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A multi-site randomized controlled feasibility study using a parallel design was conducted to determine the feasibility of the trial design and to provide preliminary evidence for whether the Bonny Method of Guided Imagery and Music (GIM) has an effect on depression, anxiety, stress, and mental wellbeing in persons with depression. Participants (N = 14) with depression were randomly allocated to either receive a series of 10 biweekly individual GIM sessions or a waitlist period followed a series of group GIM sessions. Participants completed the Inventory of Depressive Symptomotology–Self-Report; Depression, Anxiety and Stress Scales; and Warwick-Edinburgh Mental Well-Being Scale at pretest, midpoint, posttest, and 6-week followup. After onset of the COVID-19 pandemic, recruitment was terminated early and sessions were shifted to telehealth. Results indicate that the design is feasible with minor adjustments, and that the GIM condition had high safety, tolerability, and acceptability. Treatment outcome analyses are also reported.

BACKGROUND: As lung ultrasound (LUS) has emerged as a diagnostic tool in patients with COVID-19, we sought to investigate the association between LUS findings and the composite in-hospital outcome of ARDS incidence, ICU admission, and all-cause mortality. METHODS: In this prospective, multi-center, observational study, adults with laboratory-confirmed SARS-CoV-2 infection were enrolled from non-ICU in-patient units. Subjects underwent an LUS evaluating a total of 8 zones. Images were analyzed off-line, blinded to clinical variables and outcomes. A LUS score was developed to integrate LUS findings: ≥ 3 B-lines corresponded to a score of 1, confluent B-lines to a score of 2, and subpleural or lobar consolidation to a score of 3. The total LUS score ranged from 0–24 per subject. RESULTS: Among 215 enrolled subjects, 168 with LUS data and no cur-rent signs of ARDS or ICU admission (mean age 59 y, 56% male) were included. One hundred thirty-six (81%) subjects had pathologic LUS findings in ≥ 1 zone (≥ 3 B-lines, confluent B-lines, or consolidations). Markers of disease severity at baseline were higher in subjects with the composite outcome (n = 31, 18%), including higher median C-reactive protein (90 mg/L vs 55, P <.001) and procalcitonin levels (0.35 lg/L vs 0.13, P =.033) and higher supplemental oxygen requirements (median 4 L/min vs 2, P =.001). However, LUS findings and score did not differ significantly between subjects with the composite outcome and those without, and were not associated with outcomes in unadjusted and adjusted logistic regression analyses. CONCLUSIONS: Pathologic findings on LUS were common a median of 3 d after admission in this cohort of non-ICU hospitalized subjects with COVID-19 and did not differ among subjects who experienced the composite outcome of incident ARDS, ICU admission, and all-cause mortality compared to subjects who did not. These findings should be confirmed in future investigations. The study is registered at Clinicaltrials.gov (NCT04377035).

In recent years and in the light of climate changes, many destinations in the Arctic parts of Europe have been successful in capitalizing on an increased interest in polar tourism. Leading up to the COVID-19 crisis, visitor numbers remained modest in Greenland, a self-ruled Arctic nation under the Danish Commonwealth. However, as the nation’s tourism rebuild coincides with the opening of two new international airports in 2023, visitor numbers are expected to rise higher than ever before. Successful marketing, combined with a rising global focus on the Arctic, has led to a growing volume of tourists and a corresponding rise in political and societal interest in tourism. Already today, tourism is viewed as one of Greenland’s three economic pillars, next to the dominant fishing industry and mining. Also, it is perceived by many as a promising lever for the Arctic nation’s future economic development (Bjørst and Ren, 2015). The tourism offerings in Greenland are predominantly adventure tourism and similar to other Arctic destinations, the experiential core is rested, as argued by Lee et al. (2017) in “a context of geographical peripherality” (p.1). In other words, in being and feeling as a tourism experience truly off the beaten track. As an Arctic destination heavily affected by climate change, Greenland has witnessed increasing interest from a global public, something that is believed to have helped bring the destination closer in the mind of potential visitors. The destination has also received unexpected media attention and exposure as a result of growing geo-political interest in the Arctic: for instance, when US president Trump proposed to buy the island in 2019. The national DMO, Visit Greenland, has been quick to make the most of this global access and the general rising interest on social media. In securing continued growth, efficient marketing of the destination has been identified by Visit Greenland as essential. Visit Greenland markets its products and experiences around the ‘big Arctic five’: dogsledding, whale watching, Northern Lights, ice/snow, and the nation’s pioneering people. In combination with sailing, hiking, fishing and hunting, as well as cultural offerings, such as kaffemik coffee parties in private homes and visits to handicraft workshops, these comprise the products offered to the nearly 100,000 people who visit Greenland annually (Statistics Greenland, 2019).To better understand how Visit Greenland works in marketing Greenland as a tourist destination, the case of social media influencers is explored. To do so, a review of the social media marketing literature is provided which zooms in on social media marketing, tourism and social media influencers in tourism. Encapsulation and decapsulation is introduced as an analytical tool to explore the study’s material and presented in the following analysis. After a short introduction to our methodology and case, empirical material from interviews with professional social media influencers sponsored by the DMO to promote the destination is used to show how users negotiate online presence and social media content during their travels in Greenland. In conclusion, the trade-offs and balancing acts of being ‘online’ and ‘off the beaten track’ are discussed, seeing them as equally important but at times hard to reconcile.

Last Aid courses (LAC) were introduced in 2015 in three countries (Norway, Germany and Denmark) to teach the public about palliative care. The main aims of LAC are to stimulate the public discussion about death, dying and palliative care and to enable people to participate in end-of-life care in the community. At present the International Last Aid working group includes members from 18 countries from Europe, Brazil and Australia. Usually LACs are held in a classroom setting with 6-20 participants and two facilitators. Initially the 2nd International Last aid Conference was planned in October 2020 in Maribor, Slovenia. When the pandemic struck this became impossible. To cope with the demanding challenges and the fact that physical group meetings and conferences became impossible in 2020 Last Aid International had to find ways of continuing the work. A taskforce on Online Last Aid Courses was established in Germany and LACs were held Online via different web based platforms. The 2nd International Last Aid Conference took place online with 174 delegates from 18 countries. The implications and effects of COVID-19 on the development of Last Aid International will be presented and discussed in detail.References: 1. Bollig G, Meyer S, Knopf B, Schmidt S, Bauer EH. First Experiences with Online Last Aid Courses for Public Palliative Care Education during the COVID-19 Pandemic. Healthcare (Basel). 2021 Feb 5;9(2):172. doi: 10.3390/healthcare9020172. https://www.mdpi.com/2227-9032/9/2/172 2. Zelko E, Bollig G. Report from the 2. International LAST AID Conference Online—The social impact of palliative care, October 30 2020, Maribor, Slovenia. AIMS Medical Science 2021, Volume 8, Issue 1: 42-45. doi: 10.3934/medsci.2021005 https://www.aimspress.com/article/doi/10.3934/medsci.2021005

Abstract Objectives Camostat mesilate is a drug that is being repurposed for new applications such as that against COVID-19 and prostate cancer . This induces a need for the development of an analytical method for the quantification of camostat and its metabolites in plasma samples. Camostat is, however, very unstable in whole blood and plasma due to its two ester bonds. The molecule is readily hydrolysed by esterases to 4-(4-guanidinobenzoyloxy)phenylacetic acid (GBPA) and further to 4-guanidinobenzoic acid (GBA). For reliable quantification of camostat, a technique is required that can instantly inhibit esterases when blood samples are collected. Design and methods An ultra-high-performance liquid chromatography-tandem mass spectrometry method (UHPLC-ESI-MS/MS) using stable isotopically labelled analogues as internal standards was developed and validated. Different esterase inhibitors were tested for their ability to stop the hydrolysis of camostat ester bonds. Results Both diisopropylfluorophosphate (DFP) and paraoxon were discovered as efficient inhibitors of camostat metabolism at 10 mM concentrations. No significant changes in camostat and GBPA concentrations were observed in fluoride-citrate-DFP/paraoxon-preserved plasma after 24 h of storage at room temperature or 4 months of storage at −20 °C and −80 °C. The lower limits of quantification were 0.1 ng/mL for camostat and GBPA and 0.2 ng/mL for GBA. The mean true extraction recoveries were greater than 90%. The relative intra-laboratory reproducibility standard deviations were at a maximum of 8% at concentrations of 1–800 ng/mL. The trueness expressed as the relative bias of the test results was within ±3% at concentrations of 1–800 ng/mL. Conclusions A methodology was developed that preserves camostat and GBPA in plasma samples and provides accurate and sensitive quantification of camostat, GBPA and GBA by UHPLC-MS/MS.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has a severe impact on the general population. During the pandemic, children may develop emotional and psychological symptoms, including increased worries about health and illness, known as health anxiety symptoms (HASs). We aimed to explore HAS in 7–9-year-old children from the Danish Odense Child Cohort (OCC) during the first COVID-19 lockdown period in Denmark, and to examine associations with potential risk factors. Material and methods: OCC is a cohort of children born between 2010 and 2012, which originally recruited 2874 of 6707 pregnancies (43%). Among the current OCC population of 2430 singleton children, 994 participated in this study (response rate 40%). Children and their parents filled out questionnaires about child HAS, family exposure to COVID-19 infection and parental HAS. Adjusted odds ratios (aORs) were calculated between high score child HAS (≥90th percentile) and covariates by use of logistic regression. Results: Most children (n = 686, 69%) reported few worries about their health. Children reporting high score HAS also had higher levels of internalizing symptoms at age 5; aOR 2.15 (1.20;3.85), p = .010, and higher levels of maternal and paternal HAS; aOR 2.40 (1.44;3.97), p = .001, and 2.00 (1.10;3.65), p = .023, whereas no association with child sex or familial exposure to COVID-19 was detected (n = 65, 6.5%). Conclusions: High score child HAS during the first lockdown period of the COVID-19 pandemic was not associated with family exposure to COVID-19 infection, but to being a more anxious child a priori and to HAS in parents.

INTRODUCTION: Being physically active is important in the prevention of adverse health effects in older adults, such as falls (1), cardiovascular outcome (2) and mortality (3). Although many older adults are positive toward physical activity, the factors limiting participation in physical activity are numerous and the COVID-19 pandemic has compounded the problem by dramatically reducing the amount and quality of social gatherings and interactions for older adults. The objective of this study was to investigate changes in physical activity due to the COVID-19 pandemic, among community-dwelling older adults in Denmark. METHODS: We assessed different exertion levels, frequencies, and duration of physical activity of 62 older adults (70.4±4.3yrs) during leisure time activity undertaken over a period of seven days, using the Physical Activity Scale for Elderly (PASE). The results of the scale are calculated, unitless values. The pre-pandemic measures were obtained late 2019 and January 2020, while the second and third measures were obtained one month into the first and second lockdown period in Denmark (April 2020 and January 2021 respectively). A repeated measures ANOVA with Greenhouse-Geisser corrections was used to test for differences between time points, with Bonferroni corrections used as post hoc test. RESULTS: The PASE score for the total leisure activities, moderate and strenuous sports were: pre-pandemic 39.8 (±26.4), 12.2 (±13.9) and 3.1 (±6.4); first lockdown: 32.7 (±22.1), 6.8 (±11.5) and 2.5 (±8.7) and; second lockdown: 16.3 (±10.3), 3.3 (±5.7) and 0.8 (±2.2). There was a reduction in total leisure activities from pre-pandemic to: (i) first lockdown by 17% (P=0.03) and; (ii) second lockdown by 59% (P<0.01). The PASE score for moderate exertion levels of sports was reduced from pre-pandemic to: (i) first lockdown by 44% (P<0.01) and; (ii) second lockdown by 73% (P<0.01). CONCLUSION: The total leisure activities for the older adults in our study decreased by 59% from pre-pandemic period to the second lockdown, which equals the PASE score of a combination of walking for 1-2 hour 3-4 times a week and 1-2 hours of moderate sports 1-2 days a week. Since recent literature indicates that physical activity levels can affect both the risk of falling and the risk of getting osteoporosis, this data may suggest that Community-dwelling older adults in Denmark might face a higher risk of experiencing fall related fractures during the pandemic. 1. García-Hermoso, A, et al., Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med, 2020. 50(6): p.1095-1106. 2. Sawyer, K, & Castaneda-Sceppa, C, Impact of aerobic physical activity on cardiovascular and noncardiovascular outcomes: Is anyone too old to exercise? Aging Health, 2010. 6(2): p.251-260. 3. Saint-Maurice, P.F, et al., Association of Daily Step Count and Step Intensity With Mortality Among US Adults. JAMA, 2020. 323(12): p.1151–1160.

Teaching in Danish vocational education and training (VET) during the COVID-19 crisis switched to remote teaching from March 2020 and thus occurred under conditions that dif-fered significantly from the ordinary ones. This changed pupils’ context for teacher-guided supervision as well as teachers’ mandatory control of pupils’ attendance Teaching in Danish vocational education and training (VET) during the COVID-19 crisis switched to remote teaching from March 2020 and thus occurred under conditions that dif-fered significantly from the ordinary ones. This changed pupils’ context for teacher-guided supervision as well as teachers’ mandatory control of pupils’ attendance. In the article, pupils describe the changed context for the pedagogy in VET in focus group interviews. They also reflect on how it influenced the pedagogy and the way they make themselves visible to the teacher in the digital setting. Drawing on sociological theory, such elements of the pedagogy are analyzed seen in the light of concepts such as power, control, and discipline in the remote teaching.