An investigation of Head Start preschool children's executive function, early literacy, and numeracy learning in the midst of the COVID-19 pandemic.

The COVID-19 pandemic's impact on preschool children's school readiness skills remains understudied. This research investigates Head Start preschool children's early numeracy, literacy, and executive function outcomes during a pandemic-affected school year. Study children (N = 336 assessed at fall baseline; N = 237-250 assessed in spring depending on outcome; fall baseline sample: mean age = 51 months; 46% Hispanic; 36% Black Non-Hispanic; 52% female) in a network of Head Start centers in four states (Nevada, New Jersey, Pennsylvania, and Wisconsin) experienced low in-person preschool exposure compared to national pre-pandemic norms. Children experienced fall to spring score gains during the pandemic-affected year of 0.05 SD in executive function, 0.27 SD in print knowledge, and 0.45-0.71 SD in early numeracy skills. Descriptively, for two of the three early numeracy domains measured, spring test score outcomes were stronger among children who attended more in-person preschool. We discuss implications for future research and policy.

Pharmacy Students' and Pharmacist Preceptors' Perceptions of the Hospital Rotation Experience during the COVID-19 Pandemic.

Background: The COVID-19 pandemic brought significant disruptions to pharmacy experiential education. To ensure the safety of students and staff, university and rotation site educators needed to make changes rapidly to adapt to the dynamic environment. Objectives: To explore the impact of the COVID-19 pandemic on pharmacy students and their preceptors during experiential rotations and to identify any barriers to learning that arose and opportunities for improvement. Methods: Two online questionnaires were developed to explore the perceptions of pharmacy students and preceptors during experiential rotations. The following topics were examined: support for rotations by the hospital and the university, perceived safety, accessibility of resources, interpersonal interactions, professional development, assessment and evaluation, and overall impressions. All Advanced Pharmacy Practice Experience students from the University of Toronto who completed 1 or more rotations at North York General Hospital during the 2020/21 academic year and their preceptors were invited to participate. Results: Sixteen and 25 questionnaires were completed by students and preceptors, respectively. Both groups agreed that they were adequately prepared for the rotations and felt safe. There was a decrease in interpersonal interactions, while the use of virtual communication tools increased. Lessons learned included the need for timely communications and access to resources for learners and preceptors, contingency plans for staff shortages and outbreaks, and workspace assessments. Conclusions: During the COVID-19 pandemic, implementation of experiential rotations was associated with many challenges, but pharmacy learners and preceptors believed the overall experience was not significantly affected.

Contexte: La pandémie de COVID-19 s'est accompagnée de perturbations importantes dans le domaine de la formation pratique en pharmacie. Les éducateurs de l'université et du lieu de stage ont dû rapidement apporter des changements pour s'adapter à l'environnement dynamique et assurer la sécurité des étudiants et du personnel. Objectifs: Étudier les effets de la pandémie de COVID-19 sur les étudiants en pharmacie et leurs précepteurs pendant les stages pratiques et identifier les obstacles qui se sont présentés ainsi que les améliorations possibles. Méthodes: Deux questionnaires en ligne ont été préparés pour étudier les perceptions des étudiants en pharmacie et des précepteurs pendant les stages pratiques. Les sujets suivants ont été examinés: le soutien de l'hôpital et de l'université pour les stages, la perception de la sécurité, l'accessibilité des ressources, les interactions interpersonnelles, le perfectionnement professionnel, l'évaluation et les impressions générales. Tous les étudiants du programme Advanced Pharmacy Practice Experience de l'Université de Toronto qui ont effectué un ou plusieurs stages à l'Hôpital général de North York au cours de l'année universitaire 2020­2021 et leurs précepteurs ont été invités à participer. Résultats: Les étudiants et les précepteurs ont répondu à 16 et 25 questionnaires, respectivement. Les deux groupes ont convenu qu'ils étaient bien préparés aux stages et qu'ils se sentaient en sécurité. On a observé une diminution des interactions interpersonnelles, tandis que l'utilisation d'outils de communication virtuels a augmenté. Les leçons tirées comprennent: la nécessité de communiquer en temps opportun et l'accès aux ressources pour les apprenants et les précepteurs; les plans d'urgence en cas de pénurie de personnel et d'épidémies; et les évaluations de l'espace de travail. Conclusions: Pendant la pandémie de COVID-19, la mise en œuvre des stages pratiques a été associée à de nombreux défis, mais les apprenants en pharmacie et les précepteurs ont estimé que l'expérience globale n'a pas été touchée de manière significative.

Navigating Virtual Delivery of Assessments for Head Start Children During the COVID-19 Pandemic

Many preschool agencies nationwide continue to experience closures and/or conversions to virtual or hybrid instruction due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. Despite the importance of understanding young children?s learning and development during the COVID emergency, limited knowledge exists on adaptable practices for assessing young children during the pandemic. We assess the learning of 336 Head Start children across four states and three different time periods during the 2020 to 2021 school year, using adaptations of traditionally in-person assessments of early numeracy, early literacy, and executive functioning. In doing so, we distill early lessons for the field from the application of a novel, virtual assessment method with the early childhood population. This article describes the adaptations of assessment administration for virtual implementation and incorporation of feedback into continued virtual delivery of assessments. Applications and limitations in broader contexts are discussed.

The seroprevalence of COVID-19 in patients living with HIV in metropolitan Detroit.

BACKGROUND: COVID-19, a novel respiratory illness caused by SARS-CoV-2, has become a global pandemic. As of December 2020, 4.8% of the 941 people living with HIV in our Ryan White clinic have tested polymerase chain reaction positive for SARS-CoV-2. The aim of our study was to estimate the seroprevalence of COVID-19 in our Ryan White people living with HIV, irrespective of known past infection. METHODS: We conducted a cross-sectional study that recruited people living with HIV in the Ryan White program at Henry Ford Hospital in Detroit, Michigan, from September 2020 through May 2021. All Ryan White patients were offered participation during clinic visits. After informed consent, patients completed a survey, and had blood sampled for SARS-CoV-2 antibody testing. RESULTS: Of the 529 individuals who completed the written survey, 504 participants were tested for SARS-CoV-2 antibody and 52 people living with HIV were COVID-19 immunoglobulin (Ig) G positive resulting in a seroprevalence of 10.3%. Among 36 persons with PCR-confirmed COVID-19, 52.8% were IgG negative. Inclusion of PCR positive but IgG-negative people living with HIV yields a COVID-19 infection prevalence of 14.1%. CONCLUSIONS: These findings suggest that passive public health-based antibody surveillance in people living with HIV significantly underestimates past infection.

Hospital in Home COVID-19 Monitoring: A Novel Approach to Keeping a Watchful Eye on Older Adults

Older adults suffering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at increased risk of death and hospitalization-related complications. The coronavirus disease 2019 (COVID-19) pandemic has forced adaptations in Telehealth, allowing COVID-19 patients to be managed at home. Traditionally, Hospital in Home (HIH) patients have better clinical outcomes and lower mortality compared to similar hospitalized patients. However, effectiveness of HIH for COVID-19 older adults remains unknown. This study examines the effect of age on rates of hospital readmission and overall mortality for patients enrolled in HIH after initial COVID-19 hospital discharge. A HIH COVID-19 monitoring program was developed to facilitate earlier hospital discharge and monitoring. Retrospective data between March 2020 and January 2021 were analyzed. Of the 402 subjects (age:26-99;mean:61.8), 13 (6.1%) subjects <65 years old vs 19 (10%) subjects □65 years old were readmitted to the hospital at least once. Two (0.94%) subjects <65 years old and 12 (6.3%) subjects □65 years old died. Older adults were 1.719 times more likely to be re-hospitalized (p=0.005) and 7.153 times more likely to die (p=0.017) compared to younger adults. Age remains a significant predictor of hospital readmission and mortality in subjects previously hospitalized for COVID-19 even when followed by monitoring programs like HIH. Further studies are needed to determine the best way to reduce hospital readmission and mortality rates for older adults after initial COVID-19 hospital discharge.

Telehealth and HIV Care During the COVID-19 Pandemic

Background The COVID-19 Pandemic led to many restrictions in health care services, and as a consequence, an expansion of telehealth capabilities. In order to meet the needs of PLWH along the Care Continuum, we developed a process to promote the use of our MyChart app. This HIPAA-compliant app allows patients to view their medical records, communicate with their providers, make appointments, and have video visits on their smart devices. This report describes our preliminary findings. Methods PLWH enrolled in the Ryan White Program, in the Infectious Diseases Clinic at Henry Ford Hospital who had not used telehealth services were asked to sign up for our MyChart (electronic medical record software) initiative. A telehealth Navigator interviewed and taught PLWH how to download and use MyChart, and supplied pre-loaded phones, as needed, to make virtual visits accessible. We collected demographic and clinical information and reasons for not using telehealth services. Results From October 2020 to May 2021, 209 PLWH were enrolled into our pilot program (Table 1). Of these: 48% were 45-64 years old (yo), while 21% were >/+ 60 yo and 3% < 25 yo;75% were male, 85% Black;48% MSM, and 84% virally suppressed (HIV RNA < 200 copies/mm3). When asked why they were not using telehealth services, 29% reported a lack of technology or capability to install MyChart on their phones, 27% needed further education, and 18% and had not prioritized installation of the application. Conclusion The crises created by the COVID-19 pandemic revealed a new role for telehealth services. Although available to all PLWH in our RW program, many had never used telehealth services. Over half lacked compatible devices or needed help to download or use the app. Compared to younger PLWH, older individuals were more likely to need assistance. Further work is needed to understand and promote digital parity. Disclosures All Authors: No reported disclosures

Immunologic resilience and COVID-19 survival advantage.

BACKGROUND: The risk of severe coronavirus disease 2019 (COVID-19) varies significantly among persons of similar age and is higher in males. Age-independent, sex-biased differences in susceptibility to severe COVID-19 may be ascribable to deficits in a sexually dimorphic protective attribute that we termed immunologic resilience (IR). OBJECTIVE: We sought to examine whether deficits in IR that antedate or are induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection independently predict COVID-19 mortality. METHODS: IR levels were quantified with 2 novel metrics: immune health grades (IHG-I [best] to IHG-IV) to gauge CD8+ and CD4+ T-cell count equilibrium, and blood gene expression signatures. IR metrics were examined in a prospective COVID-19 cohort (n = 522); primary outcome was 30-day mortality. Associations of IR metrics with outcomes in non-COVID-19 cohorts (n = 13,461) provided the framework for linking pre-COVID-19 IR status to IR during COVID-19, as well as to COVID-19 outcomes. RESULTS: IHG-I, tracking high-grade equilibrium between CD8+ and CD4+ T-cell counts, was the most common grade (73%) among healthy adults, particularly in females. SARS-CoV-2 infection was associated with underrepresentation of IHG-I (21%) versus overrepresentation (77%) of IHG-II or IHG-IV, especially in males versus females (P < .01). Presentation with IHG-I was associated with 88% lower mortality, after controlling for age and sex; reduced risk of hospitalization and respiratory failure; lower plasma IL-6 levels; rapid clearance of nasopharyngeal SARS-CoV-2 burden; and gene expression signatures correlating with survival that signify immunocompetence and controlled inflammation. In non-COVID-19 cohorts, IR-preserving metrics were associated with resistance to progressive influenza or HIV infection, as well as lower 9-year mortality in the Framingham Heart Study, especially in females. CONCLUSIONS: Preservation of immunocompetence with controlled inflammation during antigenic challenges is a hallmark of IR and associates with longevity and AIDS resistance. Independent of age, a male-biased proclivity to degrade IR before and/or during SARS-CoV-2 infection predisposes to severe COVID-19.

The use of short message service (SMS) to reduce outpatient attendance in ophthalmic clinics during the coronavirus pandemic.

PURPOSE: In order to minimize the risk of transmission of coronavirus disease 2019 (COVID-19), many clinic appointments were postponed to lower patient attendance. Actively calling patients to postpone appointments is a labour-intensive process. We were the first ophthalmic clinics in Hong Kong to use short message service (SMS) to dispatch messages simultaneously to a large number of patients to offer postponement of appointments. The aim of this study is to evaluate whether SMS is an effective method to reduce outpatient attendance during the COVID-19 pandemic. METHODS: This is an observational study reviewing data on SMS messages sent to all patients attending ophthalmology clinics of a tertiary eye centre in Hong Kong. All SMS were sent at least 5 days before the scheduled appointments. The text message included an enquiry hotline for postponement of appointments and offered drug refill. The study included data from February to April 2020. Two hundred patients were invited to take part in a questionnaire on satisfaction level and reason(s) for appointment rescheduling. RESULTS: During the study period, a total of 17,028 SMS were sent. The overall response rate was 23.6%. 14.3% postponed their appointments. This led to an overall 13.9% reduction of clinic attendance. The overall satisfaction was high (96%). The main reason for postponing appointment was worries about infection risk (93.1%). CONCLUSION: SMS was an efficient and cost-effective flow-control method which was well accepted by patients and can reduce outpatient attendance. The time saved can potentially allow healthcare workers to conduct other infection control measures during the COVID-19 pandemic.