Mino Bimaadiziwin Homebuilder Program's Impact on Sustainable Livelihoods Among Youth in Garden Hill and Wasagamack First Nations: An Evaluative Study

The Mino Bimaadiziwin Homebuilders postsecondary education pilot project built Indigenous youth capacity and houses in two remote Anishinini reserves—Garden Hill and Wasagamack. To evaluate this community-led project, a sustainable livelihood assessment holistically measured the impact on 45 of the 70 (64%) Homebuilder students and the community. The community benefited by gaining three culturally appropriate houses built from local lumber and employment opportunities for Anishinini instructors. A longitudinal survey found five of the six livelihood assets improved sta-tistically and significantly, including satisfaction with social relationships, cultural awareness, in-come and ability to pay bills, housing safety, and human development. Students reported better relations with their families and neighbourhood. Most (85%) of the 70 Homebuilder students earned postsecondary certificates either in forestry, homebuilding, or both while obtaining a training sti-pend, which elevated their incomes. These positive outcomes occurred despite project underfunding, COVID-19 pandemic lockdown, climate change events, and inequitable housing policies under the Indian Act. Based on this project's success, we recommend investing in Indigenous-led postsecond-ary education in community homebuilding projects. However, to attain equitable housing and human rights, a plan is needed to overturn the Indian Act keeping Indigenous people "wards of the state” and their land in trust. © 2023 Canadian.

Alterations in programmed death ligand expression in whole blood cells in COVID-19 patients

Background: Infections with SARS-CoV- 2 cause the coronavirus disease 2019 (COVID-19) pandemic. Alterations in immune cells of COVID-19 patients may predict the subsequent severity of disease. The changes in composition of immune cells in COVID-19 patients include lymphopenia, lower neutrophil to lymphocyte-ratios and an eosinopenia in about 50 to 80% of hospitalized patients. Eosinophils and neutrophils can interact with T cells via immune checkpoints receptors such as programmed death (PD)-1 on T cells and its counterpart PD-ligand 1 (PD-L1) on eosinophils or neutrophils. There are only limited studies on PD-1 and PD-L1 expressions in viral infections, we aimed to elucidate the interplay of T cells and other peripheral cells by analysing the immune checkpoints PD-1 and PD-L1 in expression during COVID-19. Method(s): Using flow cytometry, we have now analysed the immune checkpoint receptor expressions on whole blood cells from a total of 38 COVID-19 patients. The patient cohort comprises all ages and both sexes with the disease severity ranging from mild, moderate to severe, with ~10% mortality. We have further been investigating 21 biomarkers (G-CSF, GM-CSF, IFN-gamma, TGF-beta1, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-23, IL-33, IP-10, MCP-1, MIP-1beta, TNF-alpha, and YKL-40) in plasma on a cohort of 76 COVID-19 patients using the MesoScale Multiplex Assay platform, with 48 healthy controls. Result(s): PD-L1 expression on eosinophils was significantly lower in COVID-19 patients in initial stages of infection, relative to healthy controls. There was an inverse relationship between disease progression and the expression of PD-1 on CD8+ T cells. These data suggests that analysis of PD-L1- PD1 cell networks in immune cells of EDTA blood of COVID-19 patients can predict disease outcomes. While most detectable biomarkers are strongly increased in COVID samples overall compared to healthy controls, the more severe the disease the higher the blood biomarker concentration. Conclusion(s): Taken together, the analysis of PD-L1- PD1 cell networks in immune cells together with plasma biomarkers of COVID-19 patients can predict disease outcomes.

Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study.

INTRODUCTION: Uniform case definitions are required to ensure harmonised reporting of neurological syndromes associated with SARS-CoV-2. Moreover, it is unclear how clinicians perceive the relative importance of SARS-CoV-2 in neurological syndromes, which risks under- or over-reporting. METHODS: We invited clinicians through global networks, including the World Federation of Neurology, to assess ten anonymised vignettes of SARS-CoV-2 neurological syndromes. Using standardised case definitions, clinicians assigned a diagnosis and ranked association with SARS-CoV-2. We compared diagnostic accuracy and assigned association ranks between different settings and specialties and calculated inter-rater agreement for case definitions as "poor" (κ ≤ 0.4), "moderate" or "good" (κ > 0.6). RESULTS: 1265 diagnoses were assigned by 146 participants from 45 countries on six continents. The highest correct proportion were cerebral venous sinus thrombosis (CVST, 95.8%), Guillain-Barré syndrome (GBS, 92.4%) and headache (91.6%) and the lowest encephalitis (72.8%), psychosis (53.8%) and encephalopathy (43.2%). Diagnostic accuracy was similar between neurologists and non-neurologists (median score 8 vs. 7/10, p = 0.1). Good inter-rater agreement was observed for five diagnoses: cranial neuropathy, headache, myelitis, CVST, and GBS and poor agreement for encephalopathy. In 13% of vignettes, clinicians incorrectly assigned lowest association ranks, regardless of setting and specialty. CONCLUSION: The case definitions can help with reporting of neurological complications of SARS-CoV-2, also in settings with few neurologists. However, encephalopathy, encephalitis, and psychosis were often misdiagnosed, and clinicians underestimated the association with SARS-CoV-2. Future work should refine the case definitions and provide training if global reporting of neurological syndromes associated with SARS-CoV-2 is to be robust.

Understanding SARS-CoV-2 Delta and Omicron variant transmission and vaccine impact in schools and child-care settings in Australia: a population-based study.

Background: Over 214 million students globally have been affected by school closures during the COVID-19 pandemic. To address knowledge gaps on transmission of SARS-CoV-2 delta (B.1.617.2) and omicron (B.1.1.529) variants in educational settings we examined virus transmission in schools and early childhood education and care settings (ECECs) in New South Wales (NSW), Australia in relation to mitigation measures, including COVID-19 vaccination. Methods: Secondary transmission from children and adults with laboratory-confirmed SARS-CoV-2 infection who attended a school (n = 3170) or ECECs (n = 5800) while infectious was investigated over two periods: 1) June 16 to September 18, 2021 (delta outbreak), and; 2) October 18 to December 18, 2021 (delta and omicron; schools only). Close contacts of cases underwent 14 days quarantine and SARS-CoV-2 nucleic acid testing. Secondary attack rates (SARs) were calculated and compared with state-wide notification data, school attendance, and vaccination status. Findings: 1187 schools and 300 ECECs had students (n = 1349) or staff (n = 440) attend while infectious. Of 24,277 contacts investigated, most (91.8%; 22,297/24,277) were tested and 912 secondary cases identified. The secondary attack rate (SAR) was 5.9% in 139 ECECs and 3.5% in 312 schools. The risk of becoming a secondary case was higher in unvaccinated school staff (OR 4.7; 95% CI: 1.7-13.3), particularly ECEC staff (OR 9.0; 95% CI: 3.6-22.7) and unvaccinated school students than in vaccinated school staff. SARs were similar for delta (4.9%) and omicron BA.1 (4.1%) in the unvaccinated and higher compared with vaccinated contacts (0.9% and 3.4%, respectively). Increasing school attendance rates raised case incursions and secondary case numbers, but not community-wide infection rates. Interpretation: Vaccination reduced SARS-CoV-2 transmission rates in schools, although less so for omicron than delta variants. Despite higher community-based transmission rates, in-school transmission remained low and stable with high attendance, suggesting that community restrictions, rather than school closures, best mitigated COVID-19 impacts. Funding: NSW Government Department of Health.

IS IT TIME FOR PATIENT-INITIATED METHOTREXATE MONITORING?

Background/Aims Regular blood monitoring is recommended to ensure safety in patients on methotrexate (MTX). During the COVID pandemic, British Society of Rheumatology (BSR) sanctioned a reduction in monitoring for patients stable on MTX for 12 months. In accordance Devon CCG approved changing local Shared Care Guidelines (SCG), reducing the frequency to six monthly in stable MTX patients. Our aim was to assess whether monitoring frequency changed during the pandemic, and if so whether any patients came to harm. Methods Patients stable on MTX monotherapy for at least a year to 31.3.2020 were identified via hospital pathology. 854 patients identified;the mean number of days between monitoring requests was calculated for the year to April 2020, and year to April 2021, respectively. A subanalysis of 229 patients who had reduced from monthly to three monthly blood tests at similar time points was undertaken. Tests included: platelets (PLT), mean cell volume (MCV), neutrophils (NEUT), estimated glomerular filtration rate (eGFR), and alanine aminotransferase (ALT). Confidence intervals evaluated any differences in the results between monthly and three-monthly frequencies, in terms of overall distribution as well as at an individual patient level. Additionally, the numbers of 'catastrophic' test results, as defined by the Royal College of Pathologists, were calculated for the higher frequency and reduced frequency years. Results Testing frequency in the year to April 2020 approximated to monthly, and three-monthly in the year to April 2021. Sub-analysis in 229 patients showed the overall distributions of PLT, MCV, NEUT, eGFR and ALT results were no more likely to be outside normal laboratory parameters when tested less frequently. Furthermore, individual patients were no more likely to have results outside normal laboratory parameters with less frequent testing. Overall, our analysis indicated that reduced monitoring did not lead to more abnormal results. Additionally, 'catastrophic' results were extremely uncommon, and did not increase with reduced testing. Routine MTX monitoring revealed no catastrophic results, these only occurred in patients being managed for co-existing morbidities. Conclusion MTX monitoring reduced during the pandemic but not in adherence to updated SCG. We evidence that reducing frequency of routine blood monitoring did not increase abnormal results or cause harm in stable MTX patients. Significant blood abnormalities were rare and universally occurred only with co-existing morbidities. Across primary and secondary care workloads are increasing, resources are limited, and cost efficiencies needed. These findings support a review of the frequency of routine blood monitoring;is now the time to shift to patient-initiated testing in those stable on MTX monotherapy.

Climate justice is central to addressing the climate emergency's psychological consequences in the Global South: a narrative review

The United Nations has signalled a 'code red', marking climate change as an existential threat for humanity. The world is rapidly warming, and the consequences of climate change include an increase and intensification in flooding, droughts, wildfires, and other traumatic exposures. Although countries in the Global South have contributed least to global warming, they are the most vulnerable owing to historical inequities. The concept of 'climate justice' recognises that historical racial discrimination, class disenfranchisement, political misrecognition, and other social injustices make surviving climate change and thriving within it more challenging. This narrative review considers the psychological consequences of the climate emergency through a climate justice lens. The article discusses the unequal exposures to psychological adversities, socio-historical barriers to adaptations and, finally, institutional betrayal that complicates the experience of psychological distress. The review concludes by pragmatically discussing how psychology could support climate justice ends.

Multiplex PCR CMOS Biochip for Detection of Upper Respiratory Pathogens including SARS-CoV-2

A 1024-pixel CMOS biochip for multiplex polymerase chain reaction application is presented. Biosensing pixels include 137dB DDR photosensors and an integrated emission filter with OD∼6 to perform real-time fluorescence-based measurements while thermocycling the reaction chamber with heating and cooling rates of > ±10°C/s. The surface of the CMOS IC is biofunctionalized with DNA capturing probes. The biochip is integrated into a fluidic consumable enabling loading of extracted nucleic acid samples and the detection of upper respiratory pathogens, including SARS-CoV-2. © 2021 JSAP.

Navigating COVID-19: Insights from research on social ostracism

The COVID-19 pandemic and associated social distancing and lockdowns has caused unprecedented changes to social life. We consider the possible implications of these changes for mental health. Drawing from research on social ostracism emphasizing the importance of social connection for mental well-being, there is reason for concern regarding the mental health effects of the crisis. However, there are also reasons for optimism;people can be surprisingly resilient to stressful situations, the impact of ostracism tends to depend on social norms (which are rapidly changing), and mental health depends primarily on having at least one or two close social connections. Given the scale and unprecedented nature of the social disruption that occurred, we see strong reason for concern, but not despair. © The Author(s) 2020.

‘Slanted truths’: Fictional alternatives to save our futures

The current escalation of climate catastrophes, as represented at the macro-level, via fires, tornadoes and floods or, at the micro-level, via plagues, pestilence and pandemics (Covid-19 the latest in a long historical line), are signs of a world becoming increasingly hard to inhabit (Klein, 2019). However, the human behaviours behind so much of our climate crises is very hard to shift, and it is current, co-ordinated (and both local and global) remedial action that is required, in order to address such a huge and ‘wicked’ problem (Marshall, 2014). How, then, do we grab the climate ‘nettle’? In this article, I propose that thinking of new and alternative near-future worlds can help us focus on what we want and how we can get there. Such fictional projections have sometimes been called ‘science fiction’ (Sayler, 2019). © 2020, British Psychological Society. All rights reserved.

COVID-19 pandemic and the dental practice

Coronavirus disease 2019 (COVID-19), originating in Wuhan, China in December 2019 has become a pandemic affecting numerous countries worldwide, with over 1353 positive cases and 4 deaths confirmed in South Africa thus far. Dental practitioners are at the forefront of this outbreak through direct and contact transmission via face-to-face communication and through the generation of significant amounts of droplets and aerosols during routine dental procedures, posing potential risks of infection transmission. There are no guidelines for South African dental practitioners to follow in the time of the COVID-19 pandemic. This paper provides consolidated evidence and best practice on how to prevent and minimise the spread of infection within the dental setting through the use of a flowchart. The level of evidence provided is based on global recommendations and experience. We conclude that unless dental professionals stick to stringent infection control practices, they are likely to contribute to the spread of the COVID-19. We recommend that during this outbreak, dental professionals consider scaling down on their normal routine, and protect themselves and patients. Focus should be on the management of pain, sepsis and trauma. The epidemic will pass, and dental professionals should outlast the scourge.