ABSTRACT
This scoping review aims to describe the main barriers to food security imposed by the COVID-19 pandemic in low-income U.S. households, identify effective community-based implementation frameworks and strategies, and discuss the lessons learned from implementing community-based approaches during the COVID-19 pandemic. Most cited barriers were categorized into the Community/Society-Policy category of "Social determinants of health in communities." Out of the twelve included studies, only five (42%) adopted an implementation framework in their food-insecurity interventions. This study can guide the development and sustainability of food programming during emergencies with possible transfer of lessons learned to food programs in low-income populations.Copyright © 2022 Taylor & Francis Group, LLC.
ABSTRACT
Social isolation is associated with increased risk and mortality from many diseases, such as breast cancer. Socially isolated breast cancer survivors have a 43% higher risk of recurrence and a 64% higher risk of breast cancer-specific mortality than socially integrated survivors. Since Covid-19 has dramatically increased the incidence of social isolation, it is important to determine if social isolation affects the response to endocrine therapy and/or recurrence after the therapy is completed. Since previous studies indicate that social isolation increases circulating inflammatory cytokines, we investigated if an anti-inflammatory herbal mixture Jaeumkanghwa-tang (JGT) prevents the adverse effects of social isolation on breast cancer mortality. Estrogen receptor positive mammary tumors were initiated with 7,12-dimethylbenz[a]anthracene. When a rat developed a palpable mammary tumor, it was either socially isolated (SI) by housing it singly or a rat was allowed to remain group-housed (GH). Tamoxifen (340ppm via diet) or tamoxifen + JGT (500ppm via drinking water) started when the first mammary tumor reached a size of 11 mm in diameter. Tamoxifen administration ended when a complete response to this therapy had lasted for 9 weeks (corresponds to 5 years in women). During tamoxifen therapy, social isolation non-significantly reduced the rate of complete responses to 21%, from 31% in GH group (p>0.05). After the therapy was completed, SI significantly increased local mammary tumor recurrence (p<0.001;45% GH vs 75% SI). RNAseq analysis was performed in the mammary glands. Gene set enrichment analysis (GSEA) of transcriptome showed that the increased recurrence risk in socially isolated rats was associated with an enrichment of IL6/JAK/STAT3 signaling: this result was confirmed in the tumors. In addition, oxidative phosphorylation (OXPHOS) pathway was suppressed: the suppressed genes included those involved in mitochondrial pyruvate transport and conversion of pyruvate to acetyl CoA as well as genes in the TCA cycle and mediating electron transport in mitochondrial complexes I-IV. Social isolation also increased the expression of inflammatory receptor for advanced glycation end-products (RAGE) (p≤0.05). Consumption of an anti-inflammatory JGT inhibited IL6/JAK/STAT3 signaling, upregulated OXPHOS signaling and prevented the increased risk of mammary cancer recurrence in socially isolated animals. The percentage of recurrences in the SI rats dropped from 75% without JGT to 22% with JGT (p<0.001). Breast cancer mortality among socially isolated survivors may be most effectively prevented by focusing on the period following endocrine therapy using tools that inhibit IL6/JAK/STAT3 inflammatory cytokine signaling and correct disrupted OXPHOS and mitochondrial dysfunction.
ABSTRACT
There is a growing need for qualified project managers who have skill sets that include leadership, people management, technical and business knowledge. As a result, formal project management (PM) education is increasingly important in many educational institutions. However, the prevailing industry judgment regarding the approaches taken by most institutions is that they are not adequate to meet the needs of the industry due to lack of exposure to "real" situations, lack of critical thinking and not knowing how to properly deal with conflicts. We present a case study of a novel teaching approach that combines face-to-face and/or online interactions in part to adapt to COVID-19 while increasing student employability through six complementary practices. They are a) blended learning environment, b) learn by doing, c) multidisciplinary pedagogical practices, d) continuous improvement, e) integration of teaching and research, and f) delivery by former/current project managers. © Proceedings of the 2021 AIS SIGED International Conference on Information Systems Education and Research.
ABSTRACT
Post-Covid-19, the standard neoliberal model for higher education, particularly in the West, has finally been fundamentally challenged. For those of us who have been tentatively seeking to disrupt and resist this model in academia, explore alternative approaches, methods, and an alternative practice in academia;this global moment seems a great opportunity to openly explore such alternatives. It is in this international and historical context that I offer an exploration of my own variation on the theme of ‘Scholar-Activism’, in the field of International Relations (IR) and, more particularly, the feminist community within that field. As with my recently defended PhD thesis, I will be taking interdisciplinary insights from fields such as education, sociology, anthropology, and political geography, to outline my own approach. Essentially, this approach can be summed up by the following ‘equation’: Scholar-Activism + Self-Care = A Compassionate Higher Education. It is hoped that such an approach may lead to a greater balance between the competing interests of success, productivity, and self-care and wellness. © 2022 selection and editorial matter, Narelle Lemon;individual chapters, the contributors.
ABSTRACT
Background: In attempts to rapidly immunize a greater proportion of the Ontario population against COVID, public health officials recommended extending the interval between vaccine doses and allowed "mixing of vaccine types". The impact of these decisions on the antibody response to the vaccine, particularly in the community dwelling elderly population is unknown. Methods: The STOPCoV study is designed to compare the IgG antibody response to spike protein and receptor binding domain (RBD) after COVID vaccination in those aged ≥ 70 years relative to a cohort aged 30-50 years. This prospective decentralized observational study is conducted remotely on a digital platform (www.stopcov.ca). Participants signed an e-consent, completed questionnaires and will submit dried blood spot (DBS) specimens 6-8 times over 48 weeks after the second vaccine dose. DBS samples were analyzed for IgG antibodies to spike and RBD by an in-house ELISA. We report here the ratio-normalized levels of anti-spike and anti-RBD IgG antibodies prior to and at 2 weeks after the second vaccine with comparisons between age groups. Linear regression models were used to determine the effect of age on the ratio normalized RBD antibody levels 2 weeks post second dose of vaccine after adjusting for potential confounders determined a priori. Results: 1286 persons enrolled between May 17 and July 31, 2021. 1194 participants (853 > 70 years;341 aged 30-50) completed at least one study related task. 761 (64.1%) are female. Most received an mRNA vaccine, with 863 (74%) receiving the same vaccine brand, and 196 (17%) receiving mixed brands over 2 doses. Two weeks after the second vaccine dose, the median interquartile rangeanti-spike antibody level was 0.76 [0.45, 1.16] for those ≥70 compared to 1.3 [0.98, 1.56] for those 30-50 (p<0.001). The median anti-RBD antibody levels were 0.28 [0.15, 0.53] and 0.66 [0.41, 1.08] (p<0.001) for the older and younger cohorts respectively. After adjusting for gender, cardiovascular disease, cancer, diabetes, transplant or immune suppression, body mass index, vaccine brand, and time between doses, participants ≥70 had lower levels of anti-RBD antibodies at 2 weeks after 2nd dose (β=-0.14, 95% confidence interval-0.19,-0.08, p<0.0001). Conclusion: High antibody levels against COVID-19 are attainable after 2 doses of mRNA vaccines. Levels were higher with Moderna than Pfizer. Delay of the second dose to 4 months or mixing of brands had minimal impact on the antibody level but levels are lower in the elderly.
ABSTRACT
Purpose: This paper aims to map key strategic concerns that Commonwealth Caribbean States will face in combating economic crimes and strengthening financial integrity in the post-pandemic era. Design/methodology/approach: Horizon scanning was used to conduct a qualitative policy analysis of key regulatory developments in international anti-money laundering and combating the financing of terrorism (AML/CFTP) and tax governance, from the perspective of Commonwealth Caribbean countries. Findings: This paper finds that the COVID-19 pandemic might widen several fault lines, along the Global North/South axis, in international AML/CFTP and tax regulatory governance. These include the “sustainable development” gap in AML/CFTP norm-making;making the Financial Action Task Force fit-for-purpose;renewed campaigns against “harmful tax competition”;and international commitment to scaling up technical assistance to combat economic crimes in developing countries. It questions the sustainability of the prevailing “levelling the playing field” regulatory approach to AML/CFTP and tax matters and whether serious consideration ought not to be given to mainstreaming “differential treatment” in international AML/CFTP and tax standards, for resource-strapped Caribbean countries. Originality/value: To the best of the author’s knowledge, this paper is the first attempt to assess the strategic policy risks and challenges that will arise from balancing economic recovery and fighting economic crimes by small and vulnerable Commonwealth Caribbean States in the post-pandemic era. © 2021, Emerald Publishing Limited.
ABSTRACT
Introduction: E-cigarette or Vaping Product Use Associated Lung Injury (EVALI) and Coronavirus Disease 2019 (COVID-19) are both relatively new disease processes which can cause acute respiratory failure. This report describes the case of a 17-year-old male with a history of vaping cannabis during the first wave of the COVID-19 pandemic in Michigan. Report: A previously healthy 17-year-old male presented with cough, shortness of breath, chest pain, fever, and hypoxia requiring 40L high flow nasal cannula (HFNC) and 100% FiO2 to maintain oxyhemoglobin saturations of 88%. He showed no tachypnea or retractions, mimicking the “happy hypoxia” reported in COVID-19 patients. His physical exam demonstrated inspiratory crackles and migratory diminished breath sounds. Chest x-ray showed mild peri-bronchial thickening, subtle right perihilar opacities, and hyperexpansion. Bloodwork showed a procalcitonin of 10 nanograms/milliliter, ESR of 10 millimeters/hour, and CRP of 3.5 milligrams/deciliter. Three prior SARS-CoV2 tests were negative, but given clinical suspicion, the patient was treated as a Patient Under Investigation (PUI) for COVID-19 for 48 hours and re-tested. Care was aligned with institutional COVID-19 guidelines to minimize aerosol-generating procedures;diagnostic bronchoscopy, positive pressure ventilation, and transport for chest CT were discouraged, especially as our patient was awake, interactive, and with gradually improving trajectory. Infection prevention guidelines prohibited our patient's parents from leaving his room for a private interview, but friends alerted them to a history of vaping cannabis, which our patient corroborated. He was transitioned towards supportive care for EVALIinduced bronchoconstriction and improved with beta agonists, systemic steroids, and HFNC. After his fourth negative SARS CoV2 test, the patient underwent a high-resolution chest CT, which showed diffuse ground-glass opacities with subpleural sparing. He was discharged after four days with Pediatric Pulmonology follow up. He was counseled against further e-cigarette or cigarette use. Discussion: This case illustrates challenges in the diagnosis of EVALI during the COVID-19 pandemic, particularly among adolescents. Both conditions present with acute respiratory failure absent another source. Both can have significant hypoxia, elevated inflammatory markers, and an ARDS phenotype. Both demonstrate ground-glass opacities on CT scan. Importantly, here are differences in the workup, management, and public health implications of EVALI and COVID-19. Both are reportable to the Department of Public Health and warrant intervention: Anti-vaping campaigns and restriction on access for EVALI, infection control and immunization programs for COVID-19. As the world endeavors to contain the COVID-19 pandemic through surveillance, treatment, and immunization, we also hope to regain momentum against EVALI.
ABSTRACT
BACKGROUND: Bell's palsy is a lower motor neurone facial weakness of unknown aetiology, although reactivation of a virus within the facial nerve has been proposed. METHODS: A prospective study was conducted of Bell's palsy cases presenting to our paediatric ENT unit over a 19-week period, from February to June 2020. Patients were invited for severe acute respiratory syndrome coronavirus-2 antibody testing. A text-message questionnaire was sent to other ENT centres to determine their observational experience. RESULTS: During the study period, 17 children presented with Bell's palsy, compared with only 3 children in the same time period in the previous year (p < 0.0001). Five patients underwent severe acute respiratory syndrome coronavirus-2 antibody testing, the results of which were all negative. Four out of 15 centres questioned perceived an increased incidence in paediatric Bell's palsy. CONCLUSION: Clinicians are encouraged to be vigilant to the increase in paediatric Bell's palsy seen during the coronavirus disease 2019 pandemic, which may represent a post-viral sequela of coronavirus disease 2019.
Subject(s)
Bell Palsy/epidemiology , COVID-19/epidemiology , Bell Palsy/etiology , Bell Palsy/virology , COVID-19/complications , Child , Female , Humans , Incidence , Male , Prospective Studies , Surveys and Questionnaires , United Kingdom/epidemiologyABSTRACT
BACKGROUND: Coronavirus disease 2019 personal protective equipment has been reported to affect communication in healthcare settings. This study sought to identify those challenges experimentally. METHOD: Bamford-Kowal-Bench speech discrimination in noise performance of healthcare workers was tested under simulated background noise conditions from a variety of hospital environments. Candidates were assessed for ability to interpret speech with and without personal protective equipment, with both normal speech and raised voice. RESULTS: There was a significant difference in speech discrimination scores between normal and personal protective equipment wearing subjects in operating theatre simulated background noise levels (70 dB). CONCLUSION: Wearing personal protective equipment can impact communication in healthcare environments. Efforts should be made to remind staff about this burden and to seek alternative communication paradigms, particularly in operating theatre environments.