Creating Comics to Address Well-Being and Resilience During the COVID-19 Pandemic.

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

Creating Community During COVID-19: A Virtual Art Gallery to Address Social Isolation During a Pandemic.

The COVID-19 pandemic, a public health crisis, significantly impacted millions of people around the world. "Creating Community During COVID-19" is a community-engaged virtual art gallery that explores resilience, social cohesion, and creativity during the onset of the pandemic in the United States. It aimed to address social isolation and encourage inclusion at a large public university in the early days of the pandemic. The community was invited to submit artworks that reflected how they are staying connected during the pandemic. The artworks were then qualitatively analyzed and highlighted three key themes: (1) reflecting (turning inward), (2) advocating (turning outward), and (3) engaging (coming together). This arts-based project demonstrates promise as a creative approach for promoting social cohesion and positive health and well-being, especially in times of uncertainty.

Impact of COVID-19 on travel intention in Silicon Valley of India - testing the efficacy of the theory of planned behaviour

Travel intention is an important factor in understanding the traveller's preferences in the travel and tourism business. The purpose of the research is to understand the impact of COVID-19 on travel intention in the Silicon Valley of India and to test the efficacy of the theory of planned behaviour to predict travel intentions. This empirical research followed a quantitative analysis using the data acquired from a structured questionnaire. Convenience sampling was followed to collect the data from the respondents. The multiple linear regression results indicate a significant relationship between attitude, subjective norm, and perceived behaviour control on the intention to travel. The research is limited to respondents from Silicon Valley. The study contributes to the limited literature available in developing countries with respect to understanding the efficacy of the theory of planned behaviour to predict travel intention. The policymakers and health authorities can use the study findings to make decisions and develop policy regulations during the pandemic. Copyright © 2023 Inderscience Enterprises Ltd.

The New Generation of Contact Tracing Solution: The Case of Morocco

Nowadays, the entire world is struggling to adapt and survive the global pandemic. Moreover, most countries had a hard time keeping up with the new mutations of COVID-19. Therefore, taking preventive measures to control the spreading of the virus, including lockdowns, curfews, social distancing, masks, vaccines, is not enough to stop the virus. However, using the new technologies to adapt the prevention measures and enhance the existing ones will be more efficient. Most countries have already developed their non-pharmaceutical interventions measures (NPIs), mainly contacts tracing solutions at the pandemic beginning. Using those mobile applications, the authorities were able to reduce the spreading of the virus. Nevertheless, the virus is evolving, mutating, and becoming more and more dangerous to survive. Therefore, these mobile applications have become less effective in facing the constant changes of the pandemic situation. To that end, the need for enhancing and evolving contact tracing became more urgent. The goal here is to control the spread of the new variants and keep up with the rapid changes happening around the world. In this paper, we will present a detailed view of the new solution built to take contact tracing to a new level, empowered by the Bluetooth Low Energy technology for communication, advanced encryption method for security and data privacy, as well as secured storage and data management to have a system capable of slowing the COVID-19 variants from spreading and save lives. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Remaking and Living with Resource Frontiers: Insights from Myanmar and Beyond

Myanmar, a nation situated between India, China and Southeast Asia, has long histories of colonialism, violence, and resource extraction. This special issue introduction, written in the midst of Myanmar's 2021 military coup and the COVID-19 pandemic, offers two critical and feminist interventions–‘remaking' and ‘living with'–to understand the contested and embodied political geographies of extractive resource frontiers in Myanmar. ‘Remaking' focuses on the long roots of resource frontiers, underscoring the historical and spatial processes through which Myanmar's plural authorities have restructured diverse territories for accumulation and extraction from the pre-colonial period to the recent ‘democratic transition'. ‘Living with' resource frontiers bring attention to people's everyday lives, and why and how they adapt, resist, comply, suffer and profit from resource frontiers. In bringing together a diverse set of literatures with original empirical research, the articles in this collection offer analyses of Myanmar's pre-coup period that inform contemporary post-coup politics. Together, they demonstrate the material, affective, and embodied nature of resource frontiers as they are (re)made and lived with–in and beyond militarised spaces like Myanmar. © 2022 Taylor & Francis Group, LLC.

Challenges and strategies with international recruitment in early phase gene therapy trials

The Children's NIHR Clinical Research Facility at Royal Manchester Children's Hospital has been involved in numerous early phase gene therapy trials for diseases such as GM1 gangliosidosis, Gaucher disease, MPSIIIA and MPSII. These trials have necessitated international recruitment which brings challenges for both site and families. In addition, we also actively recruited participants during the Covid-19 global pandemic, amplifying these challenges. A typical patient journey on one of these trials would involve being approached soon after diagnosis due to the rapid progression of these diseases and the need for early intervention. The family would then relocate to the UK with relatively short notice and commence an intensive period of screening involving a lot of extensive information for them to retain and invasive procedures for the patient. Some of these families will speak no English at all which is an additional barrier to managing the parental anxiety and expectations of the trial and its outcome. Once eligibility is confirmed the families are then faced with an extended stay in the UK without the support of their extended family/community. This impacts parent's employment and other siblings who may or may not be with them and who may also be affected by the same disease. Following administration of the gene therapy, participants then commence intensive follow up often associated with immunosuppressants. Close working with the local clinicians is essential for patient safety and trial integrity. Good engagement with families once they have returned to their home country is vital in obtaining continuing trial data and ensuring retention and compliance with attending future visits. Follow up visits are essential for safety and efficacy data for the progression of gene therapy trials. Travel restrictions brought about by the covid 19 pandemic exacerbated these challenges but with good communication and engagement we have mostly overcome them.

Early Short-Term Use of Different Doses of Corticosteroid in Hospitalized Pediatric Patients with Coronavirus Disease 2019 Pneumonia

Objective Encouraged by reports of favorable outcomes following the use of corticosteroids in patients with moderate-to-severe coronavirus 2019 (COVID-19) pneumonia, we aimed to present our experience with early short-term corticosteroid use at our center in pediatric patients with COVID-19 pneumonia. Methods One hundred and twenty-nine pediatric patients were included in the study. Patients were divided into four groups according to the type and dose of corticosteroids given: Group 1 (those receiving dexamethasone 0.15 mg/kg/d);Group 2 (those receiving methylprednisolone 1 mg/kg/d);Group 3 (those receiving methylprednisolone 2 mg/kg/d);and Group 4 (those receiving pulse methylprednisolone 10-30 mg/kg/d). Results Of 129 patients, 19 (14.7%) patients were assigned to Group 1, 30 (23.3%) patients to Group 2, 30 (23.3%) patients to Group 3, and 50 (38.8%) patients to Group 4. Thirty-two (24.8%) patients were followed in the pediatric intensive care unit (PICU), of whom 13 (10%) required mechanical ventilation, and 7 (%5.4) died. In Group 4, the hospitalization length was significantly longer than in other groups (p < 0.001, p < 0.001). No significant difference was found among the groups in terms of mortality (p = 0.15). The most common comorbidity was obesity (33%). A significant association was found between the presence of comorbidity and mortality (p < 0.001). All patients who died had an underlying disease. Cerebral palsy was the most common underlying disease among the patients who died. Worsening of lymphopenia was significant in patients with severe COVID-19 pneumonia at the time of transfer to the PICU (p = 0.011). Conclusion Although children usually have a milder course of COVID-19 than adults, underlying diseases and obesity increase the severity of disease manifestations also in children. Further studies are needed to define the exact role of corticosteroids in COVID-19 patients. © 2022. Thieme. All rights reserved.

From Early Intervention to Graduate Education-- to CSD Leadership...Robert Augustine

An interview with Robert Augustine, American Speech-Language-Hearing Association (ASHA) 2023 president, is presented. Among the issues he discussed include his experience of growing up in Livingston, Illinois, what drove his decision to expand his scope beyond communication sciences and disorders (CSD) to graduate program administration, and issues among the association's priorities that he wants to emphasize.

Menstrual Irregularities Post-COVID-19 Infection/Vaccination in Indian Population

Introduction: Increased reporting of menstrual disturbances post-vaccination and inadequate inclusion of questions about menstruation in vaccine trials and disease progression studies have been the baseline for conducting this study. We aim to assess the influence of vaccines and COVID-19 infection on menstruation and identify patterns, if any, in cycles post-disease/vaccination. Methods: A multicenter observational study was performed using a questionnaire-based survey via an online link. The participants who filled the survey were predominantly in the age group of 21–25 years (80%). Participants with prior menstrual irregularities were eliminated from the study. Results: The prevalence of unusual menstrual cycles post-infection/vaccination was 21.7%. A total of 17.11% experienced changes post-vaccination and 22.8% of the infected individuals reported abnormalities post-COVID-19 disease. A substantial increase in dysmenorrhea was reported (p <0.001) post-infection/vaccination. An increase in menstrual flow was observed in 14.9% post-vaccination and 23.9% post-infection. Conclusion: Menstrual changes post-vaccination were insignificant;however, significant differences in menstruation were reported post-infection. The study strengthens the association between COVID-19 and menstruation and urges the inclusion of menstrual health in disease intervention studies.

Exercise precision medicine for type 2 diabetics: Targeted benefit or risk?

Concurrent exercise and metformin administration may reduce the acute and chronic effects of exercise on glucose metabolism in patients with type 2 diabetes (T2D). However, several studies suggest that combing metformin and exercise treatment may have no additive effect and even cause adverse effects in T2D patients. This case report aimed to highlight the challenges associated with prescribing exercise to type 2 diabetes patients undergoing metformin treatment. A 67-years old woman was followed-up for 5 months, including assessment of the acute and chronic glucose and lactate metabolism induced by concomitant exercise and metformin. The findings were four-fold: 1) During a high-intensity interval training bout, blood glucose systematically decreased, while blood lactate concentrations fluctuated randomly;2) Basal blood lactate levels were well above 2 mmol/L on days with medication only;3) Combined exercise and metformin administration induced additive effects on the normalization of glucose and 4) high levels of physical activity had a positive impact on the continuous glucose fluctuations, while decreased levels of physical activity induced a large fluctuation of glucose due to home confinement of an infectious disease caused by the SARS-CoV-2 virus. Our findings showed that when combined with exercise and metformin treatment for T2D patients, exercise may contribute to improving glycemic control while metformin may elevate lactate levels in the long term. The observed results underline the need to prescribe exercise and monitor lactate levels for reducing possible risks associated with metformin treatment and reinforce the importance of tailoring exercise therapy.

Mental Health in the Workplace

The increasing societal awareness of employee mental health issues, especially within the ongoing COVID-19 pandemic, has led to a great deal of research examining the occupational predictors and outcomes of mental ill health. The consequences of employee mental illness can be significant to organizations, whereas providing employee mental health resources may offer a competitive advantage. This article provides a review of the definitions of employee mental health, the costs of employee mental illness to organizations and to society as a whole, and the role of the workplace in promoting positive mental health, preventing mental illness, intervening to address employee mental ill health, and accommodating employees experiencing mental health challenges. We present recommendations for future research and implications for practice.

Outcome of Program Kesihatan Optimum Sanubari (SANUBARI) Wellness-based Self-management Intervention in Coaching Healthcare Workers for Well-being in COVID-19 Pandemic

Introduction: This study measured the outcome of the Optimal Health Program (OHP) among frontline healthcare workers during the COVID-19 pandemic. The OHP is a wellness-based self-management intervention focused on well-being to gain optimal health. OHP is originally from Australia and has been translated, culturally adapted and branded as the Program Kesihatan Optimum Sanubari (SANUBARI). The program was conducted as a psychosocial intervention and the outcomes measured were self-efficacy, coping styles and well-being. Methods: Eligible participants were nurses who actively managed COVID-19 inpatients in Hospital Kuala Lumpur and committed to complete the intervention. Those who did not provide consent or had comorbidity, unstable medical or psychiatry illnesses were excluded. 43 nurses were recruited through convenience sampling method and completed outcome measures from General Self-Efficacy Scale, Brief COPE and WHO-5 Well-being Index, before and 1-month after the intervention. The OHP was conducted via group-based, using OHP Sanubari workbook with 5 weekly sessions by trained facilitators and lasted for 60 to 90 minutes per session. Results: Significant improvement was observed 1-month post intervention for self-efficacy (t(42)=5.64, p <0.001) and well-being(t(42)=2.14, p<0.05);different approach coping strategies(acceptance, use of informational support, positive reframing, active coping, and planning) and avoidant coping strategies(distraction, venting, denial, and substance use). Whilst, humor coping reduced significantly 1-month post-intervention (t(42)=3.66, p<0.05). Conclusion: This study reports the positive outcome of OHP on the mental health status of healthcare workers during the pandemic. This program can be considered as a tool towards optimal health throughout their career. © 2023 Authors. All rights reserved.

Data-informed building energy management (DiBEM) towards ultra-low energy buildings

To support building operations in reaching ultra-low energy targets, this paper proposes a data-informed building energy management (DiBEM) framework to improve energy efficiency systematically and continuously at the operation stage. Specifically, it has two key features including data-informed energy-saving potential identification and data-driven model-based energy savings evaluation. The paper demonstrates the proposed DiBEM with a detailed case study of an office and living laboratory building located in Cambridge, Massachusetts called HouseZero. It focuses on revealing the performance of the energy-efficient interventions from two-years' building performance monitoring data, as well as evaluating energy savings from the interventions based on the data-driven approach. With Year 1 as baseline, several interventions are proposed for Year 2 including improvements to controls and operation settings, encouragement of occupants' behavior for energy savings, and hardware retrofitting. These were deployed to heating/cooling, domestic hot water, lighting, plug and other loads, and photovoltaic (PV) systems. To quantify the impacts of different interventions on energy end uses, several data-driven models are developed. These models utilize linear regression, condition model, and machine learning techniques. Consequently, the heating/cooling energy consumption that was already ultra-low in Year 1 (12.8 kWh/m2) is further reduced to 9.7 kWh/m2 in Year 2, while the indoor thermal environment is well maintained. The domestic hot water energy is reduced from 2.3 kWh/m2 to 1.2 kWh/m2. The lighting energy is only increased from 0.3 kWh/m2 in pandemic operations without occupancy in Year 1 to 0.8 kWh/m2 in partial normal operations in Year 2, while the indoor illuminance level meets occupants' requirements. Combined with other relatively constant loads and the reduction of plug and other loads due to COVID building operation restrictions, the total energy use intensity is thereby reduced from 54.1 kWh/m2 to 42.8 kWh/m2, where 5.4 kWh/m2 of energy reduction for Year 2 is estimated to be contributed by the energy-efficient interventions. PV generation is 36.1 kWh/m2, with an increase of 1.4 kWh/m2 from a new inverter. In summary, this paper demonstrates the use of DiBEM through a detailed case study and long-term monitoring data as evidence to achieve ultra-low energy operations. © 2022 Elsevier B.V.

Parent resolution of diagnosis and intervention fidelity in a parent-delivered intervention for pre-school children with autism: A mixed methods study

Background: There is growing interest in parent-delivered interventions (PDI) for children with autism. Treatment fidelity has been associated with child outcomes in PDI but little is known about what impacts fidelity. One factor not previously examined is parents' resolution to the autism diagnosis which involves adjusting expectations about the child and sensitively responding to their cues, strengths and needs. Relatively little is known about resolution in the context of autism but there is evidence of an association between resolution and parent wellbeing. Method: The study adopted a mixed methods approach to examine whether there is an association between PDI fidelity and parent resolution to diagnosis, and whether resolution is associated with parent wellbeing. Parents of 31 preschool children diagnosed with autism who attended up to 12 Parent-delivered Early Start Denver Model (P-ESDM) coaching sessions participated in the study. A thematic analysis of parent interviews was also undertaken to identify themes raised by resolved and unresolved parents in interviews. Results: There was no difference in overall mean fidelity scores between resolved and unresolved parents. Those classified as resolved had lower depression scores and parenting stress scores than parents classified as unresolved. The qualitative analysis revealed that parents' perceptions of their child's progress and their hopes for the future appeared to distinguish resolved and unresolved parents. Conclusions: Findings suggest that parent wellbeing and child progress may predict resolution which was not related to parent treatment fidelity in this study. Parent wellbeing and resolution status should be assessed at entry to PDI.

Clinical and Cardiovascular Characteristics of Patients Suffering ST-Segment Elevation Myocardial Infarction After Covid-19: A Systematic Review and Meta-Analysis

ST-segment elevation myocardial infarction (STEMI) is one of the fatal complications following Covid-19. We aimed to systematically assess the clinical sequels as well as cardiovascular findings in patients suffering STEMI following Covid-19.The manuscripts databases including PubMed, Web of knowledge (ISI), SCOPUS, Embase, and Google Scholar were deeply searched by the two reviewers using the relevant keywords related to the issue considered in the current review. Of 88 studies initially reviewed, 9 articles were included in final assessment. Nine articles including 447 patients with Covid-19 were included in the study. In terms of electrocardiographic findings, anterior lead involvement was reported in 12% - 61.6% of cases, inferior lead in 28.2% - 75% and lateral involvement in 7.7% - 100% of cases. The prevalence of LBBB was in the range of 10.7% - 61.6% of cases. In terms of echocardiographic findings, a decrease in left ventricular ejection fraction was reported in 60% - 88% of patients. Wall motion abnormality was also observed in 60% - 82.1% of patients. In terms of angiographic findings, the multi-vessel disease was reported in 17.9% - 69% of cases. Also, 24% - 83% of cases needed to revascularization procedures. Cardiac arrest was also reported in 3.1% - 28.2% of cases. Based on the meta-analysis performed on the mortality of patients with STEMI in the field of Covid-19, the pooled prevalence of mortality was estimated at 25.2% (95%CI:17.5%-34.8%). Mortality and adverse consequences of STEMI in patients with Covid-19 are far higher than in the general population. Therefore, in-hospital cardiovascular tracking and monitoring of Covid-19 patients with potential cardiovascular disorders is necessary to achieve a more favorable outcome. © 2021 Elsevier Inc.

Mental Health Weekly revisits key moments for the mental health field in 2022

As a new year gets underway, Mental Health Weekly looks back at some noteworthy moments in the field. In 2022, one of the most highly anticipated programs for the field was the 988 mental health and suicide prevention crisis hotline, launched July 15, 2022. Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline.

MH service delivery, 988 gratitude, on readers' minds in 2023

Editor's note: Last week in Mental Health Weekly's Annual 2023 Preview Issue, we featured some of your responses to the most pressing challenges and new opportunities that await you in the new year. Here are more of your responses. Thanks to all who submitted comments.

When it comes to hope, the rich get richer: A daily diary study of fluctuations in state hope

The current study examined the association between dispositional and state hope in college students using a 2 -week diary. Specifically, we tested whether dispositional hope predicts lower levels of daily changes in state hope over a 2-week period as well as whether higher-than-normal levels of state hope would result in higher-than -normal levels on subsequent days. Data were collected from 101 students (Mage = 25.91) who were studying online due to COVID-19 restrictions. The sample was predominantly female (74 %) and Black (49 %) or His-panic/Latinx (25 %). The results indicated that individuals with higher levels of dispositional hope at the beginning of the study experienced lower levels of lability in state hope compared to their counterparts with lower levels of dispositional hope. Additionally, when individuals reported levels of state hope on a particular day that were higher than average for them, they experienced a boost in state hope the following day. These results highlight the self-perpetuating nature of hope, and suggest that some individuals are less susceptible to daily fluctuations in hope than others based on their disposition. Furthermore, the results emphasize that hope varies both between - and within - persons.

Support for those not affected: How macroeconomic policies have shaped COVID's impact on sectoral activity

Considering the different dynamics of the COVID-triggered real shocks and macroeconomic measures during the first two waves of the pandemic, using official quarterly data for 2020 the paper studies how economic support measures have impacted the economic performance of sectors in EU countries. The paper shows that: (1) for all analysed sectoral groups, the economic support measures effects were much smaller than the corresponding non-pharmaceutical interventions impacts;(2) sectoral groups did not receive economic support in proportion to the corresponding nonpharmaceutical interventions;(3) sectoral groups with greater non-pharmaceutical interventions did not receive even systematically bigger effects of the economic support measures;and (4) the net overall effects of the COVID-triggered measures on sectoral value added vary considerably between sectors. By evaluating the potential opportunity costs of the ‘flat' economic support activity, the study's results also help to identify measures that could eventually be implemented once the pandemic has ended to mitigate the potential opportunity costs of the sector non-specific implementation of economic support measures, which will become apparent in the recovery period following the pandemic. © 2022 Economic Society of Australia, Queensland