A Call to Action: Person-Centered Care Aligned with Reproductive Justice for Incarcerated Pregnant People with Substance Use Disorder

Although research has proven that jails and prisons are ineffective in preventing or reducing substance use among pregnant people, the USA continues to rely heavily on the criminal legal system as its intervention. Pregnant people with an opioid use disorder are more likely to experience incarceration than pregnant people without an opioid use disorder. In some states, pregnant people are transported from jail to prison through the process of safekeeping in order to receive physical or mental health care that the jail does not provide, despite conviction status. When pregnant and postpartum safekeepers with an opioid use disorder experience incarceration, they face barriers related to continuity of physical and behavioral health care, have limited access to maternal-infant attaching opportunities at delivery, and are at risk for an opioid-related overdose upon release. This commentary describes clinical care challenges that impact the reproductive health needs of pregnant safekeepers with an opioid use disorder and offers solution-focused innovations to reduce harm. Such solutions include uninterrupted optimal dosing of medication and integrated prenatal clinics, specialized substance use disorder treatment, and opportunities to integrate lactation programs and perinatal dyadic-focused services

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Online Faculty Development: An African Lusophone Ophthalmic Society Experience During the COVID-19 Pandemic

PURPOSE: Faculty development for procedural specialists aims at developing both their medical education and surgical competence. This has been challenging during the COVID-19 pandemic, especially in under-resourced settings and African Lusophone ophthalmology community has been no exception. The Mozambican College of Ophthalmology (MOC) and the Continuing Professional Development Committee of the International Council of Ophthalmology (ICO) established a collaboration to enhance simulation-based clinical teaching competence in cataract surgery. METHODS: Ten Mozambican ophthalmologists experienced in teaching cataract surgery participated in a group mentoring assisted 6 month/11 flipped-learning online experience on curriculum design, which included practice-based and social learning strategies, continuous bidirectional feedback, individual and group reflection opportunities, and the demonstration of declarative and procedural competencies. Program evaluation consisted of pre and pos-test knowledge assessment; individual homework, informed by curated reading and a recorded lesson; feedback surveys for each module and one month after the program\u27s conclusion, and a longitudinal project on creating a simulation-based education session on one step of cataract surgery. RESULTS: Participants a) highlighted the opportunity to advance their scholarly teaching skills as facilitators; b) showed an increase in knowledge post-test, expressed commitment to improve their learning experiences´ design, include interactive educational methods, and provide constructive feedback; and c) formed a sustained community of practice of ophthalmologists educators (CoP). CONCLUSION: This online faculty development program, assisted by group mentoring, held during the COVID-19 pandemic, facilitated the development of a CoP and was effective in enhancing teaching competence in curriculum design to apply in simulation-based learning environments

Changes in humpback whale singing behavior with abundance: Implications for the development of acoustic surveys of cetaceans

Acoustic surveys of vocal animals can have significant advantages over visual surveys, particularly for marine mammals. For acoustic density estimates to be viable, however, the vocal output of the animals surveyed needs to be determined under a range of conditions and shown to be a robust predictor of abundance. In this study, the songs of humpback whales, one of the most vocal and best studied species of marine mammals, were tested as predictors of abundance. Two acoustic metrics, the number of singing whales and amount of songs produced, were compared with the number of whales seen traversing a study site on the eastern coast of Australia over an 18 year period. Although there were predictive relationships between both metrics and numbers of passing whales, these relationships changed significantly as the population grew in size. The proportion of passing whales that sang decreased as the population increased. Singing in humpback whales, therefore, is a poor predictor even of relative abundance and illustrates the caution required when developing acoustic survey techniques particularly when using social vocalizations. (C) 2017 Acoustical Society of America

Setting an Inclusive Appalachian Table: Lessons from the first 4-years of the Appalachian Food Summit

The Appalachian Food Summit is a community of writers, scholars, chefs, farmers, brewers, restauranteurs, community activists and traditional mountain food enthusiasts gathered around the table to honor the past, celebrate the present and support a sustainable future for Appalachian food and people. Founded in 2013, the first Summit gathering was hosted in the Spring of 2014 at the Hindman Settlement School in Hindman, Kentucky and garnished national media attention. Since then, the Summit has hosted an additional two annual gatherings, drawing hundreds of participants from the Appalachian region and beyond, for a day long symposium and dinner. Currently housed with Grow Appalachia at Berea College, the Summit seeks to be a movement building network that balances academic and advocacy interests by connecting scholars and writers with policy makers, farmers, chefs and others working in the local foods and agriculture sector. Lora Smith, co-chair of the Appalachian Food Summit, will share the organization’s vision for the next three years of development and engage the audience in a conversation on how the Food Summit can better serve the Appalachian Studies Association community and advance Appalachian foodways scholarship and research

The politics of austerity in Ireland

Since the onset of the sovereign debt crisis, the crisis-stricken countries in Europe have been pushed to take drastic steps to consolidate their finances and reduce their budget deficits. Despite strong public opposition and largely damaging short-run effects, the countries have undertaken many of the internationally recommended/mandated reforms and spending cuts. In this Forum, authors from Greece, Ireland, Italy, Spain and Portugal report on the fiscal consolidation achieved in their respective countries — and the sacrifices that have made it possible. Furthermore, the authors detail what remains to be done to resolve the crisis.Author has checked copyrightAM

How Early Implementations Influence Later Adoptions of Innovation: Social Positioning and Skill Reproduction in the Diffusion of Robotic Surgery

We report from a multi-level study investigating the diffusion of robotic surgery in the Italian health care system between 1999 and 2010. A combination of qualitative and quantitative methods allowed us to link organization-level processes associated to the adoption and implementation of the innovation with its diffusion at population level. Our findings advance our understanding of how early implementations influence later adoptions, by drawing attention to how search for social gains pushes some peripheral actors to pioneer a new technology or work practice, and to engage in practices of discursive persuasion and skill reproduction that constitute them as ‘exemplary users’ and that may eventually trigger and support isomorphic diffusion even in the presence of persisting uncertainty about the technical and/or economic benefits of the innovation