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

The fictions of J.M. Coetzee : master of his craft?

The thesis argues that through the portrayal of a sequence of authors-as-protagonists who write from within the apartheid andpost-apartheid condition, the South African novelist J. M. Coetzee engages with the 'paradox of postcolonial authorship'. Whilst striving symbolically to retrieve the lost and silenced histories of colonised Others, writers of conscience (or conscience-stricken writers) risk re-enacting the very authority they seek to challenge. Taking account of Coetzee's recent material and adding to ongoing debates, the research traces the non-systematic shifts and transitions in the corpus in which Coetzee rehearses and revises his understanding of the ethics of intellectualism in parallel with the emergence of the 'new South Africa'. The thesis identifies three general tendencies in the trajectory of the work. Firstly, the early fiction is read within Coetzee's project of 'demythologising history' as a means of laying bare the 'madness of civilisation' and thereby exposing colonialist history as another ideologically inflected discourse. The middle phase engages with debates about the limits of representing the racial Other. Through the dialectical motifs of speech and silence, Coetzee attempts to bridge the impasse of postcolonial authorship: the racial Others in these novels are both silenced by oppression and silent in resistance. Finally, published on the cusp of regime change, and then postapartheid, the later novels are read as confessions in which the figure of the angstridden and dislocated white writer strives for persoflal nc1 historit tut(' d reconciliation'. The trajectory of the oeuvre crystallises notions of ethical writing practices, sparely portrayed in the sequence of meta-generic 'Costello lectures'. The academic and novelist Elizabeth Costello endorses notions of feeling and sentiment ("heart-speech") over and above the discourses of reason and rationality, thereby developing Coetzee's concern with the formulation of the private speaking to and informing the public sphere. The thesis assesses how successfully, as a member of a white academic elite in South Africa, Coetzee accommodates his various roles as author, public intellectual and citizen (or private individual with both rights, and obligations to society). Overturning Edward Said's formulation of the public intellectual 'speaking truth to power', Coetzee is sceptical about what constitutes 'truth' and refuses to take confrontational positions. Yet, by withdrawing from the public domain as he makes interventions (speaking through Elizabeth Costello, for instance), Coetzee self-consciously problematises his own position (what he might call a 'nonposition'), lending weight to the claim that he is politically evasive.EThOS - Electronic Theses Online ServiceArts and Humanities Research Council (AHRC)GBUnited Kingdo

The fictions of J. M. Coetzee: master of his craft?

The thesis argues that through the portrayal of a sequence of authors-as-protagonists who write from within the apartheid andpost-apartheid condition, the South African novelist J. M. Coetzee engages with the 'paradox of postcolonial authorship'. Whilst striving symbolically to retrieve the lost and silenced histories of colonised Others, writers of conscience (or conscience-stricken writers) risk re-enacting the very authority they seek to challenge. Taking account of Coetzee's recent material and adding to ongoing debates, the research traces the non-systematic shifts and transitions in the corpus in which Coetzee rehearses and revises his understanding of the ethics of intellectualism in parallel with the emergence of the 'new South Africa'. The thesis identifies three general tendencies in the trajectory of the work. Firstly, the early fiction is read within Coetzee's project of 'demythologising history' as a means of laying bare the 'madness of civilisation' and thereby exposing colonialist history as another ideologically inflected discourse. The middle phase engages with debates about the limits of representing the racial Other. Through the dialectical motifs of speech and silence, Coetzee attempts to bridge the impasse of postcolonial authorship: the racial Others in these novels are both silenced by oppression and silent in resistance. Finally, published on the cusp of regime change, and then postapartheid, the later novels are read as confessions in which the figure of the angstridden and dislocated white writer strives for persoflal nc1 historit tut(' d reconciliation'. The trajectory of the oeuvre crystallises notions of ethical writing practices, sparely portrayed in the sequence of meta-generic 'Costello lectures'. The academic and novelist Elizabeth Costello endorses notions of feeling and sentiment ("heart-speech") over and above the discourses of reason and rationality, thereby developing Coetzee's concern with the formulation of the private speaking to and informing the public sphere. The thesis assesses how successfully, as a member of a white academic elite in South Africa, Coetzee accommodates his various roles as author, public intellectual and citizen (or private individual with both rights, and obligations to society). Overturning Edward Said's formulation of the public intellectual 'speaking truth to power', Coetzee is sceptical about what constitutes 'truth' and refuses to take confrontational positions. Yet, by withdrawing from the public domain as he makes interventions (speaking through Elizabeth Costello, for instance), Coetzee self-consciously problematises his own position (what he might call a 'nonposition'), lending weight to the claim that he is politically evasive

'Many kinds of strong voices' : transnational encounters and literary ambassadorship in the fiction of Margaret Atwood and Hanan Al-Shaykh

This research began as an attempt to question to what extent a politics of solidarity and the evolution of a ‘transnational feminism’ which travels across borders can be established within Arab and Western literary novels. While this study, in spirit, takes its lead from the call for ‘feminism without borders’ within the writings of two contemporary women writers, the Canadian Margaret Atwood and the Lebanese Hanan Al-Shaykh, it responds to the notion of transnationalism and literary ambassadorship from the perspective of Arab-Western relations. This process raises key questions for the reading of women’s writings across sensitive cultural divides: How can the literary contributions of Margaret Atwood and Hanan Al-Shaykh help in reshaping the form and content of a transnational and cultural interaction between the Arab World and the West? Do women writers articulate their concerns in the same manner across cultures? To what extent can literature cross borders and be fully engaged within diverse women’s concerns? And what might hinder the circulation of a transnational literary interaction? These contemporary women writers have been studied in the belief that their novels are committed to a transnational feminist agenda. Both writers place their feminist concerns within a national framework that they constantly negotiate. However, this comparison to test the value of women’s writings across borders has been challenged by a more complex study of factors that intervene along the way. The politics of reception, the processes of production, circulation, and consumption of the writers’ literary texts, the writers’ own shifting allegiances moving from nationalism to broader multicultural, cosmopolitan and transnational frameworks, are all factors to be taken into account. These factors have a direct impact on the context through which the literary texts have to be studied. Hence, this study seeks to contribute to this task by showing how these writers are engaged in the process of adjusting, reconstructing and even transcending their cultural milieus.EThOS - Electronic Theses Online ServiceApplied Science UniversityGBUnited Kingdo