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1.
Polit Geogr ; 97: 102646, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1907672

ABSTRACT

COVID-19 has changed the permeability of borders in transboundary environmental governance regimes. While borders have always been selectively permeable, the pandemic has reconfigured the nature of cross-border flows of people, natural resources, finances and technologies. This has altered the availability of spaces for enacting sustainability initiatives within and between countries. In Southeast Asia, national governments and businesses seeking to expedite economic recovery from the pandemic-induced recession have selectively re-opened borders by accelerating production and revitalizing agro-export growth. Widening regional inequities have also contributed to increased cross-border flows of illicit commodities, such as trafficked wildlife. At the same time, border restrictions under the exigencies of controlling the pandemic have led to a rolling back and scaling down of transboundary environmental agreements, regulations and programs, with important implications for environmental democracy, socio-ecological justice and sustainability. Drawing on evidence from Southeast Asia, the article assesses the policy challenges and opportunities posed by the shifting permeability of borders for organising and operationalising environmental activities at different scales of transboundary governance.

2.
Med Teach ; : 1-15, 2022 Apr 20.
Article in English | MEDLINE | ID: covidwho-1805780

ABSTRACT

The Covid-19 pandemic necessitated Emergency Remote Teaching (ERT): the sudden move of educational materials online. While ERT served its purpose, medical teachers are now faced with the long-term and complex demands of formal online teaching. One of these demands is ethical online teaching. Although ethical teaching is practiced in face-to-face situations, online teaching has new ethical issues that must be accommodated, and medical teachers who wish to teach online must be aware of these and need to teach ethically. This Guide leads the medical teacher through this maze of complex ethical issues to transform ERT into ethical online teaching. It begins by setting the context and needs and identifies the relevant fundamental ethical principles and issues. It then guides the medical teacher through the practical application of these ethical principles, covering course design and layout (including the curriculum document, implementation, on-screen layouts, material accessibility), methods of interaction (synchronous and asynchronous), feedback, supervision and counselling, deeper accessibility issues, issues specific to clinical teaching, and assessment. It then discusses course reviews (peer-review and student evaluations), student monitoring and analytics, and archiving. The Guide aims to be a useful tool for medical teachers to solidly ground their online teaching practices in ethical principles.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307302

ABSTRACT

Remdesivir is a nucleoside analog approved by the FDA for treatment of COVID-19. Here, we present a 3.9-Å-resolution cryoEM reconstruction of a remdesivir-stalled RNA-dependent RNA polymerase complex, revealing full incorporation of three copies of remdesivir monophosphate (RMP) and a partially incorporated fourth RMP in the active site. The structure reveals that RMP blocks RNA translocation after incorporation of three bases following RMP, resulting in delayed chain termination, which can guide the rational design of improved antiviral drugsFunding: This work was supported in part by Welch Foundation grantsF-1604 (to K.A.J.) and F-1938 (to D.W.T.), National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) R01AI110577 (to K.A.J) and National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health (NIH) R01114223 (to K.A.J.) and R35GM138348 (to D.W.T.), Army Research Office Grant W911NF-15-1-0120(to D.W.T.), and a Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation Medical Research Award (to D.W.T.). D.W.T is a CPRIT Scholar supported by the Cancer Prevention andResearch Institute of Texas (RR160088) and an Army Young Investigator supported by the Army Research Office (W911NF-19-1-0021).Conflict of Interest: All authors declare no competing interests.

4.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328380

ABSTRACT

This article was migrated. The article was marked as recommended. COVID-19 is a strong disruptive force that has not only influenced our global health and economy but also has changed the way we teach, learn and communicate with our students. It has disturbed the regular education pattern and the standard practices that we adapted over many years. The challenge is beyond changing the mode of delivering instructions from face to face to online. The real challenge is in creating a culture that supports the adoption of innovative practices, which require different skills and competences from the teacher, student, mentor and administrator, and at the same time maintaining the quality of the products. In other words, changing what was exceptional to be the norm over a short period of time. This article describes our approach "Open Learning" in managing such change. Our over-riding philosophy is about ensuring that students have high quality resources, and the enthusiasm and learning skills to benefit from them. At the same time we want to optimise the use of the available online applications and learning management system so that their use is within the capability of our faculty. This paper describes the evolution of our approach and the principles upon which it has been based. Our experiences over the past few months will transform the educational experience of our students over the years to come.

5.
BMJ Open Qual ; 11(1)2022 02.
Article in English | MEDLINE | ID: covidwho-1685602

ABSTRACT

SETTING: Based at a busy city hospital, the alcohol care team is a drug and alcohol specialist service, taking referrals for a wide range of patients with substance use disorders (SUD). OBJECTIVES: Patients with SUD are at high risk of vitamin D deficiency; this relates to frequent fractures and proximal myopathy. The coronavirus pandemic brought vitamin D into focus. Local guidelines advise that patients at high risk of vitamin D deficiency are offered replacement. There were no local data on vitamin D deficiency prevalence or any mention of patients with SUD in local vitamin D guidelines. The main aim of this project was to offer vitamin D checks and replacement to all appropriate patients. RESULTS: We collected data on 207 patients, [pilot study (n=50) and two subsequent samples (n=95 and n=62)]. Our pilot study showed that no patients were offered vitamin D testing or replacement. We then offered vitamin D checks to 95 patients. Most had low vitamin D (30 patients were vitamin D deficient and 26 were vitamin D insufficient). We provided vitamin D replacement and follow-up advice. Quality improvement was demonstrated 6 months later. We collected data on a further 62 patients who were all on our current or recent caseload. Following exclusions, nearly half (48%) of patients had had a vitamin D check. Almost all of these (95%) had low vitamin D (60% being classified as deficient). CONCLUSIONS: Patients had not been offered vitamin D replacement despite often having multiple risk factors for vitamin D deficiency. Vitamin D checks (and subsequent replacement) rose in frequency since the outset of this project. Local guidelines should add SUD as a risk factor for vitamin D deficiency. Hospital admission provides a rich opportunity to offer this simple intervention to patients who are often poorly engaged with community services.


Subject(s)
Substance-Related Disorders , Vitamin D Deficiency , Hospitals , Humans , Pilot Projects , Substance-Related Disorders/diagnosis , Substance-Related Disorders/epidemiology , Vitamin D , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/epidemiology
6.
Journal of Marketing Education ; : 02734753221074284, 2022.
Article in English | Sage | ID: covidwho-1673720

ABSTRACT

The COVID-19 pandemic was an unprecedented event in modern history, transforming the nature of higher education. As course delivery moved online, marketing educators were faced with higher workloads and more demands on their time. Anecdotal evidence suggested that faculty were working more, and as the 2020?2021 school year progressed, reports of fatigue and burnout were prevalent. An empirical study measures the perceived increases in workload among marketing faculty and the outcomes of that work, as well as levels of burnout. In addition, a model of burnout antecedents is proposed and tested. On average, marketing educators experienced moderate levels of burnout, which was increased by work demands in research and teaching, as well as student interaction, whereas research productivity decreased burnout. Burnout was not influenced by gender, rank, tenure status, or institution type.

9.
Nat Commun ; 12(1): 5033, 2021 08 19.
Article in English | MEDLINE | ID: covidwho-1366816

ABSTRACT

Characteristic properties of type III CRISPR-Cas systems include recognition of target RNA and the subsequent induction of a multifaceted immune response. This involves sequence-specific cleavage of the target RNA and production of cyclic oligoadenylate (cOA) molecules. Here we report that an exposed seed region at the 3' end of the crRNA is essential for target RNA binding and cleavage, whereas cOA production requires base pairing at the 5' end of the crRNA. Moreover, we uncover that the variation in the size and composition of type III complexes within a single host results in variable seed regions. This may prevent escape by invading genetic elements, while controlling cOA production tightly to prevent unnecessary damage to the host. Lastly, we use these findings to develop a new diagnostic tool, SCOPE, for the specific detection of SARS-CoV-2 from human nasal swab samples, revealing sensitivities in the atto-molar range.


Subject(s)
Adenine Nucleotides/chemistry , COVID-19/diagnosis , CRISPR-Associated Proteins/metabolism , CRISPR-Cas Systems , Oligoribonucleotides/chemistry , RNA, Bacterial/genetics , Ribonucleases/metabolism , SARS-CoV-2/genetics , COVID-19/genetics , COVID-19/metabolism , COVID-19/virology , Diagnostic Tests, Routine/methods , Humans , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity
10.
Sports Health ; : 19417381211032226, 2021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1320046

ABSTRACT

CONTEXT: Transmission of communicable diseases observed in sporting organizations is often preventable. Early detection, isolation, and treatment can significantly diminish time lost. Until recently, there has been a paucity of standardized guidelines outlining feasible, preventable measures to protect both athletes and staff from contagious illnesses. Therefore, the purpose of this narrative was to highlight optimal prevention practices for transmission mitigation, with a particular focus on hygiene activity and travel considerations in professional sporting organizations. EVIDENCE ACQUISITION: Current recommendations from the Centers for Disease Control and Prevention and peer-reviewed journals. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 5. RESULTS: Communicable illness prevention strategies begin at the level of sufficient personal hygiene practices. Common area surface cleaning recommendations, including shared equipment sanitization between usage as well as designated equipment use to specific athletes, should be considered to minimize cross-contamination, in particular, for liked-position players. Intelligent design for shared areas can include redistributing the layout of communal spaces, most feasibly, spreading locker designation a minimum distance of 6 ft from one another. Travel considerations can include placing most susceptible passengers closest to window seating, boarding last and exiting first. Team physicians should have knowledge of essential personnel medical histories in an effort to risk stratify staff members and players in the setting of communicable disease. CONCLUSION: Providing a framework for illness management and prevention is important when considering the effects on player health, missed time, performance, and overall cost. Containment of commonly observed communicable illnesses can be optimized with sufficient personal hygiene practices, common area surface cleaning recommendations, intelligent design for shared areas, travel and hotel considerations, as well as appropriate screening tools and isolation techniques. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): B.

11.
Ther Adv Psychopharmacol ; 11: 20451253211027699, 2021.
Article in English | MEDLINE | ID: covidwho-1314239

ABSTRACT

Individuals with serious mental disorders (SMD) may have a higher risk of vitamin D (VIT-D) deficiency. They also experience higher mortality because of coronavirus disease 2019 (COVID-19) infection. Therefore, we have conducted a comprehensive review to examine the significance of VIT-D for public health and public mental health during the ongoing COVID-19 pandemic. This review had three specific aims, from a global perspective to (a) create a profile of VIT-D and review the epidemiology of VIT-D deficiency, (b) explore VIT-D deficiency as risk factor for SMD and COVID-19 infections and (c) examine the effectiveness of VIT-D supplementation for both conditions. We found that, in terms of SMD, the evidence from laboratory and observational studies points towards some association between VIT-D deficiency and depression or schizophrenia. Mendelian randomisation studies, however, suggest no, or reverse, causality. The evidence from intervention studies is conflicting. Concerning COVID-19 infection, on proof of principle, VIT-D could provide a plausible defence against the infection itself and against an adverse clinical course. But data from observational studies and the first preliminary intervention studies remain conflicting, with stronger evidence that VIT-D may mitigate the clinical course of COVID-19 infection rather than the risk of infection in the first place. From a public health and public mental health point of view, based on the currently limited knowledge, for individuals with SMD, the benefits of VIT-D optimisation through supplementation seem to outweigh the risks. VIT-D supplementation, however, should not substitute for vaccination or medical care for COVID-19 infection.

13.
J Clin Pathol ; 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1236475

ABSTRACT

AIMS: Public Health England has identified that in COVID-19, death rates among ethnic minorities far exceeds that of the white population. While the increase in ethnic minorities is likely to be multifactorial, to date, no studies have looked to see whether values for routine clinical biochemistry parameters differ between ethnic minority and white individuals. METHODS: Baseline biochemical data for 22 common tests from 311 SARS-CoV-2 positive patients presenting to hospital in April 2020 in whom ethnicity data were available was retrospectively collected and evaluated. Data comparisons between ethnic minority and white groups were made for all patient data and for the subset of patients subsequently admitted to intensive care. RESULTS: When all patient data were considered, the ethnic minority population had statistically significant higher concentrations of C reactive protein (CRP), aspartate aminotransferase and gamma-glutamyl transferase, while troponin T was higher in the white group. A greater proportion of ethnic minority patients were subsequently admitted to intensive care, but when the presenting biochemistry of this subset of patients was compared, no significant differences were observed between ethnic minority and white groups. CONCLUSION: Our data show for the first time that routine biochemistry at hospital presentation in COVID-19 differs between ethnic minority and white groups. Among the markers identified, CRP was significantly higher in the ethnic minority group pointing towards an increased tendency for severe inflammation in this group.

14.
Lancet Digit Health ; 3(6): e383-e396, 2021 06.
Article in English | MEDLINE | ID: covidwho-1221078

ABSTRACT

Health information technology can support the development of national learning health and care systems, which can be defined as health and care systems that continuously use data-enabled infrastructure to support policy and planning, public health, and personalisation of care. The COVID-19 pandemic has offered an opportunity to assess how well equipped the UK is to leverage health information technology and apply the principles of a national learning health and care system in response to a major public health shock. With the experience acquired during the pandemic, each country within the UK should now re-evaluate their digital health and care strategies. After leaving the EU, UK countries now need to decide to what extent they wish to engage with European efforts to promote interoperability between electronic health records. Major priorities for strengthening health information technology in the UK include achieving the optimal balance between top-down and bottom-up implementation, improving usability and interoperability, developing capacity for handling, processing, and analysing data, addressing privacy and security concerns, and encouraging digital inclusivity. Current and future opportunities include integrating electronic health records across health and care providers, investing in health data science research, generating real-world data, developing artificial intelligence and robotics, and facilitating public-private partnerships. Many ethical challenges and unintended consequences of implementation of health information technology exist. To address these, there is a need to develop regulatory frameworks for the development, management, and procurement of artificial intelligence and health information technology systems, create public-private partnerships, and ethically and safely apply artificial intelligence in the National Health Service.


Subject(s)
COVID-19 , Learning Health System , Medical Informatics , Artificial Intelligence/trends , Contact Tracing/methods , Health Information Interoperability , Humans , Mobile Applications , Population Surveillance/methods , Public-Private Sector Partnerships , Robotics/trends , Systems Integration , United Kingdom
15.
Lancet ; 397(10288): 1979-1991, 2021 05 22.
Article in English | MEDLINE | ID: covidwho-1219658

ABSTRACT

The demographics of the UK population are changing and so is the need for health care. In this Health Policy, we explore the current health of the population, the changing health needs, and future threats to health. Relative to other high-income countries, the UK is lagging on many health outcomes, such as life expectancy and infant mortality, and there is a growing burden of mental illness. Successes exist, such as the striking improvements in oral health, but inequalities in health persist as well. The growth of the ageing population relative to the working-age population, the rise of multimorbidity, and persistent health inequalities, particularly for preventable illness, are all issues that the National Health Service (NHS) will face in the years to come. Meeting the challenges of the future will require an increased focus on health promotion and disease prevention, involving a more concerted effort to understand and tackle the multiple social, environmental, and economic factors that lie at the heart of health inequalities. The immediate priority of the NHS will be to mitigate the wider and long-term health consequences of the COVID-19 pandemic, but it must also strengthen its resilience to reduce the impact of other threats to health, such as the UK leaving the EU, climate change, and antimicrobial resistance.


Subject(s)
Delivery of Health Care/trends , Demography/trends , State Medicine/organization & administration , Aging , COVID-19 , Cost of Illness , Healthcare Disparities/trends , Humans , Life Expectancy , Maternal-Child Health Services , Mental Health , Multimorbidity/trends , Oral Health/trends , State Medicine/trends , United Kingdom/epidemiology
16.
Industry and Higher Education ; : 09504222211008117, 2021.
Article in English | Sage | ID: covidwho-1194422

ABSTRACT

The options for conventional graduate careers have become more limited in the last 20 years. This has stimulated an increase in university programmes and modules designed to encourage students to start their own businesses. The recent global Covid-19 pandemic is likely to make the job market even more difficult for those graduating from universities in the next few years. A career as an entrepreneur is a realistic alternative to employment in the ?gig? economy for many young graduates. University-based incubators can provide a sheltered learning environment for those wishing to develop business ideas without incurring a large financial burden. In this paper, the authors draw on a range of literature (business incubation, entrepreneurial learning, human capital and communities of practice) to develop a model of a university-based incubator that will support young people in their transition to becoming real entrepreneurs.

17.
Sports Health ; 13(4): 359-363, 2021.
Article in English | MEDLINE | ID: covidwho-1133569

ABSTRACT

In this brief report, we describe the safety of reopening US Olympic and Paralympic Training facilities (USOPTFs) during the coronavirus disease 2019 (COVID-19) pandemic from July 2020 through October 2020. We evaluated the prevalence of COVID-19 infection at the time of reentry and cardiopulmonary sequelae of COVID-19 in elite athletes. All athletes returning to a USOPTF were required to go through a reentry protocol consisting of an electronic health history, a 6-day quarantine including twice-daily symptom surveys, COVID-19 polymerase chain reaction and antibody testing, physical examination, 12-lead electrocardiogram, high-sensitivity cardiac troponin I, and pulmonary function testing. Athletes with current or prior COVID-19 infection also underwent an echocardiogram, cardiology consultation, and additional testing as indicated. All athletes followed rigorous infection prevention measures and minimized contact with the outside community following reentry. At the time of this report, 301 athletes completed the reentry protocol among which 14 (4.7%) tested positive for active (positive polymerase chain reaction test, n = 3) or prior (positive antibody test, n = 11) COVID-19 infection. During the study period, this cohort accrued 14,916 days living and training at USOPTFs. Only one (0.3%) athlete was subsequently diagnosed with a new COVID-19 infection. No cardiopulmonary pathology attributable to COVID-19 was detected. Our findings suggest that residential elite athlete training facilities can successfully resume activity during the COVID-19 pandemic when strict reentry and infection prevention measures are followed. Dissemination of our reentry quarantine and screening protocols with COVID-19 mitigation measures may assist the global sports and medical community develop best practices for reopening of similar training centers.


Subject(s)
COVID-19/epidemiology , Housing , Infection Control/methods , Pandemics , Physical Conditioning, Human , Sports , COVID-19/complications , COVID-19 Testing , Competitive Behavior , Electrocardiography , Humans , Para-Athletes , Physical Examination , Quarantine , Respiratory Function Tests , SARS-CoV-2 , Troponin I/blood , United States
18.
J Psychiatry Neurosci ; 46(2): E232-E237, 2021 03 11.
Article in English | MEDLINE | ID: covidwho-1127808

ABSTRACT

Background: Monitoring of white cell counts during clozapine treatment leads to cessation of therapy if levels fall below predetermined values. Reductions in white cell counts, driven by lower levels of lymphocytes, have been observed with coronavirus disease 2019 (COVID-19). Neutropenia during COVID-19 has not been reported. We present data for 56 patients who were taking clozapine and had COVID-19. Methods: We included patients who were taking clozapine at the time they tested positive for COVID-19. We compared absolute neutrophil counts, lymphocyte counts and white cell counts between baseline and the first week of infection, and baseline and the second week of infection. Results: We observed reductions in absolute neutrophil counts (p = 0.005), lymphocyte counts (p = 0.003) and white cell counts (p < 0.001) between baseline and the first 7 days of COVID-19. All cell counts had returned to baseline levels by days 8 to 14. Six patients experienced neutropenia (absolute neutrophil counts < 2.0 × 109/L) and of those, 4 underwent mandatory cessation of clozapine. For 3 patients, clozapine treatment had been established for more than 6 months with no previous neutropenia, neutrophil levels returned to baseline within 2 weeks and no further neutropenia was observed on restarting treatment. Limitations: This was a retrospective chart review; larger cohorts are required. Clozapine plasma levels were largely not measured by clinicians. Conclusion: These data strongly suggest that mild neutropenia in the acute phase of COVID-19 in patients who are well established on clozapine is more likely to be a consequence of the virus than of clozapine treatment.


Subject(s)
Antipsychotic Agents/adverse effects , COVID-19/complications , Clozapine/adverse effects , Neutropenia/etiology , Psychotic Disorders/drug therapy , Schizophrenia/drug therapy , Adult , Aged , Aged, 80 and over , Antipsychotic Agents/therapeutic use , COVID-19/blood , Clozapine/therapeutic use , Female , Humans , Leukocyte Count , Leukopenia/etiology , Lymphocyte Count , Lymphopenia/etiology , Male , Middle Aged , Neutropenia/chemically induced , Neutrophils , Retrospective Studies , SARS-CoV-2 , Young Adult
19.
Mol Cell ; 81(7): 1548-1552.e4, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1051876

ABSTRACT

Remdesivir is a nucleoside analog approved by the US FDA for treatment of COVID-19. Here, we present a 3.9-Å-resolution cryo-EM reconstruction of a remdesivir-stalled RNA-dependent RNA polymerase complex, revealing full incorporation of 3 copies of remdesivir monophosphate (RMP) and a partially incorporated fourth RMP in the active site. The structure reveals that RMP blocks RNA translocation after incorporation of 3 bases following RMP, resulting in delayed chain termination, which can guide the rational design of improved antiviral drugs.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antiviral Agents/chemistry , RNA, Viral/chemistry , RNA-Dependent RNA Polymerase/chemistry , SARS-CoV-2/physiology , Virus Replication , Adenosine Monophosphate/chemistry , Adenosine Monophosphate/therapeutic use , Alanine/chemistry , Alanine/therapeutic use , Antiviral Agents/therapeutic use , Catalytic Domain , Humans , Viral Proteins
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