The mediating role of social connectedness and hope in the relationship between group membership continuity and mental health problems for vulnerable young people

Aims: The DisCOVery study sought to better understand the experiences of young people with complex emerging mental health problems over the longer-term social restrictions related to the COVID-19 pandemic. Following the 'social cure' theory, this study aimed to investigate the association, and potential mechanisms, of group membership continuity and reducing mental ill-health amongst vulnerable young people. Method(s): Cross-sectional survey data from a sample of 105 young people aged 16-35, collected approximately 1 year after the global COVID-19 outbreak (January-July 2021). Correlational and path analyses were used to test the associations between group membership continuity and mental health problems (depression, anxiety, psychotic-like experiences), and the mediation of these associations by hope and social connectedness (in-person and online). Results and Conclusion(s): Prior multiple group memberships were associated with the preservation of group memberships during the COVID-19 pandemic. In-person social connectedness, online social connectedness and hope mediated the relationship between group membership continuity and mental health problem symptoms. The results suggest that clinical and public health practice should support vulnerable young people to foster and maintain their social group memberships, hopefulness and perceived sense of social connectedness as a means to potentially help prevent exacerbated symptoms and promote recovery of mental health problems, particularly during significant life events.

Using Absorbable Suture For Traumatic Wound Closure To Avoid Additional Hospital Visit For Suture Removal During The Covid 19 Pandemic: A Randomized Controlled Trial

Introduction: The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing, changings, and suture removal since they are usually repaired with non-absorbable sutures. In a matter of fact, these visits can be avoided by using absorbable sutures instead. However, absorbable sutures carry the theoretical risk of wound infection. In this study, our aim was to determine whether absorbable sutures are better than non-absorbable sutures in repairing lacerations during the COVID-19 pandemic. The first and second objectives were to assess the rate of infection and the number of postoperative hospital visits. Method(s): A sample of 469 patients with traumatic skin lacerations were analysed during the COVID-19 pandemic in April-July 2020. In the control group, wounds were repaired using non-absorbable sutures, while rapid-onset absorbable sutures were used in the treatment group. By conducting a phone call follow-up after 21 days, several parameters regarding infection signs and hospital visits were compared between both groups. Result(s): No statistically significant difference was observed between both groups regarding wound infection (p-value= 0.623). Using absorbable sutures resulted in fewer postoperative hospital visits than non-absorbable sutures (p-value= 0.001). This study is limited because the assessment of wound infection was subjective to the patient by a phone call follow-up. Conclusion(s): Using absorbable sutures to close traumatic skin lacerations is safe. They should be considered during a pandemic to reduce hospital visits for suture removal, which will subsequently enhance social distancing and relieve hospital load.

How attachment styles predict changes in sexual desire: A study of sexual dynamics in COVID-19

The COVID-19 pandemic has had far-reaching impacts on many aspects of life, including sexual behaviours and preferences. In this longitudinal study, the authors used attachment theory to investigate changes in an individual's sexual desire for their partner as well as changes in their sexual desire for someone other than their primary romantic partner (extradyadic desire) over the first wave of the pandemic in Canada. Based on past research that has shown that avoidant individuals tend to avoid intimacy, the authors reasoned that increased contact with their romantic partner due to physical distancing guidelines and lockdown rules would contribute to avoidant individuals' experiencing less sexual desire for their partner and greater extradyadic desire over time. In contrast, individuals high on attachment anxiety tend to seek proximity, especially during times of stress. The authors predicted that individuals' sexual desire for their partner would increase and their extradyadic desire would decrease. They tested these hypotheses using a cohabiting, dyadic sample (N = 308 individuals);study participants were contacted at 1-month intervals for three successive months and asked to complete an online survey. Our hypotheses were partially supported. As predicted, individuals high on attachment avoidance experienced higher levels of extradyadic desire, and individuals high on attachment anxiety reported lower extradyadic desire over time. Contrary to predictions, however, neither attachment pattern was associated with changes in sexual desire for the partner. The authors examine the theoretical implications of these findings, highlighting the need for a more fine-grained assessment of stress and the interaction between stress and attachment orientations in future research.Copyright © Sex Information and Education Council of Canada, 2023.

The Analysis of Dynamic Processes of Virus Transmission: How Could Diagnostic Tests and Vaccinations Can Stop COVID-19 Pandemic?

Objectives: COVID-19 reached its fourth year of pandemic since 2020. The repeated waves of infections have been driven by multiple factors such as pathological traits of variants, diagnostic accuracy, and vaccination conditions. This study revisits and analyzes the dynamic processes of viral transmission to generate new scientific knowledge. Method(s): A cascade model of viral transmission from one case to another was developed, and theoretically analyzed how the number of infected cases at time t, D+[t], can be changed at time t+1, D+[t+1], considering six parameters: 1) k:level of transmission, 2) Rt: effective reproduction number, 3) rho: capture rate of infected cases, 4) theta: immunity protection rate in individuals, 5) epsilon: evasion rate from vaccines, and 6) Sn: test sensitivity. Result(s): The formula which associates D+[t] with D+[t+1] was given as follows: D+[t+1] = K.D+[t], where K = {(1-Sn) + (1-rho) / rho}{1-Rtk (1-theta(1-epsilon))k} / {1-Rt (1-theta(1-epsilon))}. Also, assuming K be smaller than 1, the lower limit of test sensitivity to stop the viral transmission was formulated: Sn > {Rt (1-theta(1-epsilon))-Rtk(1-theta(1-epsilon))k} / {(1-Rtk(1-theta(1-epsilon))k)rho}. In example computations, the formula indicated that a one-off PCR test with the sensitivity of 85% would not be sufficient to contain highly contagious infections such as the Omicron variants, and that it would be practically impossible to control the situation with the immune-evasive sub-variants in circulation. Conclusion(s): The theory developed in this study broadens the science on evidence-based public health and will be useful for outcomes studies and informed decisions on public policy for pandemic control.Copyright © 2023

Improving Antiviral Drug Research by Focusing on the Systems Theory Approach.

The conventional drug design method focuses on the reductionist approach of simplifying complex things. Pharmaceutical development following this approach is thorough and detailed. However, it does not guarantee satisfactory results for all drugs. Systems theory, which explores the nature of things from a holistic perspective based on their integrity and relevance, has played a vital role in the prevention and treatment of major viral diseases. Based on the interpretations of examples of the holistic approach in drug designs at home and abroad, novel coronavirus infection demonstrates the advantages of combining reductionist and systemic theories in the research of antiviral drugs, with a view to providing guidance for the design and development of antiviral drugs as well as scientific solutions for the prevention and treatment of viral diseases.Copyright © 2023 Chinese Pharmaceutical Association. All rights reserved.

Planning for a potential paediatric bronchiolitis surge: How Inter-Professional Education (IPE) was used to build a practice-ready clinical team

Introduction: Bronchiolitis is the most common cause for paediatric respiratory hospital admissions in young children in the UK.1 Following the relaxation of international SARS-Cov-2 lockdown measures a potential national surge in cases was predicted, highlighting a need for more collaborative working across core specialities.2 This prompted the use of the principles of Inter-Professional Education (IPE) to prepare and deliver an intervention to improve outcomes for these patients.3 Objectives: * To plan, deliver and evaluate an educational intervention focussed on improving the knowledge, skills and attitudes needed to care for a sick child with bronchiolitis * To utilise the principles of IPE to improve competence and confidence across core specialities involved in the care of a sick child with bronchiolitis Methods: A team from the Adult Intensive Care Unit (AICU) and the Paediatric High Dependency Unit (PHDU) from the Royal Berkshire Hospital in Reading delivered an inter-professional teaching session focussed on caring for the sick child with bronchiolitis. The patient journey was utilised as a framework to teach the core knowledge, skills and attitudes needed to clinically manage a child from the Emergency Department (ED) to the Intensive Care Unit (ICU). Each session included a lecture about bronchiolitis - describing pathophysiology and how to recognise the deteriorating child;a skills and drills tutorial - highlighting the need for weight-based calculations for high flow nasal oxygen, intravenous fluids and drugs;and a practical simulation scenario - focussing on the stabilisation and management of a sick child awaiting retrieval to the Paediatric Intensive Care Unit (PICU). Result(s): 135 healthcare professionals from a range of adult and paediatric disciplines involved in the care of children across the patient journey attended one of fourteen teaching sessions delivered between September to December 2021. Attendees completed a feedback questionnaire. One hundred and twenty-two (90%) reported an extremely high degree of satisfaction overall, with many saying they would recommend the teaching sessions to others. Areas of personal and professional development were highlighted across the following main themes: gaining theoretical knowledge;understanding key equipment;performing drug calculations;preparing for intubation and ventilation;assessing the need for chest physiotherapy techniques;and more collaborative team-working. Free text comments demonstrated that the attendees felt the teaching sessions: built confidence through the sharing of new or improved knowledge and skills;facilitated a safe space to practice using simulation;and provided the opportunity to learn about and from each other. Many of the attendees also commented on areas they wanted to reinforce and further develop in daily clinical practice as a direct result of the sessions. Conclusion(s): On-going evaluation is taking place as the teaching sessions continue throughout the year, facilitating the inclusion of additional inter-professional groups from across core specialities. These sessions have been used as a template for the development of further planned IPE with a more varied range of paediatric clinical cases and presentations. These will continue to build on the transferable knowledge and skills that increase competence and confidence in caring for the sick child whilst developing a more collaborative practice-ready workforce.

Multi-dose CT contrast injectors: Is it time for change?

Introduction: The COVID-19 pandemic presented new and exacerbated existing challenges to the Australian healthcare workforce. Principally, health care demands have grown by approximately 14.9% over the past four years, Medicare costs from CT alone rose from $145 to 790 million per annum over the past 20 years and disrupted global supply lines during 2021 resulted in an 80% reduction of available CT iodinated contrast worldwide.1-3 Innovations to improve workflow efficiencies as well as lower operational costs and wastage of CT contrast media have become paramount. This study sought to compare the savings metrics between an existing single-use CT contrast delivery system and a newly introduced multi-dose syringeless contrast injector. Method(s): Workflow efficiency savings were calculated through the average time each staff member (n = 5) spent refilling each injector system after a completed injection. A retrospective analysis assessed theoretical monetary and contrast media savings and based on one month (February 2022) of injection protocol data. Total contrast administration, consumable use and clinical wastage were calculated and compared through each contrast delivery system technique. Discussion/Conclusion: The multi-dose injector comparatively recorded in an average monthly workflow efficiency saving of 38.26% (seven hours and 29 minutes). Monthly contrast usage decreased 29% (15.2 L) and operational expenses declined 51% ($11,574) through utilisation of the multi-use injector. These findings indicate, when compared to a single-use system, the multi-use injector is a highly efficient contrast delivery system with significant financial return on investment.

Evaluation of Distance and Face-to-Face Anatomy Education From the Perspective of Students During the COVID-19 Pandemic Period

During the COVID-19 pandemic, a questionnaire was administered to the students who took anatomy courses through distance education in the Faculties of Medicine and Dentistry. Through the questionnaire, the aim was to figure out whether the infrastructure of Firat University was ready and adequate for distance education, how efficient the distance theoretical and practical anatomy classes were, and in what proportions the students would prefer to take face-to-face and distance anatomy classes when the pandemic is over. A questionnaire of 35 questions was applied to 555 students studying at the Medicine and Dentistry Faculties of Firat University. The students widely accepted the opinion that Firat University successfully implemented the distance education system, and distance education offered the opportunity to receive the lessons repeatedly regardless of time and place. In addition, it has been determined as a common opinion that anatomy classes given via distance education were equally beneficial as face-to-face education in terms of duration, content, and efficiency. Despite these advantages, the lack of face-to-face interaction and weak information permanence were reported as the negative aspects of distance education. The students emphasized that applied anatomy classes and especially cadaver studies should be conducted face to face. Anatomy education is quite substantial in the acquisition and development of professional skills. It is considered that distance anatomy education will be inadequate to provide this gain. The high demand for face-to-face practical classes by students also backs this up.Copyright © 2023, Universidad de la Frontera. All rights reserved.

A Medical Device Information Data Sheet (MDIDS) to Support the Interoperability of Externally Controllable Infusion Pumps for Tele-Critical Care1

Problem and Motivation. Medical device remote control technologies can enable remote experts to contribute to patient care during tele-critical care during public health emergencies like COVID-19 to address the shortage of local clinical expertise. The benefit of such technologies may be further amplified if one remote-control application can operate multiple interoperable medical devices (e.g. multiple types of ventilators or IV pumps) to support the typical diversity of deployed medical devices in one institution. However, due to the variation in capabilities of different makes/models of the same device type, this unified remote control capability requires the standardization of the data interfaces of similar devices to provide sufficient information about these devices to enable safe remote control. Method(s): Medical Device Interface Data Sheets (MDIDS) [1] can provide a useful tool for documenting current and future device interface requirements and capabilities. We examined several clinical use scenarios where externally controllable infusion pumps are used to support tele-critical care, based on which we generalized an MDIDS for remotely controllable infusion pumps. To validate this generic MDIDS, we cross-checked it with the capabilities of several externally controllable infusion pumps: the NeuroWave Accupump, Eitan Medical Sapphire, and the BD Alaris GH. Result(s): During the development of the generic remotely controllerable infusion pump MDIDS, we were able to identify the common and specific data elements that different infusion pumps need to provide at their data interfaces, considering the great diversity in these devices related to infusion mechanism, infusion programming methods, device alarms and alerts, and system settings. The resulting MDIDS includes over 100 data elements, many of which are essential for safety, including those common across different pump types (e.g., maximum settable infusion rate, occlusion alarm) and those specific to certain pump types (e.g., syringe size for syringe pumps). We developed the generic MDIDS as the theoretical basis and developed an application in our OpenICE open-source interoperability research platform [2] to remotely control the above three infusion pumps either via serial communication (representing controlling the infusion pump at a distance limited by a physical wired connection inside or outside the patient room) or across the Internet using the web extension service of OpenICE (representing situations where remote experts have no physical access to the patient). Conclusion. MDIDS for externally controllable medical devices can provide a solid basis to improve the safety and interoperability of medical device remote control technologies in the tele-critical care context. They can also benefit the research, development, and testing of physiological closed-loop control systems. We applied the MDIDS methodology to infusion pumps and ventilators to support the integration of these devices to the U.S. Army Telemedicine & Advanced Technology Research Center (TATRC) National Emergency Tele-Critical Care System.

Covid Shielding Stories: Co-Produced Research to Understand the Voice of People Living with Arthritis and Auto-Immune Disease

Background/Aims Up to one-third of people with rheumatological conditions were required to 'shield' from COVID-19. This co-produced, qualitative research aimed to understand experiences of the shielding process and the impact of shielding upon people's lives. Methods Adults who shielded due to rheumatological disease participated in audio-recorded interviews and focus groups (FGs). Framework analysis combined inductive and deductive approaches. Creative materials were collected. Two patient contributors proposed the study, are co-investigators, and conducted the research alongside a clinical academic and four-member patient advisory group. COREQ and GRIPP2 guidelines were followed. Full ethical approval was granted by the University of Manchester Research Ethics Committee (2021- 11544-20348). Results Data were generated from 28 interview and 12 FG participants between October 2021-January 2022. 15 people contributed creative materials. Characteristics included 44/48 (85%) female, ages 18-75 years, non-white 10/48 (21%), all UK regions (Table 1). Corbin & Strauss's theory, 'Three lines of work: Managing chronic illness', frames the findings. Shielding increased and shifted the burden of 'illness work' onto patients, e.g., in gaining access to vaccines and navigating risks and uncertainties due to COVID-19. 'Life work' was increased as participants struggled to access food and medicines. Participants' self-identity was re-appraised in the context of their illness. Many feared for their lives because of their diagnosis for the first time, increasing 'biographical work'. Participants' perceived value to society changed over time: feeling equal to the general population at the first UK national lockdown;abandoned by society due to 'freedom day' and formal shielding's end. 'Emotional work' was added to 'Three lines of work'. Shielding notification induced fear, stress, devastation, shock and disbelief, balanced by a feeling of being protected. Emotions experienced include anxiety, guilt, anger and frustration. Mental health problems were experienced, often for the first time. Many continued to shield beyond formal shielding's end. Conclusion This co-produced, qualitative research highlights experiences and impact of shielding including increased illness, life, biographical and emotional work. Clearer, personalised information would help shielders to understand their risk and vaccine response, informing re-integration into society.

Countering Vaccine and Health Mis and Disinformation: An Evidence-Based Approach

COVID-19 was the first pandemic that unfolded in an information environment transformed by the ubiquitous mass and social media. Sensational misinformation and deliberate disinformation proliferated capturing hearts and minds. Traditional medical and public health organization's voices were well-intentioned and informed to communicate about the threat of SARSCoV- 2 infection and appropriate countermeasures (for example, masking and vaccines) but were overwhelmed. This new reality on communicating health and science was called out by the World Health Organization in 2020 as an Infodemic. In 2021, the U.S. Surgeon General issued his first report entitled 'Confronting Health Misinformation: The U.S. Surgeon General's Advisory on Building a Healthy Information Environment' urging at scale investment to tackle misinformation. Yet, while warnings were issued, mis- and disinformation proliferated with a palpable casualty emerging with waning vaccine confidence and uptake globally. This fundamental tenet of public health-vaccination-is at risk as a credible defense against disease and illness. This is not due to the microbial vectors but instead the societal response gathering momentum during the COVID 'infodemic'. This endemic challenge on how we communicate health and science will be described with an evidence-based perspective vetted in the field of communication with conceptual, scientific and theoretical grounding. This presentation will offer approaches to help build scientific, health and vaccine literacy, counter mis- and dis-information and foster strategic health communication capabilities at all levels of society.

Sars-Cov-2 Vaccine from Infected Plant Attenuated Virus Using Acer Cincinatum (Vine Maple)

Purpose of study Proposal for an oral (or if required, parenteral) COVID-19 vaccination based upon this described technology. Investigational theory under study for the past 9 months of COVID-19 growing season. Coronavirus can attack and infect plant species. It was found that SARS-CoV-2 can infect various plant species. Others have found plants, for example tobacco as a good growth medium for Coronavirus and SARS-CoV-2. This current study has found various plants species infected with SARS-CoV-2 by rPCR. As the plants were located beside a well used hiking trail for humans, and were infected along the trail including various species with SARS-CoV-2, hypothesized that human airborne contact had caused infection in the bordering plants. Humans were observed to be coughing while walking on the trail, and were not wearing masks. The plant leaves developed small circular colonies of the virus, which became self-limited at several millimeters in diameter. All of the plants were clear of these lesions before the COVID-19 Pandemic. The plants 'immune' system produced antiviral agents, including lectins which limited the growth of the colonies and prevent death of the leaf and whole plant. The fungal cultures of the 'spots' were negative. The rPCR of all spots tested in the present series was positive for SARS-CoV-2. Hypothesis, that self-augmentation of the virus occurred by the natural culturing in plant leaves that produce antiviral agents as part of their 'immune system.' Hypothesis, a symbiotic type relationship developed between the plant using its chemical immune system, and the virus allowed to replicate in an augmented fashion to allow both the virus and the host to survive and grow. As the top candidates for the oral vaccine are nontoxic, hypothesis involves the maceration of the infected leaves, mixing with a nontoxic adjuvant and flavoring to promote assimilation and palatability, with the proposed route of entry being mastication, thus exposing the oral-nasal mucosa to the vaccine, with the probable best of immunity to usual exposure to the SARS-CoV-2 virus, that is the oral-nasal mucosal and upper airway route. As many types of animals are now infected with SARS-CoV-2, it is further hypothesized that this oral vaccine could also be mass produced to add to various animals by feedstock and oral route. Methods used Hypotheses formed through observations. Testing of observations by pPCR, viral cell culture, fungal culture, light and electron microscopy. Summary of results pPCR SARS-CoV-2 positive, cell culture 'lysis experiment' positive, EM and light microscopy positive, fungal culture negative. Conclusions TABLE OF HYPOTHESES AND STUDY RESULTS (HYPOTHETICAL, OBSERVED, PROVEN) 1. The first hypothesis that the virus is attenuated by the plant, using its innate chemical immune system. Similarly, Pasteur used chemical such as phenol to attenuate viruses for wome of the first successful vaccines. Observed. 2. Hypothesis, the plants 'immune' system produced antiviral agents, including lectins, flavonoids, and others, which limited the growth of the colonies and prevent death of the leaf and whole plant. Proven. 3. Hypothesis is that the nontoxic plants, such as Vine Maple sp.(Acer cincinatum), could be used to produce and oral plant attenuated vaccine. Hypothesis. 4. Hypothesis involves the maceration of the infected leaves, mixing with a nontoxic adjuvant and flavoring to promote assimilation and palatability, with the proposed route of entry being mastication, thus exposing the oral-nasal mucosa to the vaccine, with the probable best of immunity to usual exposure to the SARS-CoV-2 virus, that is the oral-nasal mucosa, upper airway. (Figure Presented).

Patient perspectives of safe and routine deprescribing for older people living with polypharmacy: an interview study

Introduction: Stopping medicines where harms outweigh benefits (deprescribing) (1) can reduce adverse events from inappropriate polypharmacy. Deprescribing should be undertaken in a patient-centred way with shared decision-making. However, there is a lack of evidence about the patient perspective on how deprescribing should be safely and routinely implemented in UK primary care. Such evidence is needed to enhance the implementation of deprescribing in primary care. Aim(s): * To identify optimal methods of introducing and actioning deprescribing from the patient's perspective * To understand the nature of support patients require during deprescribing * To identify patient views on the involvement of different healthcare professionals in deprescribing. Method(s): UK patients aged >=65 years taking >=5 medicines and living in their own homes were recruited through social media, service user groups and NIHR People in Research. An interview guide was developed using deprescribing literature, patient and public involvement input, and informed by the theoretical implementation framework Normalisation Process Theory (2). Interviews were conducted online (Microsoft Teams) or via telephone, audio recorded and transcribed verbatim. Data were analysed using the Framework method. Result(s): Twenty patients, diverse in age and gender, were recruited and three main themes developed: 1. 'Why deprescribe now?' focused on the importance of communicating the deprescribing rationale;2. 'Monitoring and follow-up' in which safety netting around deprescribing and patients' motivations to self-monitor after deprescribing interventions were highlighted;3. 'Roles and relationships' focused on patient views of different healthcare professionals involved in deprescribing and the interpersonal skills needed to develop therapeutic relationships. Conclusion(s): Optimal methods of introducing deprescribing from the patient's perspective included communication of a convincing and well-communicated rationale for stopping medicines. Patients required support from a range of healthcare professionals with whom they had an existing therapeutic relationship. Whilst patients were motivated to self-monitor any unwanted/unexpected effects post-deprescribing, this was under the condition that timely support would be available when needed. These findings provide a deeper understanding of patients' needs for the implementation of safe and routine deprescribing in primary care, and these should be considered when designing medication review and deprescribing services. A strength of this study was the overall diversity in age and gender of the patients interviewed. However, although multiple recruitment pathways were utilised, due to the COVID-19 pandemic, recruitment was mainly online which will have excluded patients who did not have access to the internet.

A qualitative exploration of the implementation of the Prescribing course Designated Prescribing Practitioner role in community pharmacy

Introduction: To alleviate NHS workload pressures Scottish Government wish to train more pharmacist independent prescribers (IPs) for community pharmacy (1). A critical aspect for IP training is the role of Designated Prescribing Practitioner (DPP) for the period of learning in practice. A paucity of work has focussed on implementation of the DPP role with a recent cross-sectional survey (2) indicating that further qualitative exploration is warranted. Aim(s): To explore the implementation of the DPP role in Scottish Community Pharmacy (CP). Method(s): Following a survey (2) participants opted in to qualitative semi-structured online mini-focus groups. This included key stakeholders likely be involved in the implementation of the DPP role (e.g Directors of Pharmacy, Prescribing Leads, Education and Training leads, IP qualified CPs). The topic guide was informed by the survey key findings, Royal Pharmaceutical Society DPP Framework and the Consolidated Framework for Implementation Research and piloted with academic and practice-based stakeholders. All focus groups were conducted using Zoom, recorded, transcribed, and independently analysed thematically, by two researchers, using the Framework Approach. Data generation continued until data saturation. Result(s): Data were generated from six mini-focus groups with 12 key stakeholders across Scottish Health Boards. Key themes derived related to: views on the DPP role, characteristics of potential DPPs, facilitators and barriers to implementation. Participants supported DPP implementation and noted benefits of pharmacists training pharmacists. They noted that potential DPPs need to be confident and competent and be active prescribers. Facilitators for implementation included: new contracted services (e.g. NHS Pharmacy First Plus), growing need for more IPs, and the impact of COVID-19. Barriers included: limited time, capacity, resources, and support to take on the DPP role. Pharmacists were also considered risk averse which could influence role uptake. Conclusion(s): This theory-based work involved a range of key stakeholders and highlights that there is a need to further consider interventions to overcome barriers related to capacity and resource related issues. A limitation relates to the dyadic nature of some focus groups that may have affected data collection. Future research should focus on further theory-based work evaluating structures, processes, and outcomes of DPP role implementation.

Approach to COVID-19 vaccine hesitancy based on some psychological symptoms and attachment theory: A web-based community survey

Objective: The aim of this study is to investigate the effects of psychiatric symptoms such as anxiety, obsession, hostility, and attachment styles, which may be associated with COVID-19 vaccine hesitancy. Method(s): A total of 504 adult participants were included in the study. The sociodemographic data form, including questions on information about participants' COVID-19 infection history and concerns about COVID-19 vaccines, was filled out by the participants. The participants were evaluated with the anxiety, obsessive-compulsive disorder (OCD), hostility, and paranoid ideation subscales of the Symptom Checklist - Revised 90 scale and the Adults Attachment Style Scale (AASS). The participants were divided into three groups: "vaccinated group (VG)," "nonvaccinated but intend to get vaccinated group (IGV)," and "nonvaccinated group and not intend to get vaccinated group (NIGV)." Results: The mean score of the AASS secure subscale was higher (p=0.009), while the SCL-90 anxiety subscale was lower (p=0.003) in the NIGV group. The mean score of the SCL-90 OCD subscale in the NIGV group was lower than that in the IGV group (p=0.040). Regression analysis showed that concerns about the safety of vaccines (OR: 140, p<0.001) and having secure attachment style (OR: 1.787, p=0.019) increase the intention to not be vaccinated. However, it was found that high anxiety scores decreased the intention not to be vaccinated (OR: 0.966, p=0.035). Conclusion(s): The findings of the current study indicate that secure attachment style and clinical psychiatric entities such as anxiety and obsession were effective on vaccine hesitancy. However, this interaction needs to be interpreted carefully in the context of the perceived level of COVID-19 threat, more detailed information about the safety and necessity of vaccines, the relationship of individuals with their social environment, and the predominance of vaccine hesitancy in their social environment.Copyright © 2023 Yerkure Tanitim ve Yayincilik Hizmetleri A.S.. All rights reserved.

Perceptions of e-Learning by Deaf and Hard of Hearing Students Using Asynchronous Multimedia STEM Tutorials

COVID-19 has impacted education in innumerable ways at all levels. For institutions of higher education, budgetary deficits, fluctuating enrollments and personnel decisions have come to the fore, galvanizing efforts to expand education to diverse student audiences, including online curricular portfolios. Developing digital materials for learning purposes, or e-learning materials, is not as straightforward as it may seem. The traditional approach is multimedia instruction, the presentation of both pictures and words in an e-learning format to foster learning. However, multimedia instruction, to develop meaningful learning, needs to support the active processing of the learner who engages with those materials. The Cognitive Theory of Multimedia Learning (CTML) informs the development of effective multimedia e-learning materials. However, given the dearth of CTML studies directed at students of diverse and underrepresented populations, such as d/Deaf and hard-of-hearing students (DHH), it is unclear as to the extent that CTML principles may inform effective multimedia instruction for this group. We recruited DHH students to view an asynchronous, online multimedia tutorial covering foundational chemistry concepts applicable to biochemistry and to complete a brief questionnaire that inquired about their e-learning perspectives. A mixed-methods approach was used to characterize responses. Students characterized their use of the tutorial's features as broadly serving three different functions and also placed a strong emphasis on the benefits of the accessibility features. These findings have implications for the applicability of at least one CTML principle for this student population. At the same time, DHH students both perceived learning benefits from tutorial features and suggested additional improvements to the tutorial that invoke other CTML principles. The survey and recruitment procedure were reviewed and approved by the RIT Human Subjects Research Office (Federal Wide Assurance# FWA 00000731). Informed consent was obtained from all individual participants included in the study. This study was funded by a Ronald D. Dodge Memorial Endowment Fund grant.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.

IMPLEMENTATION INSIGHTS from SITE CHAMPIONS and STATE LEADS POST-ROLLOUT of the SAFER BABY BUNDLE

Background: National rollout of the Safer Baby Bundle (SBB) is recommended by the National Stillbirth Action and Implementation Plan for improving the standard of antenatal care at scale to reduce stillbirth. Progressive implementation over 2.5 years, commenced from mid-2019. This qualitative study aims to understand the process enablers and barriers influencing the effectiveness of SBB implementation. Method(s): Semi-structured interviews with SBB site leads/champions (17 maternity services) and state program leads across Queensland (QLD), Victoria (VIC) and New South Wales (NSW) were conducted post-implementation of SBB to explore local, regional, and state implementation strategies, processes and experiences. Normalization Process Theory was used as an analytic framework for thematic analysis to understand different approaches and contexts for SBB implementation. Result(s): 17 site leads (6 VIC, 5 NSW, 6 QLD) and 6 state program leads were interviewed from Sept to mid-Nov 2022. Findings indicate strong local leadership, shared regional and state-based learning opportunities, consistency of information and endorsement by clinical networks were key implementation supports. Barriers included limitations and inconsistencies across data and information systems, and constraints with protected time for training and improvement activities. High turnover and re-deployment of leads due to external factors (e.g., COVID, extreme weather events) disrupted timelines, impacting commitment and engagement with the initiative. Conclusion(s): Despite differences in resources, approaches, and timelines between sites and states for SBB implementation, similar key barriers and enablers were identified. An in-depth understanding of the factors underpinning successful implementation of the SBB will guide future activities to support sustainable change.

Pterin interactions with gold clusters: A theoretical study

Gold (Au) nanoclusters (NCs) are novel materials with low cytotoxicity and high chemical stability. These properties are in high demand during the bioimaging. Moreover, the optical properties of gold clusters allow to use them as colorimetric and luminescent bionanosensors. Pterins are low molecular weight organic compounds, which are used in medicine as biomarkers of phenylketonuria, vitiligo, inflammation and immune system activation, cancer, COVID-19, etc. We have investigated the possibility of gold nanosensors usage to detect pterin (Ptr). Ptr-Aunq structures (n = 1–6;q = 0–2) Gibbs energy of complexation (Eb) have been obtained using density functional theory. The highest Eb was determined for the complexes of Au62+ and Au32+ in acidic and alkaline aqueous solution, respectively. The detection of pterin with gold clusters seems to be prospective using both colorimetric and fluorescent detection because of the intense S0→S1 transition in the absorption spectrum of the Au5+ complex. Raman detection of pterin should be performed at alkaline pH because of the dramatic changes in the spectrum of Ptr−1 upon the addition of Au clusters. We believe that these tunable changes of the pterin spectra due to Au clusters and nanoparticles attachment could be exploited in further studies on nanosensor design. © 2023

Clinical Evidence and Theory of COVID-19 by Traditional Chinese Medicine.

This study aims to investigate the etiology, pathogenic properties and pathogenic characteristics of corona virus disease-2019(COVID-19)in traditional Chinese medicine(TCM),so as to provide ideas for clinical treatment based on syndrome differentiation. Efforts were made to retrive relevant literature concerning clinical studies,theoretical discussions and TCM diagnosis and treatment schemes issued by the state and various provinces,municipalities,autonomous regions and municipalities directly under the central government in relation to TCM from China Knowledge Network(CNKI)and Wanfang Database,and to analyze and summarize the etiology,pathology,theoretical viewpoints,clinical symptoms and signs,syndrome differentiation and medication rules. Currently,the common understanding of the etiology of COVID-19 in the field of TCM is the infection of "pestilential pathogen". However,there is a dispute over cold and heat or mixed understanding of cold and heat in terms of pathogenic attributes. The pathogenic factors are different from each other in dampness,toxin,dryness,fire(heat),wind,filth,depression,etc. There are various understandings on the pathogenesis including dampness,cold,heat,toxin,stasis,phlegm,stagnation,knot,dryness,filth, deficiency,blocking,collapse and asthma,etc. The etiology and pathogenesis are often mixed up. Integration of cold and heat,dryness and dampness,and other contradictory pathogens or pathogenesis is widely seen,which lacks the logicality of theoretical systems,and does not in line with the thinking characteristics of TCM on the etiology,pathogenesis,and syndrome differentiation of exogenous diseases. The main idea of medication in treatment is to diffuse the lung,clear away heat,eliminate dampness,resolve phlegm and repel foulness with aromatics. Maxing Shigantang is used as the core prescription. Chosen warm acrid drugs are mainly the ones with the effect of fragrance,removing dampness,resolving phlegm,and invigorating spleen. They are not the ones with the effects of warming yang and dissipating cold,but the combination of cold and heat,suggesting the complexity of etiology and pathogenesis. COVID-19 is categorized as plaque in TCM,and its etiology is "pestilential pathogen". This pestilential pathogen possesses not only the basic properties of toxin and filth,but also the characteristics of dampness,heat and wind. Throughout the course of the disease,phlegm,stasis,stagnation and other secondary pathogenic factors also occur. The evolution of pathogenesis is characterized by depression,blocking,and deficiency. There are more evidences that the pestilential pathogen of COVID-19 belongs to heat property no matter in the aspects of clinical manifestation,transmission law(syndrome differentiation at different stages),or in compatibility of medication.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Clinical Application and Advantages of Sanjiao Theory in Sanren Decoction.

Sanrentang,originally contained in the Regulations on Febrile Diseases written by WU Ju-tong in the Qing dynasty,was composed of eight traditional Chinese herbs to treat damp-warm diseases. It is a treatment method of gradually clearing away damp heat of tri-jiao,with characteristics of separating dispersion and mobilizing discharge. "Separating dispersion" means dispersion in separated ways,with different ways to eliminate dampness to export the dampness,heat,evil and turbid out of the body. "Mobilizing discharge" means discharge to stretch and unblock the Qi,to get rid of dampness and evil. It can be seen,Sanrentang,as a desiccating formula,taking "separating dispersion and mobilizing discharge" as the cubic basis,has a significant effect on both internal and external dampness associated with pathogenic heat syndrome,and its clinical application is quite extensive. After consulting the data of the past 10 years,the authors gave a brief overview on the syndrome theory,clinical application and pharmacological effects of Sanrentang, and elaborated the therapeutic effect and pharmacological effect of Sanrentang in the clinical application of upper,middle and lower Tri-jiao respectively,providing theoretical reference for effective development and utilization of Sanrentang. Coronavirus disease-2019(COVID-19)swept the world in early 2020 and it is a great challenge for the medical community to seek for effective prevention and treatment methods. For COVID-19,although the cause of the disease belongs to the Qi of "pestilence",many doctors have different opinions on the pathogenic characteristics. However,they all agree with the clinical characteristics of "dampness". COVID-19,which has the attribute of "dampness evil",is so sticky that it can't be cured at once. In addition to the main symptoms such as fever and cough,it is also characterized by the middle-jiao dampness symptoms such as poor appetite,fullness of abdomen,loose stool and diarrhea. It is worthy to further explore the application prospect of Sanrentang in COVID-19 prevention and treatment.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.