Improving prevention, monitoring and management of diabetes among ethnic minorities: contextualizing the six G’s approach

Objective: People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of devel-oping diabetes and face greater barriers to accessing healthcare resources compared to their ‘white British’ counter-parts. The extent of these barriers varies by demographics and different socioeconomic circumstances that people find themselves in. The purpose of this paper is to present and discuss a new framework to understand, disentangle and tackle these barriers so that improvements in the effectiveness of diabetes interventions for BAME communities can be achieved. Results: The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors is essential in increas-ing knowledge of healthy eating, engagement in physical activity and utilisation of healthcare services. Use of the six G’s framework alongside a community centred approach is crucial in developing and implementing culturally sensi-tive interventions for diabetes prevention and management in BAME communities. This could improve their health outcomes and overall wellbeing

Higher education in dark times: from the democratic renewal of Brazilian universities to its current wreck

This article discusses the recent expansion and democratization of Brazil’s higher education system from the beginning of the twentyfirst century to the present, concluding with its contemporary clash with the far-right government, which has placed universities and scientific knowledge under attack – an experience had around the globe. In the last two decades, Brazilian public universities have become more diverse in terms of the class and racial backgrounds of students, as well as their larger expansion with new campuses in the hinterlands, the Amazon, and the peripheries of metropolitan areas. Private higher education has also expanded enormously – in part, thanks to capital concentration, inflow of foreign capital, massive public subsidies and oligopolistic strategies. In both public and private sectors, Brazilian higher education has experienced a renascence. However, since 2018, the new power bloc, concentrated around President Bolsonaro and the far right, chose Public Universities and the National Science and Research system as one of its main targets. The current regressive moment in Brazil it is not an exception, in different countries universities and science are under attack. Ultimately, this article seeks to contribute, not only to a better understanding of Brazil’s on-going experience, but also to the larger public debate on higher education policy in the Global South and other countries facing similar challenges

Antibody response to four doses of SARS-CoV-2 vaccine in rare autoimmune rheumatic diseases: an observational study

ObjectivesAntibody response to COVID-19 vaccines are reduced among immunocompromised patients but are not well-quantified among people with rare disease. We conducted an observational study to evaluate the antibody responses to the booster SARS-CoV-2 vaccine in people with rare autoimmune rheumatic diseases (RAIRD).MethodsBlood samples were collected after second, before third, after third and after fourth vaccine doses. Anti-spike and anti-nucleocapsid antibody levels were measured using an in-house ELISA assay. Logistic regression models were built to determine the predictors for non-response. Results were compared with age and sex matched healthy controls (HC).Results43 people with RAIRD were included, with a median age of 56 years. Anti-spike seropositivity increased from 42.9% after second dose to 51.2% after third dose and 65.6% after fourth dose. Median anti-spike antibody levels increased from 33.6 (IQR 7.8–724.5) post-second dose to 239.4 (IQR 35.8–1051.1) BAU after the booster dose (third dose, or fourth dose if eligible). 22.2% of participants who had sufficient antibody levels post-second dose had insufficient levels after the booster. 34.9% of participants had lower antibodies after the booster than the lowest HC had after the second dose. Rituximab in the six months prior to booster (p = 0.02) and non-white ethnicity (p = 0.04) was associated with non-response. There was a dose-response relationship between timing of rituximab and generation of sufficient antibodies (p = 0.03).ConclusionsAlthough the booster dose increased anti-spike IgG and seropositivity rates, some people with RAIRD, particularly those on rituximab, had insufficient antibody levels despite 3–4 doses