Medical morbidity and risk of general hospital admission associated with concurrent anorexia nervosa and COVID-19: An observational study.

OBJECTIVE: Investigate medical morbidity and risk of general hospital admission for patients with concurrent coronavirus disease 2019 (COVID-19) and anorexia nervosa (AN) who have not received severe acute respiratory syndrome coronavirus 2 vaccination. METHODS: United Kingdom eating disorders clinicians contributed to a database of patients with an eating disorder and COVID-19. We used this to investigate demography, symptoms, hospitalization, treatment, and outcomes for those with AN. RESULTS: We describe data for 49 patients (median age 21.5 years [interquartile range 17.0-33.5], 46 female) including 36 adults and 13 under-18-year-olds. Three (6.1% [95% confidence interval 1.3%-17.9]) were admitted to a general hospital. For this sample, the expected age-standardized hospital admission rate per COVID-19 case (based on the general population of England) was 2.6% and therefore not significantly different to the hospitalization rate we observed. Three (including two of those admitted to hospital) contracted pneumonia. One had severe pneumonia and was admitted to an intensive care unit. No deaths or use of mechanical ventilation were recorded. DISCUSSION: To our knowledge, this represents the first study investigating medical morbidity or frequency of hospitalization for patients with COVID-19 and AN. We did not find evidence that patients with AN are at increased risk of severe COVID-19. PUBLIC SIGNIFICANCE: Medical morbidity and risk of hospitalization associated with concurrent COVID-19 and anorexia nervosa (AN) had not, to our knowledge, been studied before. We used a database of patients with eating disorders and COVID-19 (to which United Kingdom clinicians had contributed) to investigate presentation, treatment, outcomes, and COVID-19 severity for those with AN and COVID-19. We did not find evidence that patients with AN are at increased risk of severe COVID-19.

A SARS-CoV-2 outbreak associated with five air force bases and a nightclub following the lifting of COVID-19-related social restrictions, United Kingdom, July-to-September 2021.

We describe the management of two linked severe acute respiratory coronavirus 2 (SARS-CoV-2) outbreaks, predominantly amongst 18-35-year-olds, in a UK county in July-to-September 2021, following the lifting of national coronavirus disease 2019 (COVID-19)-associated social restrictions. One was associated with a nightclub and one with five air force bases. On week beginning 2nd August 2021, air force contact tracing teams detected 68 cases across five bases within one county; 21 (30.9%) were associated with a night-time economy venue, 13 (19.1%) with night-time economy venues in the county's main town and at least one case per base (n = 6, 8.8%) with a particular nightclub in this town, which itself had been associated with 302 cases in the previous week (coinciding with its reopening following a national lockdown). In response, Public Health England/United Kingdom Health Security Agency, air force and local authority teams collaboratively implemented communication strategies and enhanced access to SARS-CoV-2 testing and vaccination. Key challenges included attempting to encourage behaviours that reduce likelihood of transmission to a population who may have considered themselves at low risk from severe COVID-19. This report may inform future preparation for, and management of, easing of potential future pandemic-related social restrictions, and how an outbreak in this context may be addressed.

Knowledge transfer of eLearning objects: Lessons learned from an intercontinental capacity building project.

BACKGROUND: Effective knowledge transfer of eLearning objects can hasten the adoption and dissemination of technology in teaching and learning. However, challenges exist which hinder inter-organisational knowledge transfer, particularly across continents. The ACoRD project aimed to transfer knowledge on digital learning development from UK/EU (provider) to Malaysian (receiver) higher education institutions (HEIs). This study explores the challenges encountered during the knowledge transfer process and lessons learned. METHODS: This is a qualitative study involving both the knowledge providers and receivers in focus group discussions (n = 25). Four focus group discussions were conducted in the early (n = 2) and mid-phase (n = 2) of the project by trained qualitative researchers using a topic guide designed to explore experiences and activities representing knowledge transfer in multi-institutional and multi-cultural settings. The interviews were audio-recorded, transcribed verbatim, and checked. The transcripts were analysed using thematic analysis. RESULTS: Five main themes emerged from this qualitative study: mismatched expectations between providers and receivers; acquiring new knowledge beyond the professional "comfort zone"; challenges in cascading newly acquired knowledge to colleagues and management; individual and organisational cultural differences; and disruption of knowledge transfer during the COVID-19 pandemic. CONCLUSION: This study highlights the need to create a conducive platform to facilitate continuous, timely and bi-directional needs assessment and feedback; this should be done in the early phase of the knowledge transfer process. The challenges and strategies identified in this study could guide more effective knowledge transfer between organisations and countries.

Preferences for and acceptability of telesupervision among health service psychology trainees

Telesupervision is an increasingly common practice in health service psychology training, particularly due to the COVID-19 pandemic. However, little is known about important considerations that may inform the long-term adoption of telesupervision, including its acceptability among trainees, the impact of technology-mediated supervision on critical variables such as the supervisory working alliance, and whether established supervisory best practices can be effectively employed in a telehealth format. The present study provides qualitative and quantitative data on trainee perceptions of telesupervision among a sample of 144 health service psychology students engaged in either telesupervision or hybrid supervision combining telesupervision with in-person meetings within university training clinics in the United States. Trainees completed questionnaires rating supervisory working alliance, metacommunication, quality of supervision, the identified supervisor's use of best practices, and perceptions of COVID-19 danger as well as provided qualitative responses to three open-ended questions exploring expectations around telesupervision as well as perceived advantages and disadvantages. Findings suggest that trainees find telesupervision to be highly acceptable, with over 90% of participants reporting that it met or exceeded their expectations. Ratings of critical variables such as supervisory working alliance, metacommunication, and engagement in best practices generally did not differ between the hybrid and telesupervision groups, nor were these results affected by supervision format (i.e., individual vs. group) or trainee developmental level. Unique benefits and limitations of telesupervision were highlighted. Overall, results suggest that telesupervision is a highly acceptable and beneficial tool in health service psychology training. Considerations for the ongoing use of telesupervision are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Health service psychology trainees find telesupervision to be highly acceptable and report strong supervisory alliances, effective engagement in metacommunication, and utilization of supervisory best practices via telehealth. The widely recommended practice of incorporating at least some in-person meetings was not associated with higher trainee ratings of supervision. Findings suggest that trainees across developmental levels may benefit from telesupervision as an alternative to in-person supervision, which may ultimately increase access to high-quality clinical supervision. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The severity of COVID-19 infection in patients with anorexia nervosa: an observational study

Background Patients with anorexia nervosa frequently show neutropenia, lymphopenia, and a reduced CD8 count;pro-inflammatory cytokines tend to be upregulated. The immunological response to bacterial infection is often impaired, but viral illness appears to be rare. At the beginning of the COVID-19 pandemic, clinicians expected that patients with anorexia nervosa would be at increased risk of severe infection. The present study investigated COVID-19 severity in patients with anorexia nervosa with positive SARS-CoV-2 polymerase chain reaction (PCR) tests. Methods A database was created at NHS England and Improvement, and eating disorders clinicians across the UK reported demographics, clinical characteristics, biomarkers, and outcomes of patients with anorexia nervosa and COVID-19 between May 20, 2020, and May 11, 2021. Eating disorder diagnoses were made by referring clinicians following standard clinical practice. This report follows STROBE guidelines. Findings Data were collected from 47 patients (44 female) aged 13–57 years (mean 26·8 years [SD 12·3]), including 34 adults (body-mass index [BMI] 12·0–21·3 kg/m2, mean 15·6 kg/m2 [SD 2·3]) and 13 children (percentage median BMI 68·5–129%, mean 94·0% [SD 13·4]). 37 patients (79%) had at least one of the typical COVID-19 symptoms of fever, cough, or disturbed smell or taste. One patient was asymptomatic;44 had mild disease;two developed pneumonia, which for one patient was severe. One patient (2%) required treatment for COVID-19 in a general hospital. In comparison, in the general population of England, between 2·4% and 2·7% of adults aged 18–54 years with a positive SARS-CoV-2 PCR between October, 2020, and February, 2021, were admitted to hospital. Interpretation To our knowledge, this is the first published study investigating effects of COVID-19 on patients with anorexia nervosa. Contrary to expectations, these findings suggest that anorexia nervosa does not increase the risk of severe COVID-19 infection. They also provide an insight into the effect of malnutrition on COVID-19, and viral infection in general, and offer some reassurance for patients with anorexia nervosa and clinicians about the risk from infection. Additionally, they may inform vaccination and infection control recommendations for patients with anorexia nervosa in future pandemics. The sample size was small and dependent on data submitted by clinicians;the results should therefore be treated with caution. Funding None.

Q Methodology in the COVID-19 Era.

All face-to-face studies were affected by the COVID-19 pandemic, as they could not be run in person due to rules and guidance linked to social distancing which were in force during the outbreak. Finding and testing an available COVID-secure approach for both participants and researchers was important as was the need to continue conducting such studies during this critical time. At present, the extant literature indicates a clear gap in research that elucidates how to carry out a Q methodology study online, step by step. This paper describes an option for online Q methodology using an approach that simulates all of the steps performed in a face-to-face setting using an open-source software known as Easy-HtmlQ. Using a case study in telemedicine adoption as illustration, this paper also considers the perspective of both research participants and Q methodology researchers via semi-structured interviews. Using Easy-HtmlQ V1.1 in online Q methodology studies appears to be an affordable, practical and user-friendly solution. Some of the benefits associated with running Q methodology studies online were the decreased costs, enabling the recruitment of wider number of participants, providing a COVID-19-secure environment and offering convenience to both participants and researchers during the research process. The findings of this study may contribute to increasing the number of online Q methodology studies in the future, as it has succeeded in offering a feasible approach for Q methodology researchers.

The NHLBI Study on Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC): Design and Objectives.

BACKGROUND: The Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood. METHODS: This multicenter observational cohort study will enroll at least 600 patients <21 years old who meet the Centers for Disease Control and Prevention case definition of MIS-C across multiple North American centers over 2 years. The study will collect detailed hospital and follow-up data for up to 5 years, and optional genetic testing. Cardiac imaging at specific time points includes standardized echocardiographic assessment (all participants) and cardiac magnetic resonance imaging (CMR) in those with left ventricular ejection fraction (LVEF) <45% during the acute illness. The primary outcomes are the worst LVEF and the highest coronary artery z-score of the left anterior descending or right coronary artery. Other outcomes include occurrence and course of non-cardiac organ dysfunction, inflammation, and major medical events. Independent adjudication of cases will classify participants as definite, possible, or not MIS-C. Analysis of the outcomes will include descriptive statistics and regression analysis with stratification by definite or possible MIS-C. The MUSIC study will provide phenotypic data to support basic and translational research studies. CONCLUSION: The MUSIC study, with the largest cohort of MIS-C patients and the longest follow-up period to date, will make an important contribution to our understanding of the acute cardiac and non-cardiac manifestations of MIS-C and the long-term effects of this public health emergency.

Usability and value of a digital learning resource in nursing education across European countries: a cross-sectional exploration.

BACKGROUND: Higher education is responsible for providing education that meets international benchmarks relevant to the needs of the international community. Due to the increase of digital tools in higher education, the possibility of sharing learning resources across nations has expanded. In the current project, a Norwegian university invited universities in Spain and the United Kingdom to adapt and translate e-learning resources originally developed for Norwegian nursing students for use within their respective Bachelor in Nursing programmes. AIM: The aim of the current study was to gain insights into the usability and value for learning of e-compendiums shared and implemented across three European universities. METHODS: The study adopted a descriptive cross-sectional design and included nursing students from the University of Nottingham, Valencia Catholic University, and the University of Stavanger. Data were collected in Autumn 2017 through a questionnaire adapted from the validated "Centre for Excellence in Teaching and Learning Reusable Learning Object evaluation questionnaire" The questionnaire consisted of 19 items that included two aspects: e-compendiums' value for learning and e-compendiums' usability. The different study sites were compared using a binary logistic regression analysis. Subgroups of students were compared based on their gender and age. RESULTS: A total of 480 nursing students participated in the study. The e -compendiums were overall positively rated, especially for reinforcing and retaining knowledge. Compared to the students from the University of Stavanger, students from Valencia Catholic University rated the e-compendiums more positively in most aspects of learning. Students from University of Nottingham found the e-compendiums to be more important for learning engagement compared to students at the Norwegian study site, and no differences were found in any other aspects of learning. Younger students rated the interactivity and visual components as more important compared to older students. CONCLUSIONS: Students from the University of Nottingham and Valencia Catholic University seem to accept the e-compendiums despite the fact that they were originally developed for use in another country. We argue that, when sharing e-learning resources across countries, an adaptation and translation process that includes a multicultural and multidisciplinary perspective should be carried out.

Virtual car seat checks during a pandemic.

Motor vehicle collisions are one of the leading causes of death and morbidity in children and young adults in the USA, and suboptimal child restraint use is an important risk factor for severe childhood injury and death. The restrictions due to the COVID-19 pandemic have presented unique challenges to the public health community, including how to use certified child passenger safety technicians through car seat checks. This case series assessed the feasibility of performing remote car seat checks and parental satisfaction with them. It provides preliminary evidence that remote car seat checks are feasible in a real-world environment and acceptable to caregivers during times in which in-person car seat checks are not safe or accessible.