The impacts of COVID-19 on the relationship between perceived economic inequality and political action among socioeconomic classes

Economic inequality qualifies as a structural characteristic leading to political action, albeit this relationship manifests differently across socioeconomic classes. COVID-19 pandemic has amplified existing economic inequalities in ways that increased social tensions and political unrest around the world. This research investigates the effect of COVID-19 personal impacts on the relationship between perceived economic inequality and individuals' political participation. An online survey was administered to an Italian representative sample of 1,446 people (51% women, mean age of 42.42 years, SD = 12.87). The questionnaire assessed the perceived economic inequality, the personal impacts of COVID-19 (i.e., on finance, mental health, and ability to procure resources), and individuals' involvement in political participation. Moderation analyses were conducted separately for different socioeconomic classes (i.e., lower, middle, and upper classes). Results showed that individuals who perceive greater economic inequality, while controlling for perceived wage gap, are more likely to take action, but only if they belong to the higher class. For lower-class individuals, perceiving greater inequality erodes political action. Interaction effects occurred mainly in the middle class and with COVID-19 impacts on resources procurement, which inhibits political action. Copyright © 2023 Vezzoli, Mari, Valtorta and Volpato.

Impact of the Clinical Trials Act 2018 on clinical trial activity in Japan from 2018 to 2020: a retrospective database study using new and conventional Japanese registries.

OBJECTIVE: To clarify the impact of Japan's Clinical Trials Act (CTA), which was enacted in April 2018, on subsequent clinical trial activity through an analysis of Japanese registry data. DESIGN: Retrospective database study. SETTING: We extracted information on clinical intervention studies registered between 1 April 2018 and 30 September 2020 in the conventional University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) and the new Japan Registry of Clinical Trials (jRCT). We collected and analysed information on registration dates, intervention types, funding, secondary sponsors and use of designated staff in multidisciplinary roles (research planning support, research administration, data management, statistical analysis, monitoring and auditing). The temporal trends in clinical trial activity after CTA enactment were examined. RESULTS: A total of 577 CTA-compliant specified clinical trials (ie, studies funded by pharmaceutical companies or studies evaluating the efficacy and safety of off-label drugs or devices in humans) were registered in the jRCT. During the same period, 5068 clinical trials were registered in the UMIN-CTR. The number of specific clinical trials increased immediately after the implementation of the CTA and stabilised in late 2019, whereas the number of clinical trials registered in the UMIN-CTR generally declined over time. Specified clinical trials that received industry funding and public grants were more likely to use designated staff in multidisciplinary roles. CONCLUSIONS: The implementation of the CTA has not reduced the number of specified clinical trials, but has reduced the total number of intervention trials. The use of designated staff in multidisciplinary roles is associated with funding, secondary sponsors and multicentre studies. It was inferred that funding was needed to establish research infrastructure systems that support high-quality research.

Early Nurse Management Experiences from Finnish COVID-19 Hubs: An In-Action Review.

Primary healthcare (PHC) clinics are the point of access for many COVID-19 patients; however, the focus of crisis response work has been in securing hospital capacities. The purpose of this study was to describe the early nurse management experiences from PHC clinics within Greater Helsinki dedicated to caring for all ambulatory patients with possible COVID-19 symptoms. The study objectives were to make PHC crisis response contributions known and to provide an in-action review (IAR) of crisis response efforts. Nurse managers from the four COVID-19 hubs in Greater Helsinki were interviewed using thematic pair interviews. The data were analyzed inductively using thematic analysis, by which four main themes emerged: (1) capacity development led to a state of flux, (2) infection prevention control (IPC) was critical, (3) management of staff was essential in facilitating crisis response, and (4) respondents' personal experiences. The state of flux stressed the provision of PHC services, but quick developments in telemedicine eased that burden. Conversation surrounding IPC was extensive, though discrepancies suggest that global efforts to standardize IPC practices must begin locally. Leadership was adjusted to accommodate for the crisis, especially regarding the motivation of staff. A vision to aspire toward in crisis recovery is needed.

Pathways linking climate change and HIV/AIDS: An updated conceptual framework and implications for the Philippines.

As we commemorate the 40th anniversary of the discovery of Human Immunodeficiency Virus (HIV) while fighting the ongoing COVID-19 pandemic, another global crisis - climate change - is threatening the progress achieved so far in the global fight against HIV/AIDS. The climate emergency is anticipated to generate dire health consequences worldwide in the coming decades. While the pathways that link climate change and different disease areas are better understood, the connection between climate change and HIV/AIDS is still yet to be recognized both in research and practice. In this review, we update one of the frameworks on the HIV-climate nexus described in earlier literature. Four major pathways have been identified: extreme weather events; sea level rise; changes in precipitation and temperature; and increased air pollution. These pathways impact the spectrum of HIV/AIDS-related outcomes through changes in social systems, healthcare disruption, and other climate-sensitive diseases, influenced by the social determinants of health. We also reflect on the significance of this updated framework for the Philippines, a country that is both highly vulnerable to the climate crisis and facing a rising HIV/AIDS epidemic. The framework can aid countries like the Philippines in filling gaps in research, policy, and program design to mount climate-adaptive HIV/AIDS responses. The HIV/AIDS and climate justice movements must also join forces in calling for accelerated worldwide decline in greenhouse gas emissions from all sectors to stabilize the global climate - this will benefit not just people affected by HIV/AIDS but everyone.

Covid-19 automatic detection using deep learning

The novel coronavirus disease 2019 (COVID-19) is a pandemic disease that is currently affecting over 200 countries around the world and impacting billions of people. The first step to mitigate and control its spread is to identify and isolate the infected people. But, because of the lack of reverse transcription polymerase chain reaction (RT-CPR) tests, it is important to discover suspected COVID- 19 cases as early as possible, such as by scan analysis and chest X-ray by radiologists. However, chest X-ray analysis is relatively time-consuming since it requires more than 15 minutes per case. In this paper, an automated novel detection model of COVID-19 cases is proposed to perform real-time detection of COVID-19 cases. The proposed model consists of three main stages: Image segmentation using Harris Hawks optimizer, synthetic image augmentation using an enhanced Wasserstein And Auxiliary Classifier Generative Adversarial Network, and image classification using Conventional Neural Network. Raw chest X-ray images datasets are used to train and test the proposed model. Experiments demonstrate that the proposed model is very efficient in the automatic detection of COVID-19 positive cases. It achieved 99.4% accuracy, 99.15% precision, 99.35% recall, 99.25% F-measure, and 98.5% specificity. © 2021 CRL Publishing. All rights reserved.

Profiling B cell immunodominance after SARS-CoV-2 infection reveals antibody evolution to non-neutralizing viral targets.

Dissecting the evolution of memory B cells (MBCs) against SARS-CoV-2 is critical for understanding antibody recall upon secondary exposure. Here, we used single-cell sequencing to profile SARS-CoV-2-reactive B cells in 38 COVID-19 patients. Using oligo-tagged antigen baits, we isolated B cells specific to the SARS-CoV-2 spike, nucleoprotein (NP), open reading frame 8 (ORF8), and endemic human coronavirus (HCoV) spike proteins. SARS-CoV-2 spike-specific cells were enriched in the memory compartment of acutely infected and convalescent patients several months post symptom onset. With severe acute infection, substantial populations of endemic HCoV-reactive antibody-secreting cells were identified and possessed highly mutated variable genes, signifying preexisting immunity. Finally, MBCs exhibited pronounced maturation to NP and ORF8 over time, especially in older patients. Monoclonal antibodies against these targets were non-neutralizing and non-protective in vivo. These findings reveal antibody adaptation to non-neutralizing intracellular antigens during infection, emphasizing the importance of vaccination for inducing neutralizing spike-specific MBCs.

Links between conspiracy beliefs, vaccine knowledge, and trust: Anti-vaccine behavior of Serbian adults.

RATIONALE: Immunization is a critical tool in the fight against infectious disease epidemics. Understanding hesitancy towards immunization is even more important nowadays, with the continuous threat of COVID-19 pandemic. Medical conspiracy beliefs, scientific skepticism, as well as low trust in governmental institutions, and evidence-based knowledge all have troubling effects on immunization. OBJECTIVE: To examine how these factors cross-react to influence vaccine behavior against any vaccine preventable disease (VPD), we hypothesized a model consisting of the belief in conspiracy theories as the predictor, and as the mediators subjective and objective vaccine knowledge, and trust in the health care system and science. The model was tested by examining the vaccine intentions for the children and self for any VPD. METHODS: Two separate studies were conducted on the representative samples of Serbian population; the first study investigated the intentions for child vaccination and the second study examined the vaccine intentions against any VPD, including adult vaccination. We used path analysis followed by logistic regression to analyze the data. RESULTS: The results revealed high vaccine hesitancy motivated by the belief in the vaccine conspiracy theories, through its effect on reduced trust in medical science and institutions, and low objective vaccine knowledge. CONCLUSIONS: The results of this study may be used to implement appropriate policy changes and implementation of the public health campaigns to promote immunization with a wide range of vaccines against common diseases, such as measles, human papillomaviruses, or pertussis, and novel diseases, such as COVID.