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The COVID-19 pandemic has had a profound impact on society and many governments and politicians were required to make quick decisions to protect public health. In reaching these decisions they needed to weigh advice from experts in many fields and then "sell” these decisions. However little was known at the time about the desires and aspirations of their electorates. Here we identify one such source of public opinion, signatures to various COVID-19 related Parliamentary e-petitions Whilst there were over 1,500 such e-petitions, we identify 27 common and meaningful topics and show how the strength of these topics varies between individual parliamentary constituencies. Using a measure of support for each topic in the constituencies we identify five constituency groupings. There are two Conservative voting groups, "Middle England” and "Equity of Support”, the former are located largely in southern England whilst the latter are in the midlands and northern England. The groups that show strong support in Labour voting constituencies are ones around education and funding issues. This article shows how a targeted range of e-petitions can be grouped into topics and the popularity of topics established, and thereby function as a useful way of augmenting democracy and democratic institutions. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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Background. We developed a COVID-Influenza Combination (CIC) vaccine, comprising recombinant SARS-CoV-2 Spike (rS) and quadrivalent influenza hemagglutinin (HA) protein nanoparticles (qNIV), and Matrix-MTM adjuvant. rS/Matrix-M previously demonstrated efficacy against COVID-19 in Phase 3 trials, while qNIV/ Matrix-M previously demonstrated induction of broadly cross-reactive antibodies. Here we report preliminary safety and immunogenicity results of a first-ever Phase 1/2 CIC dose-finding trial. Methods. Seropositive (COVID-19 vaccinated >= 8 weeks prior) participants (N=642) aged 50-70 years were randomized equally, to receive two intramuscular doses, 56 days apart, to 1 of 14 different dose/formulations of CIC using a design of experiments approach (dose range: rS 2.5-22.5ug, HA5-60ug;and 50ug Matrix-M), or to 1 of 2 reference formulations of either standalone rS with Matrix-M [2 doses] or qNIV with Matrix-M [1 dose only]. Pre- and post-vaccination (Days 0, 28, 56, 70, 84, 182) immunogenicity assessments including SARS-CoV-2 anti-S IgG and influenza HAI antibodies to vaccine-homologous strains. Reactogenicity was assessed 7 days following each dose, and safety outcomes assessed through Day 70. Multiple regression was used to create predictive models to assess antibody response surfaces and for dose optimization. Results. All CIC formulations were well tolerated, with a reactogenicity and safety profile generally comparable to standalone rS or qNIV. Regression modelling of post-first dose responses revealed that both rS and HA antigens in a CIC formulation modestly interfered with each other, however, interference was overcome with dose adjustment across a range of rS/HA doses. Specifically, higher rS dose ( >20ug), in a dose dependent fashion, overcame HA interference, closely matching standalone rS IgG reference responses (GMEU 16,818), whereas lower, intermediate HA dose overcame rS interference, closely matching standalone HA reference HAI responses for H3N2 (GMT 145), H1N1 (GMT 134), and B-Victoria (GMT 66);while modestly (at least 34%) lower than the reference B-Yamagata response (GMT 101). Conclusion. CIC formulations were well tolerated and immunogenic, with various dose combinations achieving response comparable to standalone vaccines.
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The initial surge of the COVID-19 pandemic and public health measures in response dramatically impacted Adult Protective Services' (APS) ability to conduct investigations and provide services, requiring agencies to quickly adapt. Our goal was to describe challenges for APS and strategies they developed to respond. We conducted 6 focus groups and 7 interviews during March-April 2021 used a semi-structured topic guide, with 31 participants from APS leadership, supervisors, and case workers in New York City, a community hard hit by the initial COVID surge. Focus groups and interviews were recorded and transcribed, with data analyzed to identify themes. Participants identified 9 major challenges, including: clients using concern about COVID-19 to refuse APS workers' access to their home, necessity to perform home visits/wellness checks on behalf of other agencies who had suspended home visits, and dependence on in-office activities including receiving paper mail. Participants reported 30 formal and informal strategies adopted to address challenges. These included 13 focusing on maximizing client engagement while maintaining client and APS worker safety, such as: adding a pre-investigation before a home visit to assess COVID-19 risk/exposure, offering clients masks and hand sanitizer to build trust, and close collaboration with other agencies/programs including joint visits. Also, 17 strategies were reported to allow for remote work and support staff, including: modifying processes to replace paper mail with electronic communication/processing, offering counseling services, formally recognizing excellent performance, and leadership reaching out personally to check on staff members. These findings may inform APS planning for future large-scale societal disruptions.
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Before the COVID-19 pandemic, the world struggled to address growing educational inequalities and fulfil the commitment to Sustainable Development Goal 4, which seeks to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The pandemic has exacerbated these inequalities and changed how education functions, moving to online and hybrid methods. The challenges in global education highlighted and worsened by the pandemic make it necessary to re-evaluate education systems and the policies in place to support access, quality and equal opportunity. This article focuses on analysing education policies at a national level. It tests a pilot policy analysis tool, the International Education Index (IEI), developed as a starting point to begin this reconsideration and create an accessible and comprehensive way to evaluate national education systems to inform decision-making and policies in the new context. This research uses Ireland and Northern Ireland to test the IEI pilot tool. The IEI consists of 54 questions across nine indicators, including institutional frameworks, education strategies, digital skills and infrastructure, twenty-first century skills, access to basic social services, adherence to international standards, legal frameworks, data gathering and availability and international partnerships. Countries can score 108 points to be categorised as having developed, emerging or nascent national education systems. Ireland scored 94 and Northern Ireland 81, indicating that they have developed national education systems.
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Introduction: Between May 2020 and April 2021 opioid overdose deaths in the US surged with more than 100,000 people dying from an overdose (CDC 2021). Medications for opioid use disorder (MOUD) substantially reduce mortality and overdose (Santo 2021) but remain underutilized with fewer than 35% of people with opioid use disorder (OUD) engaged in treatment (Jones 2019). Before the COVID-19 pandemic, federal regulations required in-person evaluation for buprenorphine initiation. At the onset of the pandemic, temporary allowances were enacted to enable buprenorphine initiation by telehealth. Audiovisual telehealth has been shown to be as effective as in-person care for buprenorphine maintenance treatment (Zheng 2017, Lin 2019), however, few studies have examined patient follow-up after audio-only buprenorphine treatment initiation. Under these allowances, the Rhode Island Buprenorphine Hotline, a free, on-demand, audio-only, 24-hour telehealth service for buprenorphine initiation, was launched. Here, we describe the characteristics of Rhode Island Buprenorphine Hotline patients and 30-day treatment follow-up in the first year of operation Methods: All patients who consented to treatment via the Buprenorphine Hotline from April 2020 to February 2021 were enrolled in a retrospective cohort study. We obtained patient demographics, substance use history, withdrawal symptoms, and 30-day treatment engagement by reviewing electronic health records and the hotline's administrative database. Using data from the Rhode Island Prescription Drug Monitoring Program (PDMP), we tracked subsequent buprenorphine prescriptions filled within 30-days of the initial telehealth encounter. Result(s): In total, the hotline received 134 calls between April 1, 2020 and February 28, 2021. Of these callers, 128 were connected to a prescriber for evaluation. Buprenorphine was prescribed in 103 encounters (80.5%, 103/128), and 92 (89.3%, 92/103) of these were new callers who filled their prescriptions within 30 days. Among individuals who filled their prescriptions, most were male (62%, 57/92) and identified as White (69.6%). Two-thirds had previously been in addiction treatment (66.3%, 61/92), but a minority were in treatment at the time of the call (7.6%, 7/92). Most callers who filled their prescriptions had previously taken buprenorphine, including prescribed (45.6%, 42/92) and non-prescribed (63%, 58/92). Most individuals previously prescribed buprenorphine had filled a prescription in the year preceding their call (73.8%, 31/42). Two-thirds of individuals who filled their prescriptions were in opioid withdrawal at the time of the call (66.3%, 61/ 92) with a mean Subjective Opioid Withdrawal Scale of 26.2 (range 4-57). Over 70% filled a subsequent prescription for buprenorphine within 30-days of the end of their hotline prescription (70.7%, 65/92), on average 5.9 days (range 0-28) after completion of their prescription. Conclusion(s): Telehealth for buprenorphine treatment delivery has rapidly expanded in response to changes in the regulatory environment and treatment access during the COVID-19 pandemic. Our findings show that over 70% of patients who filled their initial prescription after buprenorphine initiation via an audio-only encounter connect to follow-up treatment. The expansion of telehealth-delivered buprenorphine care has the potential to address treatment gaps and facilitate the delivery of on-demand services to patients when they are most motivated. Further research is needed to evaluate treatment outcomes for buprenorphine initiation via telehealth as compared to in-person care.
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Background: Intermittent lockdowns in Adelaide during 2020 necessitated the switching between online and faceto- face teaching. A pause in teaching midyear allowed for the rationalisation of existing material into a 'flipped learning' online programme. We utilised innovative approaches to assessment using online knowledge-based quizzes, novel online objective structured clinical examinations (OSCEs) (pre-clinical) and the Adelaide Medical School's unique simulation facility. Objectives: To outline the Adelaide Psychiatry curriculum and COVID-19 pandemic-associated change. Focus on novel solutions to assessment using online and videobased methods. Comment on the negative impact of social isolation and reduced clinical exposure on engagement with learning and mental health (MH) outcomes for students. Methods: Contrast the advantages and challenges of new modes of course delivery and assessment. Discuss the impact of digital teaching on the development of clinical and professional skills. Findings: The pandemic has fast-tracked the use of technology, but significantly reduced clinical experience. New methods of delivery and assessment provide promise for improved standardisation of teaching in traditional and clinical environments. Actively engaging students in learning during this transition has been challenging and disconnection has had implications for MH and professional development. Programmatic approaches to assessment that consider evolving performance in knowledge base, clinical skills and professional development may provide a more holistic picture of the development of young doctors. Conclusion: Future development of the MH curriculum will involve a careful balance of technology-driven and traditional clinical teaching. The Mental Health Medical Educator Leads Australia and New Zealand network offers a forum to share experience and promote best practice.
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Background: The mental health (MH) curriculum within undergraduate and postgraduate medical programmes in Australia and New Zealand is fundamental to MH competencies in graduate doctors. Despite a shared professional practice, there is an absence of a community of MH lead educators in medical degrees. Objectives: To develop a community of practice network, to enhance the quality, consistency and delivery of the MH curriculum and to enhance standards, resource development, teaching learning and assessment methodology. Challenges to consider include space in the curriculum, online learning during the COVID-19 pandemic and approaches to curriculum delivery posed by lived experiences of students. Methods: Development of the Mental Health Medical Education Leads Australia and New Zealand (MHMELANZ) Mental Health Educators network will be presented. Findings: MH medical education leads from a range of universities bi-nationally, representing graduate and undergraduate courses, will present an overview of the MH curriculum and current challenges and areas of focus for the MHMELANZ. Conclusion: There will be opportunity for discussion, and further development of a network, and a future special interest group with the Royal Australian and New Zealand College of Psychiatrists.
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In this paper, we study the Convolutional Neural Network (CNN) applications in medical image processing during the battle against Coronavirus Disease 2019 (COVID-19). Specifically, three CNN implementations are examined: CNN-LSTM, COVID-Net, and DeTraC. These three methods have been shown to offer promising implications for the future of CNN technology in the medical field. This survey explores how these technologies have improved upon their predecessors. Qualitative and quantitative analyses have strongly suggested that these methods perform significantly better than the commensurate technologies. After analyzing these CNN implementations, it is reasonable to conclude that this technology has a place in the future of the medical field, which can be used by professionals to gain insight into new diseases and to help in diagnosing infections using medical imaging. © 2021, EasyChair. All rights reserved.
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In early 2020, the coronavirus (COVID-19) pandemic ravaged countries across the world, causing them to essentially shut down. Communities had to retreat indoors and socially distance from one another. One aspect of life that drastically changed was schooling. It moved from traditional face-to-face spaces to online digital platforms. Students, faculty, and staffacross all levels of schooling shifted to teaching and learning vis-a-vis online digital platforms. Those of us connected to the training of the next generation of teachers navigated through the uncertainty of the COVID-19 pandemic at the preschool to post-secondary levels as well. This chapter focuses on the authors' experiences as a Black university supervisor and as a Black field placement coordinator. © 2021, IGI Global.
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Purpose: The COVID-19 pandemic has increased the demand for tele-medicine, particularly for lung transplant (LTX) recipients who are immunosuppressed and often live far from transplant centres. We report the feasibility of a 3-month semi-automated tele-coaching intervention in this population. Methods: The intervention consists of a pedometer and smartphone app, allowing transmission of activity data to a platform (Linkcare v2.7) that provides feedback, activity goals, education and contact with the researcher as required. Remote assessment pre- and post-intervention included patient acceptability using a project specific questionnaire, physical activity using accelerometry (Actigraph GT3X), HADS and the SF-36 questionnaire. Results: So far, all eligible patients approached were willing to be randomised to the intervention or usual care (n=14;COPD=4, ILD=7;CF=1;PH=2). For the intervention, usage of the pedometer was excellent, with patients wearing it for 6.9±0.1 days/week and rating the pedometer and telephone contact (9±2 out of 10) as the most vital aspects. Patient feedback has been positive, with 80% of patients responding that they ‘liked’ taking part and that it ‘helped them a lot’ to increase their activity levels. Daily steps and VMU are presented in Figure 1 and SF-36 scores in Figure 2. There were no changes in HADS scores between groups. Conclusion: Tele-coaching appears feasible in LTX recipients, with patients showing excellent adherence and providing positive feedback after 3 months. This is promising, with the on-going need to develop and evaluate ways of supporting patients remotely.
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The US Army is currently undergoing a multi-year process of adopting virtual techniques to recruit its target market. When the world pivoted to social isolation due to the COVID-19 pandemic, the Army easily adapted to the new environment. The US Army Recruiting Command, responsible for marketing the Army and processing new recruit packets, focused on leveraging virtual tools, social media intelligence analysis, and adapting its traditional culture of in-person recruiting to a more online, story-centric and visual content recruiting effort. The COVID environment expedited the expansion of virtual recruiting practices from just marketing to include most of the job application process, traditionally completed in-person. The result is an engaged online following that is reaching the target audience who are eligible for military service. The Army achieved its personnel end-strength goal for fiscal year 2020 despite closing 1,400 physical recruiting stations for two weeks, reopening less than 1 per cent through the summer and cancelling nearly all physical recruiting events. The Army also demonstrated its adaptation to virtual recruiting by digitally processing eligible civilians into the military while taking care of its existing force by adhering to nationwide social distancing mandates. © 2021, Henry Stewart Publications. All rights reserved.
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Background. Large social gatherings during the COVID-19 pandemic have been linked to extensive community transmission. Healthcare workers (HCW) that engage in these social gatherings pose a risk to the vulnerable patients they serve. Public Health-Seattle & King County identified a COVID-19 outbreak associated with a wedding in July 2020 when the 14-day incidence rate was 105 cases per 100,000 residents. HCW who attended the wedding were subsequently linked to 45 outbreaks in healthcare settings across three counties in the next month. Methods. COVID-19 case interview data was used to identify HCW cases who reported the wedding as their exposure event. The Washington Disease Reporting System (WDRS), the state database in which COVID-19 cases and epi-linkages are tracked, was queried to identify healthcare outbreaks linked to the HCW wedding-attendee cases and the HCW that they infected. NodeXL was used to visualize the resulting chains of wedding-associated healthcare transmission using a Harel-Koren Fast Multiscale layout where the network visualization's directed arrows represent putative links and direction of transmission. Numbers of associated settings, cases, and deaths were calculated. Results. Seven HCW wedding attendees were linked to outbreaks in healthcare facilities that they worked at while infectious;HCWs linked to as many as six subsequent healthcare outbreaks. In total, the wedding was connected to 45 healthcare facilities: adult family homes (N=1), hospitals (N=1), supported living agencies (N=7) and associated group homes (N=38), assisted living (N=1), home health services (N=1), behavioral health (N=2), and rehab centers (N=1). Across the settings, 277 cases were identified, including 15 deaths. Conclusion. A series of COVID-19 healthcare outbreaks was traced back to a wedding. Cases worked in multiple homes, agencies, and other healthcare settings which likely facilitated rapid and wide transmission;the structure of these healthcare settings often do not facilitate a single job providing enough hours and income to support an individual. In terms of public health learnings, addressing these outbreaks require effective contact tracing, multijurisdictional coordination, and for supported living, interventions need to be applied across households sharing staff.
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This paper explores the everyday transport and mobility challenges faced by young women living in one poor peripheral neighborhood of a North African city, Tunis. Discussion spans a two-year period covering conditions prior to and within the COVID-19 pandemic. Using an innovative participatory methodology, young women from the study neighborhood were trained to work as peer researchers in collaboration with the academic team. We examine women’s everyday mobility experiences, with particular reference to safety and the risk-avoidance practices they employ. In the context of the pandemic we then consider the impact of measures such as social distancing, lockdowns, and curfews on women’s travel safety. In the early phases of the pandemic women’s concerns around harassment seem to have been over-ridden by stronger concerns regarding disease contagion but also reflect reduced incidence of harassment due to limits imposed on transport usage and over-crowding. We conclude with reflections regarding the interventions needed for more positive post-pandemic travel scenarios, including priority seating, and boarding for women;expanded transport services into low-income areas;also improved surveillance on transport, at transport hubs and on the streets. © 2022 The Authors. Published by ELSEVIER B.V. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0)
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[Figure: see text].
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The World Health Organization (WHO) declared the novel Coronavirus (SARS-CoV-2;Covid-19) a pandemic on 11 March 2020. Unlike preceding highly contagious diseases that brought the threat of global instability this century, such as SARS-CoV, Zika virus (ZIKV), Swine flu (H1N1), and Avian flu (H5N1), Covid-19, governments across the world introduced strict measures and interruptions to daily life incomparable in living memory. Overnight, countries closed schools, higher education institutions, workplaces and shut down borders – this left people scrambling to adapt, including those implementing peacebuilding interventions. In this unprecedented situation, peacebuilding organisations have worked, responded, and adapted to the new normal. These new dynamics have created both challenges and opportunities for peacebuilding. This article documents the experiences of peacebuilders during the pandemic, making sense of changing conditions, challenges and opportunities they faced. It explores two key questions. How have peacebuilding organisations adapted during COVID-19? Has COVID-19 contributed to the move to local ownership of peacebuilding or localisation? It addresses these questions by engaging with peacebuilding organisations across different geographical regions through an online survey and key informant interviews. The main results focus on localisation, digital adaptation and funding strategy and administration challenges. © The Author(s) 2021.
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S21 Figure 1Daily steps using accelerometry (Actigraph GTX3), at baseline (hospital discharge), 3 months and 6 months for lung transplant recipients assigned to the intervention group (n=5)[Figure omitted. See PDF]ConclusionTele-coaching appears feasible in lung transplant recipients, with patients wearing the pedometer and interacting well with the app over 3 months. This is promising in the current climate, with the need to develop and evaluate innovative ways of supporting patients remotely.
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Background/Case Studies: This study was designed to assess the clinical and analytical performance of the VITROS Immunodiagnostic Products SARS-CoV-2 Antigen assay (VITROS SARS-CoV-2 Antigen) on the VITROS 3600 Immunodiagnostic System and the VITROS 5600/ XT 7600 Integrated Systems. Study Design/Methods: Detection of SARS-CoV-2 nucleocapsid protein in the VITROS SARS-CoV-2 Antigen assay is achieved using monoclonal anti-SARSCoV- 2 nucleocapsid antibodies coated onto the well. Sample is added to the coated well in the first stage of the reaction, and SARS-CoV-2 nucleocapsid antigen from the sample is captured. After washing, HRP conjugated monoclonal anti-SARS-CoV-2 nucleocapsid antibodies are added. Following a final wash, bound HRP conjugates are detected using the VITROS signal reagent. The assay cut-off for VITROS SARS-CoV-2 Antigen is 1.00;values above the cut-off are Reactive for SARS-CoV-2 antigen and values below 1.00 are Non-reactive. All VITROS testing was performed at the Ortho Clinical Diagnostics R&D lab, located in Rochester, NY, USA. RTPCR testing of clinical specimen was performed at an external clinical laboratory. Clinical performance was evaluated using 152 paired nasopharyngeal and nasal specimen that were collected in the United States between September and November 2020. Samples were stored frozen between the time of collection and testing and were from patients suspected of having contracted SARS-CoV-2 within seven days of symptom onset. Data were analyzed to calculate the positive percent agreement (PPA) and negative percent agreement to RT-PCR result. Analytical specificity was assessed by testing patient matrix spiked with inactivated organisms known to cause other respiratory infections. Exogenous compounds with potential to be present in upper respiratory specimen collected from patients suffering from upper respiratory infection were also tested for potential interference with the VITROS assay. Results/Findings: PPA for the VITROS assay in nasopharyngeal specimen was 86.2% overall and 94.8% in samples with RT-PCR cycle threshold (Ct) less than 30. PPA for nasal specimen was 83.1% overall and 92.3% in samples with RT-PCR Ct less than 30. Other respiratory organisms and potentially interfering substances were shown to not impact test results. Conclusions: The VITROS SARS-CoV-2 Antigen assay demonstrates excellent clinical agreement with RT-PCR and can be used as an aid in identifying individuals with active SARS-CoV-2 infection.
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In our tertiary level centre, the oral and maxillofacial (OMFS) rotas often change at short- notice due to service requirements and the development of guidance relating to the COVID-19 pandemic. Consequently, we have developed a novel teaching method for our dental core trainees (DCTs) to accommodate hectic schedules and conflicting availability between junior and senior staff. Here, we describe the innovative teaching approach we have established using case-based discussions via WhatsApp©. Feedback has been excellent. Respondents have stated that the most useful aspect is flexibility to participate in between tasks and across multiple sites, and 87% stated that they use the searchable summaries when managing patients. This teaching method is highly beneficial for OMFS DCTs. It allows flexibility for fluctuating schedules, is interactive, and provides an easily accessible resource whilst on call. We believe that other teams may benefit from the method if scheduling the time for regular didactic teaching is difficult, or they wish to supplement existing practices.