELD was 56. 7/11 were listed with an assessment:listing conversion of 63%.In the 15 month period Sept 2019-Dec 20 there were 27 pre-transplant reviews with 20 new patients, 4 with HCC and 16 with CLD. One CLD patient had associated HCC. The commonest liver disease indication for review was alcohol related in 8 patients. Nineteen (90%) patients were reviewed for transplant assessment suitability. 12 (63%) were referred for assessment with investigations done locally. 9 (75%) were for chronic liver disease indications and 3 (25%) were for HCC. Median UKELD was 53.5.9 assessments have been completed, with 8 wait-listed. None were converted to inpatient assessments. Overall assessment:listing conversion is high: 8/9(88.8%) overall. 3 transplanted to date. 2 HCC patients had bridging therapies locally.Of 7 not referred for assessment, 1 was suitable for a TIPSS locally, 1 needed pre-habilitation and is under follow-up, 1 was out-with HCC criteria + is managed locally (still alive). 3 were too advanced/frail + all have since died. 1 was initially thought suitable for assessment but did not progress due to alcohol relapse. During the period April 20-Aug 20 only 1 pre-transplant patient was referred as NHS services were curtailed due to the Covid-19 pandemic.112 post-transplant reviews have been delivered, in 82 recipients. 98% gave positive feedback. Post-transplant interventions delivered locally include 2 liver biopsies, 1venogram + the management of 1patient with acute rejection.ConclusionDespite the pandemic this service provided improved pre-transplant outcomes in a shorter time frame cf. the preceding 2 years and saved 139 appointments in the transplant centre. The service is efficient, popular with patients, and adds to the case for the widespread adoption of similar partnerships within liver transplant networks.
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Background: While governments draw on survey data to inform policy choices, the design, application, and interpretation of surveys can generate certain images of disability and ignore many others. Aims and objectives: This article draws attention to social circumstances of people with disabilities often unacknowledged in research evidence: hidden figures of disability. Methods: Selected results from the Canadian Survey on Disability are examined with a focus on working-age youth and adults (aged 15 to 64) with a range of disabilities. Findings: Five figures of disability and corresponding conceptual models are identified. These hidden figures of disability are the uncounted, those with needs unsupported, youth in multiple transitions, potential workers, and what may be called 'the fearful'. Several models of disability are identified intersecting with the evidence. These are the absent citizen, biomedical model and charitable model, social and economic integration model, human rights and full citizenship, and psycho-emotional model of affective disablism and ableism. Discussion: Hidden figures of disability are more than statistical tests and texts;more than calculations derived from quantitative research where people become a data point.The function of drawing hidden figures is to disclose and describe the bodily experiences of people with disabilities in their social positions and structural contexts. Conclusion: We need to see the production of evidence for policy not as painting a portrait but as portraits in the plural, and appreciate not only what is in the frame but also what faces and forms of knowledge get glossed over or brushed aside.