A Mobile Health Tool for Peer Support of Individuals Reentering Communities After Incarceration.

Individuals just released from prison, or returning citizens (RCs), face high mortality rates during the reentry period, with cardiovascular disease (CVD) being a leading cause. Peer mentors can support RCs' health, but they traditionally work in person, which may not always be feasible, particularly during pandemic outbreaks such as COVID-19. We used human-centered design to build a prototype of RCPeer, a web/mobile application (app) to support peer-led reentry efforts through CVD risk screening, action planning, linkage to resources addressing reintegration needs (e.g., housing, transportation), and goal-setting. We assessed feasibility, acceptability, and usability of RCPeer using mixed-methods. System Usability Scale (SUS) scores were 68 for peers and 66 for RCs, indicating good usability. Qualitative data suggests that RCPeer can support reentry tasks through RCs and peers sharing data, strengthen RC-peer relationships, and facilitate RCs meeting their goals. Future work is needed to enhance usability for RCs with limited technology experience.

Trust in science, social consensus and vaccine confidence.

While scholarly attention to date has focused almost entirely on individual-level drivers of vaccine confidence, we show that macro-level factors play an important role in understanding individual propensity to be confident about vaccination. We analyse data from the 2018 Wellcome Global Monitor survey covering over 120,000 respondents in 126 countries to assess how societal-level trust in science is related to vaccine confidence. In countries with a high aggregate level of trust in science, people are more likely to be confident about vaccination, over and above their individual-level scientific trust. Additionally, we show that societal consensus around trust in science moderates these individual-level and country-level relationships. In countries with a high level of consensus regarding the trustworthiness of science and scientists, the positive correlation between trust in science and vaccine confidence is stronger than it is in comparable countries where the level of social consensus is weaker.

The Origins and Future of Sentinel: An Early-Warning System for Pandemic Preemption and Response.

While investigating a signal of adaptive evolution in humans at the gene LARGE, we encountered an intriguing finding by Dr. Stefan Kunz that the gene plays a critical role in Lassa virus binding and entry. This led us to pursue field work to test our hypothesis that natural selection acting on LARGE-detected in the Yoruba population of Nigeria-conferred resistance to Lassa Fever in some West African populations. As we delved further, we conjectured that the "emerging" nature of recently discovered diseases like Lassa fever is related to a newfound capacity for detection, rather than a novel viral presence, and that humans have in fact been exposed to the viruses that cause such diseases for much longer than previously suspected. Dr. Stefan Kunz's critical efforts not only laid the groundwork for this discovery, but also inspired and catalyzed a series of events that birthed Sentinel, an ambitious and large-scale pandemic prevention effort in West Africa. Sentinel aims to detect and characterize deadly pathogens before they spread across the globe, through implementation of its three fundamental pillars: Detect, Connect, and Empower. More specifically, Sentinel is designed to detect known and novel infections rapidly, connect and share information in real time to identify emerging threats, and empower the public health community to improve pandemic preparedness and response anywhere in the world. We are proud to dedicate this work to Stefan Kunz, and eagerly invite new collaborators, experts, and others to join us in our efforts.

Care and Precision Medicine Research in the Time of COVID-19.

Purpose: Enhancing the bidirectional benefit of precision medicine research infrastructure may advance equity in research participation for diverse groups. This study explores the use of research infrastructure to provide human-centered COVID-19 resources to participants as a part of their research participation. Design: The All of Us New England (AoUNE) consortium research team developed standardized check-in telephone calls to ask participants about their well-being and share COVID-19 resources. Participants: A total of 20,559 participants in the AoUNE consortium received a COVID-19 check-in call. Methods: Research assistants called participants during March-April 2020, distributed COVID-19 resources to interested participants, and subsequently rated call tone. Results: Of the total cohort participants called, 8,512 (41%) spoke with a research team member. The majority of calls were rated as positive or neutral; only 3% rated as negative. African American and Black as well as Hispanic populations requested COVID-19 resources at higher rates than other groups. Conclusions: Calls made to AoUNE participants were received positively by diverse groups. These findings may have implications for participant-centered engagement strategies in precision medicine research.

Functional and dysfunctional fear of COVID-19: a classification scheme.

Worry about COVID-19 is a central topic of research into the social and economic consequences of the COVID-19 pandemic. In this paper, we present a new way of measuring worry about catching COVID-19 that distinguishes between worry as a negative experience that damages people's quality of life (dysfunctional) and worry as an adaptive experience that directs people's attention to potential problems (functional). Drawing on work into fear of crime, our classification divides people into three groups: (1) the unworried, (2) the functionally worried (where worry motivates proactive behaviours that help people to manage their sense of risk) and (3) the dysfunctionally worried (where quality of life is damaged by worry and/or precautionary behaviour). Analysing data from two waves of a longitudinal panel study of over 1000 individuals living in ten cities in England, Scotland and Wales, we find differing levels of negative anxiety, anger, loneliness, unhappiness and life satisfaction for each of the three groups, with the dysfunctionally worried experiencing the most negative outcomes and the functionally worried experiencing less negative outcomes than unworried. We find no difference between groups in compliance and willingness to re-engage in social life. Finally, we show a difference between the dysfunctionally worried compared with functional and unworried groups in perceptions of risk (differentiating between likelihood, control and consequence). This finding informs what sort of content-targeted messaging aimed at reducing dysfunctional worry might wish to promote. We conclude with some thoughts on the applicability of our measurement scheme for future research.

Managing the Return to Football During the COVID-19 Pandemic: A Survey of the Head Team Physicians of the Football Bowl Subdivision Programs.

BACKGROUND: COVID-19 is a severe respiratory virus that spreads via person-to-person contact through respiratory droplets. Since being declared a pandemic in early March 2020, the World Health Organization had yet to release guidelines regarding the return of college or professional sports for the 2020-2021 season. PURPOSE: To survey the head orthopedic surgeons and primary care team physicians for the National Collegiate Athletic Association (NCAA) Football Bowl Subdivision (FBS) football teams so as to gauge the management of common COVID-19 issues for the fall 2020 college football season. STUDY DESIGN: Cross-sectional study. METHODS: The head team orthopaedic surgeons and primary care physicians for all 130 FBS football teams were surveyed regarding their opinions on the management of college football during the COVID-19 pandemic. A total of 30 questions regarding testing, return-to-play protocol, isolating athletes, and other management issues were posed via email survey sent on June 5, 2020. RESULTS: Of the 210 team physicians surveyed, 103 (49%) completed the questionnaire. Overall, 36.9% of respondents felt that it was unsafe for college athletes to return to playing football during fall 2020. While the majority of football programs (96.1%) were testing athletes for COVID-19 as they returned to campus, only 78.6% of programs required athletes to undergo a mandatory quarantine period before resuming involvement in athletic department activities. Of the programs that were quarantining their players upon return to campus, 20% did so for 1 week, 20% for 2 weeks, and 32.9% quarantined their athletes until they had a negative COVID-19 test. CONCLUSION: While US Centers for Disease Control and Prevention guidelines evolve and geographic regions experience a range of COVID-19 infections, determining a universal strategy for return to socialization and participation in sports remains a challenge. The current study highlighted areas of consensus and strong agreement, but the results also demonstrated a need for clarity and consistency in operations, leadership, and guidance for medical professionals in multiple areas as they attempt to safely mitigate risk for college football players amid the COVID-19 pandemic.

COVID-19 and the myth of security

Hamourtziadou and Jackson explore the issue of COVID-19 pandemic and the myth of security. The concept of security is no longer interpreted narrowly - it is no longer understood as security of territory from external aggression, protection of national interests or global security from the threat of a nuclear holocaust. The security of people in their daily lives involves a child that did not die of starvation or through lack of medicine. It is a disease that did not spread, a job that was not cut, a dissident who was not silenced and a right that was not violated. Security is indivisible and universal, applying to the wealthy, to the poor. The United Nations identified the categories of human security including health, personal and community. What the spread of COVID-19 is showing us is that security does not consist of staying safe from invaders alone or in staying alive. Living in fear threatens every aspect of society, every aspect of life when we can't even comfort the dying, our sense of loss. Now, we have to understand that threats do not just exist outside our borders and do not always carry weapons.

The Urgency of Justice in Research: Beyond COVID-19.

The striking imbalance between disease incidence and mortality among minorities across health conditions, including coronavirus disease 2019 (COVID-19) highlights their under-inclusion in research. Here, we propose actions that can be adopted by the biomedical scientific community to address long-standing ethical and scientific barriers to equitable representation of diverse populations in research.

COVID-19: The regional impact of COVID-19 on the certification of vision impairment in Northern Ireland.

PURPOSE: In this paper we highlight the impact which the disruption of secondary care ophthalmic services, resulting from COVID-19, has had on Sight Impairment (SI) and Severe Sight Impairment (SSI) certification in Northern Ireland. METHODS: Regional data on SI and SSI certification in the period after the onset of the lockdown (19 March 2020-18 June 2020) were compared to the period immediately before lockdown (1 January 2020-18 March 2020) and to the same periods in 2019. Change documented was compared to post-lockdown reductions in primary and secondary ophthalmic care activity. RESULTS: In 2019, during the 3-month period (19 March 2019-18 June 2019), 115 individuals were certified as sight impaired (SI 36, SSI 75, unspecified 4). Of those certified, 65 were female, 49 male. Principal causes of certification were: Age-related macular degeneration (AMD) (N = 45), glaucoma (N = 20) and diabetic eye disease (DED) (N = 10). Mean VA, recorded from the better eye of those certified, was 0.96 LogMAR. In the 3 months following the onset of lockdown (19 March 2020-18 June 2020), only 37 individuals were certified (SI 6, SSI 31), 12 female and 25 male. AMD was the most frequent cause of sight impairment (N = 20). There were only two DED certifications and one due to glaucoma. Mean VA in the better eye of those certified was 1.15LogMAR. The numbers of CVI certifications completed following the introduction of COVID-19 lockdown fell by 68%, compared to the 2019 data. There was a significant reduction in the proportion of female certifications (p = 0.01), and in certifications due to glaucoma (p = 0.02). The proportion of those certified as SSI as opposed to SI in the period after the onset of lockdown rose from 68% in 2019 to 84% in 2020. The mean VA of those certified in the period after the onset of lockdown, when compared to those certified in the other three periods, was worse by between 0.21 and 0.19 LogMAR (p = 0.06). Reductions reflected change in overall primary and secondary ophthalmic care activity. CONCLUSIONS: It is inconceivable that COVID-19 has reduced the incidence of sight-threatening eye disease. We must therefore assume that a flood of newly presenting sight loss will present once the pandemic has passed. New presentations will include those who would normally have attended during the lockdown period, and patients who, had they accessed ophthalmic care at the appropriate time, would have been saved from severe levels of blindness. The implications of the predicted increase in demand for medical, social and low vision related services are huge.