Learner' Online Self-regulated Learning Skills: A Comparison Between Chinese Undergraduates and International African Undergraduates

The outbreak of the COVID-19 pandemic forced students to move from face-to-face learning to online learning. Online learning has high demands on students' Self-regulated Learning (SRL) skills. In this study, a questionnaire that used five-point Likert scale was administrated between international African undergraduates and Chinese undergraduate students to investigate their online learning behaviors. The questionnaire was composed of six categories: environment structuring, goal setting, time management, help-seeking, task strategies, and self-evaluation. 441 valid responses were received, 89 from international African students and 352 from Chinese undergraduates. The collected data were analyzed with SPSS Version 24.0. The results showed that there was no significant difference between Chinese student' and international African students' SRL skills in the six sub-scales. This may be due to the small sample size of African students and the similar learning environment. Larger samples are needed in future research to further verify the conclusion. The research results can be used as a reference for the future online learning design to strengthen learners' SRL skills. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Vaccine Hesitancy Among African Americans

The limited participation of African Americans in clinical trials has been a topic of discussion among medical and scientific researchers for some time. With the testing of coronavirus vaccines, this discussion has continued, particularly given the disproportionate impact of the virus on members of the African American community. With the public health goal of achieving widespread or "herd" immunity, the concept of "vaccine hesitancy" has also been addressed with regard to the population in general, and in relation to the African American community, among others. Vaccine hesitancy has been reported among groups from healthcare workers to rural residents to the poor. As is the case with all segments of society, African Americans are not monolithic. However, there are aspects of the issue of vaccine hesitancy which are unique and specific to the African American community in the U.S. In particular, the nature of the information about the coronavirus itself and about the vaccine, and importantly, the increasing availability of the information about the Tuskegee experiment, Henrietta Lacks, and other cases, along with the prevalence of misinformation and disinformation on aspects of science, such as that involving vaccines, are relevant to understanding the nature of vaccine hesitancy among African Americans.

Age reporting for the oldest old in the Brazilian COVID-19 vaccination database: What can we learn from it?

BACKGROUND Age misreporting affects population estimates at older ages. In Brazil, every citizen must be registered and show an identity document to vaccinate against COVID-19. This requirement to present proof of age provides a unique opportunity for measuring the oldest-old population using novel administrative data.OBJECTIVES To offer critically assessed estimates of the Brazilian population aged 80 and older based on data from the vaccination registration system (VRS). To uncover discrepancies between the number of vaccinated oldest-old people and the projections used to estimate target populations for COVID-19 vaccination. METHODS We calculate data quality indicators based on data from the VRS - namely, 100+/80+ and 90+/80+ population proportions, sex ratios, and the Myers blended index - and compare them to those based on data on target populations from Brazilian censuses and demographic projections, and from Sweden - a country with high-quality data. We also estimate vaccination coverage ratios using population projections adjusted to excess deaths as the denominators.RESULTS Requiring documentation reduces age heaping, age exaggeration, and sex ratios marginally. However, it cannot solve the problem of the misreporting of birth dates due to the absence of long-standing birth registration systems in Brazil, particularly in the northern and central regions. In addition, we find a mismatch between the projected populations and numbers of vaccinated people across regions.CONCLUSIONS Despite improvements in data quality in Brazil, we are still not confident about the accuracy of age reporting among the oldest old in the less advantaged Brazilian regions. The postponement of the 2020 census reduced the ability of authorities to define the target populations for vaccinations against COVID-19 and other diseases.CONTRIBUTIONS This is the first study to compare population estimates for the oldest old in administrative data and census data in Brazil. Age misreporting resulted in discrepancies that may have compromised the efficacy of the COVID-19 vaccination campaign.

Exploring Challenges Experienced by Teachers in Implementing Inclusive Education in Classrooms: A South African Perspective

The implementation of inclusive education in schools in South Africa has not been fully achieved despite the existence of numerous policies on the same. However, there is very scanty information on current issues that are faced by teachers during the pandemic. Therefore, the present study sought to examine challenges experienced by teachers in implementing inclusive education in classrooms within a South African context. In this study, Bronfenbrenner's ecological theory was adopted. The phenomenological research design was adopted for this study. The selected sample size in this study was eight participants obtained using purposive sampling method. In this study, semi-structured interview was used as the data collection tool. Thematic framework was adopted to analyse data in this study. The study reported that there were four main themes on classroom challenges faced by teachers namely, limited instructional time, inadequate resources, inadequate support and lastly, impact of COVID-19 pandemic. The study recommends that teachers should adopt collaborative practices with school base support teams which had the capacity to mobilise several resources available on the local community to enhance implementation of inclusive education.

Application of the Jhala Risk Scoring System (JRSS) to a SARS-CoV-2 Sequenced Population

Introduction/Objective Much was unknown initially regarding the triaging of scarce resources to manage the COVID-19 disease, particularly for prognosticating hospital admission needs, which contributed to the healthcare resource supply crisis. Thus, the authors developed the simple Jhala Risk Scoring System (JRSS). There is no report in the English literature that has explored a risk scoring system in patients with a SARS-CoV-2 sequencing result demonstrating different SARS-CoV-2 strains;hence, presented here is a first report. Methods/Case Report The JRSS assesses risk factor points based on patient's age, ethnicity, pulmonary medical history, cardiovascular medical history, diabetes history, smoking history, and laboratory parameters. From the veteran patients who had been sequenced for COVID-19 from March 2021 to June 2022 with available clinical notes or follow-up, the JRSS was applied to obtain a JRSS score. This JRSS score was then compared with the patient's admission status, SARS-CoV-2 sequence result, and survival. A JRSS score of 7 or greater would designate higher risk. Results (if a Case Study enter NA) There were a total of 11 COVID-19 positive patients meeting the inclusion criteria during the study period. 4 of these 11 patients were from March to May 2021. The patient ages ranged from 55-80 years of age and consisted of 2 Caucasian Americans and 2 African Americans. Of these 4 patients, 1 was treated as an outpatient (JRSS score 2), 2 were treated in the intensive care unit within which 1 expired (both JRSS score 9), and 1 was treated on the medical floor (JRSS score 7). All 4 patients from March to May 2021 sequenced to have Pango Lineage B.1.1.7. 7 of the 11 patients were from May to June 2022. The patient ages ranged from 69-86 years of age and consisted of 4 Caucasian Americans, 2 African Americans, and 1 decline to state. Of these 7 patients, 1 patient expired in the CLC (JRSS score 10). 5 recovered within the CLC with JRSS scores of 5, 7, and 8 for 2, 1, and 2 patients respectively. One patient required hospitalization (JRSS of 6 based clinically only as lab parameters were not performed). All 7 patients except for 1 sequenced for BA.2.12.1, a subvariant of Omicron. The 1 patient who sequenced with a different Omicron subvariant (BA.2.9) was one of the 5 patients who recovered from infection within the CLC. Conclusion The JRSS, developed early in the pandemic, is a very simple and highly successful system that helps in prognostication even with the Omicron outbreak.

Knowledge of African Traditional Medicine System: Immunomodulation

African traditional medicine is one of the oldest forms of health-care system in the continent that has continued to be relevant. It is usually holistic, treating mind and body, and includes aromatherapy, bone setting, circumcision, herbs, homeopathy massaging, spiritual therapies, maternity care, psychiatric care, music therapy, and many more. It is a very old and culturally informed method of health management that humans have used against diseases that have threatened existence. More than 60,000 of the world's higher plant species can be found in sub-Saharan Africa and the Indian Ocean Islands. These are about one-fourth of the global total and less than the 8% of the medicinal plants sold internationally from Africa. This scarcity could be due to lack of data on the traditional uses of many African plants as the knowledge is transferred orally by storytellers and traditional healers though in recent times, there are some information in print. Immunomodulation is seen as an essential feature of immunotherapy whereby immune responses are provoked, heightened, decreased, or avoided. Immune responses have been observed to be either cellular co-receptor expression, class switching, cytokine secretion, histamine release, immunoglobulin secretion, lymphocyte expression, or phagocytosis. Immune system dysfunction is responsible for various diseases like allergies, asthmas, arthritis, cancers, and infectious diseases. So modulation of immune responses is required in controlling diseases. This is requisite nowadays because of the upsurge of infectious diseases like superbugs caused by Multi-Resistant Staphylococcus aureus (MRSA) and the coronavirus (COVID-19) plus other emerging diseases. The historical view of African Traditional Medicine (ATMs) will be discussed from the point of view of specific plants used for immunomodulation in the ATMs and their efficacies following the trend of use and development of herbal medicines from crude formulations to refined dosage forms and procedures over time. Most of the ATMs are prepared as tonics and bitters to heighten and keep up immune defenses. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Complex presentations in people with diabetes: Does HbA1c help or hinder?

HbA1c measurement is widely used for diagnosis/ management/remission of diabetes with international schemes certifying comparability. A) 75 year-old Chinese female with type 2 diabetes was admitted in April 2020 with Covid-19 and diabetic ketoacidosis. Glucose was 35mmol/l and HbA1c 150mmol/mol with previous HbA1c of 45mmol/mol on metformin and alogliptin. She was treated for ketoacidosis and once-daily Lantus introduced along with supportive management of viral illness. B) 68 year-old Afro-Caribbean with type 2 diabetes on metformin before admission, presented with new onset, jerky ballistic movements of high amplitude in right arm, 10-15 movements every 5 min. Admission glucose was >33mmol/l, ketones 1.8mmol/l and HbA1c >217mmol/ mol. Hemichorea-hemiballism, a hyperglycaemia related movement was diagnosed and insulin commenced. Glucose decreased to 8-20mmol/ l, reaching 5-15mmol/ l by time of discharge. Ballistic movements resolved when glycaemic control improved with HbA1c 169mmol/mol, 25 days after discharge. C) Several days before admission, a female with diabetes over 20 years required attention from paramedics on four occasions for hypoglycaemia. Months beforehand metformin was replaced by gliclazide due to chronic kidney disease with HbA1c 50mmol/mol, and she was transfused six weeks before admission for microcytic anaemia. Gliclazide was discontinued and her diet modified which prevented further hypoglycaemic episodes. Variant haemoglobin, beta-thalassaemia which can overestimate glycaemia;undetected by HbA1c HPLC method, invalidated HbA1c as did the blood transfusion. These cases highlight that inadequate understanding of HbA1c can lead to acute presentations of dysglycaemia. As HbA1c accuracy can be affected by multiple factors, clinical assessment and triangulation are key to the management of such patients.

Assessment of Burden of COVID-19 Infection and the Dynamics in African Union Member States

Objectives: This study assessed the real-world burden of COVID-19 infection in African Union (AU) member states during the first 12 months of the pandemic using selected epidemiological measures. Method(s): Data were sourced from the African CDC and Our World in Data,for time period spanning February 2020 to January 2021. AU member states were classified into low, medium and high burden based on COVID-19 morbidity. We conducted descriptive and inferential analyses of the following epidemiological measures: morbidity and mortality rates (MMRs), case fatality rate (CFR), and case ratios. Result(s): A total of 3.2 million COVID-19 cases were reported during the first 12 months, with 2.6 million recoveries, 536,784 cases remaining active, and 77, 486 deaths. Most countries in AU experienced low burden of COVID-19 (49.1%, n=26) compared to 28.3% (n=15) with medium and 22.6% (n=12) with high burden of the disease. South Africa recorded the highest number of cases (1.31 million) followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7,888 and 5,528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 12 months, 62.43% were from high burden countries. The least testing occurred in the medium burden (18.42%) countries. The overall CFR of AU was 2.21%. Morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the period with significant (p<0.0001) variations across burden levels and regions. Continental morbidity and mortality rates of 17,359/105 population and 315.933/105 population were recorded with significant correlation (r=0.863, p<0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels. Conclusion(s): Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning and deployment of resources including vaccines.Copyright © 2023

An examination of virtual exchange on the intercultural competence of college students

This study examines the effect of a virtual exchange experience on the intercultural competence of college students from the United States and MENA (Middle East and North Africa) region. Archival data from the Stevens Initiative was used to test whether 70 students from the United States and 72 students from Iraq and Jordan gained intercultural competence upon completion of a virtual exchange program known as the Global Solutions Sustainability Challenge. Intercultural competence was measured using the variables of cross-cultural collaboration, ethnocentrism, problem solving, perspective taking, and empathy. Results showed a significant increase in cross-cultural collaboration and decrease in ethnocentrism for MENA students. There was a significant increase in problem solving for U.S. students. Contrary to expectations, perspective taking declined for both groups of students and there were no changes in empathy. Overall, the results show support for the effectiveness of virtual exchange on improving the intercultural competence of college students. In light of challenges to international travel due to COVID 19 and the high cost of study abroad, virtual exchange is a viable and creative alternative for developing intercultural competence. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Culturally Sustaining Pedagogies to Restore Individual and Collective Well-Being

This essay begins with Nikole Hannah-Jones's assessment of the solidarity that has sustained African Americans' hope that our country can still make good on the promise of democracy. This social resilience has sustained BIPOC communities through the pandemic in ways that demonstrate how personal well-being is rooted in collective wellness. Research on students' understanding of social resilience has examined how feelings of dignity and self-sufficiency foster hope and enable collective agency. This dynamic is vital to culturally sustaining pedagogies that help students engage with the lifeways that help them feel connected and hopeful. We discuss critical hip hop pedagogy as an example of culturally engaged teaching that can cultivate students' social resilience by acknowledging the dignity of their communal experiences and traditions in ways that can sustain hope and enable collective action.

Areas within the United States at the Highest Risk for African Swine Fever, Classical Swine Fever, and Foot-and-Mouth Disease Introduction

Domestic livestock production is a major component of the agricultural sector, contributing to food security and human health and nutrition and serving as the economic livelihood for millions worldwide. The impact of disease on global systems and processes cannot be understated, as illustrated by the effects of the COVID-19 global pandemic through economic and social system shocks and food system disruptions. This study outlines a method to identify the most likely sites of introduction into the United States for three of the most concerning foreign animal diseases: African swine fever (ASF), classical swine fever (CSF), and foot-and-mouth disease (FMD). We first created an index measuring the amount of potentially contaminated meat products entering the regions of interest using the most recently available Agricultural Quarantine Inspection Monitoring (AQIM) air passenger inspection dataset, the AQIM USPS/foreign mail, and the targeted USPS/foreign mail interception datasets. The risk of introduction of a given virus was then estimated using this index, as well as the density of operations of the livestock species and the likelihood of infected material contaminating the local herds. Using the most recently available version of the datasets, the most likely places of introduction for ASF and CSF were identified to be in central Florida, while FMD was estimated to have been most likely introduced to swine in western California and to cattle in northeastern Texas. The method illustrated in this study is important as it may provide insights on risk and can be used to guide surveillance activities and optimize the use of limited resources to combat the establishment of these diseases in the U.S.

Social Determinants of Health and Their Impact on Families of Children with Sickle Cell Disease during Covid-19 Pandemic

Background: According to national prevalence data, SCD has an estimated economic burden of $2.98 billion per year in the United States and caring for a child with sickle cell disease (SCD) carries its own financial burden, resulting in higher healthcare costs and unintended days lost from employment. Social experiences are known to impact health outcomes in the general pediatric population. These experiences can be examined through the construct of social determinants of health (SDOH), the "condition in which people are born, grow, work, live and age" that impact their health. Since the WHO has designated COVID-19 a pandemic in January 2020, many families in the US have suffered financially, and during the shutdowns, there was a record number of jobs lost. The objective of this study was to determine the impact of the COVID-19 pandemic on financial and employment status of SCD Families Methods: This study was part of the larger CNH Sickle Cell Disease Social Determinants of Health study that was IRB approved. Caregivers of children with SCD completed a 30-question survey reporting their experiences with SDOH that included Demographics, USDA Food Security Scale, the We Care housing screening tool, and the validated COVID-19 Employment Status/COVID-19 related household finances survey in RedCap during clinic visits and hospitalizations Results: 99 caregivers of SCD patients responded to our survey (82.5% Female, 17.5% Male) (N=97). 93.9% identified as African-American, 3% identified as Hispanic or Latinx, 1% identified as "other". Of respondents, 66% were insured through on Medicaid and 33% had private insurance. Twenty-six percent endorsed food insecurity and 2724% relied on low-cost food. Thirty-one percent lived in an apartment, 67.768% lived in a home, 1% lived in shelter or transitional housing. Sixteen percent lived in subsidized or public housing. Thirty-seven (36.8%) percent reported at least once they were being unable to pay the mortgage or rent on time at least once, 9% (8.5%) reported living with other people because of financial difficulties, 55.2% reported their home not being heated, 7.2% reported being evicted from their home and 3.1% lived in an emergency shelter or transitional housing. 6.1% had an educational level of high school graduation or less, 42.2% were college graduates or completed additional post-graduate education (N=98). Two weeks prior to the pandemic, 61.5% worked full time, 13.5% worked part time, 6.3% were unemployed with only 2.1% working from home of the 96 caregivers who responded to this question. 15.5% (N=12 of 77) reported losing their job or were furloughed during the pandemic;34.4% (N=33 of 96) reporting at least one household member losing a job or a significant amount of income. Twenty-five percent (N=21 of 83) reported it was difficult to get work/school done because of the home environment. 36.4 % (N=35 of 96) reported household income was significantly less since February 2020. 53% (N=52 of 97) worried their household income has been or will be negatively impacted by the COVID-19 pandemic. Additionally, 48.9% (N=47 of 96) worried the value of their assets (housing, savings, other financial assets) has been or will be negatively impacted by COVID-19 and its effects. Since February 2020, 9.8% (N= 9 of 97) received unemployment insurance, 30.9% (N=29 of 94) received SNAP or food stamps, 16.5% (N= 15 of 91) received from the food pantry, 6.6% (N=6 of 90) applied for temp ass.

Uptake of the Post COVID-19 Condition ICD-10-CM Diagnosis Code By Social Factors

Objectives: Post-COVID conditions (PCC) are increasingly reported in people who had COVID. Certain racial or socioeconomic groups may be at greater risk for PCC and less likely to seek care. We examined the uptake of the new ICD-10-CM diagnosis code for PCC in routine clinical practice in the United States and how it varied by race and payer group. Method(s): Using the Optum de-identified Electronic Health Record (EHR) dataset, we identified patients with an ICD-10-CM code for PCC (U09.9) between October 1, 2021, through March 31, 2022, with 6 months of prior EHR activity. The earliest diagnosis defined the index date. All concurrent diagnoses were measured on the index date. Prior COVID diagnosis was assessed using all available data before the index date. Result(s): There were 23,647 patients: 9.9% were African American, 12.1% had Medicaid, and 2.4% were uninsured. There was an overrepresentation of white patients among those with PCC (78.6% compared with 69.6% of the overall EHR in 2021). More African American (24.1%), Medicaid (23.1%), and uninsured (27.5%) patients were diagnosed in the inpatient setting or emergency department than whites (14.0%) and commercially insured patients (10.0%). Among racial groups, African Americans had the highest percentage of documented prior COVID diagnosis at 63.6%. Of concurrent diagnoses, shortness of breath and acute respiratory failure with hypoxia were higher among African Americans (13.9% and 6.1%, respectively) than whites (11.5% and 4.3%, respectively). The same pattern was seen when comparing Medicaid and uninsured to commercial payors. Conclusion(s): The PCC code was used differently across racial groups and payor types and captures varying manifestations of PCC. The differences in diagnosis locations underscore the importance of using data capturing all care settings when conducting studies using this code. Subgroup analyses are important for future studies using U09.9 due to variability in code application.Copyright © 2023

Perceptions of food among adult African Americans in the primary care setting

Introduction: The medical population lacks satisfactory information concerning the views regarding food perception among both male and female adult African Americans with consideration of chronic diseases, highest education level and marital status. The idea has not been fully exploited in research which has provoked the study. This study examines the views of food perception in relation to the health care and wellbeing of individuals. It offers satisfactory data that would in turn bring about the easy understanding of different perceptions concerning food choices, evaluating whether level of education and chronic disease play any role in decision making. It aims to make recommendations of the need for deploying healthier diet practices for better health outcomes. Methodology: The research is a mixed qualitative and quantitative study using both recorded interviews and a demographic questionnaire for data collection. Due to COVID-19 restrictions, the demographic questionnaire was transcribed by the investigator according to the volunteer participant's verbalized answers, who were conveniently selected on their scheduled clinic visit day. The participant read and signed the form after hands sanitized containing 70% ethyl alcohol gel. The second part of the study was a telephonic interview, which was recorded, and information transcribed onto an excel worksheet in preparation for analysis. Data was collected and tabulated in an excel worksheet and then uploaded to Statistical Packages and Software Services (SPSS) an IBM application that aided in simplifying data presentation in the form of graphs which made it easier to draw conclusions. Results: There were 65 participants with 48 females and seventeen 17 males, and 56.9% with a college education in the study of which 84.6% were responsible for buying and preparing food. From the research analysis of the collected data, it was discovered that 43.1% of participants admitted to not eating healthy, 23.1% being influenced by maintaining health, 21.5% to being influenced by taste, and 15.4% eating as their medical condition recommends. Conclusion: To promote healthier food choices we need to embrace useful education and motivation strategies to encourage healthy food perception and hence healthy eating. To minimize the risks that may emerge from unhealthy food perceptions, the recommendation is crucial for meaningful collaboration with African Americans to prioritize and implement improved dietary habits and reduce diet-related chronic diseases. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 Vaccine Willingness among African, Caribbean, and Black People in Ottawa, Ontario

Vaccines have been identified as a crucial strategy to control the spread of COVID-19 and reduce its impact. However, there are concerns about the acceptance of vaccines within African, Caribbean, and Black (ACB) communities. Based on a community sample of ACB people in Ottawa, Ontario (n = 375), the current study aimed to use logistic regression analysis and identify factors associated with COVID-19 vaccine willingness. A multivariate analysis shows that ACB people who believed that the ACB population is at a higher risk for COVID-19 were more likely to be willing to receive the vaccine compared to those who did not (OR = 1.79, p < 0.05). ACB people who had received at least one dose of the COVID-19 vaccine were more likely to be willing to receive it in the future (OR = 2.75, p < 0.05), and trust in government COVID-19 information was also positively associated with vaccine willingness (OR = 3.73, p < 0.01). In addition, English-speaking respondents were more willing to receive the vaccine compared to French-speaking respondents (OR = 3.21, p < 0.01). In terms of socioeconomic status, ACB people with a post-graduate degree (OR = 2.21, p < 0.05) were more likely to report vaccine willingness compared to those without a bachelor's degree. Based on these findings, we discuss implications for policymakers and directions for future research. [ FROM AUTHOR] Copyright of COVID is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Development of a core outcome set for studies investigating safety, efficacy, and implementation of COVID-19 vaccines: A collaboration with African American/Black communities in Baltimore City, Maryland

Background: Since it was declared a global pandemic in March 2020, Coronavirus Disease 2019 (COVID-19) has claimed over one million lives in the United States. Since COVID-19 vaccine rollout efforts began in Baltimore City, Maryland in December 2020, approximately 63.4% of all residents have been fully vaccinated (i.e., received their first and second doses in a two-dose series or received a single-dose vaccine). Despite efforts to implement equitable vaccine distribution in Baltimore City, prominent disparities in COVID-19 vaccine uptake persist, with poorer, predominantly Black neighborhoods frequently reporting lower levels of vaccine uptake than affluent, predominantly White neighborhoods. Guided by key principles of community-based participatory research, this dissertation explores community experiences with COVID-19 vaccines and develops a core outcome set (COS), inclusive of community-important outcomes, for use in studies evaluating the safety, efficacy, and implementation of COVID-19 vaccines. Methods: In March 2022, semi-structured interviews were held with vaccinated and unvaccinated Black residents of a community in Baltimore City reporting 40% vaccination uptake. Data were analyzed using inductive thematic analysis with subsequent subgroup analyses and thematic network analyses. To assess the extent to which outcomes measured in COVID-19 vaccine studies published between December 2019 and March 2022 aligned with factors of vaccine hesitancy, a systematic literature review (SLR) was conducted. Results from the qualitative analyses and the SLR informed the development of a candidate list of outcomes used in the first round of a Delphi study held in June 2020. After two rounds of Delphi survey distribution, a face-to-face consensus meeting was held with community members and community health workers to prioritize outcomes of interest to all relevant stakeholders and finalize the COS. Results: Thematic analysis yielded four emergent themes relating to COVID-19 vaccine uptake decision making: (I) Safety and efficacy of vaccines, (II) Perceived importance of COVID-19 vaccines in relation to pre-existing community needs, divided into two subthemes, a) Environmental injustice and (b) Personal health concerns, (III) Access to trustworthy, understandable information, and (IV) Physical access to vaccines. Participants acknowledged that physical access to COVID-19 vaccines was not a major barrier to uptake, however finding trustworthy and understandable information about the safety and efficacy of the vaccines were common areas of concern. Of all primary outcomes (N=20) identified in the 56 articles included in the SLR, 85% (n=17) corresponded with factors of vaccine hesitancy. The final COS included 19 outcomes across four "domains:" "Is the vaccine safe?";"Does the vaccine work in my body?";"Does the vaccine work in the community?";and "Outcomes identified during consensus meeting." Conclusion: The findings from this dissertation suggest that although community-important outcomes related to safety and efficacy of vaccines are often addressed in clinical studies, outcomes measuring institutional trust, economic and health impacts, community acceptance of the vaccines, and trustworthiness of vaccine information are underutilized in studies of vaccine implementation. As these social factors function as barriers to vaccine uptake, particularly among underserved communities, they should be regarded as indicators of equitable access to COVID-19 vaccines. The findings from this dissertation provide a framework with which public health researchers can begin to rethink measures of equity in vaccine rollout efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Whole Story: A Black Principal's Experience with Race, Racism, and Racial Trauma

Principal Harris, a new Black male principal at Merion High School, has found himself under fire for allegedly promoting critical race theory (CRT). He has received several forms of pushback as he navigates district and state mandates, racial trauma, invisible taxes, and microaggressions. Unfortunately, his best intentions are not good enough. This case is designed to display the various factors Black principals face in schools and districts amid ongoing public health crises (e.g., COVID-19 and racism). I describe the layered role of race, racism, and racial trauma on Principal Harris through his reflections and responses to stakeholders.

Improving Healthcare Deserts in Sub-Saharan Africa: A Health Improvement Pilot Study Leveraging a Global, Cloud-Based Telemedicine Platform

Objectives: The objective of this project was to improve healthcare deserts in Sub-Saharan Africa through sustainable knowledge transfer and capacity-building leveraging an advanced cloud-based telemedicine platform. Method(s): In 2022, WTI and its network of partners delivered 2 telehealth devices as part of the effort to create a sustainable platform to address a known health desert in a previously abandoned clinic in the village of Opoji, in the state of Edo, Nigeria. Providers were trained in two cohorts. Global Experts for this project were organized with Providence Health and their Global and Domestic Engagement (GDE) department and trained in telementoring and teleconsulting. Local Specialists were first trained on the platform and then telementored by Global Experts. To better understand the health value outcomes of these interventions, observational research was employed to measure the improvement of patient-to-provider ratios. These ratios were baselined for average patient loads. Result(s): As a result of the pilot, provider-to-patient ratios were improved. Prior to the WTI program, interventions were only available 5% of the time (9 hrs/wk vs 168 hrs/wk), with very basic expertise. After the Opoji Comprehensive Medical Center was reopened and the supporting physicians were scheduled, patients could be seen with a high level of global medical expertise 100% of the time (24 hours per day). Conclusion(s): Telemedicine technology can improve capacity-building in Sub-Saharan Africa with relatively minimal resource allocation in a replicable and scalable manner. Data collection for the pilot did have limitations. The opportunity to collect patient-reported outcomes, including patient satisfaction with telemedicine visits, exists but COVID and other barriers prevented researchers from fully implementing. By mentoring the local specialty hospital staff to deliver care by cloud-based devices, the program has developed an "Africans helping Africans" approach to achieve sustainable capacity building which can be built upon and further researched.Copyright © 2023