A Tale of Two Counties With the Same Telehealth Story: Experience with Cancer Genetics Testing During COVID-19 at a Community Hospital

Introduction: With the onset of the COVID-19 pandemic in 2020, the utilization of telemedicine now offered an alternative diagnostic and treatment resource to providers in many areas of medicine including oncology and cancer genetics. This care option paired with genetic testing labs' ability to send saliva-based DNA collection kits to patients, enabled our community hospital in Detroit to offer diagnostic testing without the patient coming to a healthcare setting for a host of reasons. Social determinants of health have been found to influence success with telehealth, and this study sought to analyze how successful telehealth cancer genetics care was throughout the Detroit Metro area. Methods: Patient demographics for in person visits six months before COVID were analyzed, and then compared with demographics of patients during the 2020-2021 pandemic period where visits were telehealth. Results: Pre-pandemic there were , 192 unique patients seen in person with the top three cities patients were from were Detroit (12.1%), Clinton Township (8.3%), and Saint Clair Shores (10.4%). During the pandemic, with telehealth as the major modality, the top three cities were Macomb (7.2%), Detroit (7%), and Clinton Township (7%). Detroit is in Wayne County, while St.Clair Shores and Clinton Township are in Macomb County. Per the US Census Bureau Macomb county has a median income of $64,641 and Wayne county has a median income of $49,359, and poverty level in Macomb county is 9.2% versus in Wayne the level is 20%. Conclusions: This paper outlines the challenges of initiating a telemedicine program in an urban community area and highlights the benefits of a concierge service in serving cancer patients who may have economic and historically poor perceived technologic abilities.

Cross-Pandemics - Turning Something Bad into Something Good

Intro: COVID-19 the most notorious Public Health Emergency (PHE), changed the way we practice medicine and taught us important lessons. The most effective measures to control pandemic are early administration and equitable access to vaccines and treatments. Governmental Public Health Agencies (GPHA) at all levels should have a leading role in coordination and implementation of control measures. Partnership between GPHA and health systems (HS) may significantly impact the scope of provided services. Monkeypox was declared PHE during the COVID-19 pandemic. It provided an opportunity to apply learned lessons that mitigated COVID-19 pandemic. Method(s): Spectrum Health (SH) is a quaternary-care HS based in Grand Rapids, Michigan. We will describe SH's response to COVID-19 and how we used our COVID experience to handle the Monkeypox outbreak. Finding(s): In response to COVID, through the phased approach (Picture 1) and collaboration with internal departments and GPHA, we opened a new clinic. Clinic was initially intended for parenteral COVID treatments but gradually evolved into a full COVID treatment center. Within 18 months we treated 12666 patients. Clinic success, efforts made to establish it, and concerns about future pandemics defined the need for a permanent and scalable centralized department which would provide continual community support with a measured response to meet community needs while minimizing impact on hospital resources, thus Community Response Department (CRD) was born. When Monkeypox PHE was declared, CRD responded immediately and efficiently using its resources and established pathways and demonstrated its own utility. Monkeypox treatment and vaccine were available to patients through the CRD within 7 days from governmental approval.Copyright © 2023

Efficacy of home respiratory culture kits in people with cystic fibrosis

Background: Respiratory cultures are an important part of clinical care for people with cystic fibrosis (CF). Telemedicine visits during the COVID-19 pandemic have not allowed for routine collection. To address this, the University of Michigan Adult Cystic Fibrosis Program mailed home culture kits to patients. We hypothesized that results from home sputum samples would be consistent with prior cultures obtained in sputum collected in clinic but that self-collected throat swabs would provide false-negative results. We also sought to determine percentage return rate. Method(s): Adults with CF were sent culture kits containing a specimen cup and a throat swab. Patients had the choice to submit either sample for processing. Medical personnel provided written instructions with the culture kits and, on occasion, instructed patients on proper collection techniques via phone. Samples were then refrigerated for up to 24 hours before a delivery service returned the specimen to a University of Michigan laboratory for analysis. Data collected from December 2020 to December 2021 (N = 77) included percentage return rate, result, source, and presence of microorganisms. Pairwise culture data of samples collected in clinic versus home-collected samples within 1 yearwere included in the analysis. Descriptive statistics and Cohen kappa correlation coefficients were computed for all culture data and subgroups (Table 1A-E). Result(s): Of 77 culture kits returned, 46 had corresponding clinic samples collected using the same method, and the remaining 21 were collected using different methods (throat swab vs sputum sample). Overall, approximately 200 kits were mailed to patients, with a return rate of 38.5%. A similar percentage of positive culture results was obtained with same method of collection: sputum and throat samples (Table 1C, D, E), although the discordance rate between cultures collected in clinic and at home ranged from approximately 10% to 30%. Correlation between clinic and home culture data was generally good throughout, except for clinic Table 1 ( 115): Analysis of respiratory culture results for (A) all cultures, (B) different collection, and (C, D, E) same collection method. *p < 0.05. Cohen kappa correlation coefficient between groups: poor agreement <0.20;fair agreement = 0.21-0.40;moderate agreement = 0.41-0.60;good agreement = 0.61-0.80;very good agreement = 0.81-1.00. PsA = Pseudomonas aeruginosa;Staph = Staphylococcus aureus.(Table Presented)versus home throat swabs, probably because of a lowevent rate in the small sample size. Conclusion(s): The data suggest that, overall, clinic and home culture kits provide similar positive results, although discordance in specific culture results was common. This may be due to natural fluctuations from culture to culture in people with CF. A limitation of this study is that the cultures being compared in our study were not completed on the same day. Nevertheless, our data also indicate that collection technique may influence results for certain microorganisms. How these differences might influence antibiotic selection and treatment outcomes in the era of telemedicine requires more investigation. The return rate was found to be relatively low, demonstrating the need for interventions to improve patient outreach and compliance.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Bearing a higher burden: Black and Latinx community perspectives on the Impact of COVID-19

OBJECTIVES/GOALS: During earlier periods of the pandemic, Black and Latinx populations in Michigan have suffered higher rates of infection, hospitalization, and deaths when compared to Whites. We conducted this study to understand how Black and Latinx residents perceived this disproportionate burden. METHODS/STUDY POPULATION: In 2021, 40 semi-structured interviews were conducted virtually in English or Spanish with Black (n=24) and Latinx (n=16) residents in Michigan areas highly impacted by COVID-19: Genesee, Kent, Washtenaw, and Wayne counties. Using a Community-Based Participatory Research (CBPR) approach, we partnered with leaders from 15 community-based organizations and health and human service agencies to develop research questions, an interview protocol, and to interpret the data. We used the data analysis software Dedoose (ver 4.12) for inductive coding (IRR=0.81). This study is a part of the NIH Community Engagement Alliance (CEAL) Against COVID-19 initiative. RESULTS/ANTICIPATED RESULTS: Participants described the significant impact of the pandemic in terms of physical and mental health, job security, and the sheer number of deaths among loved ones. They attributed the impact to comorbidities and social determinants of health disparities exacerbated by the pandemic, including income, housing, access to healthcare, as well as systemic racism. They noted being overrepresented among frontline workers with higher exposure to COVID-19, limited or misinformation about the virus, language barriers, and difficulty with social distancing. Cultural norms that promote being in close proximity, such as intergenerational households, and loss of trusted community leaders were also noted. DISCUSSION/SIGNIFICANCE: Findings reflect the needs of Black and Latinx community members in Michigan and the discussions they feel are important to highlight. We must work strategically with partners and the community to provide transparency and effective leadership, and prioritize addressing systemic disparities in SDoH.

PTSD Caused by COVID-19 Exposure and its Relation with Vulnerability to Depression and Anxiety

Depression and post-traumatic stress disorder (PTSD) diagnoses frequently co-occur. It has been seen that increases in stress and anxiety among individuals for more than two years into the coronavirus pandemic, with some exhibiting indications of post-traumatic stress, or what is now being called post-COVID stress disorder (Holland, 2019). A generalized feeling of anxiety and anguish has been sparked by COVID-19, especially among sensitive populations. A history of trauma and abuse increases the chance of developing depression, and those same traumatic events may contribute to the development of PTSD. The aim of the current study is to assess whether there is a positive correlation between the post-traumatic symptoms of COVID-19 and vulnerability to experience depression and severe anxiety in individuals. The sample analyzed for this study consisted of 110 individuals inclusive of both males and females within the age range of 20-35. The data were collected using a self-administered scales, i.e., HADS for measuring vulnerability to depression and major anxiety and DTS for measuring PTSD caused due to excess COVID-19 exposure. The data was coded, tabulated and descriptive statistics were conducted. The hypothesis 1 (H ) which states that PTSD caused due to excess COVID-19 exposure has a high positive correlation with vulnerability to depression is accepted as the correlation coefficient obtained for these two variables was 0.72 and the hypothesis 2 (H2) which states that PTSD caused due to excess COVID-19 exposure has a high positive correlation with vulnerability to major anxiety is also proved as the correlational coefficient obtained for these two variables is 0.89. both of these coefficients show a high positive correlation. The results show p<.001 for both the hypothesis which shows that the results are highly significant in the population.

Managing Building Water Disruptions in a Post-COVID World: Water Quality and Safety Risk Assessment Tool for Academic Institutions and School Settings

Fluctuating building occupancy during the COVID-19 pandemic contributed to poor water quality and safety conditions in building water distribution systems (BWDSs). Natural disasters, man-made events, or academic institutional calendars (i.e., semesters or holiday breaks) can disrupt building occupant water usage, which typically increases water age within a BWDS. High water age, in turn, is known to propagate poor water quality and safety conditions, which potentially exposes building occupants to waterborne pathogens (e.g., Legionella) associated with respiratory disease or hazardous chemicals (e.g., lead). Other influencing factors are green building design and municipal water supply changes. Regardless of the cause, an increasing number of water management policies require building owners to improve building water management practices. The present study developed a Water Quality and Safety Risk Assessment (WQSRA) tool to address gaps in building water management for academic institutions and school settings. The tool is intended to assist with future implementation of water management programs as the result of pending policies for the built environment. The WQSRA was modeled after water management practices created for controlling water contaminants in healthcare facilities. Yet, a novel WQSRA tool was adapted specifically for educational settings to allow building owners to evaluate risk from water hazards to determine an appropriate level of risk mitigation measures for implementation. An exemplar WQSRA tool is presented for safety, facility, industrial hygiene, and allied professionals to address current gaps in building water management programs. Academic institutions and school settings should examine the WQSRA tool and formulate an organization-specific policy to determine implementation before, during, and after building water-disruptive events associated with natural or man-made disasters.

Editor's Preface

Charles McDaniel, associate professor in the Interdisciplinary Core Program of Baylor University's Honors College, raises such issues in "American Christianity and the New Eugenics: Consumer-ism, Human Genetics, and the Challenge to Christian Personhood." Among Evangelical Christians, after Margaret Mead, perhaps the best-known anthropology major is Billy Graham. In a review and response, Elmer John Thiessen, adjunct professor of phi-losophy at Emmanuel Christian College, reviews Perry L. Glanzer and Na-than F. Alleman's The Outrageous Idea of Christian Teaching.

Optimizing the Interdisciplinary Design of Adaptive Platform Trials

Adaptive platform trials (APTs) are often complex clinical trials that, ideally, are well suited to answer the motivating clinical questions effectively and efficiently, with the motivating clinical questions and associated treatment arms expected to evolve over time as evidence accumulates. Recently, APTs have played a pivotal role in informing public health policy by efficiently generating compelling evidence regarding the effectiveness of therapies for COVID-19. For APTs to be maximally effective in informing future public health policy, they must be carefully tailored to address the right clinical questions, with the right balance of size, scope, rigor, and flexibility. The design process requires input from clinical and statistical domain experts and often includes input from trial implementation personnel, ethicists, and patient representatives. The design process is inherently iterative, with proposed designs evaluated through trial simulation, the identification of strengths and weaknesses of the proposed design, and revision by the team to address weaknesses. This iterative design process requires effective communication and collaboration between the statistical and clinical domain experts. This session is intended to present a current best practice in facilitating and enhancing the collaborative design process for APTs, including how best to present simulation-based trial performance to the design team and ensure effective interdisciplinary communication. The speakers have extensive experience in leading the design of APTs across multiple therapeutic areas, in both academic and industry settings. The session will begin with a brief presentation by Dr. Lewis on the basic structure of an APT and the tasks and challenges associated with the multidisciplinary design process. The subsequent discussion will be organized by the following themes: (1) considerations in the selection of the study population and primary outcome metric;(2) selecting treatment domains and factors to be compared;(3) trial simulation and communication of performance metrics to both statistical and non-statistical team members;and (4) defining and calibrating interim decision rules. Each of the 4 panel members will outline a recommended approach to facilitating 1 of the 4 design tasks, with examples drawn from their experience. The remaining time (15 min) will be available for a panel question-and-answer period. At the end of the session, the audience will have an understanding of the general organization of, and a process for facilitating, the design process for an adaptive platform trial. Panel Members Roger J Lewis, MD, PhD, is a Senior Physician in the Los Angeles County Department of Health Services, Professor of Emergency Medicine at the David Geffen School of Medicine at UCLA, and the Senior Medical Scientist at Berry Consultants, LLC, a group that specializes in innovative clinical trial design. He is also the former Chair of the Department of Emergency Medicine at Harbor-UCLA Medical Center. Dr. Lewis' expertise centers on adaptive and Bayesian clinical trials, including platform trials;translational, clinical, health services and outcomes research methodology;data and safety monitoring boards, and the oversight of clinical trials. Dr. Lewis was elected to membership in the National Academy of Medicine in 2009. He has authored or coauthored over 270 original research publications, reviews, editorials, and chapters. Dr. Lewis is a Past President of the Society for Academic Emergency Medicine (SAEM) and served on the Board of Directors for the Society for Clinical Trials. He is a fellow of the American College of Emergency Physicians, the American Statistical Association, and the Society for Clinical Trials. Juliana Tolles, MD, MHS, is an Assistant Professor of Emergency Medicine at the Harbor-UCLA Medical Center and the David Geffen School of Medicine at UCLA, and a Medical and Statistical Scientist at Berry Consultants, LLC. Her academic research interests include emergency medical services, resuscitation medicine, and trau a care. She has authored several reviews for Journal of the American Medical Association (JAMA) on statistical methodology and has lectured nationally on research methodology for the Society for Academic Emergency Medicine Advanced Research Methodology Evaluation and Design (ARMED) course. She is also a co-investigator for the Strategies to Innovate Emergency Clinical Care Trials (SIREN) network Southern California site. Kert Viele, PhD, is a Director and Senior Statistical Scientist with Berry Consultants, where he leads Berry Consultants' research enterprise. He is a leader in clinical trial implementation of Bayesian hierarchical modeling, with expertise in platform and basket trials as well as clinical trials incorporating the use of historical information. Prior to joining Berry Consultants in 2010, he was a faculty member at the University of Kentucky, where he received the Provost's Award for Outstanding Teaching and was an investigator for NSF and NIH-funded research. He has developed over 100 custom Bayesian adaptive clinical trials for clients in industry, government, and academia, and currently serves on several data safety monitoring boards for randomized clinical trials. A former editor of the journal Bayesian Analysis, Dr. Viele is also an author of FACTS (Fixed and Adaptive Clinical Trial Simulator), clinical trial simulation software currently licensed to multiple pharmaceutical, academic, and government organizations. William Meurer, MD, MS, is an Associate Professor of Emergency Medicine and Neurology at the University of Michigan Health System. In addition, he serves as a Medical and Statistical Scientist for Berry Consultants, LLC. He works to improve the care of patients with acute neurological disease both through his work on the acute stroke team and as a researcher. His work in the field focuses on the design of clinical trials with adaptive and flexible components. In addition, he is a principal investigator of the National Institutes of Neurological Disorders and Stroke (NINDS) Clinical Trials Methodology Course (http:// neurotrials.training) and a co-investigator in the clinical coordinating center of the Strategies to Innovate Emergency Care Clinical Trials (SIREN) network- also funded by NIH). He was a co-investigator on the Adaptive Designs Accelerating Promising Treatments into Trials (ADAPT-IT) project, as part of the FDA Advancing Regulatory Science initiative with NIH.

Generation Z's perceptions and attitudes toward debt: a case study of young consumers in rural Michigan, USA

PurposeWhile there is a large body of research looking at consumers' perception of debt, much of this previous research focuses on older generations. Less is known about the perceptions and attitudes toward debt of younger consumers, specifically those from Generation Z who are from rural areas in the USA. The purpose of this paper is to identify young rural consumers' perceptions and attitudes toward debt.Design/methodology/approachThis quantitative research used surveys. A well-established scale for measuring consumer attitudes toward debt has been adopted and applied. Because of the sensitive and personal nature of debt, anonymous, self-reporting questionnaires were used to allow respondents to respond freely and minimize potential bias that could be caused by socially desirable responses. The young respondents who participated in the research were invited verbally or via email by the investigators to complete the survey online via QuestionPro.FindingsThis study found the majority of consumers from Generation Z reported that using credit is basically wrong. Also, these young consumers claimed that being in debt is never a good thing. Additionally, the authors found gender differences. Young male consumers were more likely to claim that they had their debt under control, and young female consumers were more likely to claim that financial debt had influenced their life.Originality/valueThese Generation Z perceptions provide constructive data for use in evaluating and amending marketers' strategies to better connect with the young customers. Companies may want to stress how their products are risk adverse, provide a sort of financial security and will not leave the customer in debt. This is especially important following the COVID-19 pandemic as local businesses in a college community are trying to attract students back to their establishments.

Screening Older Adults for Alcohol Use

The number of older adults engaging in unhealthy alcohol use is on the rise, and this trend is expected to continue as the population ages. However, the likelihood a provider will ask an older adult about their alcohol use decreases with age. Geriatric screening tools take into account the particular features of alcohol use in older adults, but minimal research and guidance are available regarding the best method for screening. Lack of knowledge and time are significant obstacles to adequate assessment. Simply asking about alcohol consumption may be the best approach to evaluate the drinking habits of older patients.

Moving health education and behavior upstream: Lessons from COVID-19 for addressing structural drivers of health inequities

In this Perspective, we build on social justice and emancipatory traditions within the field of health education, and the field's long-standing commitment to building knowledge and shared power to promote health equity, to examine lessons and opportunities for health education emerging from the COVID-19 pandemic. Examining patterns that emerged as the pandemic unfolded in Metropolitan Detroit, with disproportionate impacts on African American and low-income communities, we consider conditions that contributed to excess exposure, mortality, and reduced access to critical health protective resources. Using a life course framework, we consider enduring impacts of the pandemic for health equity. Finally, we suggest several strategic actions in three focal areas-environment, occupation, and housing-that can be taken by health educators working in partnership with community members, researchers, and decision makers, using, for example, a community-based participatory research approach, to reduce adverse impacts of COVID-19 and promote long-term equity in health. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 Vaccination Intake and Intention Among Black and White Residents in Southeast Michigan.

Using the "3Cs" vaccine hesitancy framework which categorizes determinants of vaccine hesitancy across three dimensions-confidence, complacency, and convenience-we identify factors that shape COVID-19 vaccination intake and intention among Black and white residents in Southeast Michigan. We consider both historical discrimination in medicine and contemporary health and environmental crises (i.e., the Flint Water Crisis) as potential correlates. This study uses data from an online survey conducted between March-April 2021 in Flint and surrounding counties. we find that while historical mistreatment of Black people in healthcare and the Flint Water Crisis were of concern, those factors did not directly impact vaccination intention. Rather, concerns over safety, efficacy, and structural barriers related to access and occupation emerge as responsible for lower vaccination rates among Black residents. Effective vaccination programs require that public health authorities consider multiple factors, including the structural realities faced by racial ethnic minority groups which shape their vaccination decisions.

An exploration of structural determinants driving racial disparities in COVID-19 deaths in Michigan.

Aim: Racial disparities in COVID-19 death rates have largely been driven by structural racism in health, housing, and labor systems that place Black, Brown, and Indigenous populations at greater risk for COVID-19 exposure, transmission, and severe illness, compared to non-Hispanic White populations. Here we examine the association between taxable property values per capita, an indicator influenced by historical and contemporary housing policies that have disproportionately impacted people of color, and COVID-19 deaths. Methods: Taxable values serve as a proxy for fiscal health providing insight on the county's ability to address imminent needs, including COVID-19 responses. Therefore, higher taxable values indicate local governments that are better equipped to deliver these public services. We used county-level data from the American Community Survey, the Michigan Community Financial Dashboard, The Atlantic's COVID Tracking Project, and the Community Health Rankings and Roadmap for this cross-sectional study. Maps were created to examine the geographic distribution of cumulative death rates and taxable values per capita, and regression models were used to examine the association between the two while controlling for population density, age, education, race, income, obesity, diabetes, and smoking rates. Results: Seventy-five counties were included. The mean taxable value per capita was $43,764.50 and the mean cumulative death rate was 171.86. Findings from the regression analysis showed that counties with higher taxable values were associated with lower COVID-19 death rates (B = -2.45, P < 0.001). Conclusion: Our findings reveal a need to reevaluate current policies surrounding taxable property values in the state of Michigan, not solely for their inequitable impact on local governments' financial solvency and service quality, but also for their negative consequences for population health and racial health equity. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01817-w.

Feeling the Future at Christian End-Time Performances By Jill Stevenson,. Ann Arbor: University of Michigan Press, 2022 , pp. xii + 230, 7 illustrations. $75 cloth, $59.95 e-book

In Feeling the Future, Stevenson studies modern Evangelical end-time productions linked to churches and other religious organizations throughout the United States to demonstrate how these immersive performances construct deeply felt anxiety about future time within its viewers for specific aims: to save one's own soul and that of another, and to remain vigilant and prepared for the inevitable end times. In her Introduction, "Seeking an End,” Stevenson outlines Western Christian eschatological history before discussing modern Evangelical performances that foster future time. According to the creators of these experiences, producing anxiety about the future leads people to make better choices in their day-to-day lives as they prepare for the end.

Reusing personal protective equipment (PPE) did not increase surgical site infection in trauma surgical patients during the COVID-19 pandemic: A retrospective cohort study in Michigan Trauma Centers.

BACKGROUND: Reuse of personal protective equipment (PPE), masks more specifically, during the COVID-19 pandemic was common. The primary objective of this study was to compare pre-pandemic surgical site infection (SSI) rates prior to reuse of PPE, to pandemic SSI rates after reuse of PPE in trauma surgical patients. METHODS: A retrospective cohort analysis collected from the Michigan Trauma Quality Improvement Program database was performed. The pre-COVID cohort was from March 1, 2019 to December 31, 2019 and post-COVID cohort was March 1, 2020 to December 31,2020. Descriptive statistics were used to assess differences between variables in each cohort. RESULTS: Nearly half (49.8%) of our cohort (n = 48,987) was in the post-COVID group. There was no significant difference in frequency of operative intervention between groups (p > .05). There was no significant increase (p > .05) between pre- and post-COVID cohorts for superficial, deep, or organ space SSI when reuse of masks was common. CONCLUSION: Reuse of PPE did not lead to an increase in SSI in surgical patients. These findings are consistent with previous studies, but the first to be described in the trauma surgical patient population. Studies such as this may help inform further discussion regarding PPE usage as we continue to emerge from the current pandemic with the continuous threat of future pandemics.

A New Way to Distribute Research Seed Funding: Peer Review without Formal Review

As some of the most stable and important structures in society, colleges and universities are rarely described as nimble. Yet, when the COVID-19 pandemic hit in March 2020, institutions across the globe not only shifted within days to online instruction, but many academic researchers also immediately launched efforts to understand the virus, identify treatments, produce medical supplies, and study its impacts. While some investigators managed to make progress, other talented researchers lacked timely access to funding for key personnel, lab supplies, and incentives for study participants--the needed fuel for discoveries. Even as researchers have long called for low-barrier processes to accelerate time-sensitive research contributions, the pandemic has painfully underscored the need for rapid responses to pressing societal needs. Experimental programs offer models of the funding mechanisms needed to heighten efficiency, whether in the face of COVID or other ongoing crises. In this article, the authors discuss the shortcomings of the current, widely used peer review process and suggest that Mcubed, a novel token-based review and funding program developed at the University of Michigan (U-M), may offer significant advantages. This article describes the operation of Mcubed over an 8-year period on U-M's three campuses and details the positive results that were obtained, hoping to motivate others to engage in comparable endeavours.

Zooming Support: Stories of How a Pandemic and SAMR Improved Preservice Art Education Instruction

The transition to hybrid and online instruction during the 2020 pandemic presented unprecedented challenges to the field of art education. This resulted in newly formed communities of inquiry and support, representing a wide range of technological skills and teaching experience. This article spotlights the Michigan Art Education Association (MAEA) Higher Education Division as an example of one such group. In March 2020, the members of MAEA, started holding triweekly Zoom meetings to discuss their new roles as online art educators. Over 10 months, they bonded and provided social-emotional support, becoming a collaborative inquiry professional development group. Because technology is integral to online and hybrid teaching practices, they chose a theoretical model called Substitution, Augmentation, Modification, Redefinition (SAMR) to anchor their triweekly MAEA conversations. The SAMR model contextualized their uses of technology in relation to their pedagogical approaches, it provided a common language to describe and explain how and why they use technologies to meet specific goals and objectives. In this article, they share their stories with hope of inspiring others to form similar transformational groups.

The Advocacy Efforts for School Library Staffing during the Pandemic

Amid the ongoing pandemic, school librarians across the country have been facing a different kind of battle, one that has been going on for years in some cases: the fight for every student to benefit from the instruction and carefully curated resources a certified school librarian can provide. Several states are working to introduce or retain legislation that requires a certified school librarian in every school building. States across the country have seen a decrease in certified school librarian staffing. In some districts, positions have been reduced dramatically or cut entirely despite research showing the benefits students, staff, and the entire school community receive from these specifically trained educators. State school library associations are working diligently with lawmakers, fellow state-level education organizations, and national-level partners to advocate on behalf of their students. This article are the stories from Arizona, Michigan, Nebraska, New Jersey, and Pennsylvania about their states' fights for the right of every student to receive the services provided by a certified school librarian.

Teaching the Teachers: Early Childhood Education Programs Aim to Fill Shortages, Meet Growing Demand

Community college early childhood education programs prepare students for a career path that enjoys plenty of demand, although that's at least in part due to low wages that make hiring and retaining good workers a challenge. That challenge has become more acute during the COVID-19 pandemic, given the literally hands-on nature of the work. Demand for early childhood education programs likely would spike if President Biden's Build Back Better plan passes Congress, given that it includes money for universal preschool. Administrators and faculty of community college early childhood education programs say they're paying close attention to what's happening in Washington as well as their own states as they try to recruit students, upgrade training to deal with challenges like COVID-19 and meet the demand in their respective areas.