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The Coronavirus Disease of 2019 (COVID-19) pandemic caused a dramatic shift in radiology resident education. Primarily, physical distancing prompted a general transition to virtual learning. Common changes made by radiology residency programs included virtual rounds and readouts, the use of simulation technology, and case-based learning which utilized pedagogical approaches such as the flipped classroom for teaching residents. Virtual learning appears to be a suitable alternative to traditional, in-person learning, and may have a place post-pandemic as part of a blended curriculum with in-person and virtual components. The extent of disruption to radiology resident education varied based on the local impact of COVID-19 and the prevalence of redeployment, as did residents’ mental health and wellbeing. Accessibility of mental health resources for residents was highlighted as an issue that programs need to address during these difficult times. Moreover, the pandemic resulted in unavoidable reductions in procedural exposure which programs mitigated through the use of simulation technologies and virtual learning resources. Professional development activities such as mentorship and career planning were also dramatically impacted by the pandemic and remains a challenge that programs need to consider moving forward post-pandemic. The purpose of this review is to outline the changes made to radiology resident education as a result of the COVID-19 pandemic and suggest what changes may be worthwhile to continue.

The COVID-19 pandemic with its need for distancing has necessitated the use of virtual care in never before seen volumes. This review article aims to provide a primer on virtual care for cardiovascular professionals in Canada. The technology to facilitate remote patient interactions is already available but barriers exist. Adequate and effective cardiac virtual care (CVC) must be further developed given the need for rapid evaluation and close ongoing follow-up of patients, as seen in the areas of heart failure management, cardiac rehabilitation, electrophysiology, and hypertension. Many Canadian organizations have published resources to assist healthcare providers and patients navigate the unfamiliar virtual care landscape. While there are concerns surrounding issues such as patient privacy, access to technology, language discrepancies, and billing, these deficits provide opportunities for growth by healthcare organizations and technology companies. The integration of virtual care, home-based devices, and disruptive technologies emphasize the trend towards virtualization of healthcare, with the potential for greater personalization of healthcare interactions and continuity of care. Funding models were rapidly developed at the beginning of the COVID-19 pandemic and while some provinces have deemed these changes as permanent, the status from other provinces remains unknown. The foundations to support virtual care as a key modality for healthcare delivery in Canada have been built, and further developments may strengthen its viability as a long-term option., The COVID-19 pandemic has necessitated the use of cardiac virtual care (CVC) in unprecedented volumes in Canada. This review article aims to provide a primer on CVC for cardiovascular professionals in Canada. We review the landscape of CVC, describe the challenges and barriers inherent in this area, provide useful resources that facilitate the adoption of CVC in our day-to-day practice, and describe future developments in this method of care delivery.

Rapid urbanization coupled with increasing climate change has instigated thermal stresses and reduced the quality of life in the built environment. For climate change adaptation, it is essential to quantify the public’s perceptions of climate change. This study employs the concept of risk perception and psychological distance to understand the role of the built environment in shaping public perception. An index-based approach was used to quantify climate change risk perception and psychological distance using indicators from disaster risk reduction and climate change adaptation literature. Risk perception was constructed using three dimensions, i.e., fear, attitude, and trust, while for psychological distancing, four dimensions were used, i.e., geographic, social, temporal, and uncertainty. Local climate zone (LCZ) using WUDAPT procedure was used to identify five different built environments of Islamabad, Pakistan. Statistical tests were performed to find differences between the selected indicators and dimensions. Pearson’s correlation was used to establish the link between risk perception and psychological distancing. Results showed that there was a significant difference in risk perception and psychological distancing indicators among the LCZs. A strong negative correlation was found between risk perception and psychological distancing to climate change indexes. This study advocates the importance of the built environment in shaping public perceptions of climate change risks. This pivotal study can help in integrating the philosophies of disaster risk reduction and climate change adaptation.

Video-reflexive ethnography (VRE) is a qualitative methodology that explores the complex nature of healthcare 'as it really is'. Its collaborative and reflexive process invites stakeholders (e.g. pharmacists and pharmacy support staff) to participate in analysing their everyday work practices as captured on video footage. Through close collaboration with practitioners and attention to their work contexts, VRE may be a useful methodology to engage a time-poor pharmacy workforce in research about themselves, encouraging more practitioner involvement in practice-based research. Aside from research, VRE has also been used effectively as an intervention to facilitate learning and change in healthcare settings, and could be effective in provoking change in otherwise resistant pharmacy environments. Much like traditional ethnographic approaches, VRE researchers have relied on being present 'in the field' to observe, record and make sense of practices with participants. The COVID-19 pandemic however, has introduced restrictions around travel and physical distancing, which has required researchers to contemplate the conduct of VRE 'at a distance', and to imagine new ways in which the methodological 'closeness' to stakeholders and their workplace contexts can be maintained when researchers cannot be on site. In this commentary, we outline the rationale for participatory methods, in the form of VRE, in pharmacy research. We describe the underlying principles of this innovative methodology, and offer examples of how VRE can be used in pharmacy research. Finally, we offer a reflexive account of how we have adapted the method for use in community pharmacy research, to adapt to physical distancing, without sacrificing its methodological principles. This paper offers not only a new methodology to examine the complexity of pharmacy work, but demonstrates also the responsiveness of VRE itself to complexity, and the potential breadth of future research applications in pharmacy both during and beyond the current pandemic.

Purpose COVID-19's infection rate among adolescents is increasing; hence, it is important to prevent it as it can spread in the community through transmission in schools. It is crucial to determine the extent to which adolescents follow COVID-19 preventive measures and identify factors relating to such behaviors to implement more effective health education. This study aimed to understand factors related to COVID-19 preventive behaviors using the theory of planned behavior (TPB) and the health belief model (HBM) among adolescents in South Korea. Design and methods A cross-sectional face-to-face questionnaire survey was conducted among 272 adolescents in South Korea. Structural equation modeling was used to examine the relationships between perceived susceptibility, perceived severity, attitude, subjective norms, perceived behavioral control, intention, and COVID-19 preventive behaviors. Results Among adolescents' COVID-19 preventive behavior scores, wearing masks was the highest and distancing was the lowest. Adolescents' adherence to COVID-19 preventive behaviors was directly or indirectly associated with their perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention. Conclusions Attention to mitigate social isolation is important to improve compliance with COVID-19 preventive behaviors. Perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention explained 61.3% of adolescents' COVID-19 preventive behaviors, there is a need for education to promote relevant factors. Practice implications To increase adolescent awareness of COVID-19 and increase attitudes, subjective norms, and perceived behavior control, nurses need to provide education including the evidence for COVID-19 preventive behavior to increase adolescents' understanding and active implementation of those behaviors.

The COVID-19 pandemic and the need for physical distancing in public spaces have significant effects on sustainable mobility initiatives. Many cities around the world promoted temporary transformations of streets, redistributing road space to create emergency cycleways and expand sidewalks to allow the movement of people while granting a certain physical distance between people. While Europe and, to a lesser extent, North America have initially led these initiatives, Latin America has soon followed suit, without much of their technical experience, governance, resources and sometimes public acceptance for sustainable mobility. The paper examines if and how the major disruptive event posed by the COVID-19 has reconfigured sustainable mobility initiatives in Latin American cities. Interviewing key decision-makers, the paper reviews five initiatives across the region to examine the typology of interventions promoted and the spaces involved, the governance schemes that allowed them and the public acceptance towards such measures. The analysis demonstrates that the COVID-19 pandemic has fostered a faster adoption of sustainable mobility measures such as emergency cycleways, street pedestrianisations and other traffic calming initiatives, facilitating the creation of new coalitions and the public acceptance of these interventions thanks to the sense of urgency generated by the pandemic.

Background People's mobility improves as a result of transportation, allowing for greater accessibility. However, the COVID-19 pandemic, which began in December 2019 in Wuhan, China, has had a significant effect on mobility and accessibility to public transport. Objectives Looking at the nature of public transports in Ghana with passengers sitting close to each other coupled with the restrictions on mobility, this paper sought to investigate the effect of the pandemic on public transportation in Ghana. Method The study attempts to use an online and paper-based questionnaire that included questions on usual mode of transportation, usual mode of public transportation prior to and throughout the time of COVID-19, factors influencing public transport mode option prior to and throughout the time of COVID-19 from 1005 commuters. Statistical analysis included descriptive analysis and in addition quantitative comparative analysis. Non-parametric tests were used for inferential statistical analysis. To understand whether usual mode of transportation has evolved due to COVID-19, Wilcoxon signed-ranked test was used to contrast factors influencing mode option prior to and throughout the time of COVID-19. Results Results explained that the major impact of COVID-19 on public transportation were social distancing and increase in the cost of transportation. There was a sharp decline in the use of para transit services with high occupancy such as “trotro” to the use of taxis. Commuters considered physical distancing, occupants wearing face masks, cleanliness of vehicle and safety from traffic accidents as essential factors influencing public transport mode choice during COVID-19. The results of the cross-tabulation analysis, which looked at the relationship between the effect of COVID-19 on transportation and the effect of COVID-19 on social, economic and religious activities showed these variables were insignificant, X2 (2, N = 1005) = 3.057, p = .217. Conclusion On the basis of the study findings, some recommendations were made for policymakers and stakeholders in the transport industry in order to make it much safer and conducive to travel on public transport in a pandemic in the country.

Introduction Staff-to-staff transmission of SARS-CoV-2 poses a significant risk to the Emergency Department (ED) workforce. We measured close ( 10 min) staff interactions in a busy pediatric Emergency Department in common work areas over time as the pandemic unfolded, measuring the effectiveness of interventions meant to discourage such close contact. Methods We used a Real-Time Locating System to measure staff groupings in crowded common work areas lasting ten or more minutes. We compared the number of these interactions pre-pandemic with those occurring early and then later in the pandemic, as distancing interventions were suggested and then formalized. Nearly all healthcare workers in the ED were included, and the duration of interactions over time were evaluated as well. Results and conclusions This study included a total of 12,386 pairs of staff-to-staff encounters over three time periods including just prior to the pandemic, early in the pandemic response, and later in the steady-state pandemic response. Pairs of staff averaged 0.89 high-risk interactions hourly prior to the pandemic, and this continued early in the pandemic with informal recommendations (0.80 high-risk pairs hourly). High-risk staff encounters fell significantly to 0.47 interactions per hour in the steady-state pandemic with formal distancing guidelines in place and decreased patient and staffing volumes. The duration of these encounters remained stable, near 16 min. Close contact between healthcare staff workers did significantly decrease with formal distancing guidelines, though some high-risk interactions remained, warranting additive protective measures such as universal masking.

Highlights • The impact of the COVID-19 pandemic may be especially potent for individuals with PTSD. • PE is a well-established and efficacious treatment for PTSD. • Clinical practice strategies aid in implementation of PE during the COVID-19 pandemic., The unprecedented effects and duration of the COVID-19 crisis are likely to elevate the population’s level of anxiety due to psychological stress, economic hardship, and social isolation. This effect may be especially potent for individuals with preexisting mental health conditions, such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) therapy is a highly effective treatment for PTSD across trauma-exposed populations, and has been implemented effectively via telehealth. Nevertheless, PE implementation via telehealth may require specific adaptations during the COVID-19 crisis due to public health mandates calling for sheltering in place and physical distancing. This paper discusses strategies for implementing PE for PTSD during the COVID-19 pandemic, which may also be applied to other situations in which physical distancing must be considered.

Ethnic-racial socialization is a mechanism through which immigrant parents instill in their children a sense of pride in their culture while preparing them for negative experiences with racial and cultural out-groups. For Black immigrant parents, this can include promoting a wariness of Black Americans in their children. Through this lens, we investigated an understudied intercultural dynamic via interviews with 12 first- and second-generation African and Caribbean immigrants. Using deductive and inductive analyses, we first examined the socialization messages they received about Black Americans from their parents, finding that in addition to messages inculcating ethnic and cultural pride, the participants also heard warnings about affiliation with Black Americans. Those messages relied on personal experiences and harmful stereotypes. Second, emergent from the data were examples of the ways the participants rejected their parents’ warnings. Experiences outside of the home appeared to influence views that were alternative to their parents. This novel finding provides avenues for future research investigating Black immigrants’ paths to a sense of connection or distancing from Black Americans.

The COVID-19 pandemic has fundamentally changed the way that public health professionals work and communicate. Over a very short time span, remote working arrangements have become the norm, and meetings have shifted online. Physical distancing measures have accelerated a trend toward digital communication and social exchange. At the same time, the work of epidemiologists has been held under a magnifying glass by journalists, governments and the general public, in a way not previously seen. With social media becoming an integral part of our society over the last decade, Twitter is now a key communication tool and platform for social networking among epidemiologists (#EpiTwitter). In this article, we reflect on the use of Twitter by field epidemiologists and public health microbiologists for rapid professional exchange, public communication of science and professional development during the pandemic and the associated risks. For those field epidemiologists new to social media, we discuss how Twitter can be used in a variety of ways, both at their home institutions and during field deployment. These include information dissemination, science communication and public health advocacy, professional development, networking and experience exchange.

Leveraging cross-gender brand extensions (new product offerings under the same brand name for customers of the opposite sex) can facilitate brand growth. However, how such strategies should be implemented remains unanswered. A popular approach is to launch a brand extension in the same or a similar product category (high fit). However, for cross-gender brand extension, this strategy can dilute the gender personality of the parent brand (i.e. masculinity or femininity). We propose that launching cross-gender brand extensions in a product category with low fit is an effective strategy as it enables cognitive distancing of the extension from the parent brand. Two experiments confirm that introducing low (versus high) fit cross-gender brand extensions mitigate the parent brand’s gender personality dilution, leading to more positive evaluations of the parent brand amongst existing customers and higher purchase intention amongst new target customers for the cross-gender brand extension.

Clinical laboratory services and associated training programs faced unprecedented challenges during the coronavirus disease 2019 pandemic. With the introduction of pandemic related strictly mandated institutional policies of physical distancing, dermatopathology rotations, a key component of both dermatology and pathology residency programs, were impacted. In order to adapt to this new environment, a few modifications in resident training and education were introduced at various institutions. These disruptions initiated a change in the standard teaching approach, with a shift from face-to-face learning to a virtual and online model. These adaptations and innovations are discussed here with their likely benefits and limitations.

Although women are expected to idealize and achieve hegemonic feminine beauty standards such as being slender and lighter skinned, few studies have examined how women’s investment in achieving these restrictive feminine appearance ideals may influence their sexual attitudes and behaviors. Even less is known about Black women. We surveyed 640 Black college women to test hypotheses that endorsement of hegemonic beauty ideals would be positively associated with four dimensions of negative sexual affect (sexual guilt, shame, emotional distancing, and self-consciousness) and negatively associated with two dimensions of sexual agency (sexual assertiveness and satisfaction). Correlation and regression analyses showed that hegemonic beauty ideal acceptance was linked with greater sexual guilt, shame, emotional distancing, and sexual self-consciousness in addition to lower levels of sexual assertiveness and satisfaction. Findings highlight how endorsing restrictive, hegemonic standards of beauty is associated with Black women’s reduced sexual affect and sexual agency.

The Blitz narrative of resilience stands in contrast to the mental health risks identified as consequences of the COVID-19 pandemic. Although evidence from then-classified studies of World War 2 showed that most people managed the stress of bombing, those vulnerable and exposed to substantial trauma had lasting or severe mental illness. Studies of different towns and occupational groups identified the proportion of people killed and wounded, the percentage of housing destroyed, and the loss of paid employment as risk factors for psychological breakdown. Mothers and children suffered not only with evacuation, but also from the trauma of bombing and damage to schools. A general association between civilian physical and psychological casualties suggests that population groups with high rates of infection and mortality might be susceptible to mental illness as a result of the pandemic. Lockdown and distancing measures contrast with the wartime sense of belonging and shared identity, reinforced by community networks and social activities.

Background A Canadian academic hospital transitioned from in-person simulation training to virtual simulation in order to maintain COVID-19 physical distancing during an inpatient surgery nurse orientation program. Sample Eight nurses were onboarded to the inpatient surgery program, with a subset of four responding to the postsurvey of the virtual simulation session. Method The scenario was prerecorded and delivered over an online meeting platform to a group of new nurses. The session included an observer's checklist, prebriefing, viewing of the simulation videos synchronously and a debriefing. The nurses were sent an anonymous survey regarding the effectiveness and psychological safety of the experience. Results The nurses agreed that the nurse educators had established psychological safety using a variety of strategies and would participate in future virtual simulation sessions. Conclusion While the virtual environment of simulation education poses new challenges, it was effectively employed to facilitate learning in a physically and psychologically safe environment.

Background: In response to the COVID-19 pandemic, the UK first adopted physical distancing measures in March, 2020. Vaccines against SARS-CoV-2 became available in December, 2020. We explored the health and economic value of introducing SARS-CoV-2 immunisation alongside physical distancing in the UK to gain insights about possible future scenarios in a post-vaccination era. Methods: We used an age-structured dynamic transmission and economic model to explore different scenarios of UK mass immunisation programmes over 10 years. We compared vaccinating 75% of individuals aged 15 years or older (and annually revaccinating 50% of individuals aged 15–64 years and 75% of individuals aged 65 years or older) to no vaccination. We assumed either 50% vaccine efficacy against disease and 45-week protection (worst-case scenario) or 95% vaccine efficacy against infection and 3-year protection (best-case scenario). Natural immunity was assumed to wane within 45 weeks. We also explored the additional impact of physical distancing on vaccination by assuming either an initial lockdown followed by voluntary physical distancing, or an initial lockdown followed by increased physical distancing mandated above a certain threshold of incident daily infections. We considered benefits in terms of quality-adjusted life-years (QALYs) and costs, both to the health-care payer and the national economy. We discounted future costs and QALYs at 3·5% annually and assumed a monetary value per QALY of £20 000 and a conservative long-run cost per vaccine dose of £15. We explored and varied these parameters in sensitivity analyses. We expressed the health and economic benefits of each scenario with the net monetary value: QALYs × (monetary value per QALY) – costs. Findings: Without the initial lockdown, vaccination, and increased physical distancing, we estimated 148·0 million (95% uncertainty interval 48·5–198·8) COVID-19 cases and 3·1 million (0·84–4·5) deaths would occur in the UK over 10 years. In the best-case scenario, vaccination minimises community transmission without future periods of increased physical distancing, whereas SARS-CoV-2 becomes endemic with biannual epidemics in the worst-case scenario. Ongoing transmission is also expected in intermediate scenarios with vaccine efficacy similar to published clinical trial data. From a health-care perspective, introducing vaccination leads to incremental net monetary values ranging from £12·0 billion to £334·7 billion in the best-case scenario and from –£1·1 billion to £56·9 billion in the worst-case scenario. Incremental net monetary values of increased physical distancing might be negative from a societal perspective if national economy losses are persistent and large. Interpretation: Our model findings highlight the substantial health and economic value of introducing SARS-CoV-2 vaccination. Smaller outbreaks could continue even with vaccines, but population-wide implementation of increased physical distancing might no longer be justifiable. Our study provides early insights about possible future post-vaccination scenarios from an economic and epidemiological perspective. Funding: National Institute for Health Research, European Commission, Bill & Melinda Gates Foundation.

The worldwide pandemic situation of COVID-19 generates a situation in which healthcare resources such as diagnostic kits, drugs and basic healthcare infrastructure were on shortage throughout the period, along with negative impact on socio-economic system. Standardized public healthcare models were missing in pandemic situation, covering from hospitalized patient care to local resident’s healthcare managements in terms of monitoring, assess to diagnosis and medicines. This exploratory and intervention-based study with the objective of proposing COVID-19 Care Management Model representing comprehensive care of society including patients (COVID-19 and other diseases) and healthy subjects under integrated framework of healthier management model. Shifting policy towards technology-oriented models with well-aligned infrastructure can achieve better outcomes in COVID-19 prevention and care. The planned development of technical healthcare models for prognosis and improved treatment outcomes that take into account not only genomics, proteomics, nanotechnology, materials science perspectives but also the possible contribution of advanced digital technologies is best strategies for early diagnosis and infections control. In view of current pandemic, a Healthier Healthcare Management Model is proposed here as a source of standardized care having technology support, medical consultation, along with public health model of sanitization, distancing and contact less behaviours practices. Effective healthcare managements have been the main driver of healthier society where, positive action at identified research, technology and management segment more specifically public health, patient health, technology selection and political influence has great potential to enhanced the global response to COVID-19. The implementation of such practices will deliver effective diagnosis and control mechanism and make healthier society.

The spread of coronavirus disease 2019 has drastically altered the medical landscape and profoundly affected the way we conduct our vascular surgery practices. The pandemic was a time of change, not only in the way health care was provided, but also in how people in the health care systems interacted. Social media has rapidly become a crucial communication tool, combining physical distancing and digital connectedness. This article provides an overview of the use of online platforms in vascular surgery as a response of our community to the pandemic.

Dublin, Ireland, like most other large cities has undergone lockdown due to the outbreak of the coronavirus. Ongoing physical distancing requirements, as cities reopens, has resulted in a collapse to transit’s capacity and ability to meet demand, forcing authorities to reimagine how people can travel in a pandemic/post-pandemic world. For Dublin, campaigns have focused on encouraging those who can walk or cycle to use active transport options if they are close enough to their place of employment, when the city fully reopens. The purpose of this is to ensure adequate physical distancing can occur while alleviating the pressure on public transport systems, thereby freeing up space for those who are unable to commute via active transport and for those beyond a range in which it is feasible. Trinity College Dublin, the University of Dublin (TCD) is located in the city centre of Ireland’s capital. Since less than 1% of staff drive to the campus and students are not permitted to park on the campus, the University community has been working with Dublin City Council (DCC) to advance planning and built environment interventions to enable staff and students to safely return to work and education. This paper presents the results of the “Commuting to Trinity while Covid-19 Social Distancing is Required” Travel Survey for TCD students and staff, conducted in June and July 2020 (n = 2653). Conducted to determine how staff and students would like to travel to TCD, when the campus fully reopens, it identifies which factors influence their mode choice and choice of working locations. The Trinity University campus makes for an interesting case study as it allows us to understand how the reopening of a major employment, educational and cultural site within an urban area, which is primarily served by transit and active transport, can address physical distancing restrictions and decreased capacity of public transport.

Facial maskings have been part of the human story since time began, and the reasons for their needs and the materials that went into their making would vary according to the reasons and materials available. The health-related needs took centuries to become established, but not until the germ theory of disease became recognized. The facial mask, seen as an essential defensive tool for prevention of respiratory transmitted disease continues to be the prime personal protective piece of equipment. With air-born contaminations, such as the present pandemic SARS- CoV-2 viral infestation, why would there be opposition to the use of this personal protective cover of our airways, when until an immunologic answer is available, it is the best single prevention we have. When supported with other measures, like distancing, washing and non-crowding, society would be much safer and secure, with probable less acute and drastic outcomes due to the spread of this virus.

Background Physical distancing required by coronavirus disease 2019 (COVID-19) has limited traditional in-person resident education. We present our novel online curriculum for incorporation into traditional surgical educational programs. Methods The online curriculum utilized weekly sub-specialty themed faculty and resident created lectures, ABSITE practice questions, and weekly sub-specialty synchronized readings. Attendance, resident and faculty surveys, and completed ABSITE practice questions evaluated for curriculum success. Curriculum was adapted as COVID-19 clinical restructuring ended. Results 77% and 80% of clinical residents attended faculty lectures and resident led topic discussions as compared to 66% and 48% attending traditional in-person grand rounds and SCORE curriculum (both p > 0.05). 71.9% of residents and 16.6% of faculty reported improved resident participation while none reported decreased levels of participation (p, Highlights • Online educational platforms are useful and effective tools for the acquisition and application of knowledge. • Successful knowledge acquisition requires multimodal approach. • Resident driven educational sessions can empower residents to take change of their education. • Online educational platforms can facilitate sharing of knowledge across large distances.

The 2019 novel coronavirus pandemic has tremendously affected health-seeking behaviors. Fear of contracting the disease has been a major factor keeping patients from presenting to hospitals, even when urgent or emergent medical attention is needed. Hospitals limiting staff exposure and capacity to accommodate patients also limits opportunities to seek care. Although physical distancing is encouraged to curb infections, this call needs to be tempered with public health education for what constitutes emergencies and urgent medical conditions needing face-to-face attention. Measures to assuage fears among patients and their caregivers to ensure their safety in the hospital or health care setting need to be communicated and executed effectively. Epidermolysis bullosa is an inherited mechanobullous disorder that is usually stable, but in some patients with underlying comorbidities, close monitoring or face-to-face management is required . We present our experience and provide recommendations pertinent to epidermolysis bullosa patients of all subtypes during the coronavirus crisis.

As of the time of this writing, more Americans have died due to COVID-19 in the last 11 months than all the Americans who died in WWI and the Vietnam, Korean, and Middle East conflicts combined. More than 135,000 Americans are currently hospitalized with COVID-19, and one out of every 744 Americans has now died of this disease. Worldwide, over 2 million people have died, and many more millions sickened and hospitalized. Despite daily news reports providing witness to this tragedy, many deny the reality of the pandemic and its severity; they reject wearing masks, maintaining physical distancing, and other non-pharmaceutical interventions. Critically, the definitive answer to the management of this pandemic lies in safe and effective vaccines widely used among the population. Despite this, vaccines are likely to be rejected by a significant minority of Americans, based on recent polls. Rejection of evidence-based recommendations has been observed across nations, governments, and institutions—despite ongoing evidence of the continuing carnage due to the SARS-CoV-2 virus and definitive evidence of the value of masking and distancing and of vaccines. Why? What motivates some people to take precautions for themselves, their families, and their communities, and others to reject such evidence-based measures? In attempting to understand what leads to acceptance or rejection of a health measure (in this case, the COVID-19 vaccine), it’s critical that healthcare providers (HCPs) understand the beliefs of their patients, while understanding that a common attribute of humans is a determination to defend and hold to their beliefs; to do this, they often reject data and arguments that don’t fit with their previously determined beliefs (i.e., belief-dependent realism). Additionally, it is important to understand the context under which an individual is making decisions. Likely, due to the nature of this ongoing global pandemic (and understanding the context of how the brain makes decisions within conditions of uncertainty and within the context of traumatic events, which this pandemic qualifies as), there will be individuals who are in survival mode, focused on only what is necessary for immediate survival, or engaging in more emotion-based decision-making. This will be different for each individual and understanding this context may be helpful when progressing through the decision-making process with the patient. In the healthcare realm, success in healthcare decision-making by patients is often founded on the HCPs ability and skill in adapting information-sharing and educational efforts to the particular needs of the patient—based on how the patient thinks, synthesizes information, and makes decisions. In a previous set of articles, one of us (CMP) outlined the major tenets of the Preferred Cognitive Style and Decision-Making Model (PCSDM), which has great value for HCPs in improving communication and success in achieving the desired goal of improving vaccine uptake [2], [3], [4], [5]. In one of these articles, we noted that “current vaccine educational efforts, particularly those developed by governmental and public health authorities, invariably adopt a unimodal fact-based, left-brain cognitive style. This reflects the preferential cognitive style used by the developers and approvers of such materials—a style that may not be favored by the intended recipients—and quite obviously not a style that has changed vaccine acceptance behavior in the population. Instead, we believe it is worthwhile to identify preferred cognitive decision-making styles at the individual and group level and adopt educational strategies and message framing specific to each style. Critical to our approach is the idea that an individual’s preferred cognitive style, emotional baseline, and subsequent behavior, are all intertwined” [2]. The PCSDM outlines six representative and common cognitive styles that individuals employ to make decisions (see Table 1 ); in this case, decisions surrounding whether to accept or reject a COVID-19 vaccine. It is critical for HCPs to accurately determine the preferred cognitive style of the patient, adapt this style in regard to educational efforts and conversations, and present information in a style that is within the primary and secondary preferred cognitive styles of the patient. If an HCP communicates facts and data in line with his/her own cognitive style, but that is not the preferred cognitive style of the patient, the healthcare provider has missed communicating in a style that facilitates information processing as they engage in decision-making processes. It is a missed opportunity to educate effectively. Table 1 Cognitive Style Main Effect Verbal Expression Approach Denialist Disbelieves accepted scientific facts, despite overwhelming evidence. Prone to believe conspiracy theories “I don’t care what the data show, I don’t believe the vaccine is safe” Provide consistent messaging repeatedly over time from trustworthy sources, provide educational materials, solicit questions, avoid “hard sell” approach, use motivational interviewing approaches Innumerate Cannot understand or has difficulty manipulating numbers, probabilities, or risks “One in a million risk sounds high, for sure I’ll be the 1 in a million that has a side effect, I’ll avoid the vaccine” Provide nonmathematical information, analogies, or comparators using a more holistic “right brain” or emotive approach Fear-based Decision making based on fears “I heard vaccines are harmful and I’m not going to get them” Understand source of fear, provide consistent positive approach, show risks in comparison to other daily risks, demonstrate risks of not receiving vaccines, use social norming approaches Heuristic Often appeals to availability heuristic (what I can recall equates with how commonly it occurs) “I remember GBS happened in 1977 after flu vaccines, that must be common, and therefore I’m not getting a flu vaccine” Point out inconsistencies and fallacy of heuristic thinking, provide educational materials, appeal to other heuristics Bandwagoning Primarily influenced by what others are doing or saying “If others are refusing the vaccine there must be something to it, I’m going to skip getting the vaccine” Understand primary influencers, point out logical inconsistencies, use social norming and self-efficacy approaches Analytical Left brain thinking, facts are paramount “I want to see the data so I can make a decision” Provide data requested, review analytically with patient Open in a separate window Table from Poland CM, Poland GA. Vaccine education spectrum disorder: the importance of incorporating psychological and cognitive models into vaccine education. Vaccine. 2011 Aug 26;29(37):6145–8.

This paper examines a novel way of training Lean Manufacturing Systems and Tools utilising an Industry 4.0 methodology during the SARS-COVID2 Pandemic of 2020. Currently, it is challenging for the Integrated Production Systems Team, responsible for carrying out training on the Lean principles, to undertake the training safely and without the risk of possible disease transmission. This is due to the usual close quarters training carried out in the Engine Manufacturing Centre. Schools, Colleges and Universities have adapted and utilised technology and moved to an Industry 4.0 digitalised approach to learning and development. This is therefore an opportunity for manufacturing to follow suit and create digitised solutions to training and development opportunities, to ensure that the employees within the manufacturing facility have adequate knowledge on the Lean principles.

Purpose Physical distancing measures to combat the spread of the novel coronavirus have presented challenges for the mental health and well-being of college students. As campus activities ceased, student-athletes abruptly became isolated from teammates and were no longer able to participate in sport activities that are often central to their identity as an athlete. However, student-athletes who have supportive social connections with teammates during this pandemic may maintain their athletic identity to a greater extent and report better mental health. The present study examined how student-athletes’ mental health was associated with teammate social support, connectedness, and changes to athletic identity from before to during COVID-19. Method A sample of 234 student-athletes completed surveys before COVID-19 physical distancing (February 2020), with 135 (63% female) participating in a follow-up in the month following school closures (April 2020). Path models estimated the effects of teammate social support and connectedness (during COVID-19), as well as changes in athletic identity on indices of mental health. Results Considering all path models tested, student-athletes who received more social support and reported more connectedness with teammates reported less dissolution of their athletic identity and—in most models—reported better mental health and well-being. Indirect effects indicated that student-athletes’ change in athletic identity mediated the effects of teammate social support on psychological well-being and depression symptoms. Conclusions In addition to advancing theory on how small groups relate to mental health, these findings demonstrate the value in remaining socially connected with peers and maintaining role identities during the COVID-19 pandemic.

Background Kidney allograft biopsy is the gold standard for diagnosis of rejection. Under the current extraordinary circumstances of the coronavirus disease 2019 (COVID-19), where social distancing is key to limiting the spread of the virus, the model used to provide care to transplant recipients has undergone a very rapid transformation. In the spirit of medical distancing, we have been using the donor-derived cell-free DNA test for screening for rejection. Methods This manuscript describes our experience with this approach between March 15th and May 20th, 2020. Results This test was obtained for-cause in 23 patients and for monitoring in 9 patients. Normal results aided in foregoing biopsy in 63% of the patients where the test was obtained in the outpatient setting. The test is neither 100% sensitive nor specific for rejection; however, when used in combination with the available clinical information, can be used for determining whether bringing in a transplant recipient into a medical facility is necessary. Conclusions In the event the COVID-19 becomes a long-term challenge for our community, non-invasive biomarkers such as the donor-derived cell-free DNA may become more relevant than ever in enhancing our ability to care for our transplant patients while maximizing the distancing measures.

Since the spread of the coronavirus disease 2019 (COVID-19) was designated as a pandemic by the World Health Organization, health care systems have been forced to adapt rapidly to defer less urgent care during the crisis. The United States (U.S.) has adopted a four-phase approach to decreasing and then resuming non-essential work. Through strong restrictive measures, Phase I slowed the spread of disease, allowing states to safely diagnose, isolate, and treat patients with COVID-19. In support of social distancing measures, non-urgent studies were postponed, and this created a backlog. Now, as states transition to Phase II, restrictions on non-essential activities will ease, and radiology departments must re-establish care while continuing to mitigate the risk of COVID-19 transmission all while accommodating this backlog. In this article, we propose a roadmap that incorporates the current practice guidelines and subject matter consensus statements for the phased reopening of non-urgent and elective radiology services. This roadmap will focus on operationalizing these recommendations for patient care and workforce management. Tiered systems are proposed for the prioritization of elective procedures, with physician-to-physician communication encouraged. Infection control methods, provision of personal protective equipment (PPE), and physical distancing measures are highlighted. Finally, changes in hours of operation, hiring strategies, and remote reading services are discussed for their potential to ease the transition to normal operations., Highlights • Different regional networks of care are moving past peak demand for medical services to treat COVID-19. • A phased and triaged approach to resuming care for deferred urgent cases and non-urgent care must be implemented and communicated to clients. • This approach should include infection control methods, management of medical staff and be prepared for subsequent rounds of disease peaks.

People who migrate often experience complex inter-connections between their countries of origin and new host societies. This paper explores the ways in which Sri Lankan migrants living in New Zealand navigate distances (geographical, social and relational) between their country of origin (Sri Lanka) and new host nation (New Zealand). To explore such processes we engaged eight Sri Lankan migrant households through repeat interviews, which were enhanced by photo-elicitation, object-related methods, and go-along techniques. Drawing insights from the resulting empirical materials, we document how particular places, such as culturally-textured kitchens, can bridge distances between the two countries. Our analysis also documents how migrant negotiations of distance are dynamic, relational and determined by socio-cultural contexts.

Highlights • What is the primary question addressed by this study? What are the challenges faced by older adults who lose a loved one during the COVID-19 pandemic? • What is the main finding of this study? The risk for prolonged grief disorder is likely to be increased among those older adults who lose a loved one during this pandemic. The challenges introduced by physical distancing restrictions have changed the experience of dying. Other COVID-19-related stress and loss have further disrupted the grieving process • What is the meaning of the finding? Awareness of this risk can motivate timely preventive and/or treatment interventions that may mitigate the development of prolonged grief disorder and other bereavement -related mental health conditions in older adults. Delivering evidence-based interventions using telehealth services is feasible. We believe urgent action is warranted to make COVID-19-era telehealth policies permanent beyond the pandemic., In few periods in human history have bereavement and grief been on so many people's minds as they are today. As the coronavirus disease 2019 (COVID-19) ravages the world, we have seen many perish in a short time. Many have died alone because of requirements for physical distancing. Even more will succumb as COVID-19 continues to spread. Moreover, deaths from other causes, numbering over 50 million annually, are also happening amid physical distancing and other COVID-19-related challenges. The pandemic is affecting the way terminally ill patients are being cared for, when and how people are dying of other causes, and how bodies are being handled and bereavement rituals performed. The bereaved are required to grieve without the support of usual social and cultural rituals. Grieving is further encumbered by cascading life stressors deriving from policies needed to mitigate the pandemic. Though we are often heartened by human resilience in response to death and other hardships, for some, the burden of this pandemic will be too much. Among other mental health problems, we will likely see an increase in prolonged grief disorder. In this commentary, we review the new diagnosis of prolonged grief disorder and outline why we might anticipate increased rates of this condition on the heels of COVID-19, especially among older persons. We suggest ways we might mitigate this emerging problem.

Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared to centre-based programs. In order to minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation however can be daunting. Centres should initially focus on the collation, utilization and re-purposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed prior to COVID-19, and to improve cardiac rehabilitation delivery moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time., Virtual cardiac rehabilitation offers an alternate mechanism of care delivery to ensure cardiovascular patients receive this guideline-based therapy during the COVID-19 pandemic. The challenges and obstacles associated with implementation of virtual cardiac rehabilitation program are reviewed and pragmatic guidance to aid clinicians and administrators is provided.

NOW PUBLISHED: https://doi.org/10.1016/S2352-4642(20)30186-3. Adolescence is a period of life characterized by heightened sensitivity to social stimuli and the increased need for peer interaction. The physical distancing measures mandated globally to contain the spread of Covid-19 are radically reducing adolescents’ opportunities to engage in face-to-face social contact outside their household. In this interdisciplinary review, we describe recent literature from a variety of domains that highlights how social deprivation in adolescence might have far-reaching consequences. Human studies have demonstrated the importance of peer acceptance and peer influence in adolescence. Animal research has shown that social deprivation and isolation have unique effects on brain and behaviour in adolescence compared with other stages of life. However, the decrease in adolescent face-to-face contact might be less detrimental due to widespread access to digital forms of social interaction through technologies like social media. The findings reviewed highlight how physical distancing might have a disproportionate impact on an age group for whom peer interaction is a vital aspect of development.

For people who struggle with chronic pain, the COVID-19 pandemic poses new challenges in treatment accessibility and may heighten pre-existing anxiety related to their health condition. Likewise, many mental health providers are struggling to adapt to a new way of caring for these individuals. The current paper aims to provide evidence of the ways in which COVID-19 is impacting people with pain and to offer a contextual-behavioral perspective on treatment of patients with chronic pain during the current pandemic and any future periods of mandated physical distancing. Past research shows that adolescents and adults with chronic pain struggle with loneliness and social isolation, which emphasizes the importance of remaining connected with these patients while they are remaining at home. Further, many individuals with chronic pain have physical and mental health comorbidities that may increase the risk of COVID-19 infection and/or morbidity and mortality. Specific functional-contextual and biopsychosocial concepts common in multidisciplinary treatment of chronic pain can be usefully incorporated into a telehealth model of ACT treatment for pain. These include the use of pandemic-related metaphors, modeling acceptance of technical glitches that occur during telehealth sessions, and mindfully observing facial expressions on the computer screen when the patient is in pain. Moreover, powerful experiential exercises that make use of pandemic-related themes (e.g., wearing a mask, washing hands) are described. While barriers to the widespread implementation of ACT-consistent telehealth exist, connecting with patients in new and creative ways will be essential as the field moves forward.

In the era of COVID-19, “social distancing” has become a buzzword. Strictly speaking, social distancing refers to physically distancing by 1 to 2 m, but the overall concept is more important: disrupting the infectious chain by separating those with the disease from those without [1]. Epidemiologists have espoused the term, believing in its ability to “flatten the curve.” By reducing the exponential rise in cases, the health care system is not overwhelmed and can function sustainably over the long term [1]. Although this concept’s main intention is to control disease, in the hospital setting, it provides the equally important added benefit of ensuring continuity of vital services should intrahospital transmission occur [2]. We are part of a 1,700-bed hospital, with a radiological service strength of over 600 (41 residents, 77 attending physicians [nuclear medicine, interventional, diagnostic], 273 radiographers, and 240 nurses and administrative support staff). This article describes our measures and early experiences with safe distancing in our radiology service.

Background Positive reappraisal and distancing are two distinct cognitive reappraisal strategies for emotion regulation. Critically however, research examining the impact of elevated trait anxiety on cognitive reappraisal has often conflated these strategies. Thus, the present study investigated whether high-trait-anxious (HTA) women can effectively utilize positive reappraisal and distancing to regulate emotional responses to negative stimuli. Methods Twenty-six HTA women and twenty-seven low-trait-anxious (LTA) women were investigated in a self-generated reappraisal paradigm. Subjective measures of emotional regulation and event-related potentials (ERPs) were recorded while participants were instructed to passively view neutral or negative pictures, or to reinterpret negative pictures in a positive way (positive reappraisal) or a detached and unemotional way (distancing). Results HTA women, as compared to LTA women, reported smaller reductions in negative affect after positive reappraisal and smaller reductions in emotional arousal after distancing. Though ERP data did not reveal corresponding differences in the centro-parietal late positive potential during emotion regulation, data did reveal HTA women exhibited enhanced recruitment of cognitive control during positive reappraisal and greater preparatory processing before engaging in distancing. Limitations Future research should examine the generalizability of the present results in clinical anxiety individuals, male sample and other reappraisal strategies. Conclusions Overall, HTA women appeared to recruit more cortical resources, suggestive of compensatory mechanisms, to achieve a similar performance as LTA women when engaging in positive reappraisal and distancing strategies to regulate negative emotions. Therefore, the findings demonstrate that HTA women are characterized by the inefficient implementation of positive reappraisal and distancing strategies.

Public green spaces provide physical and mental respite, which have become essential and elevated services during the COVID-19 pandemic. As visitation to public parks and recreation areas increased during the pandemic, the challenge of maintaining visitor safety and protecting environmental resources was exacerbated. A key visitor safety practice during the COVID-19 onset was maintaining a physical distance of six feet (1.8 m) between groups. A novel data set documented and compared physical distancing compliance and off-trail behavior on multiple-use trails across multiple states and within select U.S. communities, attending to the impact of select environmental factors. Nearly 6000 observations revealed physical distancing compliance varied and the environmental factors of trail width, density, and signage influenced its variability. Similarly, off-trail movement was related to trail width and density. Clearly the environment matters as people negotiate the ‘new normal’ of physical distancing during physical activity and outdoor recreation participation. Given the ongoing COVID-19 pandemic and likelihood of future health crises, this project provides important information and insight for trail and other public green space management, monitoring, and modelling moving forward. Management implications As both trail width and visitor density impacted physical distancing, a combination of trail design that accommodates distancing requirements and density management practices that provide sufficient trail user spacing is essential to retain safe and active trail use. Off-trail movement was influenced by both trail width and density, so ensuring safe off-trail spaces exist and using durable off-trail materials can minimize disturbance and protect visitors. Signage is inconsistently significant to influence trail-compliant distancing behavior, but optimizing its placement and content may improve effectiveness. Compliant trail behavior varied by trail width, visitor density, and trail location; therefore, site-specific information is necessary to understand possible visitor behavior and design/implement mitigation strategies.

Highlights • Physical distancing is necessary to mitigate SARS-CoV-2 transmission. • Difficult to implement distancing in complex health care settings. • Systems engineering approaches highlight work system elements and interactions. • Work system analyses identify individual challenges and solutions for distancing., As health care systems explore new ways of delivering care for patients with and without COVID-19, they must consider how to maintain physical distancing among health care workers and patients. Physical distancing in high complexity systems such as health care is particularly challenging and may benefit from a human factors and systems engineering perspective. We discuss challenges to implementing and maintaining physical distancing in health care settings and present possible solutions from a human factors and systems engineering perspective.

Objective This study pursues further empirical validation of the “Medical Error Disclosure Competence (MEDC)” guidelines. The following research questions are addressed: (1) What communicative skills predict patients’ perceived disclosure adequacy? (2) To what extent do patients’ adequacy perceptions predict disclosure effectiveness? (3) Are there any significant sex differences in the MEDC constructs? Methods A sample of 193 respondents completed an online survey about a medical error they experienced in the past 5 years, and about the subsequent disclosure of that error to them. Results One in four patients had experienced a medical error, only a third of them received a disclosure. Only interpersonal adaptability influenced disclosure adequacy, with a large effect size. Adequacy, in turn, predicted both patients’ relational distancing and approach behaviors. Nonverbally skillful disclosures significantly decreased the likelihood of patient trauma. Expressions of remorse significantly increased patient resilience. Nonverbal skills (-) and a full account (+) predicted patients’ tendency to harm themselves. Males were more reactive to disclosures than female patients. Conclusion MEDC guidelines-adherent disclosure communication maintains the provider-patient relationship, increase patient resilience, and decreases patient trauma after a medical error. Practice implications Given the results of this study, adherence to the MEDC-guidelines must be considered “safe practice.”

This work highlights a popular form of volunteer tourism in Southeast Asia — Teaching English as a Foreign Language Volunteer Tourism (TEFL VT). Given the limited literature on this niche form of tourism, the purpose of this paper was to gain a better understanding of and differentiation between TEFL VT and TEFL jobs in Thailand based on analyzing the content of position advertisements. TEFL jobs were found to be predominantly long-term paid positions located in Bangkok that preferred college-educated native English speaking Western expatriates with teaching experience, whereas TEFL VT programs were primarily short-term, outside of Bangkok, and did not require teaching experience nor formal education beyond high school. TEFL VT programs were also less restrictive than TEFL jobs with regards to who could apply, required payment, involved activities outside of teaching, and focused not solely on students but also volunteer benefits while distancing themselves from the mass tourism industry.

This systematic search and review of international literature (1979–2017) finds links between emotion management and gender (in 1/2 the studies), and teaching attrition outcomes (1/3). Results contextualise these connections, suggesting female teachers use deep acting strategies, though experience more emotional exhaustion and unpleasant emotions. Male teachers practice distancing and surface acting, and experience depersonalisation, but also success in controlling disruptions and stimulating subject interest. Studies are limited by self-reported data and omission of school context, but highlight important teacher organisational identifications, suggesting future research use observational methods for understanding emotion management as an embedded, interactionist phenomenon.

Background Research about online child sexual exploitation material (CSEM) users focuses on psychological assessments, demographics, motivations, and offending rates. Little is known about their understandings of children in CSEM. Objective From an anthropological perspective, examine CSEM users’ constructions of children and childhood online and offline, and explore how these factor into their crimes. Participants and setting CSEM users in UK group programs. Methods In-depth ethnography, including 17 months of participant observation in group programs with 81 CSEM users, 31 semi-structured interviews with group participants, and inductive analysis of themes illuminated by childhood theory from anthropology. Results When referring to children offline, many participants claimed to align with Euro-American norms and constructions surrounding children’s learning, protection, irrationality, inexperience, asexuality, and innocence. However online, many constructed children differently: as less or not “real,” and as sexualized. This rendered children in CSEM fundamentally different, which facilitated offending, assisted in overcoming barriers, and allowed participants to hold conventional beliefs about children and childhood while engaging in incongruent online activity. Vital in this process was Internet use and associated distancing, detachment, anonymity, and cultural othering. The program used victim empathy to restore dominant norms to online children, for which participants invoked feelings, recognized their role in abuse, extrapolated consequences for victims, and reinforced norms. Conclusions Constructions of children and childhood were central in offending. The complexities of negotiating “real” versus “not real” in both offending and victim empathy are discussed, as are conceptual distinctions between “constructions” and “cognitive distortions,” and implications for treatment and prevention.

The emotion of awe occurs when one feels small relative to something vaster than the self; it leads to benefits such as care for others. However, because awe elicits the experience of a “small self,” it is unclear to what extent awe positively versus negatively affects responses to subsequent stressors. If personal obstacles seem trivial in comparison to awe-inspiring stimuli, stressors should seem either manageable or unimportant, but if one's capabilities seem comparatively insignificant, stressors should seem unmanageable. We hypothesized that awe would have a generally positive effect on responses during a subsequent performance stressor, but that this would further depend on whether people tended to spontaneously take on a self-distanced versus self-immersed perspective. In the face of awe, focusing less on the self (self-distanced perspective) should make obstacles in particular seem trivial, whereas focusing more on the self (self-immersed) should lead one's capabilities to seem insignificant. Using the biopsychosocial model of challenge/threat, we found that spontaneous self-distancing significantly moderated awe's effects on responses during a subsequent performance stressor (speech task): For participants who self-distanced, the awe condition led to cardiovascular responses consistent with greater challenge than the neutral control condition (reflecting evaluating the stressor as more manageable); for participants who self-immersed, awe predicted relative threat (less manageable stressor). There was no support for awe making people care less about the stressor (as reflected in cardiovascular responses consistent with task engagement). This offers insight into how awe can have divergent effects on people's experiences during performance stressors.

This study focuses on examining interpersonal functions of two English reportative adverbs: reportedly and allegedly. In Martin and White’s (2005) typology of “resources of intersubjective positioning,” which this work employs, reportative adverbs are associated with the function of attribution, as they are used to “attribute the proposition to some external source” (Martin and White, 2005: 111). The aim of this study is to establish the contexts in which they signal different types of attribution (acknowledgement and distancing), and to identify any additional functions they perform. Most of the illustrative examples come from the British National Corpus and the Corpus of Contemporary American English. The type of attribution is demonstrated to depend on such factors as the syntactic position of the adverb, the type of sentence it occurs in, the amount of information given in the context and its status. Allegedly is shown to additionally perform a countering function. It is used to challenge the interlocutor’s right to claim knowledge and to undermine the reliability of the interlocutor’s claims. Reportative adverbs are thus shown to indicate both the status of the information presented by the speaker and the speaker’s position towards the information presented by the interlocutor.

To combat the global COVID-19 crisis, governments and health organizations rely on collective cooperation among every ordinary individual to adhere to non-pharmaceutical interventions (NPIs), such physical distancing which includes, as examined in our study, staying at home. Thus, we ask the question: do individual differences in how individuals see themselves as connected to or separated from others (i.e., independent vs. interdependent self-construal) predict their stay-at-home adherence? In an online study (N = 358; 47.1% female, Mage = 40.48; 74.02% White), we measured trait self-construal, inclusion of others in the self (IOS), self-control and likelihood to stay-at-home in various scenarios. Results revealed a significant indirect, sequential effect of self-construal on stay-at-home adherence via IOS and self-control. Specifically, participants with a more accessible interdependent (vs. independent) self-construal reported higher stay-at-home adherence intentions as a consequence of greater IOS and self-control. Theoretical and practical implications are discussed.

Highlights • Nursing students are an essential workforce during a pandemic. • The coronavirus disease 2019 pandemic provides opportunities for nurse leaders to identify creative solutions. • Future policies need to focus on the role of advanced practice simulation training and telehealth., Background The coronavirus disease 2019 (COVID-19) disrupted the education and clinical training of nursing students. Clinical sites shut out students over low equipment supplies, physical distancing requirements, and redeployment of staff. Purpose and Methods The purpose of this paper is to highlight a progressive solution to engage nurse practitioner students as part of the COVID-19 response given the disruption of their traditional clinical training environments so that student could continue to matriculate and graduate in a timely manner. Findings Nurse practitioner students swiftly responded and were deemed an essential part of the nursing workforce. Discussion Policy implications for advanced nursing practice and education for telehealth and simulation research moving forward is also provided.

Impacts of coronavirus disease 2019 (COVID-19) on the transport sector and the corresponding policy measures are becoming widely investigated. Considering the various uncertainties and unknowns about this virus and its impacts (especially long-term impacts), it is critical to understand opinions and suggestions from experts within the transport sector and related planning fields. To date, however, there is no study that fills this gap in a comprehensive way. This paper is an executive summary of the findings of the WCTRS COVID-19 Taskforce expert survey conducted worldwide between the end of April and late May 2020, obtaining 284 valid answers. The experts include those in the field of transport and other relevant disciplines, keeping good balances between geographic regions, types of workplaces, and working durations. Based on extensive analyses of the survey results, this paper first reveals the realities of lockdowns, restrictions of out-of-home activities and other physical distancing requirements, as well as modal shifts. Experts' agreements and disagreements to the structural questions about changes in lifestyles and society are then discussed. Analysis results revealed that our human society was not well prepared for the current pandemic, reaffirming the importance of risk communication. Geographical differences of modal shifts are further identified, especially related to active transport and car dependence. Improved sustainability and resilience are expected in the future but should be supported by effective behavioral intervention measures. Finally, policy implications of the findings are discussed, together with important future research issues.

COVID-19 procedural restrictions and concerns from both practitioners and patients have led to a decrease in cosmetic procedures performed. Reduced clinic space, the necessity of distancing between people, and patient preference for a smaller care team may restrict trainees from observing, assisting with, or performing procedures. Thus, trainees may be limited in their ability to learn, practice, and meet the required number of cases to achieve competence, subsequently necessitating a sustained demand for alternative methods of learning. In this review, we examine the efforts made thus far by both dermatologists and dermatology organizations to meet the educational procedural needs of trainees and compensate for limitations during the pandemic and highlight areas in which innovation may still be needed.