What are People in Bali Doing in Pandemic: Understanding the Shape of Health Behavior and the Pitutur Tua

In the early occurrence of the Covid-19 pandemic, Indonesian and the world regarded Bali having a unique mechanism. Balinese or Bali residents are assumed excellently immune or difficulty infected from Covid-19. Interestingly, Balinese do not show overwhelmed panic as occurs in other areas although the Covid-19 cases in Bali are not low. There are various reasons why Balinese's actions to protect their health consider beliefs, religion, and culture. This paper is a survey of the Balinese's distinctive perception and behavior to face Covid-19. The information was gained from comments, opinions, and information about typical behavior posted on mass media and social media. The main source of the information was the WhatsApp groups of Banjar community (60 people), Bali academicians (76 people), Hindu organization alumni (113 people), and Bali medical staff (30 people). This study collected the information and conversations during early months of the pandemic in 2020 and 2021 when the Covid-19 cases skyrocketed and the government implemented the Community Activities Restrictions Enforcement (PPKM). This study concludes that the belief in the power of nature makes the sincerity and acceptance more easily appear. Moreover, tradition strengthens the trust. Support in social life also increases cooperative actions to the rules or advices of the Bali government and the custom village assembly to protect society from the pandemic.Copyright © 2021 Muslim OT et al.

A qualitative study exploring how youth use TikTok to learn about mental health and mental health services in British Columbia, Canada

Aims: Youth are increasingly seeking health information through online platforms, such as websites, social media, and online forums. TikTok emerged as a popular platform for disseminating and consuming health information during the COVID-19 pandemic. As such, this study aimed to explore how youth used TikTok to access information about mental health and mental health services during the pandemic. Method(s): Twenty-one interviews were conducted over Zoom with youth (ages 12-24) who lived in British Columbia, Canada and had accessed TikTok for mental health information during the pandemic. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using an inductive approach. Result(s): Youth described TikTok as a safe place to talk about mental health and share personal experiences. This helped youth feel less alone with their struggles and facilitated conversations about mental health with friends, family, and service providers. Participants also described how mental health content on TikTok helped them be more mindful of their own mental health and the different resources and coping strategies available and encouraged them to seek services. For those hesitant or unable to access services, TikTok provided immediate support. Youth appreciated the ease of accessing this information, given the platform's engaging and digestible format (i.e., short videos) and predictive nature of its algorithm. However, participants expressed concerns with the spread of misinformation and the lack of verifiable information on the platform. Conclusion(s): TikTok is as a practical platform to disseminate mental health information to youth. However, efforts to establish strategies for preventing and reporting misinformation are warranted.

Beyond Utterances: Embodied Creativity and Compliance in Dance and Dementia

Practices of creativity and compliance intersect in interaction when directing local dances remotely for people living with dementia and their carers in institutional settings. This ethnomethodological study focused on how artistic mechanisms are understood and structured by participants in response to on-screen instruction. Video data were collected from two long-term care facilities in Canada and Finland in a pilot study of a dance program that extended internationally from Canada to Finland at the onset of COVID-19. Fourteen hours of video data were analyzed using multimodal conversation analysis of initiation–response sequences. In this paper, we identify how creative instructed actions are produced in compliance with multimodal directives in interaction when mediated by technology and facilitated by copresent facilitators. We provide examples of how participants' variably compliant responses in relation to dance instruction, from following a lead to coordinating with others, produce different creative actions from embellishing to improvising. Our findings suggest that cocreativity may be realized at intersections of compliance and creativity toward reciprocity. This research contributes to interdisciplinary discussions about the potential of arts-based practices in social inclusion, health, and well-being by studying how dance instruction is understood and realized remotely and in copresence in embodied instructed action and interaction. © 2023 by the authors.

Specifically designed family communication booklet to help staff to communicate effectively with Intensive Care Unit patients' next of kin

Introduction: Families of patients admitted to the Intensive Care Unit (ICU) experience significant emotional distress.1 Visiting restrictions mandated during the COVID-19 pandemic presented new barriers to family communication, including a shift from regular bedside nursing updates and in-person family meetings to scheduled, clinician-led telephone calls and video calls.2 This resulted in loss of non-verbal clues and feedback during family discussions, difficulties establishing rapport with families and risked inconsistent messages and moral injury to staff.3 Objectives: We aimed to design a system where all ICU family discussions were documented in one place in a standardised format, thereby clarifying information given to families to date and helping staff give families a consistent message. In addition, we aimed to provide practical advice for the staff making family update telephone calls and strategies for managing difficult telephone conversations. Method(s): We designed and implemented an ICU family communication booklet: this was colour-coded blue;separate to other ICU documentation within the patient notes;and included communication aids and schematics to help staff optimise and structure a telephone update. Using Quality Improvement methodology, we completed four Plan-Do-Study-Act (PDSA) cycles and gathered qualitative and quantitative feedback: this occurred prior to the project and at one,12,18 and 21 months post introduction. We implemented suggested changes at each stage. We designed staff surveys with questions in a 5-point Likert scale format plus opportunity for free comments. Twenty-one months post implementation, we designed and delivered an MDT awareness campaign using the 'tea-trolley training' method,4 departmental induction sessions for new ICU doctors and nurses and a 'Message of the Week' initiative. An updated version of the booklet was introduced in February 2022 (Figure 1). Result(s): Staff survey results are shown in Table 1. Forty-six staff participated in tea trolley training, feedback form return rate 100%. Following feedback, the family communication booklet was updated to include the following: a prompt to set up a password;a new communication checklist at the front, including documentation of next of kin contact details, a prompt to confirm details for video calls, confirm primary contact and whether the next of kin would like updates during the night;consent (if the patient is awake) for video calls while sedated;information regarding patient property;prompt to give families our designated ICU email address to allow relatives to send in photographs to display next to patients' beds;prompts to encourage MDT documentation and patient diary entry. Conclusion(s): During unprecedented visiting restrictions in the COVID-19 pandemic, we implemented an ICU family communication booklet which has been so successful that we plan to use it indefinitely. We plan to further develop this tool by encouraging MDT involvement, seek further staff feedback in six months' time, incorporate this structure into our electronic patient information system when introduced and collect feedback from patients and their next of kin at our ICU follow up clinic. This communication booklet would potentially be reproducible and transferable to other ICUs and could be used as part of a national ICU family communication initiative.

Minimally Invasive Coronary Artery Revascularization During Current Pandemics, New Hope! - Our Experience in a Third World Country

Objective: Since the last decade, the notion of minimally invasive cardiac surgery (MICS) has gained worldwide rapid popularity. Bangladesh is not far from mastering this technique due to the increasing interest of both patients and surgeons. Meanwhile, during this COVID-19 era could it help patients, remains the main question. In this context, we have operated on a total of 523 patients from October 2020 to November 2021 including, 89 patients who were MICS and among them, 17 were coronary artery bypass grafting. Method(s): We have included all patients who underwent minimally invasive coronary artery surgery in our hospital from October 2020 to November 2021 irrespective of single (MIDCAB) / multi-vessel disease (MICAS) or combined valve replacement with coronary revascularization. Data were collected from the hospital database, telephone conversations, and direct clinic visits. All data were analyzed statistically and expressed in the form of tables. Result(s): In the last 14 months of pandemics we have operated on a total of 89 MICS patients, among them 10 were Minimally Invasive Direct Coronary Artery Bypass (MIDCAB), 6 were double or triple vessels coronary artery surgery (MICAS), 1 patient underwent upper-mini aortic valve replacement along with coronary revascularization. One of our patients needed re-exploration for chest wall bleeding on the same day. Mean ICU and hospital stay in our series were less than conventional revascularization. There was no in-hospital or 30 days' mortality in our series. Conclusion(s): Cardiac surgery these days is headed toward less invasive approaches with the aid of technology, advanced instruments, and pioneer's lead. But from our in-hospital results we conclude that by avoiding median sternotomy, these minimal invasive revascularization techniques can provide hope to the patients by alleviating symptoms with restored vascularity, reduced morbidity, preventing sudden cardiac death. Health costs reduction with shorter hospital and ICU stay are the added benefits.

Helping Hands

Introduction: We work in a large, tertiary Teaching Hospital Critical Care unit. As such we have a sizeable and diverse workforce from multiple professional backgrounds. We noted both anecdotally, and from the formal process of Exit Interviews that the changes imposed by the Covid-19 pandemic were impacting on team relationships. Physical barriers enforced by social distancing, as well as the burden of increased patient numbers and changes to job roles had driven apart nursing and medical teams. Critical care appeals to many staff because of the MDT and the chance to work with highly qualified, ambitious colleagues with varying skill sets. Nurturing this positive working relationship between different teams requires a commitment from all to share the burden of increased pressures wherever possible. Objective(s): The aims for this project are to identify specific areas within the working relationship between the medical team and the nursing team that can be improved. More than this, we want to open wider conversation about how teams can work more collaboratively for the benefit of the working environment, staff mental health and ultimately the patient. Method(s): We created an e-survey with input from the critical care matrons and psychologists before distributing amongst nursing staff. Questions focused on communication, practical support and the general working relationship. Each section contained MCQ's and white space questions to allow us to collect both quantitative and qualitative data. Following collection of responses we identified common themes that could be addressed and created an eye-catching poster with specific suggestions for the medical team. Result(s): Communication: Common themes were more presence on the unit with more regular walk-rounds and that STAT medications are often prescribed but not communicated to the nurse at the bedside and are therefore delayed. Practical support: Common suggestions were helping with repositioning patients and relieving breaks. Others included, pulling blood gases, printing off blood request forms and working in pairs for lines so that the nurse doesn't have to be engaged. Working relationship: suggestions mainly focused around introducing ourselves and level of training as well as social integration of the two teams. A few said that improving the communication and assisting with tasks would feed into improving the relationship. A few also said that the survey itself was a good start. Discussion(s): The survey generated many useful suggestions as well as demonstrating an open and receptive attitude. Responses were used to create a poster that gives clear and practical advice to the medical team. This method is easily reproducible and we believe that we have already seen positive changes that have been widely well received. We plan also to send a follow up survey once changes have become ingrained into the culture of the workforce. Acknowledgements Matthew Powell Jane Atkins Nathan Shearman Helen Horton.

Use of Chatbots in the Covid-19: A Systematic Literature Review

Artificial-Intelligence (AI) is becoming more widespread in several areas, from economics and government to consumer-services and even healthcare. In fact, in the latter, there was a big use increase in the past three years, also due to the COVID-19 pandemic. Several solutions have been implemented to tackle the several challenges imposed by this new disease, being one of such solutions chatbots. In this article, we present the results of a Systematic Literature Review (SLR) that identifies the Chatbots applications in COVID-19 disease. In this SLR, we identified 9987 papers from which we selected 30 studies, on which we performed a full-text analysis. From our research, we could conclude that several solutions were implemented, with good acceptance by citizens, despite several limitations, such as limited time to develop the solutions (which narrowed some features, such as AI voice conversation), lack of global implementation and infrastructure limitations. © 2022 Associacao Portuguesa de Sistemas de Informacao. All rights reserved.

Effective Messaging Strategies for Colorectal Cancer Screening: The Development of the 2022 NCCRT Messaging Guidebook for Black and African American People

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States (US) and disproportionately impacts Black individuals. The US Preventive Services Taskforce began recommending CRC screening for individuals aged 45-49 in 2021, however effective strategies to increase screening participation in Black individuals in this age group are unknown. Thus, the National Colorectal RoundTable (NCCRT) used a mixed methods approach to identify barriers and facilitators to CRC screening in Black individuals, with specific focus on those age 45-49. Results informed the development of the 2022 NCCRT Messaging Guidebook for Black & African American People. Method(s): We conducted a mixed-methods study in a large, nationally representative sample of unscreened Black individuals. We first conducted semi-structured qualitative interviews with Black individuals over age 45, recruited from the Schlesinger Group qualitative research platform. Findings informed content for a subsequent survey to understand barriers and facilitators, administered broadly via the Prodege online research platform. Messages to encourage screening participation were developed based on learnings from prior ACS and NCCRT work. Message were tested using MaxDiff analytic methods and reviewed by a multidisciplinary advisory committee for inclusion in the Guidebook. Result(s): There were 10 qualitative interview and 490 survey participants. The average age of participants was 52.7 (s.d.56.1) for interviews and 55.3 (s.d.57.3) for surveys. 40.0% were female and 38.2% lived in the Southeast US (Table). The most frequently reported barrier to screening was procrastination (40.0% in age 45-49;42.8% in age 50-65;34.2% in age .55). Procrastination was often attributed to financial concerns (20.8% in age 45-49) and COVID-19 (27.0% in age 50-54;21.8% in age .55) (Figure). Of those age 45-49, the majority preferred to receive screening information from a health care provider (57.5%), however only 31.7% reported that a provider had initiated a screening conversation. Several messages rated as highly effective in encouraging screening were included in the NCCRT Guidebook. Conclusion(s): We identified several age-specific barriers to CRC screening and developed unique messaging to motivate screening among unscreened Black individuals age 45 and over. Messages that tested positively are publicly available as a resource for organizations and institutions that aim to increase screening rates.

What matters to us: Bridging research and accurate information through dialogue (BRAID) to build community trust and cultivate vaccine confidence.

Despite higher rates of SARS-CoV-2 infections and mortality, vaccine uptake in Black and Latinx populations remained disproportionately low, including in the Bronx, New York. In response, we used the Bridging Research, Accurate Information, and Dialogue (BRAID) model to elicit community members' COViD-19 vaccine-related perspectives and informational needs and inform strategies to improve vaccine acceptance. We conducted a longitudinal qualitative study over 13 months (May 2021-June 2022), with 25 community experts from the Bronx including community health workers, and representatives from community-based organizations. Each expert participated in 1-5 of the 12 conversation circles conducted via Zoom. Clinicians and scientists, attended circles to provide additional information in content areas identified by the experts. Inductive thematic analysis was used to analyze the conversations. Five overarching themes, related to trust, emerged: (1) disparate and unjust treatment from institutions; (2) the impact of rapidly changing COVID messages in the lay press (a different story every day); (3) influencers of vaccine intention; (4) strategies to build community trust; and (5) what matters to community experts [us]. Our findings highlighted the influence of factors, such as health communication, on trust (or lack thereof) and vaccine intention. They also reinforce that creating safe spaces for dialogue and listening and responding to community concerns in real time are effective trust-building strategies. The BRAID model fostered open discussion about the factors that influence vaccine uptake and empowered participants to share accurate information with their community. Our experience suggests that the model can be adapted to address many public health issues.

Integrating Bioethics and Neonatal Palliative Care in a Pandemic: The Scope of Advocacy and Online Collaboration for Exceptional Life-Sustaining Medical and Surgical Interventions in a Regional Neonatal Intensive Care Unit

Purpose of Study: The regional NICU is an essential healthcare resource for families of newborns with serious life-threatening illnesses. Mechanical ventilation, cardiovascular therapies, therapeutic hypothermia, and neonatal surgeries are common life-sustaining interventions. Our NICU serves an underprivileged population in a resource poor environment and several ethical questions frequently emerge when facing extremes of innovative therapies. The pandemic and rapidly changing institutional protocols accentuated challenges faced by frontline NICU teams caring for newborns at risk for devastating illnesses and death. Concurrently, evolving paradigms in neonatal ethics required urgent and high quality palliative care in a background of racial and socioeconomic inequities, restrictive visitation policies, and limited healthcare resources. The purpose of this study was to ensure that neonates and their families receive ethically sound care, timely referrals for innovative therapies, and specialized palliative care in the strained and uncertain environment of the COVID-19 pandemic. Methods Used: The key steps consisted of structured and impromptu discussion forums for specialized palliative care and medical ethics, perinatal case conferences and pediatrics grand rounds on virtual platforms, educational webinars for interdisciplinary teams, and improved electronic communication. Online collaboration and innovative combinations of in-person and virtual meetings were utilized for urgently Incorporating clinical updates. Summary of Results: 1. A neonate with severe HIE and postnatally diagnosed congenital diaphragmatic hernia required emergent ECMO center referral. NICU providers utilized a structured bioethics and palliative care framework for providing family support and discussing the prognostication challenges of acute illnesses. 2. Many important bioethical questions emerged while caring for infants with life-threatening chromosomal abnormalities. Ethical tension was addressed by teaching tools, quality of life and pediatrics ethics conversations, mitigation of moral distress, contemporary clinical and surgical experience, community engagement, and family perspectives. 3. Ethical conflicts are central in the decision to resuscitate neonates born between 22 and 23 weeks of gestation. To provide urgent prenatal consultations and attend high risk deliveries, we collaborated across geographically distant healthcare systems, unified management strategies and analyzed outcomes data. 4. NEC in several extremely preterm babies had devastating outcomes and the team respected each family's voice with compassionate, shared decision-making for both curative care surgeries and palliative care. Conclusion(s): The new workflows, telephone and video conferences, and redirection to telehealth based family meetings did not change important outcomes during the pandemic. Advocacy and education for integrating bioethics and palliative care were vital facets of neonatal critical care in a resource poor and ever-changing pandemic environment.

Lung cancer patients' views on screening and experiences of treatment and care - findings from the Global Lung Cancer Coalition's third annual global survey

Introduction: In 2022, the Global Lung Cancer Coalition (GLCC), a partnership of 42 patient organisations across 30 countries, ran its third annual global patient experience survey on the continued impact of COVID-19 on people living with lung cancer. Method(s): A steering group of patients, advocates, and clinicians developed the survey, asking questions around screening, patients' involvement in decision-making, and preferences in speaking to their treatment team. 555 patients from 21 countries responded, including 83 from the UK and Ireland. [Figure presented] Results: The results show that all responding patients in Ireland and 9 in 10 in the UK would attend a screening appointment if it was available and they were invited. Only a small proportion said they would not attend, and a minority were unsure. When asked if they have been involved in decisions about their treatment and care, a large proportion of patients in both countries stated they have not felt fully involved. The majority of patients in the UK and Ireland prefer speaking to their treatment team in person in a range of situations. However, if patients are worried about something, they would be willing to have a telephone conversation with their treatment team. Conclusion(s): The findings on screening are encouraging given the National Screening Committee's recent recommendation to implement a targeted screening programme in the UK. In Ireland, advocacy organisations continue to lobby the Government for a national programme, and it is positive to see high levels of patient support. Treatment teams should be asking and supporting patients to be as involved in decisions around their treatment and care as they wish to be. Finally, it is clear that patients prefer to discuss their treatment and care face-to-face. Treatment teams should seek to understand patients' preferences, and health systems should put in place relevant provisions to offer virtual appointments. Disclosure: No significant relationships.Copyright © 2023 Elsevier B.V.

Expanding Access to Opioid Use Disorder Treatment Via Telehealth in Lewis County, Washington

Purpose of Study Lewis County is in southwest Washington state. With a population per square mile of 31.4, Lewis County is more rural than the rest of the state (101.2 per square mile). Citizens of the county, as well as health care workers at Chehalis Family Medicine (located in Lewis County), report concerns over rates of opioid use disorder. While Lewis County's age adjusted rate per 100,000 of deaths due to opioid overdose from 2014-2017 was lower than that of Washington state (7.6 vs 9.3), its rate of opioid related hospitalizations was significantly higher (110.7 vs 81.5). Methods Used An asset-based approach was used to learn how Lewis County has been addressing opioid use disorder amongst its citizens. Interviews with health care providers, patients at Chehalis Family Medicine, and the pastor of a local church were performed. These conversations revealed a lack of access to public transportation creates a major barrier to receiving opioid use disorder treatment. A literature review of interventions implemented in rural areas to deliver medically assisted opioid use disorder treatment was performed. Summary of Results The recent use of telemedicine to deliver suboxone treatment at Chehalis Family Medicine has increased access to medically assisted treatment of opioid use disorder. Telemedicine has become more prevalent with some loosening of governmental regulations due to the COVID-19 pandemic. Based upon articles by Guille et al and Weintraub et al, administration of medically assisted opioid use disorder treatment via telehealth offers a means to expand access to care in rural communities. They demonstrated no significant differences in patient outcomes. Implementation of telemedicine at other suboxone clinics in Lewis County would improve access to suboxone treatment. Conclusions A strength-based framework allows the existing assets in Lewis County to be appraised so future work can build upon what has already proved effective for the community. Regarding opioid use disorder treatment, Lewis county has several low barrier suboxone clinics which could increase access for rural patients through implementation of telemedicine. Chehalis Family Medicine's recent success with telemedicine in suboxone treatment could serve as a template for how to do so effectively.

Increasing interest in post-secondary education in the CF population

Background: Planning for college and post-secondary education has historically been a challenge for people with cystic fibrosis PwCF) because of a shortened life expectancy and the high cost of CF treatments. According to the Cystic Fibrosis Foundation Patient Registry, the median age of death was 32 in 2019 for PwCF in the United States [1]. Those who are healthy enough to plan for post-secondary education typically need financial assistance to offset the cost of tuition. This need has led many PwCF to contact Cystic Fibrosis Foundation Compass, a free, personalized case management service that provides information and resource referrals, for assistance with education-related expenses. Over the course of the pandemic, Compass observed a spike in interest of people seeking financial assistance and other resources to explore further education. We sought to better understand the increase in education requests from 2019 to 2021. Method(s): Compass data from January 1, 2019, through December 31, 2021, were reviewed.We reviewed data for all inquiries categorized as education, which include requests for scholarships, financial aid, and vocational rehabilitation. Compass also collects information on caller demographic characteristics such as age, household size, and household income, and this information was reviewed for all education inquiries during the 3-year period. We do not typically ask why callers are requesting financial assistance. Result(s): There was an increase in requests for financial assistance for education in 2020 and 2021: 98 scholarship requests in 2019, 140 in 2020, and 238 in 2021. The average age of PwCF requesting financial assistance with educationwas 24 all 3 years. One PwCF with an income of $100,000 or more requested financial assistance with education in 2019, five in 2020, and 13 in 2021. Conclusion(s): The number of education requests Compass receives has increased every year since 2019. The average age of PwCF making requests was 24, which is considered a non-traditional student by the National Center for Education Statistics [2]. Therewas also an increase in callers with high household incomes requesting financial assistance with education expenses. The approval of elexacaftor/tezacaftor/ivacaftor in 2019 may have contributed to the increase in requests each year, because PwCF eligible for and taking this medication may be experiencing better health outcomes and able to focus on furthering their educations. The COVID-19 pandemic may also have contributed because fewer people were able to work outside the home and may have elected to further their education as a result. Financial hardships due to the pandemic may also explain the increase in requests for financial assistance, even for those with high household incomes. Our results showa continued increase in requests each year. We are interested in identifying and exploring the cause of this increase through survey or conversations with those seeking education assistance through Compass. We will continue to follow the data to see if the increase continues as the COVID-19 pandemic ends.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Easing anxiety for adults in higher education: Regaining self within subversive, interdisciplinary bibliotherapy, and visual journaling

Anxiety was viewed as a normative part of life. Since the onset of COVID-19, the view of anxiety has moved from being a normative part of life to being a victimizing condition. Literacy and anxiety are not separated within bibliotherapy. To reduce student anxiety, it is instigated a dialogic interaction between visual journals with university literacy courses in reading as a life act. Students were not saying they were "anxious" about an event that would pass;their "being" was being labelled as anxiety. In recognizing this, the chapter sets out to counter stress triggers by providing students with a sense of voice, self-identity, and small-group and whole-class conversations. The instructional design involved some guiding questions woven with themes of teacher modelling and guidance, visual journaling (VJ), dialogic discourse, and bibliotherapy. Ideas for deeper thinking were consistently included in the weekly VJs prior to class, so pre-thinking time was built into the response. The VJ will be a weekly instructional device and will also be used creatively as a reflective mirror for learning and thought they have reflected upon from assigned readings. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A Comparison Between In-Person and Virtual OSCE on Advanced Communication Skills for Senior Medical Students (Sci200)

Outcomes: 1. Evaluate the effectiveness of a virtual communication workshop in comparison to prior in-person format. 2. Gauge medical students' level of emotional support during an advanced communication workshop in the virtual setting. Introduction: Medical schools rapidly adopted virtual learning in response to the COVID-19 pandemic. Many descriptions of virtual objective-structured clinical examinations (OSCE) have been published;however, there have been no studies comparing the effectiveness of in-person and virtual formats for medical students. Method(s): The investigators revised a previously conducted workshop from in-person to virtual format. The workshop is a five-station formative OSCE focused on advanced communication skills for senior medical students. After each station, examinees completed a self-assessment checklist (Communication Behavior Checklist;CBC) and received checklist-based assessments (CBC and modified Master Interview Rating Scale;mMIRS) from two same-level peers. Afterward, a faculty-led debrief was performed to review clinical cases, emotional responses, and student questions. A post-OSCE survey based on one collected after the prior in-person OSCE was distributed to students. Result(s): Eighty-three students participated in the virtual OSCE. Overall, CBC scores were lower in the virtual OSCE compared to in-person (p<0.05). There was no difference in mMIRS scores between virtual and in-person OSCE. Sixty-seven out of 83 (80.7%) students completed the post-OSCE survey. Results showed no difference between virtual and in-person OSCE in terms of educational value, whether the OSCE would change the way participants talk to patients, and preparedness to have serious conversations with patients. All 67 students somewhat or strongly agreed with feeling emotionally supported during the virtual OSCE. Discussion(s): In conclusion, a virtual OSCE on advanced communication skills was well received by students who reported similar educational value compared with a prior in-person OSCE. Students felt emotionally supported in the virtual format. While student performance related to interview process (mMIRS) was similar, scores on interview content (CBC) were significantly lower in the virtual environment compared with the prior in-person OSCE. For future virtual iterations, modifications may be necessary to ensure adequate instruction on interview content.Copyright © 2023

Congregational Care: Philosophical Reflection on a Case Study

Congregational care strengthens relationships and supports spiritual growth. This article establishes groundwork for developing congregational care at First Baptist in Edmonton (FBC) by introducing a spiritual needs approach to engage people in conversation and by using a Spiritual Styles Assessment that has 36 questions to foster communication among congregational members. The article has four parts. The first introduces the congregation and a list of spiritual needs. The second part includes information about the Spiritual Styles Assessment and spirituality research. Parts three and four describe attitudes, skills and practices that enhance communicative action by helping people talk together and practice radical welcome as a foundation for congregational care. The purpose for establishing a foundation for congregational care is to suggest a way forward for a congregation that faces significant differences in values, beliefs, expectations, personal experience, and faith assumptions, even among people who have known each other for years. FBC is trying to find ways to reach understanding and offer care to all who enter the Sanctuary. The purpose of the article is to reflect philosophically on what congregants need from each other as signs of respect, inclusion and caring. The article outlines attitudes, skills, and practices that create communicative communities that are capable of nurturing congregational care by developing human understanding based on faith experience and communicative action.

"It's normal to admit you're not okay": New York City college students shaping mental health through journaling

Emerging data make clear that, while there are common pandemic experiences related to mental health across different populations, access to those shared experiences is often disproportionate. In the context of exploring expansive definitions of health as part of their Introduction to Urban Community Health course, students at a large, public university in New York City were given the opportunity to engage with the Pandemic Journaling Project (PJP) beginning in June 2020. This paper explores the impact of both creating their own journals, and reading and reflecting on the public entries of others, on student mental health, and on students' abilities to discuss and process their health status, holistically defined. It raises questions of how definitions of "normal" in relation to feelings of diminished mental health are shared and reified in the context of the pandemic, asking if the process of journaling might be a way not just to capture mental health histories of the pandemic, but also to create an inclusive, therapeutic space for a conversation around mental health.Copyright © 2022

Evaluation of an expert center video clinic for patients with chronic spontaneous urticaria

Background: The COVID-19 pandemic dramatically disrupts health care around the globe. The recent COVID-CU study performed at urticaria centers of reference and excellence (UCAREs) demonstrated that the rate of face-to- face consultations decreased from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. As of now, it is largely unclear how this affects patients with chronic urticaria. Method(s): We assessed a UCARE video clinic for chronic spontaneous urticaria (CSU) for applicability and satisfaction by patients. Result(s): From January of to October of 2021, 78 patients (mean age 39.7 yrs, 73.3% female) with CSU participated in this survey study. More than 90% patients perceived the image transmission and sound quality as smooth and without distortion. Virtually all patients (96.9%) found that the previously provided explanations and instructions on technical handling were easy to understand and accurate. Patients rated the scheduling and planning of the video consultation as good (98.5%) and stated that it was effortless and within reasonable time (93.8%). Overall, 90.8% felt safe and well informed when using the technology. Most patients reported that the specified time of 20 minutes was sufficient (75.4%), that they were able to address all relevant points (68.8%), and that they received sufficient information about their disease (70.8%) during the video consultation. Almost 80% reported that they felt they were being treated professionally and that they were satisfied with how the conversation with their treating physician unfolded. The majority of patients adjusted quickly and easily to the situation of a video consultation (84.6%) and felt well treated with regard to their medical needs (73.9%). In general, the concept of a video clinic and remote treatment were well perceived and easy to use for most patients (81.5%), and the majority could imagine being treated regularly in this setting in the future (75.4%). Conclusion(s): UCARE video clinic consultations are well received by patients with CSU, which suggests that this instrument may be useful during and beyond the COVID-19 pandemic in the management of patients with chronic urticaria by specialized centers.

COVID-19-Related FAQs as a Form of Online Institutional Communication An Exploratory Study

The COVID-19 pandemic has affected everyone's life, and COVID-19 prevention and control measures have altered everyone's daily routine. Such measures have been put in place through legislative and regulatory acts, whose typical linguistic features make them not always accessible to the population they apply to. Therefore, other forms of communication have been used as a form of mediation, for instance by institutions and news media outlets, to share information on and thus facilitate the implementation of such measures among the population. This paper presents an exploratory micro-analysis of an English and an Italian webpage containing frequently asked questions (FAQs), a web genre often used for knowledge dissemination but still scarcely investigated from a linguistic perspective. The aim of the FAQs examined is to explain the provisions adopted to tackle the second wave of the pandemic (the two webpages were available online in September 2020) to a non-specialised and non-better specified audience. After briefly discussing the content distribution, the study adopts a conversation analysis perspective to identify the type of questions used and the (lack of) question-conditioned relevance in adjacency pairs. Copyright (©) 2022 Katia Peruzzo.

How did Covid 19 pandemic effect the patients' compliance to allergen immunoterapy and biologicals in an outpatient allergy clinic?

Background: One of the most disadvantageous group of people in Covid 19 pandemic are those with chronic diseases who have been unable to reach medical services they should have. The aim of our study was to investigate if our patients receiving either subcutaneous allergen immunotherapy (SCIT) or biologicals had been effected in terms of compliance to their treatment. Method(s): All of our patients that were being followed in our outpatient clinic receiving a regular treatment -either SCIT or a biological agent -before January 2020 were included in the study. The study group consisted of a total of 223 adult patients of whom 128 were on SCIT and 95 on a biological agent. We applied a conversation based survey to each patient by means of a phone call or during an office visit to identify any disruption in their treatment. We also screened our patient files to collect demographic data and data related to the diagnosis and duration of therapy. Patients were also asked if they had past Covid -19 infection or not. Result(s): Out of 128 patients receiving SCIT for an aeroallergen or venom,124 patients (median age 38 (min-max 18-66)) could have the survey completed. Eighty one patients (63.3%) reported that they couldn't continue their treatment while 43 (37.6%) patients could. The most common reasons of noncompliance were the reluctance of patients to go to the hospital with the fear of getting Covid 19 infection (n = 36 ;44.4%) and the difficulties in supplying the allergen immunotherapy product (n = 15;18.5%). Fourteen patients (17.3%) left the treatment as they were already close to the end of the scheduled treatment duration. Ninety one patients (median age 53 (min-max 19-75)) out of 95 who were on a biological treatment-either omalizumab or mepolizumab-had completed the survey. Only nine patients (9.9%) left the treatment while 82 patients (90.1%) did not. The most common reason for noncompliance was similarly the reluctance to go to the hospital in 4 (4.4%) of the patients . Twenty one of the SCIT patients (16.9%) and 22 patients (24.2%) receiving biologicals had documented Covid 19 infection. Conclusion(s): Covid 19 pandemic had a negative effect on our patients'compliance to their treatment. This effect was apparently higher in the patients receiving SCIT who should have their shots only in an allergy clinic under close supervision while patients on biologicals may receive their treatments in other healthcare centers.