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BackgroundThe COVID-19 pandemic has significantly impacted mental health and well-being. Mobile mental health apps can be scalable and useful tools in large-scale disaster responses and are particularly promising for reaching vulnerable populations. COVID Coach is a free, evidence-informed mobile app designed specifically to provide tools and resources for addressing COVID-19–related stress. ObjectiveThe purpose of this study was to characterize the overall usage of COVID Coach, explore retention and return usage, and assess whether the app was reaching individuals who may benefit from mental health resources. MethodsAnonymous usage data collected from COVID Coach between May 1, 2020, through October 31, 2020, were extracted and analyzed for this study. The sample included 49,287 unique user codes and 3,368,931 in-app events. ResultsUsage of interactive tools for coping and stress management comprised the majority of key app events (n=325,691, 70.4%), and the majority of app users tried a tool for managing stress (n=28,009, 58.8%). COVID Coach was utilized for ≤3 days by 80.9% (n=34,611) of the sample whose first day of app use occurred within the 6-month observation window. Usage of the key content in COVID Coach predicted returning to the app for a second day. Among those who tried at least one coping tool on their first day of app use, 57.2% (n=11,444) returned for a second visit; whereas only 46.3% (n=10,546) of those who did not try a tool returned (P

BackgroundAs smartphones are now used by most Americans, it is increasingly possible for mental health mobile apps to be disseminated to the general public. However, little is known about how mobile mental health apps are used by the general population outside of a controlled research design. ObjectiveOur objective is to describe how the general population engages with Mindfulness Coach, an iOS- and Android-based app designed to deliver a mindfulness training course. MethodsUsing anonymous download and analytics data, we characterized the reach, usage, retention, and impact of Mindfulness Coach. We included mobile analytics data from all unique downloads of Mindfulness Coach between August 1, 2018, and April 8, 2019 (N=104,067) as well as starred reviews from all Mindfulness Coach users who provided reviews of the app as of March 1, 2020. Mindfulness characteristics were measured by an in-app assessment using the Five-Facet Mindfulness Questionnaire–Short Form (FFMQ-SF). ResultsUsers engaged, on average, in 4.3 visits to the app (SD 8.8; median 2; 90th percentile 8) and associated with an average total of 49.2 interactions with the app (ie, clicks within the app) (SD 113.8; median 19; 90th percentile 105). Users spent an average of 16.2 minutes (SD 63.1) engaged with the app over the full study time period. There were strong linear effects of app engagement on total FFMQ-SF scores. For example, FFMQ-SF scores were associated with more time spent engaged with the app (R2=.23; P

ContextOutcomes after cardiopulmonary resuscitation (CPR) remain poor. We have spent 10 years investigating an "informed assent" (IA) approach to discussing CPR with chronically ill patients/families. IA is a discussion framework whereby patients extremely unlikely to benefit from CPR are informed that unless they disagree, CPR will not be performed because it will not help achieve their goals, thus removing the burden of decision-making from the patient/family, while they retain an opportunity to disagree.ObjectivesDetermine the acceptability and efficacy of IA discussions about CPR with older chronically ill patients/families.MethodsThis multi-site research occurred in three stages. Stage I determined acceptability of the intervention through focus groups of patients with advanced COPD or malignancy, family members, and physicians. Stage II was an ambulatory pilot randomized controlled trial (RCT) of the IA discussion. Stage III is an ongoing phase 2 RCT of IA versus attention control in in patients with advanced chronic illness.ResultsOur qualitative work found the IA approach was acceptable to most patients, families, and physicians. The pilot RCT demonstrated feasibility and showed an increase in participants in the intervention group changing from "full code" to "do not resuscitate" within two weeks after the intervention. However, Stages I and II found that IA is best suited to inpatients. Our phase 2 RCT in older hospitalized seriously ill patients is ongoing; results are pending.ConclusionsIA is a feasible and reasonable approach to CPR discussions in selected patient populations.

As a team of job-embedded instructional coaches in an ethnically and economically diverse learning environment, the authors are dedicated to thinking through and troubleshooting the improvement of teaching and learning in the three learning communities that make up Clover Park High School. They agree with commentator Laurie Olsen who writes, "Data provide both a stark picture of how we're doing and a wonderful tool for stimulating dialogue about how a school community is faring and what it considers important." The authors and their colleagues make use of qualitative and quantitative data to form the basis for the professional development--and the goal of improved student achievement--that they create and facilitate. They use a number of quantitative data sets, disaggregated for factors such as gender, ethnicity, and socioeconomic status, content, and grade levels. These include state standardized tests, building-administered assessments, building graduation rates, and grade reports. They use multiple assessments to give them a more complete picture of teaching and learning in the building. Their conversations around improvement often begin with their interpretations of and concerns around the data. In addition, they spend time in classrooms on a regular basis to collect a variety of real-time, qualitative data. These include artifacts such as observation notes and video. From here, they begin to build professional development that bridges the gaps between the research-based best practices that are supported by their district, the capacities and belief systems of their teachers, the real quantitative and qualitative indicators of achievement by their students, and the overall context in which teaching and learning occur. While their main goal is to solve problems, their focus is also to create a community of learners. They engage teachers in the processes they would like to see them engage with their own students: they place thought-provoking issues in front of them and then ask them to reflect, respond, and act on what they've learned in the form of the crucial changes in practice that are suggested. Looking at data is a crucial first step in the process of making meaningful changes in instructional practice. But the real challenge is to create the space for honest and trustful discourse both one-on-one and in groups about what actions those data actually suggest.

Space travel presents unlimited opportunities for exploration and discovery, but requires better understanding of the biological consequences of long-term exposure to spaceflight. Immune function in particular is relevant for space travel. Human immune responses are weakened in space, with increased vulnerability to opportunistic infections and immune-related conditions. In addition, microorganisms can become more virulent in space, causing further challenges to health. To understand these issues better and to contribute to design of effective countermeasures, we used the Drosophila model of innate immunity to study immune responses in both hypergravity and spaceflight. Focusing on infections mediated through the conserved Toll and Imd signaling pathways, we found that hypergravity improves resistance to Toll-mediated fungal infections except in a known gravitaxis mutant of the yuri gagarin gene. These results led to the first spaceflight project on Drosophila immunity, in which flies that developed to adulthood in microgravity were assessed for immune responses by transcription profiling on return to Earth. Spaceflight alone altered transcription, producing activation of the heat shock stress system. Space flies subsequently infected by fungus failed to activate the Toll pathway. In contrast, bacterial infection produced normal activation of the Imd pathway. We speculate on possible linkage between functional Toll signaling and the heat shock chaperone system. Our major findings are that hypergravity and spaceflight have opposing effects, and that spaceflight produces stress-related transcriptional responses and results in a specific inability to mount a Toll-mediated infection response.

The evolution of pest resistance to management tools reduces productivity and results in economic losses in agricultural systems. To slow its emergence and spread, monitoring and prevention practices are implemented in resistance management programs. Recent work suggests that genomic approaches can identify signs of emerging resistance to aid in resistance management. Here, we empirically examined the sensitivity of genomic monitoring for resistance management in transgenic Bt crops, a globally important agricultural innovation. Whole genome resequencing of wild North American Helicoverpa zea collected from non-expressing refuge and plants expressing Cry1Ab confirmed that resistance-associated signatures of selection were detectable after a single generation of exposure. Upon demonstrating its sensitivity, we applied genomic monitoring to wild H. zea that survived Vip3A exposure resulting from cross-pollination of refuge plants in seed-blended plots. Refuge seed interplanted with transgenic seed exposed H. zea to sublethal doses of Vip3A protein in corn ears and was associated with allele frequency divergence across the genome. Some of the greatest allele frequency divergence occurred in genomic regions adjacent to a previously described candidate gene for Vip3A resistance. Our work highlights the power of genomic monitoring to sensitively detect heritable changes associated with field exposure to Bt toxins and suggests that seed-blended refuge will likely hasten the evolution of resistance to Vip3A in lepidopteran pests. [ABSTRACT FROM AUTHOR]

Students of public speaking are often asked if a basic public speaking course helped them deal with their fear of public speaking. Comparisons of anxiety levels between students enrolled in traditional 15-week semester courses and those enrolled in intensive courses has received little attention. The purpose of this exploratory, quasi-experimental study was to determine whether students enrolled in intensive public speaking courses reported higher levels of communication apprehension, i.e., speech anxiety. Participants were 722 undergraduate students who completed the Personal Report of Public Speaking Anxiety instrument. The findings indicated that students enrolled in intensive public speaking courses had significant moderate communication apprehension scores compared to students enrolled in 15-week semester courses. It is argued that the study indicates that there are factors that should be explored in further research on intensive public speaking courses.

Writing on contemporary culture and social life, sociologists and cultural theorists have been describing new or changing forms of movement, variously described as cultural "flows," "liquid life," or a "networked society." The change in such movements or mobilities of people, media, material goods, and other social phenomena, including the reach or extension of such movements, connections between "global" and "local life," the creation of new spaces and places, and new speeds and rhythms of everyday social practice, is arguably the most important contrast between contemporary social life and that of just a decade or two ago. Despite these changes and longer conversations about their meanings in a range of disciplines, mobilities and their relations to learning within education are still understudied and undertheorized. This article maps current and relevant engagements with mobility and learning across conceptual and empirical studies. (Contains 1 table.)