ENACT study : what has helped health and social care workers maintain their mental wellbeing during the COVID-19 pandemic?

A growing body of research has highlighted the adverse impact of COVID-19 stressors on health and social care workers’ (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental wellbeing of HSCWs during the third lockdown period in Scotland. Using a cross-sectional design, participants (n= 1364) completed an online survey providing quantitative data and free open-text responses. A multi-method approach to analysis was used. The majority of HSCWs were found to have low wellbeing scores, high levels of COVID-19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental wellbeing. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help-seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental wellbeing. Our findings illuminate the complexity of the effects of the COVID-19 pandemic on HSCWs’ wellbeing and will inform future intervention development seeking to increase positive adaptation and improve staff wellbeing. Addressing barriers to mental health help-seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics

Single hepatocytes show persistence and transcriptional inactivity of hepatitis B

© 2020, Balagopal et al. This is an open access article published under the terms of the Creative Commons Attribution 4.0 International License.There is no cure for the more than 270 million people chronically infected with HBV. Nucleos(t)ide analogs (NUCs), the mainstay of anti-HBV treatment, block HBV reverse transcription. NUCs do not eliminate the intranuclear covalently closed circular DNA (cccDNA), from which viral RNAs, including pregenomic RNA (pgRNA), are transcribed. A key gap in designing a cure is understanding how NUCs affect HBV replication and transcription because serum markers yield an incomplete view of intrahepatic HBV. We applied single-cell laser capture microdissection and droplet digital PCR to paired liver biopsies collected from 5 HBV/HIV-coinfected persons who took NUCs over 2-4 years. From biopsy 1 to 2, proportions of HBV-infected hepatocytes declined with adherence to NUC treatment (P < 0.05); we extrapolated that eradication of HBV will take over 10 decades with NUCs in these participants. In individual hepatocytes, pgRNA levels diminished 28- to 73-fold during NUC treatment, corresponding with decreased tissue HBV core antigen staining (P < 0.01). In 4 out of 5 participants, hepatocytes with cccDNA but undetectable pgRNA (transcriptionally inactive) were present, and these were enriched in 3 participants during NUC treatment. Further work to unravel mechanisms of cccDNA transcriptional inactivation may lead to therapies that can achieve this in all hepatocytes, resulting in a functional cure.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 Vaccine Responses in Individuals with Antibody Deficiency: Findings from the COV-AD Study

BACKGROUND: Vaccination prevents severe morbidity and mortality from COVID-19 in the general population. The immunogenicity and efficacy of SARS-CoV-2 vaccines in patients with antibody deficiency is poorly understood. OBJECTIVES: COVID-19 in patients with antibody deficiency (COV-AD) is a multi-site UK study that aims to determine the immune response to SARS-CoV-2 infection and vaccination in patients with primary or secondary antibody deficiency, a population that suffers from severe and recurrent infection and does not respond well to vaccination. METHODS: Individuals on immunoglobulin replacement therapy or with an IgG less than 4 g/L receiving antibiotic prophylaxis were recruited from April 2021. Serological and cellular responses were determined using ELISA, live-virus neutralisation and interferon gamma release assays. SARS-CoV-2 infection and clearance were determined by PCR from serial nasopharyngeal swabs. RESULTS: A total of 5.6% (n = 320) of the cohort reported prior SARS-CoV-2 infection, but only 0.3% remained PCR positive on study entry. Seropositivity, following two doses of SARS-CoV-2 vaccination, was 54.8% (n = 168) compared with 100% of healthy controls (n = 205). The magnitude of the antibody response and its neutralising capacity were both significantly reduced compared to controls. Participants vaccinated with the Pfizer/BioNTech vaccine were more likely to be seropositive (65.7% vs. 48.0%, p = 0.03) and have higher antibody levels compared with the AstraZeneca vaccine (IgGAM ratio 3.73 vs. 2.39, p = 0.0003). T cell responses post vaccination was demonstrable in 46.2% of participants and were associated with better antibody responses but there was no difference between the two vaccines. Eleven vaccine-breakthrough infections have occurred to date, 10 of them in recipients of the AstraZeneca vaccine. CONCLUSION: SARS-CoV-2 vaccines demonstrate reduced immunogenicity in patients with antibody deficiency with evidence of vaccine breakthrough infection

Chloe K. Tanner Oral History Interview

Interview of Chloe K. Tanner by Jay Hammond and Verna Richardson regarding life in the early twentieth century, coming of telephones and automobiles, and geographic placement of families

Compensation of nutrient pollution by herbivores in seagrass meadows

© 2015 Elsevier B.V. The capacity of natural systems to absorb disturbances without undergoing major change is a critical aspect of stability. While human-driven increases in resources are well known to cause profound change to habitat-forming perennials, often as an indirect effect on enhanced growth of opportunistic species, less is known about the natural capacity for consumption to compensate for this excess production. Nutrient inputs to seagrass systems increase the production of epiphytic algae and lead to seagrass decline however, it is relatively unclear whether grazers can compensate for this elevated production. Small invertebrate mesograzers are important herbivores in these systems, grazing predominately on epiphytic algae, potentially increasing the survival of seagrass during periods of nutrient enrichment. Using a cage-free technique and catchment-based nutrient concentrations, we experimentally manipulated mesograzer abundance and nutrient concentrations simultaneously in a subtidal Posidonia angustifolia meadow to test for trophic compensation. We tested the hypotheses that nutrient enrichment not only stimulates mesograzers to increase consumption, but that this increase in rate of consumption also matches the rate of increase in the production of epiphytes. Consecutive increases in nutrient addition caused consecutive increases in epiphyte production in treatments of reduced herbivory, but not in treatments of natural herbivory. Mesograzers fully compensated for the effects of minor nutrient addition and nearly compensated for the effects of moderate nutrient addition by decreasing the accumulation of epiphytic algae on seagrass leaves. Although nutrient addition alters food availability and quality of epiphytes, the abundance of grazing amphipods did not increase in treatments of natural herbivory, suggesting that the greater consumption of epiphytes was due to an increase in per capita grazing. These results suggest that herbivores may not only counter the effects of resource enhancement but may fully compensate minor to moderate events of nutrient pollution by consuming the additional productivity of opportunistic species that can cause loss of community dominants.Link_to_subscribed_fulltex