ABSTRACT
Medical misinformation is more pervasive today because of widespread and near instantaneous dissemination of information via the internet and social media platforms. Consequences of medical misinformation may include decreased uptake of needed health care resources, delays in seeking care, vaccine hesitancy, medication non-compliance, increased disease outbreaks and/or burden, and increased hospitalization and mortality. It disproportionately impacts underserved populations, including Black patients, those who identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and more), and patients with reduced health literacy skills or who are digitally disadvantaged. Medical misinformation challenges health care professionals not only to provide the best care possible, but to assist patients in finding accurate information. Preprint publications, although potentially beneficial in rapidly disseminating new scientific discoveries, often have not undergone peer review and may contribute to the widespread propagation of inaccurate or overstated results, thereby perpetuating the spread of medical misinformation when it exists. The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of practicing evidence-based medicine and the need for cautious review of preprint publications and articles from predatory publishers in addition to usual and customary literature evaluation techniques. Everyone plays a role in preventing the spread of medical misinformation, with pharmacists uniquely positioned as trusted and highly accessible professionals who may help combat its spread. The goal of this article is to define medical misinformation and related terms, outline mechanisms by which it is spread, describe its clinical impact, highlight how it disproportionately impacts underserved populations, provide actionable strategies to prevent its spread, and give examples of practical tactics to help identify, correct, and alert individuals about the possible presence of medical misinformation.Copyright © 2023 Pharmacotherapy Publications, Inc.
ABSTRACT
The contemporary political situation has been characterized, in recent years, by the emergence of multiple forms of populism. Since populist discourses have often used migrants and migrations instrumentally, one should clarify what populism, souverainism and the ‘spatialization of fear' actually mean. In this sense, many European states have ambiguously wavered between the rejection of supranational entities (as in the case of the United Kingdom with the Brexit, or the first version of Marine Le Pen's Front National) and the desire to strengthen European borders, considered culturally homogeneous, against the ‘threat' of foreigners arriving from Africa and Asia. Ever since the coronavirus emergency exploded, populism has been similarly ambiguous with regard to cities, which are sometimes considered the receptacle for all evil (and all diseases), while at other times they are a political model (with obvious reference to the Greek polis) to be defended, once again, in the clash of civilizations that characterizes our era. If, in fact, there are many studies on the construction of the populist discourse at the national or supranational scale, less attention has been paid to the urban scale, which also plays a key role in the articulation between identity rhetoric, practices of confinement and spatial imagery. In this turbulent context, Palermo has also experienced some episodes, albeit not very well known, of populist anti-migrant rhetoric. Since the prevailing narrative for now, due to Covid-19, focuses on security obsessions, migrants have been linked to a stigma that configures them as carriers of dangerous diseases, not only at the national scale but also and especially at the urban level. By building on the existing scientific literature on populism, and through the use of a qualitative methodology based on critical discourse analysis, this contribution aims to outline the links between migration, populism and health emergencies, starting from a theoretical framework and then describing the specific case of Palermo, still subject to rapid changes. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
The contemporary political situation has been characterized, in recent years, by the emergence of multiple forms of populism. Since populist discourses have often used migrants and migrations instrumentally, one should clarify what populism, souverainism and the ‘spatialization of fear’ actually mean. In this sense, many European states have ambiguously wavered between the rejection of supranational entities (as in the case of the United Kingdom with the Brexit, or the first version of Marine Le Pen’s Front National) and the desire to strengthen European borders, considered culturally homogeneous, against the ‘threat’ of foreigners arriving from Africa and Asia. Ever since the coronavirus emergency exploded, populism has been similarly ambiguous with regard to cities, which are sometimes considered the receptacle for all evil (and all diseases), while at other times they are a political model (with obvious reference to the Greek polis) to be defended, once again, in the clash of civilizations that characterizes our era. If, in fact, there are many studies on the construction of the populist discourse at the national or supranational scale, less attention has been paid to the urban scale, which also plays a key role in the articulation between identity rhetoric, practices of confinement and spatial imagery. In this turbulent context, Palermo has also experienced some episodes, albeit not very well known, of populist anti-migrant rhetoric. Since the prevailing narrative for now, due to Covid-19, focuses on security obsessions, migrants have been linked to a stigma that configures them as carriers of dangerous diseases, not only at the national scale but also and especially at the urban level. By building on the existing scientific literature on populism, and through the use of a qualitative methodology based on critical discourse analysis, this contribution aims to outline the links between migration, populism and health emergencies, starting from a theoretical framework and then describing the specific case of Palermo, still subject to rapid changes. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Introduction: The Covid-19 pandemic has highlighted vaccination challenges with MS disease modifying treatments (DMTs). B cell depleting agents and sphingosine-1-phosphate receptor modulators have been proposed to have the most significant effect on vaccine efficacy. Objectives/Aims: To provide an overview of the humoral response of our treated adult MS patients to a completed COVID- 19 vaccination series. Methods: This is a retrospective study of patients of the Holy Name MS Center. We introduced, as part of standard of care, SARS-Covid Spike Antibody IgG semi-quantitative testing for patients who completed vaccination and were interested in this testing. It was conducted between March 25 and May 14, 2021 with most labs performed by Quest. We extracted information regarding patient age, vaccine type, date of vaccination completion and DMT / last treatment date. Data were quantitatively analyzed. IRB approval was obtained for this study. Results: There were a total of N=114 patients, age (mean & plusmn;SD) 50.9 y & plusmn;13, of whom 49 (43%) did not make a positive antibody result;this included 42 patients on infusion anti-CD20 therapy, 3 on fingolimod, 2 on natalizumab, 1 on glatiramer acetate (GA) and one following high dose solumedrol. Of 54 patients treated with infusion anti-CD20 medication who had antibodies checked, only 12 (22%) were positive;there was no statistical difference in immunity by vaccine type, Chi sq (1, N=54) = 1.38 p-value .24. The earliest post-infusion vaccination completion that yielded a positive result was day 73. Fingolimod treated patients (5) all received Moderna mRNA vaccines with 40% developing a humoral response with lowest absolute lymphocyte count at time of positive result, 274. 91% of natalizumab treated patients (20/22) did develop a humoral response, with the two negative tests in a 51- and 53-year-old who received the Janssen vaccine. 88% (7/8) of GA patients were antibody positive (negative result in 66-year-old). All teriflunomide (n=11), dimethyl fumarate/ diroximel fumarate (n=4), interferon (n=5), and remote alemtuzumab (n=2) patients made positive responses. Conclusions: We confirmed that MS patients receiving anti- CD20 infusion therapies are likely at a humoral immunity disadvantage following vaccination. This study is limited in retrospective design, small un-balanced groups, and lack of longitudinal data. We cannot exclude the possibility of a more robust delayed humoral response.
ABSTRACT
Background: The COVID-19 pandemic has raised novel questions for people with multiple sclerosis (pwMS), which worldwide registries will help answer. One question is - how will disease modifying treatment (DMT) use affect the efficacy of a future vaccine against SARS-CoV2 (the virus that causes COVID- 19) in pwMS? To begin to address this question, we evaluated our patients who were clinically diagnosed with Covid-19 for antibodies (Ab). Objectives: To determine the frequency of SARS-CoV-2 Ab in our patients with Covid-19 and co-morbid MS, and describe their clincal characteristics. Methods: This is a case series of pwMS who are patients of the Holy Name MS Center and were either proven by PCR or highly suspected of active COVID-19 infection as of July 15, 2020. Results: Of the 11 patients included, 91% (n=10) were female, average age 50.5 years (range 34-64 years);7 patients treated with an anti-CD 20 monoclonal Ab (6 ocrelizumab (OCR), 1 rituximab (RTX)), 1 teriflunomide, 1 interferon beta-1a, and 2 patients not on DMT. Nine tested positive for SARS-CoV2 Ag by nasopharyngeal PCR;1 was not tested but had a household exposure who tested positive and herself had clinical symptoms of cough, dyspnea, myalgia, weakness, fatigue and headache;and 1 patient tested negative for SARS-CoV2 PCR but was febrile with cough, fatigue and headache during the pandemic. Of this series, 5 tested positive for SARS-CoV2 Ab (Abbott test);of which only 1 was on treatment with OCR (with absent CD19 cells). In terms of clinical outcome - 4 patients (all OCR/RTX treated) required hospital admission for supplemental non-invasive oxygen. All patients survived infection. Conclusions: This case series suggests that MS treatment with monoclonal anti-CD20 drugs may be associated with some increased risk of developing COVID-19. All of our patients who required hospitalization for this infection were treated with anti- CD20 threapy. Patients with MS who are on OCR/RTX may be less likely to mount an antibody response to this infection, whereas patients treated with interferons and teriflunomide can. Lack of seroconversion following OCR treatment was also noted in another case series of pwMS (Thornton 2020). Although it is reassuring that B-cells are not required to recover from COVID-19 infection, as evidenced by a case series of X-linked agammaglobulinemia patients (Soresina et al. 2020), our findings raise further questions for the health and safety of our patients with respect to this pandemic. Will OCR treated patients be at a unique risk to suffering reinfection from COVID-19 given they are less likely to seroconvert? And, how effective will a future vaccine be in patients treated with OCR (and similar monoclonal antibodies).
ABSTRACT
In this work, we present the results of a role-playing game experience carried out with a group of 9- to 12-year-old children during the COVID-19 emergence. The ‘harmony in education’ approach has been used to adapt the game design to the constraints imposed by the online context and the young age of the students involved. The results show the effectiveness of the approach in terms of 21st-century skills training with particular evidence on perspective-taking. © 2020, Springer Nature Switzerland AG.