When Right-Wing Populism Becomes Distorted Public Health Communication: Tracing the Roots of Jair Bolsonaro's Epidemiological Denialism

This article delineates key links between right-wing populism and epidemiological denialism. Building on a comparative analysis of central tropes from Brazilian president Jair Bolsonaro's 2018 campaign and his public-facing response to the COVID-19 pandemic, we argue that his engagement during both periods employs two key elements of right-wing populism: Antielitism, or the view that the political establishment is irredeemably disconnected from the citizenry, and anti-pluralism, or the blaming of political and social problems on scapegoat populations. During the COVID-19 outbreak, this denigration of public trust fuels denialism or the systemic attempt to downplay severity to minimize public response. Developing a thematic analysis around Bolsonaro's speeches, interviews, and personal social media, we address how anti-elitist and anti-pluralist strategies from the 2018 campaign inform the pandemic response. These include the discrediting of governmental bodies, the villainization of progressive activists, and the assignation of blame on foreign actors. Our goal is to provide an in-depth case study of how communication bolstering epidemiological denialism is propagated-an increasingly vital conversation as right-wing populism and health misinformation proliferate.

The Nox A1 ambulatory system is reliable when self-applied

Background Home Sleep Apnea Tests (HSAT) increases access to SDB diagnostic testing (Safadi, 2014). A previous study defined a reliable HSAT if: ≥4hours total recording time, an intelligible position signal and respiratory effort, airflow and oximetry for at least 80% of the night were recorded, however, admits no standardized criteria in the literature (Domingo, 2010). Aim To test the reliability of a self-applied HSAT using the Nox-A1 ambulatory system (NOX Medical, Iceland). Method Patients self-applied the HSAT guided by industry produced video and written instructions. Signals for the HSAT included;two electro-occulagrams (EOG), two sub-mental electromyograms (EMG), a single modified frontal encephalogram (EEG), a lead I ECG, single leg anterior tibialis EMG, chest and abdominal inductance respiratory effort, nasal pressure airflow, WristOx 2 3150 SpO2 (Nonin Medical, Inc., USA) and 3-D accelerometer and body position sensor. Analysed with ProFusion PSG 4 (Compumedics Limited, Australia) after importing data into Nexus. 33 consecutive studies were recorded during lock-down. Recording satisfactory if SpO2 signal and EEG present >80% of study, it was considered a failure if doctor requested test repeat. Results 33 subjects, age 43.1 ± 13.7 years, BMI 27.4 ± 6.0 kg/m2, 66.6% male. 81.8% of studies satisfactory. 6% of studies needed a repeat in-lab PSG due to 1) loss of oximetry & EEG and 2) loss of EEG Discussion 6% doctor request repeat in-lab PSG is comparable to a study (Lloberes, 2001) of partially self-applied HSAT. Demonstrated good reliability with this self-applied COVID-safe method of HSAT.

Online Conversations for Equity, Action, and Networking: A Pilot Project Highlighting Diversity in the Ocean Sciences

The onset of the COVID-19 pandemic and the Black Lives Matter movement urged institutions to redress shortcomings in their diversity, equity, and inclusion goals and initiatives. The School for the Environment (SFE) at the University of Massachusetts Boston (UMass Boston), a public research minority serving university in the United States of America, responded to this call through launching the Online Conversations for Equity, Action, and Networking (OCEAN) program. This pilot project funded by Woods Hole Sea Grant aimed to amplify the voices of Black, Indigenous, and People of Color (BIPOC) in the marine sciences. A collective of SFE undergraduate and graduate students hosted virtual department seminars, undergraduate meet and greets, and podcast interviews for invited BIPOC speakers. Pre- and post-surveys were developed to evaluate the efficacy and reach of the OCEAN programming and the results indicate that the program had an overall positive effect on the UMass Boston community. Ultimately, the OCEAN program provides an example for launching and evaluating virtual BIPOC science engagement and outreach initiatives. © 2023 Association for the Sciences of Limnology and Oceangraphy.

If you build it, will they come? Is test site availability a root cause of geographic disparities in COVID-19 testing?

OBJECTIVES: The purpose of this study was to examine the relationship between test site availability and testing rate within the context of social determinants of health. STUDY DESIGN: A retrospective ecological investigation was conducted using statewide COVID-19 testing data between March 2020 and December 2021. METHODS: Ordinary least squares and geographically weighted regression were used to estimate state and ZIP code level associations between testing rate and testing sites per capita, adjusting for neighbourhood-level confounders. RESULTS: The findings indicate that site availability is positively associated with the ZIP code level testing rate and that this association is amplified in communities of greater economic deprivation. In addition, economic deprivation is a key factor for consideration when examining ethnic differences in testing in medically underserved states. CONCLUSION: The study findings could be used to guide the delivery of testing facilities in resource-constrained states.

Nurse-patient communication on the south Texas border: Negotiating language and cultural discordance during the COVID-19 pandemic

Throughout the COVID-19 pandemic, medical professionals have experienced unforeseen and often under-discussed hurdles to meeting the surging demand for patient care. In particular, practitioners in under-resourced areas have faced enormous barriers when attempting to adequately address the swell in demand. Analyzing these tensions through the growing body of literature on patient communication during the COVID-19 pandemic, this article centers the work experiences of registered nurses serving on the frontlines of the South Texas-Mexico border of Laredo, Texas. Using a qualitative method of semi-structured and in-depth interviews with nurses working inside two COVID-19 hospital units, our thematic analysis reveals the work challenges generated by language discordance and cultural differences experienced between travel nurses, patients, and their families. Our findings further exposed the added workload and work strain generated from the language and cultural barriers experienced by local bilingual nurses, tracking how during a global pandemic such barriers place material strain on nurses' workload.

The evolving role of social determinants of health to advance health equity

Efforts are steadily increasing to address social determinants of health (SDH) within healthcare delivery systems. Policies and practices in nonhealth sectors impact health and health equity. Therefore, the crux of health policies and interventions is a clear and accurate understanding of how and why the social determinants differentially impact health, healthcare, and health outcomes. The fundamental drivers of health inequities are the fundamental drivers of social inequities. The concept that health and health inequities are driven by social determinants is increasingly the focus of nursing articles, conferences, courses, vision statements, toolkits, research, and scholarly projects. Addressing social conditions that impact health is not new to nursing but, an upstream perspective that focuses on (1) systems and structures, (2) policy and politics, (3) historical drivers of disparities, and (4) structural racism as a root cause of health inequities is new. Historical and contemporary policies have created the structures that shape the SDH and have profound and enduring effects on our patients' health, healthcare, and health outcomes. Nurses can lead social change but only with a clear understanding of SDH and its evolving role in advancing health equity. © 2022 Elsevier Inc. All rights reserved.

Surfacing Inequities and Their Broader Implications in the CS Education Research Community

Problem. Diversity, equity, and inclusion (DEI) need to be embedded throughout the computer science education (CSEd) research community in order to achieve empirically-based strategies in CSEd that is responsive to the needs of all of its constituents. However, there are no comprehensive studies that investigate what the barriers and challenges to DEI are among CSEd researchers. Research Question. When considering DEI among the CSEd research community, what barriers and challenges do different CSEd researchers face when conducting research? Method. We conducted a systematic literature review, developed a survey from the literature, and analyzed the quantitative and qualitative data from participants (n=72). Findings. Beyond finding that over half of the participants reported the COVID-19 pandemic as a barrier to engaging in research, participants reported that working more than an average 40-hour work week each year was a challenge. The lack of computing education being recognized as a subdiscipline within CS departments also was a barrier. Participants also reported that a lack of 1) awareness and adoption of practices from other education research fields and 2) general educational research theory were significant challenges for the CSEd research field. With respect to DEI, participants noted that lack of diversity among CSEd research partners/collaborators, among CSEd researchers in the community and among CSEd research community leadership are challenges for the community. Implications. Employing cultural competence is integral to CSEd research as we, as a community, inherently navigate differences in identities among researchers, and between researchers, practitioners, and participants in the currently unrepresentative and inequitable state of our field. As we grow our attitude, awareness, knowledge, and skill in cultural competence, we produce better-equipped allies, and greater resilience and belonging among community members from historically marginalized groups. We urge the community and relevant stakeholders to understand how to remove the barriers and challenges identified in our study. © 2022 ACM.

Creating Relevant Extended Reality Field Clinical Experiences for Teacher Candidates in the COVID Era: Best Practices for Educator Preparation Programs Working With English Language Learners

Creating authentic and relevant field clinical experiences for teacher candidates is an essential foundational component of an effective educator preparation program (EPP). It is through these classroom interactions that teacher candidates gain meaningful insight into the day-to-day processes that accompany. Once remote instruction began due to COVID, field clinical and internship placements were immediately suspended leaving faculty in EPPs having to turn to virtual alternatives to complete course hours and key assignment requirements. These changes included the introduction of virtual learning modalities and venues such as tutorials, webinars, and even faculty and alumni-generated online learning series to compensate for the lack of contact hours. This work explores how the virtualfocused clinical experiences were conceptualized in addition to a qualitative analysis of teacher candidate self-efficacy as well as academic performance evaluated using a specially designed metric-based rubric emphasizing the transition from face-to-face to the virtual venue of clinical practice.

TREATMENT OF HYPERGLYCAEMIA IN ACUTE STROKE: RESULTS FROM THE TRIAL OF EXENATIDE IN ACUTE ISCHAEMIC STROKE (TEXAIS)

Background and aims: Hyperglycaemia in acute ischaemic stroke (AIS) is common, reduces the efficacy of stroke thrombolysis and thrombectomy, with worse clinical outcomes. Insulin therapies are difficult to implement and maintain, and may cause symptomatic hypoglycaemia. An alternative treatment is Exenatide, a GLP-1 agonist that lowers blood glucose with a very low risk of hypoglycaemia. Methods: The Trial of Exenatide in Acute Ischaemic Stroke (TEXAIS) enrolled adult patients with AIS ≤9 hours of stroke onset to receive treatment with short-acting Exenatide (5μg bid subcutaneous injection) or Standard care for 5 days, or until hospital discharge (whichever sooner).Primary outcome: proportion of patients with ≥8 point improvement in NIHSS score (or NIHSS 0-1) at 7 days. Results: 350 patients randomised, median age 71 years (IQR 62, 79), and median NIHSS 4 (IQR 2, 8). Planned recruitment (n=528) stopped early due to Covid and time constraints. On Admission the median blood glucose was 6.7 (IQR 5.70, 8.50), and 42% patients had hyperglycaemia (>7.0 mmol/L). Primary outcome occurred in 97/171 (56.7%) in Standard care group vs 104/170 (61.2%) in Exenatide group [aOR: 1.22 (CI 0.79, 1.88) p=0.38]. Mean daily per-patient frequency of hyperglycaemia was significantly less in the Exenatide group (p=0.002). No episodes of hypoglycaemia reported over the treatment period. Nausea/vomiting occurred in 7/174 (4.0%) patients on Exenatide. Conclusions: In this Phase 2 trial Exenatide did not significantly reduce neurological disability at 7 days. Exenatide significantly reduced frequency of hyperglycaemic events, and was safe to use. These results warrant further investigation with larger Phase 3 trials.

Mental Health of People with Difficult to Treat Asthma in a Large National Population Survey

Rationale Difficult to treat asthma (DTTA) is asthma that is uncontrolled despite medium/high ICSLABA treatment and/or maintenance oral corticosteroids (OCS);severe asthma is a subset. Previous research suggests that anxiety and depression are common among patients with severe asthma;these may impact asthma control and quality of life. Screening for anxiety and depression has been recommended, followed by appropriate psychiatrist/psychologist referral. However, little is known about whether the mental health support needs of people with DTTA are being met, and any attributable health service utilisation. The aims of this study were to explore mental health issues, and healthcare utilization, in people with DTTA within a nationally-representative population of people with a diagnosis of asthma.Methods The DTTA Survey was a cross-sectional survey in February-March 2021 of 5457 participants aged ≥18 years with current asthma, randomly selected from a large web-based survey panel of adult Australians. All survey participants answered demographic questions and questions regarding asthma symptoms, medications and health service use, with additional questions for those with DTTA. DTTA was identified based on ERS/ATS criteria.Mental status was assessed via reported comorbidities, mental health referrals and treatment, and the Hospital Anxiety and Depression Scale (HADS) which assesses feelings in the previous week. The Consultation and Relational Empathy (CARE) measure was also used to gauge participants' perceptions about the consultation process with their general practitioner.Results 1170 (21.4%) of participants had DTTA. Of these 56.8% (664/1170) were female (Table). The proportions of DTTA participants who reported being told by a doctor/nurse that they had anxiety or depression, and selected “have at present” for these diagnoses, were 35.9% and 28.9% respectively;21.8% indicated both. However, by HADS, 63.4% self-reported current anxiety symptoms and 39.9% current depression symptoms. 50% reported feeling more anxious about their asthma due to COVID19. Overall, 47.9% of those with DTTA (561/1170) reported treatment for anxiety or depression in the previous year. Treatments included medication (72.7%);Cognitive Behavioural Therapy (42.8%);and mindfulness training (23.9%). Concerning mental health support, 611 participants (52.2%) had consulted with a psychologist or counsellor in last 5 years;38.8% of those visits were within the previous 3 months. Over half these consultations (52.5%) were initiated by the participant, and 33.6% by the GP. Conclusion The findings from this representative population survey provide insights regarding prevalence and management of anxiety and depression among people with DTTA, and may assist clinicians in supporting their mental health needs. (Table Presented).

Global patterns of daily CO2 emissions reductions in the first year of COVID-19

Observed daily changes in CO2 emissions from across the globe reveal the sectors and countries where pandemic-related emissions declines were most pronounced in 2020. Day-to-day changes in CO2 emissions from human activities, in particular fossil-fuel combustion and cement production, reflect a complex balance of influences from seasonality, working days, weather and, most recently, the COVID-19 pandemic. Here, we provide a daily CO2 emissions dataset for the whole year of 2020, calculated from inventory and near-real-time activity data. We find a global reduction of 6.3% (2,232 MtCO(2)) in CO2 emissions compared with 2019. The drop in daily emissions during the first part of the year resulted from reduced global economic activity due to the pandemic lockdowns, including a large decrease in emissions from the transportation sector. However, daily CO2 emissions gradually recovered towards 2019 levels from late April with the partial reopening of economic activity. Subsequent waves of lockdowns in late 2020 continued to cause smaller CO2 reductions, primarily in western countries. The extraordinary fall in emissions during 2020 is similar in magnitude to the sustained annual emissions reductions necessary to limit global warming at 1.5 degrees C. This underscores the magnitude and speed at which the energy transition needs to advance.

Influenza - prevention is better than cure

Influenza, caused by influenza A or influenza B viruses, is usually a self-limiting disease in healthy patients but is associated with increased morbidity and mortality in high-risk groups and can result in more than 11 000 deaths annually in South Africa. Non-pharmacological prevention measures reduce the spread of infection, and the incidence of influenza was reduced following the implementation of these measures in 2020 to prevent the spread of coronavirus infections. Influenza vaccination is currently the most effective method to prevent and control influenza infection. It is, on average, around 59% effective depending on the patient's age, comorbidities and accuracy of the strains predicted for the season. Treatment for mild influenza focuses on the management of symptoms. Patients at high risk for severe and/or complicated disease should be treated for five days with antivirals (oseltamivir or zanamivir), preferably within 48 hours of onset of symptoms. © Medpharm

Influenza – prevention is better than cure

Influenza, caused by influenza A or influenza B viruses, is usually a self-limiting disease in healthy patients but is associated with increased morbidity and mortality in high-risk groups and can result in more than 11 000 deaths annually in South Africa. Nonpharmacological prevention measures reduce the spread of infection, and the incidence of influenza was reduced following the implementation of these measures in 2020 to prevent the spread of coronavirus infections. Influenza vaccination is currently the most effective method to prevent and control influenza infection. It is, on average, around 59% effective depending on the patient’s age comorbidities and accuracy of the strains predicted for the season. Treatment for mild influenza focuses on the managemen of symptoms. Patients at high risk for severe and/or complicated disease should be treated for five days with antivirals (oseltamivir or zanamivir), preferably within 48 hours of onset of symptoms.

The Pandemic-Resilient Office Tower

This paper examines architectural design strategies to create a “Pandemic-Resilient Office Tower.” In addition to incorporating a suite of measures to impede the spread of disease, the design’s defining feature is its ability to flex between normal and health-crisis modes. The building’s operation is optimized for both of these conditions, and will seek to anticipate unknown stressors. A proposed Class-A office building in Manhattan’s Hudson Yards that features this approach is analyzed, including qualitative and quantitative considerations. Building entrance sequence, lobby layout, vertical circulation, core design, wellness, and productivity aspects are considered, lessons learned and insights for further research are shared, and larger questions relating to a resilient design ethos and its lessons for both health and climate crises are explored. © 2020, Council on Tall Buildings and Urban Habitat. All rights reserved.

Global fossil carbon emissions rebound near pre-COVID-19 levels

Fossil CO2 emissions in 2021 grew an estimated 4.2% (3.5%–4.8%) to 36.2 billion metric tons compared with 2020, pushing global emissions back close to 2019 levels (36.7 Gt CO2).