Young people with complex emerging mental health problems: Packages of care and peri-pandemic experiences

The PRODIGY trial found that for young people with complex emerging mental health problems in the UK (N = 270), Social Recovery Therapy did not confer additional benefits above and beyond treatment as usual. Treatment as usual in the trial was, however, surprisingly comprehensive. A study was conducted to evaluate the provision of 'packages' of standard youth mental health care, and the association of provision with trial outcomes. In a subsequent study individuals who participated in the PRODIGY trial (N = 13) were interviewed about their experiences during the COVID-19 pandemic. The restrictions imposed by the COVID-19 pandemic have had significant and wide-ranging impacts on young people due to social isolation, disruption to education and employment opportunities, and young people with pre-existing mental health difficulties were considered to have been disproportionality affected. The results of this study indicated a reciprocal relationship between participants' mental health and their response to the pandemic. Participants told stories of both how the pandemic exacerbated their difficulties, but equally told stories of how their long-standing experiences of managing adversity supported them to cope during pandemic-related social restrictions.

Coronavirus Measures: Physical Distancing, Wayfinding, and New Spatial Orientations

In this creative mediation we explore measures of the coronavirus pandemic—unfolded through the seemingly simple act of ‘physical distancing’—to show the myriad of mobility, wayfinding, and spatial orientations that shape the socio-material fabric of collective life. Physical distancing has mandated new measures of how people orient their body amongst other bodies in public space. In-situ measurements of spatial and affective registers attempt to alleviate possible contagions while adhering to health advice. The importance of measurement and the practice of measuring has never been as obvious and integral to daily life. However, the notions of measure—how one feels, moves, acts, thinks, and reflects—have been long imbued in the governance of collective goals, practices, and action. We highlight performative, sensory, and aesthetic responses to these new measures, suggesting these individualised performances of measure should be indicative of the sensory shifts required to tackle possible future crises and changes. © Copyright 2021 by American Association of Geographers.

MetaMap versus BERT models with explainable active learning: Ontology-based experiments with prior knowledge for COVID-19

Emergence of the Coronavirus 2019 Disease has highlighted further the need for timely support for clinicians as they manage severely ill patients. We combine Semantic Web technologies with Deep Learning for Natural Language Processing with the aim of converting human-readable best evidence/ practice for COVID-19 into that which is computer-interpretable. We present the results of experiments with 1212 clinical ideas (medical terms and expressions) from two UK national healthcare services specialty guides for COVID-19 and three versions of two BMJ Best Practice documents for COVID-19. The paper seeks to recognise and categorise clinical ideas, performing a Named Entity Recognition (NER) task, with an ontology providing extra terms as context and describing the intended meaning of categories understandable by clinicians. The paper investigates: 1) the performance of classical NER using MetaMap versus NER with fine-tuned BERT models;2) the integration of both NER approaches using a lightweight ontology developed in close collaboration with senior doctors;and 3) the easy interpretation by junior doctors of the main classes from the ontology once populated with NER results. We report the NER performance and the observed agreement for human audits. Copyright © 2022 for this paper by its authors.

Africa trade and Covid-19: the supply chain dimension

The economic crisis generated by the COVID-19 pandemic is likely to be the deepest since records began. In Africa, trade volumes are projected to decrease by 8% for exports and about 16% for imports for 2020, compared with previous historic trend estimates (WTO, 2020a). Managing the pandemic has generated a unique blow to the world economy, simultaneously affecting supply, demand and trade. Supply has been affected directly through the suspension of operation of economic units across multiple activities. The lockdowns have directly affected many services, such as hospitality and retail services, with a knock-on effect on their domestic and foreign suppliers. In addition, restrictions applied on the movement of people and goods represent a huge hit to activities such as tourism and transportation. The fall in commodity prices constitutes a significant blow to the trade and macroeconomic situation of many African countries that rely on few agricultural and mineral commodities. Meanwhile, the anticipated massive fall in income from tourism is going to hit many other countries that rely on tourism. Trade is also being affected, as COVID-19 is increasing international trade costs through additional inspections, reduced hours of operation, road and border closures and increased transport costs. Africa is primarily involved upstream, providing intermediate products and services to a wide range of global supply chains. African exports, including their value added, are therefore being affected simultaneously by the impact on direct exports but also by the impact on exports between third countries. Europe (the EU and the UK) appears to be particularly important in the integration of African firms into global supply chains. More than 60% of African value added in global exports is embedded in European production. This value added embedded in part directly in exports to Europe but also indirectly in the exports of third countries to Europe. In order to recover and build resilience in the medium to long term, African economies should maintain momentum and ambition on the landmark African Continental Free Trade Area (AfCFTA) Agreement. A rapid and ambitious implementation of the AfCFTA will help the recovery from Covid-19 impacts, while reducing Africa's exposure to future adverse effects of global shocks related to health, food supply and climate change, and more regional shocks such as the locust crisis in East Africa. The pandemic has highlighted that a robust supplier management system that takes into account sub-tier dependencies and proximity is a prerequisite for today's supply chain, and in turn has underlined the need to use the AfCFTA as a springboard for developing Africa's industrial base. The delay to the start of trading offers a window of opportunity for creative thinking on how to reconfigure the AfCFTA to reflect the new realities and risks of the twenty-first century. The health sector needs to be elevated as the heart of the AfCFTA Agreement and prioritised in the initial stages of implementation. Pharmaceutical and medical products should not be included on the sensitive item or exclusion lists of state parties' tariff schedules and should be prioritised in the finalisation of rules of origin and harmonisation of standards. Member states should also consider adding health and education services to the priority list of services sectors for the first round of services negotiations, and revisiting the AfCFTA built-in agenda to introduce a new ambitious work programme of simultaneous negotiations on Phase 2 issues (intellectual property rights, investment and competition policy) and Phase 3 issues (e-commerce) in 2021-2022. In addition to developing more regional value chains, African countries need to protect the position they have achieved in existing global value chains. The implementation of the AfCFTA is instrumental to this goal but insufficient. While investment has been substantially affected, African countries must assure that it is oriented to the sectors with the highest impacts in terms of competitive

Named Entity Recognition and Relation Extraction for COVID-19: Explainable Active Learning with Word2vec Embeddings and Transformer-Based BERT Models

Deep learning for natural language processing acquires dense vector representations for n-grams from large-scale unstructured corpora. Converting static embeddings of n-grams into a dataset of interlinked concepts with explicit contextual semantic dependencies provides the foundation to acquire reusable knowledge. However, the validation of this knowledge requires cross-checking with ground-truths that may be unavailable in an actionable or computable form. This paper presents a novel approach from the new field of explainable active learning that combines methods for learning static embeddings (word2vec models) with methods for learning dynamic contextual embeddings (transformer-based BERT models). We created a dataset for named entity recognition (NER) and relation extraction (REX) for the Coronavirus Disease 2019 (COVID-19). The COVID-19 dataset has 2,212 associations captured by 11 word2vec models with additional examples of use from the biomedical literature. We propose interpreting the NER and REX tasks for COVID-19 as Question Answering (QA) incorporating general medical knowledge within the question, e.g. “does ‘cough’ (n-gram) belong to ‘clinical presentation/symptoms’ for COVID-19?”. We evaluated biomedical-specific pre-trained language models (BioBERT, SciBERT, ClinicalBERT, BlueBERT, and PubMedBERT) versus general-domain pre-trained language models (BERT, and RoBERTa) for transfer learning with COVID-19 dataset, i.e. task-specific fine-tuning considering NER as a sequence-level task. Using 2,060 QA for training (associations from 10 word2vec models) and 152 QA for validation (associations from 1 word2vec model), BERT obtained an F-measure of 87.38%, with precision = 93.75% and recall = 81.82%. SciBERT achieved the highest F-measure of 94.34%, with precision = 98.04% and recall = 90.91%. © 2021, Springer Nature Switzerland AG.

Alleviating debt distress and advancing the sustainable development goals

External debt levels will be unprecedented in 2021—in this last decade of action to secure the sustainable development goals (SDGs)—and mostly in distress for low-income-developing countries (LIDC) and least developed countries (LDCs). However, increased levels of debt distress were on the horizon even before the dire economic effects of COVID-19. These high levels of external debt and a decreasing inability to access international capital were already expected to impede the advancement of the SDGs;the situation has become far graver because of the Great Lockdown and efforts to stymie transmission of COVID-19. The international community faces perhaps its greatest challenge: it must alleviate poor countries debt burdens exacerbated by COVID-19 to effectively combat its spread, but there is no consensus as to how to achieve this. Though there is no historical parallel to the current debt crisis, the heavily indebted poor country initiative (HIPC) suggests debt relief alone will be insufficient to keep the SDGs on track. While the challenges that arise with regards to the scaling up of debt swap initiatives—learned from previous efforts—are formidable, this article provides critical reflection as to their effective operationalization within the current context: responding to the economic and social devastation wrought by COVID-19 and keeping the SDGs on track. It shows how debt swaps can be effectively deployed as part of a revitalized global partnership for development, for the advancement of the SDGs and broader debt sustainability. © 2021 The Authors. Sustainable Development published by ERP Environment and John Wiley & Sons Ltd.

Containment of procedure-associated aerosols by an extractor tent: effect on nebulized drug particle dispersal.

BACKGROUND: Several medical procedures involving the respiratory tract are considered as 'aerosol-generating procedures'. Aerosols from these procedures may be inhaled by bystanders, and there are consequent concerns regarding the transmission of infection or, specific to nebulized therapy, secondary drug exposure. AIM: To assess the efficacy of a proprietary high-efficiency-particulate-air-filtering extractor tent on reducing the aerosol dispersal of nebulized bronchodilator drugs. METHODS: The study was conducted in an unoccupied outpatient room at St. James's Hospital, Dublin, Ireland. A novel real-time, fluorescent particle counter, the Wideband Integrated Bioaerosol Sensor (WIBS), monitored room air continuously for 3 h. Baseline airborne particle count and count during nebulization of bronchodilator drug solutions were recorded. FINDINGS: Nebulization within the tent prevented any increase over background level. Nebulization directly into room air resulted in mean fluorescent particle counts of 4.75 x 105/m3 and 4.21 x 105/m3 for Ventolin and Ipramol, respectively, representing more than 400-fold increases over mean background level. More than 99.3% of drug particles were <2 µm in diameter and therefore small enough to enter the lower respiratory tract. CONCLUSION: The extractor tent was completely effective for the prevention of airborne spread of drug particles of respirable size from nebulized therapy. This suggests that extractor tents of this type would be efficacious for the prevention of airborne infection from aerosol-generating procedures during the COVID-19 pandemic.