Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Defining an Infant\u27s Race and Ethnicity: A Systematic Review.

Infant race and ethnicity are used ubiquitously in research and reporting, though inconsistent approaches to data collection and definitions yield variable results. The consistency of these data has an impact on reported findings and outcomes

Markets, schools and the convertibility of economic capital : the complex dynamics of class choice

While economic capital is not synonymous with cultural, social or symbolic capital in either its constitutional or organisational form, it nevertheless remains the more flexible and convertible form of capital. The convertibility of economic capital has particular resonance within ‘Celtic Tiger’ Ireland. The State’s reluctance to fully endorse an internal market between schools has resulted in middle class parents using their private wealth to create an educational market outside State control in the private sector to help secure the class futures of their children. Using data from recent studies of second-level education in Republic of Ireland, and data compiled on the newly emerging ‘grind’ schools (businesses selling educational programmes on a purely commercial basis outside the control of the Department of Education and Science), we outline how the availability of economic capital allows well-off middle class parents to choose fee-paying schooling, or to opt out of the formal school sector entirely to employ market solutions to their class ambitions. The data also show that schools are not passive actors in the class game; they actively collude in the class project to their own survival advantage.Focusing too much on the dynamics of parental choice between schools leads to a neglect of the markets in education being created outside of the school system: the ‘choice’ that exists is no longer simply between schools, but also between schools and private businesses. Focus on parental choice also forecloses debate about the central roles that schools themselves play in perpetuating class inequality.Not applicableti,ke.kpw30/9/1

Disjointed Innovation: The Political Economy of Digitally Mediated Institutional Reform

Current attention to social media and governance has focused on the enactment of networked communication and information use by and for governance with particular attention to the role of civil society. This paper argues that such a focus, while illuminating a possibly utopian perspective on political participation, often obscures even recent government reforms, existing institutional arrangements, and the myriad processes by which knowledge is translated to action in political settings. Drawing from and extending core perspectives within historical institutionalism, the paper examines three streams of theory and research: temporal models, coordination models, and the political effects of public policies where policies themselves may be conceptualized as institutions. Illustrations are drawn from American and European politics and used to ground as well as to probe models. The objective of the paper is a conceptualization that rebalances attention between agency and structure and that simultaneously considers the political past as well as the future