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1.
Vaccines (Basel) ; 10(11)2022 Nov 10.
Article in English | MEDLINE | ID: covidwho-2123896

ABSTRACT

Background: Current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are administered systemically and typically result in poor immunogenicity at the mucosa. As a result, vaccination is unable to reduce viral shedding and transmission, ultimately failing to prevent infection. One possible solution is that of boosting a systemic vaccine via the nasal route resulting in mucosal immunity. Here, we have evaluated the potential of bacterial spores as an intranasal boost. Method: Spores engineered to express SARS-CoV-2 antigens were administered as an intranasal boost following a prime with either recombinant Spike protein or the Oxford AZD1222 vaccine. Results: In mice, intranasal boosting following a prime of either Spike or vaccine produced antigen-specific sIgA at the mucosa together with the increased production of Th1 and Th2 cytokines. In a hamster model of infection, the clinical and virological outcomes resulting from a SARS-CoV-2 challenge were ameliorated. Wuhan-specific sIgA were shown to cross-react with Omicron antigens, suggesting that this strategy might offer protection against SARS-CoV-2 variants of concern. Conclusions: Despite being a genetically modified organism, the spore vaccine platform is attractive since it offers biological containment, the rapid and cost-efficient production of vaccines together with heat stability. As such, employed in a heterologous systemic prime-mucosal boost regimen, spore vaccines might have utility for current and future emerging diseases.

2.
Emergency Medicine Journal : EMJ ; 39(9), 2022.
Article in English | ProQuest Central | ID: covidwho-2020101

ABSTRACT

BackgroundIn 2018 a Wales-wide improvement project was launched to design an emergency department quality and delivery framework (EDQDF). The project aimed to combine top-down and bottom-up working to describe and implement what good looks like for emergency departments. The collaborative design of the EDQDF took place between 2018 and 2020;the project’s currently in its implementation phase. This evaluation asks about the barriers and enablers pertaining to implementation of the EDQDF, which was designed using the CAREMORE methodology, found to be a promising tool for collaborative improvement projects for health services (Nelson et al 2018).MethodsWe interviewed 8 participants involved with the EDQDF (nurses n3;consultant paramedic n1;policy-maker n1;project managers n2;senior level manager n1). We thematized the data according to preconceived concepts and to identify emerging themes.ResultsStrong emergent themes include: challenges of combining top-down/bottom-up working;interdependencies on other parts of the system as a barrier to implementation;staff pressures;the positive perception of a developing network for ED-staff.Covid-19 significantly shifted the focus of the project to reconsider ‘access’ for patients, especially remote access to advice, ED appointments, or teletriage and streaming to alternative services. Some participants perceived this positively, others negatively.When considering ‘patient access’, participants often referred to technological advancement as an answer to problems such as overcrowding, and regularly invoked the language of consumerism. Participants demonstrated a conflict between a desire for the slick operational models used by fast-food chains (participants often mentioned chains like Starbucks and domino’s pizza, for instance), and a recognition of the differences between the delivery of care and a consumer product.ConclusionThe primary barrier to implementation is considered to be the interdependent nature of the health system;ED pressures were perceived as symptomatic of failures elsewhere in the health and social care system.

3.
BMC Pregnancy Childbirth ; 22(1): 572, 2022 Jul 18.
Article in English | MEDLINE | ID: covidwho-1938296

ABSTRACT

BACKGROUND: Rates of perinatal mental health difficulties (experienced during pregnancy and the 12-months postpartum) increased worldwide during the COVID-19 pandemic. In the UK, anxiety and depression were estimated to affect more than half of perinatal women during the first national lockdown. However, little is known about women's qualitative experiences of distress. This study aimed to extend published quantitative findings resulting from the same data set (Harrison et al., Women Birth xxxx, 2021;  Harrison et al., J Reprod Infant Psychol 1-16, 2021) to qualitatively explore: 1) the feelings and symptoms associated with maternal perinatal distress during the COVID-19 pandemic; and 2) the associated sources of distress. METHODS: As part of an online survey during May 2020, 424 perinatal women responded to an open-ended question regarding a recent experience of distress. Qualitative data were analysed using an initial content analysis, followed by an inductive thematic analysis adopting a realist approach. Data were explored in the context of self-reported perinatal anxiety and depression symptoms. RESULTS: Initial content analysis of the data identified twelve distinct categories depicting participants' feelings and symptoms associated with psychological distress. Despite the high rates of probable depression in the sample, women's descriptions were more indicative of anxiety and general distress, than of symptoms traditionally related to depression. In terms of the associated psychosocial stressors, a thematic analysis identified five themes: Family wellbeing; Lack of support; Mothering challenges; Loss of control due to COVID-19; and Work and finances. Unsurprisingly given the context, isolation was a common challenge. Additionally, psychological conflict between maternal expectations and the reality of pregnancy and motherhood, loss of autonomy and control, and fears surrounding family health, safety, and wellbeing underlay many of the themes. CONCLUSIONS: This study presents an array of feelings and symptoms expressed by perinatal mothers which may be useful to consider in relation to perinatal wellbeing. Furthermore, our data highlights several common sources of distress, including multiple COVID-19 specific factors. However, many were related to more general perinatal/maternal experiences. Our findings also point to considerations that may be useful in alleviating distress in pregnancy and early motherhood, including social support, realistic perinatal/maternal expectations, and support for those with perceived perinatal trauma.


Subject(s)
COVID-19 , Anxiety/epidemiology , Anxiety/psychology , Communicable Disease Control , Emotions , Female , Humans , Mothers/psychology , Pandemics , Pregnancy , Qualitative Research
4.
The High School Journal ; 104(4):208-219, 2021.
Article in English | ProQuest Central | ID: covidwho-1688434

ABSTRACT

In fall 2021, four students and two teachers from a high school in Providence, Rhode Island recorded an hour and a half long discussion on how schooling and education has changed in the wake of a global pandemic, and its potential for change. Many students involved have spent their entire educational career in this small public charter system, which is made up of majority students of color from Providence. "Returning to Normal": Student Experiences After Quarantine Ashley Herrera Mantanico: I took this question about what normal looked like before and I feel like much has changed in terms of our own perspectives because there's more focus on mental health and how it affects students of color in my school. Other students may not benefit from how the school system works and are looked as being "lazy" but genuinely they have different ways of learning, it doesn't mean they are dumb or not trying, if you have a group of students failing, something is wrong about how subjects are being taught or what the curriculum allows teachers to show their students.

5.
Vet Immunol Immunopathol ; 237: 110254, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1239778

ABSTRACT

This study was performed to elucidate whether the route of booster vaccination affects the immune response against respiratory vaccine viruses in pre-weaning beef calves that receive primary intranasal (IN) vaccination during the first month of life. The objective was to compare the serum neutralizing antibody (SNA) titers to BHV1, BRSV, and BPI3V, cytokine mRNA expression and mucosal BHV1- and BRSV-specific IgA in nasal secretions following administration of IN or subcutaneous (SC) modified-live virus (MLV) booster vaccines 60 days after primary IN vaccination in young beef calves. Twenty-one beef calves were administered 2 mL of an IN MLV vaccine containing BHV1, BRSV, and BPI3V (Inforce3®) between one and five weeks of age. Sixty days after primary vaccination, calves were randomly assigned to one of two groups: IN-MLV (n = 11): Calves received 2 mL of the same IN MLV vaccine used for primary vaccination and 2 mL of a SC MLV vaccine containing BVDV1 & 2 (Bovi- Shield GOLD® BVD). SC-MLV (n = 10): Calves were administered 2 mL of a MLV vaccine containing, BHV1, BRSV, BPI3V, and BVDV1 & 2 (Bovi-Shield GOLD® 5). Blood and nasal secretion samples were collected on days -61 (primary vaccination), -28, -14, 0 (booster vaccination), 14, 21, 28, 42 and 60 for determination of SNA titers, cytokine gene expression analysis and nasal virus-specific IgA concentrations. Statistical analysis was performed using a repeated measures analysis through PROC GLIMMIX of SAS®. Booster vaccination by neither IN nor SC routes induced a significant increase in SNA titers against BHV1, BRSV, and BPI3V. Subcutaneous booster vaccination induced significantly greater BRSV-specific SNA titers (on day 42) and IgA concentration in nasal secretions (on days 21 and 42) compared to calves receiving IN booster vaccination. Both IN and SC booster vaccination were able to stimulate the production of BHV1-specific IgA in nasal secretions. In summary, booster vaccination of young beef calves using either SC or IN route two months after IN MLV primary vaccination resulted in comparable SNA titers, cytokine gene expression profile and virus-specific IgA concentration in nasal secretions. Only a few differences in the systemic and mucosal immune response against BHV1 and BRSV were observed. Subcutaneous booster vaccination induced significantly greater BRSV-specific SNA and secretory IgA titers compared to IN booster vaccination.


Subject(s)
Cattle Diseases/immunology , Respiratory Syncytial Virus Vaccines/immunology , Respiratory Syncytial Virus, Bovine/immunology , Administration, Intranasal/veterinary , Animals , Animals, Newborn , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/immunology , Antibodies, Viral/blood , Antibodies, Viral/immunology , Cattle , Cattle Diseases/prevention & control , Cytokines/blood , Immunization, Secondary/veterinary , Immunogenicity, Vaccine , Respiratory Syncytial Virus Vaccines/administration & dosage
6.
J Reprod Infant Psychol ; : 1-16, 2021 Feb 13.
Article in English | MEDLINE | ID: covidwho-1081940

ABSTRACT

Background: Increasing evidence has linked repetitive negative thinking (RNT) to postnatal depression and anxiety, yet the factors moderating this relationship have been minimally investigated. During the COVID-19 pandemic of 2020, social restrictions imposed to reduce viral transmission limited access to social support, which is critical to postnatal psychological wellbeing - potentially intensifying RNT.Objective: We examined whether perceived social support (from friends, family, and a significant other) played a moderating role in the relationship between RNT and maternal postnatal anxiety and depressive symptoms.Methods: A sample of women (N = 251) who had given birth in the preceding 12 months completed an online battery of standardised measures during the COVID-19 'lockdown' of May 2020.Results: As predicted, social support moderated the relationship between RNT and depression such that the association between RNT and depression was stronger for women who reported lower levels of social support. Interestingly, this finding emerged for social support from friends only; for support from family and significant other, social support did not play a moderating role. Further, and unexpectedly, overall social support did not moderate the relationship between RNT and postnatal anxiety, however, social support from friends was a significant moderator.Conclusions: High levels of perceived social support from friends (but not family or significant others) buffered the effects of RNT on depression and anxiety during the postpartum period. Strategies to bolster peer social support may be a valuable inclusion in interventions to prevent and treat postnatal depression and anxiety.

7.
Women Birth ; 35(3): 232-241, 2022 May.
Article in English | MEDLINE | ID: covidwho-1014880

ABSTRACT

PROBLEM: Prenatal depression and anxiety are linked to poor maternal and infant outcomes. We need to understand predictors of poor mental health to identify at-risk women, and targets for support. BACKGROUND: Previous research has demonstrated a relationship between low levels of perceived social support, and depression and anxiety in pregnant women. However, there is a lack of research into the factors that may mediate this relationship. AIM: As social distancing measures (e.g., lockdown) are likely to negatively affect women's perceived support in the prenatal period, we investigated the relationship between perceived social support and both anxiety and depression in UK-based pregnant women during the COVID-19 pandemic. Further, we examined two potential mediators that may contribute to psychological symptoms: repetitive negative thinking and loneliness. METHODS: We administered a battery of online measures to a sample of pregnant women (N=205) between May-June 2020, during the first peak of the pandemic in the UK, when perceived social support was likely to be low. RESULTS: Consistent with predictions, perceived social support was significantly negatively related to depression, anxiety, loneliness and repetitive negative thinking. Furthermore, repetitive negative thinking and loneliness mediated the relationship between perceived social support and both depression and anxiety. Moreover, perceived social support and loneliness were associated with specific types of online behaviours. CONCLUSIONS: Taken together, the findings shed light on the processes through which social support may exert its effects on depression and anxiety and highlight potential therapeutic targets for interventions which aim to prevent and treat mood disorders in perinatal cohorts.


Subject(s)
COVID-19 , Pessimism , Anxiety/psychology , COVID-19/epidemiology , Communicable Disease Control , Depression/psychology , Female , Humans , Loneliness/psychology , Pandemics/prevention & control , Pregnancy , SARS-CoV-2 , Social Support
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