Strategies to increase vaccine uptake in pregnant and breastfeeding individuals: a scoping review

Objective: To identify and map strategies to increase vaccine uptake in pregnant and breastfeeding populations with the aim of informing practice and strategies to increase vaccination uptake in this group. Study Design: We conducted a scoping review of the literature wherein we used a comprehensive search algorithm to identify relevant publications indexed in six electronic databases. We included studies that reported on pregnant and breastfeeding individuals, examined an intervention to improve vaccine uptake, and reported outcomes related to change in vaccine attitude, perspective, intention, behaviour, or uptake. Interventions were mapped using a five-level social ecological framework (intrapersonal, interpersonal, institutional, community, and policy level) or as bundled interventions, when strategies targeted multiple levels. Result(s): The search yielded 5458 publications after deduplication, of which 63 were included in the final review. Included studies reported mostly on the uptake of influenza, pertussis, tetanus toxoid and COVID-19 vaccines in 17 high- and middle-income countries. Studies varied in terms of design, sample size, scope and study output (Table 1) and described interventions corresponding to all levels of the social ecological framework (Figure 1). Most studies (33.3%) described using bundled interventions, although intrapersonal (31.7%) and institutional (15.9%) strategies were also widely employed. While the reported uptake (5% to 93%) varied based on comparator group, vaccine type, country and intervention(s), most strategies were deemed effective when implemented in the context of experimental and observational studies. Conclusion(s): The published literature points to several successful strategies for increasing vaccine uptake among pregnant and breastfeeding individuals. Incorporating these strategies into guidelines and protocols could increase the uptake of routinely recommended and new (COVID-19) vaccines in this population. [Formula presented] [Formula presented] Copyright © 2022

Translating Science into Improved Health for All.

Our world is at a turning point with biological and social pathogens wreaking havoc at the same time that science and technology are exploding with new discoveries. It is a pivotal time for the new report Oral Health in America: Advances and Challenges to be released and a pivotal time for our profession to take action and lead. The art, science, and practice of dentistry is very different from 20 y ago when the original Surgeon General's report was released. We are on the precipice of individualized health care where providers will collaborate to deliver diagnostics and therapeutics that are data driven and inclusive of the social determinants of health. To move forward with alacrity requires a strong scientific foundation, effective educational approaches, an understanding of the upstream determinants of health, and partnerships across the health professions and beyond. Oral health has never been more important, and now is the time for our profession to further develop, elevate, and translate the science into practice and policy to improve the nation's health.

"I Teach the way I believe": EFL Teachers' Pedagogical Beliefs in Technology Integration and its Relationship to Students' Motivation and Engagement in the COVID 19 Pandemic Year

This study aimed to investigate language teachers' pedagogical concepts and attitudes and the effect of these on students' motivation and engagement levels. Its results were based on a cross-sectional correlational research survey which was conducted online. The participants in the study were chosen at random from among 205 language teachers (n= 205) and 317 language students (n= 317) from various higher educational institutions in Asian countries. Results of the study of language teachers revealed that the respondents' pedagogical ideas and orientations were positive when it came to using technology-based teaching in their language classroom. Results of gender differences indicated that female language teachers showed a firmer belief in student-centered online language learning than their male counterparts. On the other hand, males are more likely than females to utilize technology in the language classroom, and their attitudes relating to it are more favorable than those of their female counterparts. The levels of language learning motivation and engagement among students were also investigated. The findings also showed a high level of language learning engagement among both male and female students. Furthermore, the test of relationship showed that the firmer the instructors' belief in the importance of student-centered teaching and the incorporation of technology in the language classroom, the more driven and engaged the students are in language learning. Students' motivation and involvement in online language learning are not related to their views about the significance of instructors in their life, which is contrary to what many people believe. When it comes to incorporating technology into language courses, there are several pedagogical assumptions that enable EFL teachers to do so effectively. More broadly stated, this study has implications for increasing language instructors' digital literacy to develop more motivating, productive, and engaging language courses for 21st-century learning to improve language students' digital literacy. © 2021 Society for Research and Knowledge Management. All rights reserved.

Quality of life in the perspectives of teachers in COVID 19 Pandemic Era: Implications for funding allocation for faculty well-being initiatives

People all around the globe have been impacted by the COVID-19 global health crisis, which has led to severe mental and psychological health problems and a weakened overall sense of well-being. However, there is not a lot of information available regarding the effect of COVID-19 on Indian instructors. The objective of this research was to discover if COVID-19 impacts the professional teachers' quality of life (QoL) in India. The descriptive study that included 890 licensed teachers was the respondents of this cross-sectional approach. The primary instrument in this research was the COVID-19 Impact on Quality of Life (COV19-QoL). Statistics used to evaluate the data included descriptive statistics, t-test, and one-way ANOVA to measure the effect of COVID-19 on the QoL of instructors. Results showed that it had a modest impact. COVID-19 impacted QoL differently depending on the program degree. The effect of COVID-19 on the patient's overall quality of life did not vary greatly according to age, sex, marital status, employment status, monthly salary, whether or not they had any COVID-19-related cases near their home, whether or not they knew anyone who had contracted or died from COVID-19, and whether or not they believed they were at risk. Teachers' mental health and quality of life must also be attended to, and supports must be offered to enable them to cope with the ramifications of the COVID-19 pandemic. This research has added to the increasing body of literature on the pandemic's effect, making it an important source of data for future investigations. © 2021 Galenos Publishing House. All rights reserved.

Safe delivery of surgical tracheostomies in COVID-19 patients during the pandemic

Introduction: During the corona virus disease (COVID-19) pandemic frontline units worldwide faced the challenging task of providing highrisk services (like surgical tracheostomy) while safe-guarding the very people performing the high risk procedures. The aim of our study was to assess the incidence of COVID-19 infection among staff involved in surgical tracheostomy on COVID-19 patients Method: A surgical tracheostomy protocol and operation theatre modifications were put in place at our centre, dictated by local resources staff availability and previous tracheostomy experience. Between 26/ 03/2020 and 27/05/2020, staff participating in 71 tracheostomy procedures were sent a questionnaire. The presence of COVID-19 symptoms (new onset continuous cough, fever, loss of taste and/or loss of smell) in tracheostomy staff and patient related data were analysed Result: Among the responders (72/122), compliance with personal prophylaxis equipment use was 100%. Eleven (15%,11/72) reported key COVID-19 symptoms and self-isolated. 10 had a COVID-19 swab test and three tested positive. One staff attended (1/72) hospital for symptomatic treatment, none required hospitalisation. 43/72 staff (60%) underwent a COVID-19 antibody test, 18.6% (8/43) were positive Among the tracheostomised patients, the mean age was 58 years(29- 78) and 65.5% were males. The median time from intubation to ST was 15 days (range 5-33, IQR=9). There were no tracheostomy related deaths and overall mortality was 11%(6/55) Conclusion: Safe delivery of tracheostomy during a pandemic like COVID-19 is possible with strict adherence to personnel protective equipment, surgical protocols and regulation of traffic flow in theatres to mitigate the potential transmission of COVID-19 among surgical staff Take-home Message: Compliance with PPE, adherence to tracheostomy protocol and local modifications can mitigate potential COVID-19 transmission among health care personnel .

A contrasting of the pernicious and the salubrious: An assessment of the global impact of the covid 19 pandemic on technology and information

In this paper, we do an assessment of the global impact of the Covid 19 pandemic on Technology and Information. Technology is assessed through the indicators of Robotics, 3 D printing, Internet of Things (IoT), Artificial intelligence (AI) and Biotechnology. Information is assessed through the indicators of Access/Privacy, Data growth, False news and social media and Knowledge and learning. There has been a heightened interest in Robotics due to public health and labour shortages. In the long term, this could translate into increased replacement of human labour across sectors like agriculture, food and healthcare. The pandemic has stimulated rapid manufacture of medical components through the accelerated adoption of 3D printing technology. Going forward, there is a high probability of an accelerated replacement of traditional manufacturing processes with 3D printing technologies. This is more so in healthcare. IoT usage remains high in the pandemic. Certain sectors have witnessed dramatic increments in quantums of data flows. Going forward, there will be an increased dependence on IoT in everyday use. This will be particularly true for health monitoring and surveillance. The pandemic has seen a massive uptick in the adoption of AI chatbots and other AI applications.In the long term, AI will see increased spending on Research and Development. Adoption timelines will shorten. In hot pursuit of the development of Covid 19 related vaccines and therapeutics, the synthetic biology industry has seen a surge in investment. In the long run, the global competition for leadership in biotechnology will only become more fierce. The pandemic has broadened the use of digital surveillance. Going forward, companies and countries will likely expand digital surveillance. Social and commercial activities have seen digitalisation on a large scale. The future is likely to see a significant shift to an online first culture and an increase in the rate of growth of data volume. The pandemic has facilitated the creation of a fertile environment for fake news. Going ahead, there are heightened prospects of an intensification of the existing geopolitical competition in misinformation. The pandemic has widened the adoption of online learning. Moving ahead, this could have the unfortunate consequence of widening the existing digital divide in society, which in turn could perpetuate inequity. © 2021 Universitatea de Vest Vasile Goldis din Arad. All rights reserved.

An urgent need to review the approach to a febrile child in the COVID-19 era?

Background: There have been reports of a new hyperinflammatory syndrome in children defined as the Paediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS-TS). Our hospital has experienced a great proportion of children attending an Emergency Department (ED) with possible PIMS-TS so far reported in the UK. Objectives: We describe the clinical and biochemical findings in children with possible PIMS-TS in the context of a local ED. Settings: Queen Elizabeth Hospital (QEH), Woolwich, a District General Hospital (DGH) in South London. Participants: From 14th March to 18th May 2020, children presenting to QEH and transferred to tertiary care for possible PIMS-TS, with a history of fever and hyperinflammatory symptoms, raised inflammatory markers and without a clear clinical or microbial cause were identified. Demographic data, clinical and laboratory data were recorded as median [range]. Results: 17 children (12 male) were identified aged 11 [1-16] years. 17/17 had a fever;other common symptoms were conjunctival injection, rash and gastrointestinal symptoms. Lymphopenia and raised inflammatory markers were evident. 15/17 were tested with nasopharyngeal and oropharyngeal SARS-CoV-2 PCR swabs and 15/15 were negative. Before transfer, one child required intubation and four required inotropes. All children were transferred to a tertiary unit, 10 within the first 24 hours. After transfer, 2/17 had microbial causes evident on urine/stool culture. Conclusions: PIMS-TS is proving challenging to diagnose in a DGH ED because of heterogeneity of symptoms and laboratory markers, overlapping with other diseases, and cardiac complications despite deceptively benign presentations. There is an urgent need to review the approach to a febrile child in this setting, to optimise identification of PIMS-TS. Prognostic markers and risk stratification methods would help paediatricians working in the ED and general paediatric wards. © 2021. All Rights Reserved.

Repurposing mefenamic acid in the management of covid-19

With the growing understanding of coronavirus disease-2019 (COVID-19) pathogenesis, different therapeutic targets are being considered for the management of COVID-19. The development of new drugs is a time-consuming process;hence, many drugs acting on similar therapeutic targets/sites in the COVID-19 treatment are repurposed in COVID-19. In this article, an expert panel deliberated on the existing evidence on the immunopathogenesis, therapeutic targets under consideration for treatment of COVID-19, and the place of mefenamic acid in the therapy landscape of COVID-19. The expert panel has also provided recommendations regarding the dose and regimen of mefenamic acid in different phases of the COVID-19 disease.

Cutaneous manifestations in paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome-coronavirus 2 infection

Paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection (PIMS-TS) has been defined by the Royal College of Paediatrics and Child Health as 'a child presenting with persistent fever, inflammation and evidence of single or multi-organ dysfunction' (https://www.rcpch.ac.uk/resources/guidance-paediatric-multisystem-inflammatory-synd rome-temporally-associated-covid-19-pims). We describe the skin manifestations in 17 paediatric patients presenting from 14 March to 18 May 2020 to a single institution with features of PIMS-TS. Common presenting symptoms in these 17 children included fever, rash and gastrointestinal symptoms. Less common presentations included cough, epistaxis, arthralgia, headache and respiratory symptoms and were only present in one patient. Median age at presentation was 11 years (range 1-16), and the male-to-female ratio was 1.8 : 1.The majority of patients were black, Asian and minority ethnic (BAME);nine were of Afro-Caribbean descent, three were white, two were Turkish, one was Albanian, one was Indian and one was Hispanic. Within this group, nine (53%) presented with a skin rash, eight (47%) with conjunctival involvement and three (18%) with cheilitis. The time of onset of cutaneous disease was variable, but most patients presented with a rash at admission or within a few days of admission. The rash was polymorphous, but the most common skin presentations were a maculopapular eruption and fixed urticaria, particularly on the trunk and limbs. In addition, acral presentations were seen with erythematous oedematous ears and fingers. The but it may represent an antibody or immune complexmediated postinfectious inflammatory syndrome (Verdoni L, Mazza A, Gervasoni A et al. An outbreak of a severe Kawasaki -like disease at the Italian epicentre of the SARS CoV-2 epidemic: an observational cohort study. Lancet 2020;Epub ahead of print). As dermatologists collate databases of images and histopathology of skin disease with this new virus, SARS-CoV-2, a clearer picture of the pathophysiology of this disease should emerge. We propose that in any child presenting with persistent fever, rash and evidence of systemic inflammation, PIMS-TS should be considered, and urgent specialist referral sought, in light of the serious cardiac complications that may arise. Further investigation is needed into the apparent higher rate of PIMS-TS in BAME children and the association with SARS-CoV-2 infection.

Pregnancy and COVID-19: pharmacologic considerations.

In this review, we summarize evidence regarding the use of routine and investigational pharmacologic interventions for pregnant and lactating patients with coronavirus disease 2019 (COVID-19). Antenatal corticosteroids may be used routinely for fetal lung maturation between 24 and 34 weeks' gestation, but decisions in those with critical illness and those < 24 or > 34 weeks' gestation should be made on a case-by-case basis. Magnesium sulfate may be used for seizure prophylaxis and fetal neuroprotection, albeit cautiously in those with hypoxia and renal compromise. There are no contraindications to using low-dose aspirin to prevent placenta-mediated pregnancy complications when indicated. An algorithm for thromboprophylaxis in pregnant patients with COVID-19 is presented, which considers disease severity, timing of delivery in relation to disease onset, inpatient vs outpatient status, underlying comorbidities and contraindications to the use of anticoagulation. Nitrous oxide may be administered for labor analgesia while using appropriate personal protective equipment. Intravenous remifentanil patient-controlled analgesia should be used with caution in patients with respiratory depression. Liberal use of neuraxial labor analgesia may reduce the need for emergency general anesthesia which results in aerosolization. Short courses of non-steroidal anti-inflammatory drugs can be administered for postpartum analgesia, but opioids should be used with caution due to the risk of respiratory depression. For mechanically ventilated pregnant patients, neuromuscular blockade should be used for the shortest duration possible and reversal agents should be available on hand if delivery is imminent. To date, dexamethasone is the only proven and recommended experimental treatment for pregnant patients with COVID-19 who are mechanically ventilated or who require supplemental oxygen. Although hydroxycholoroquine, lopinavir/ritonavir and remdesivir may be used during pregnancy and lactation within the context of clinical trials, data from non-pregnant populations have not shown benefit. The role of monoclonal antibodies (tocilizumab), immunomodulators (tacrolimus), interferon, inhaled nitric oxide and convalescent plasma in pregnancy and lactation needs further evaluation. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Effective usage of gamification techniques to boost student engagement

As the engineering education fraternity is getting accustomed to the new normal amidst the global COVID- 19 pandemic, online teaching has been gaining much attention in the recent past. While teachers are getting adjusted to this new way of teaching, it is paramount that the teaching-learning process caters to the needs of our millennial learners. Considering all these factors, the teacher must continuously work towards always keeping the students motivated. The authors of this paper brought in a series of innovative gamification constructs throughout a semester across multiple courses to gauge the level of involvement of students during the online lectures as well as the Learning Management System (LMS). The motive was the ensure that the students actively participate in all deliberations, thereby positively impacting the online learning process. The participants of the study were 56 second year Post Graduate students who were undergoing online classes. Several tasks, as well as assessments, were assigned to the students. While doing so, students were introduced to new gamification tools like Mentimeter, Edpuzzle, Kahoot, Quizizz and many more at regular intervals to break the monotony and keep them on their feet waiting for the next task to be performed. This not only meant that the students started participating in the classes more actively but also kept them engaged with a variety of innovative tools. The results clearly showed that the students started learning the concepts better while keeping competitive spirits. When it came to individual activities, there was an urge in students to outperform each other, which meant that the students would go that extra mile to get the things done. At the same time, team tasks had a high level of collaboration resulting in effective learning and building camaraderie. The students prefer learning through multiple sources and multiple platforms. By leveraging technological advancements and bringing in gamification in learning, the overall teaching-learning process gets highly benefited. © 2021, Rajarambapu Institute Of Technology. All rights reserved.