Factors associated with low knowledge of biosafety in medical interns at a university in Peru in the context of the COVID-19 pandemic

Introduction: The right to pre-professional practices protected under Peruvian Law allows the student in the last year of the human medicine career to begin to participate in health care procedures and interventions under the guidance of a tutor. Objective: to determine the factors associated with low knowledge of biosafety in medical interns at a university in Peru in the context of the covid-19 pandemic. Methods: an observational, prolective and cross-sectional design was carried out. The sample consisted of 336 human medicine interns, who were selected by simple random probabilistic sampling. A valid and reliable instrument was used to determine the level of knowledge in biosafety. A bivariate and multiple logarithmic binary regression model was used to calculate the crude and adjusted prevalence ratio with their respective 95% confidence intervals for the factors associated with the level of knowledge in biosafety. Results: high, medium and low levels of knowledge of 44.6%, 26.8% and 28.6% respectively were found. Married marital status (RPA 0.418, 95% CI 0.181 – 0.968), living with people at risk for severe symptoms from covid-19 (RPA 0.472, 95% CI 0.344–0.647), undergoing medical internship in a hospital, and having been diagnosed by covid-19 in the last 12 months (RPA 0.586, 95% CI 0.387–0.887) were associated with a level of knowledge under biosafety by multiple logarithmic binary regression model. Discussion: married marital status, living with people at risk for severe symptoms of covid-19, undergoing medical internship in a hospital center and having been diagnosed with covid-19 have an inversely proportional relationship with low knowledge in biosafety. In medical interns in the context of the covid-19 pandemic. © 2022, Faculty of Medical Sciences, Santa Rosa del Aguaray Branch, National University of Asuncion. All rights reserved.

Factors associated with health outcomes among the uninsured population

The United States health care system lacks uniform and universal health coverage, causing approximately 10% of the population to be without health insurance, a critical determinant of health care access. Safety net organizations, including free clinics, provide free and/or reduced health care services to sociodemographic disadvantaged individuals. Despite concerns about the uninsured population, free clinic patients have not been sufficiently studied. This dissertation was designed to address this gap by adding to the literature and was designed around three empirical chapters utilizing mixed methodology.The first study used cross-sectional primary data to examine the differences between perceived and physiological stress levels and the effect of a social support network among uninsured free clinic patients. Findings suggest that higher levels of perceived stress are not significantly more prevalent than higher levels of salivary cortisol among these populations. Higher levels of social networking are significantly associated with lower perceived stress levels;having more friends than family members is slightly more associated with lower levels of perceived. However, social support and networking was not significantly associated with patients' salivary morning cortisol levels.The second study utilized a qualitative approach regarding COVID-19 vaccine perception and hesitancy among uninsured free clinic patients. Social networks are found to be important factors in reducing vaccine hesitancy. Hesitant patients had concerns related to vaccines' safety, effectiveness, and side effects. Lack of valid and reliable COVID-19 vaccination information was a challenge among this study's participants.The third study also utilized cross-sectional primary data to examine whether certain factors, including the component of patient-centeredness, are associated with patient autonomy among these populations. Findings conclude that Spanish speaking patients at the free clinic have a stronger belief in a paternalist model of the provider-patient relationship. Better communication between patients and providers results in higher levels of autonomy. Higher levels of educational attainment and better communication partnership were associated with higher levels of a free clinic patient's understanding of treatment risks.In conclusion, this dissertation's focus was to understand characteristics of an uninsured population to help develop strategies and intervention on changing behaviors, providing information that leads to their better health outcome. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Leveraging an essentials and extension assessment and evaluation model to differentiate in pandemic learning

Teachers at Riverview High School (RHS) in Anglophone East School District, New Brunswick in Canada, have worked as professional learning community teams to establish a new paradigm of assessment and evaluation during the pandemic outbreak. The Essentials and Extension Model of Assessment and Evaluation has successfully been adapted to courses across grades and disciplines to provide support to struggling students and personalized learning opportunities for all students. This model was well established at RHS when schools were closed for the remainder of the 2020 school year due to COVID-19. When teachers and students were required to transition to a remote learning environment, this model facilitated that transition at RHS. This chapter gives an overview of the literature behind the model, a description of the system, and the effects of the model on student learning. © Springer Nature Switzerland AG 2021. All rights reserved.

A UNIVERSAL BASIC INCOME FOR BRAZIL: FISCAL AND DISTRIBUTIONAL EFFECTS OF ALTERNATIVE SCHEMES

The Covid-19 pandemic outbreak has led to an increasing interest in universal basic income (UBI) proposals, as it exposed the inadequacy of traditional welfare systems to provide basic financial security to a large share of the population. In this paper, we use a static tax-benefit microsimulation model to analyse the fiscal and distributional effects of the hypothetical implementation in Brazil of alternative UBI schemes that partially replace the existing tax-transfer system. The results indicate that introducing a UBI/Flat Tax system in the country could be both extremely effective in reducing poverty and inequality and economically viable. © 2023, Universidade Federal do Rio de Janeiro. All rights reserved.

Five key questions educators ask about SEL

Schools have become increasingly interested in social-emotional learning (SEL) over the past decade, and that interest has grown due to concern about student well-being resulting from the COVID-19 pandemic. However, there is confusion around SEL. Christi Bergin, Christina Cipriano, Tia Barnes, Shannon B. Wanless, researchers who have studied and designed SEL for decades, respond to questions frequently asked by educators as they consider an SEL approach for their school. They discuss what SEL is, its benefits, how it aligns with other programs, how to select an SEL program, and where to learn more about SEL programs. © 2023 by Phi Delta Kappa International.

Descriptive Study Investigating Impact of Transition to Universal Health Insurance Coverage on Utilization of Healthcare in Sudan, 2016 - 2021

Objectives: Since 2016, Sudan was transitioning from limited healthcare subsidization to universal health coverage (UHC). Increasing healthcare access was widely considered beneficial, but some worried that UHC would overwhelm clinical services. In 2020 and 2021 UHC faced the challenge of Covid-19. We undertook a review of national healthcare utilization and enrolment data in order to better understand the impact of UHC in Sudan. Method(s): We conducted a descriptive study using National Health Insurance Fund databases. We analyzed annual enrolment, participating facilities, prescription volume and utilization from 2016 to 2021. Enrolment was stratified by employment status (government, informal sector, private sector, pensioner, impoverished). Utilization was assessed by type of care: primary, specialty, chronic disease and other;we calculated the ratio of primary to specialty care visits. We used the Mann-Kendall test for evaluating trends. Result(s): Participating facilities increased from 2,083 in 2016 to 3,549 in 2019, with slight contraction to 3,495 during 2020-21. Annual enrolment increased significantly, from 16.4 million in 2016 to 36.5 million in 2021 (p value < 0.01). The impoverished sector had the largest increase in enrolment (217%);informal sector had the lowest enrolment growth rate (7%). Volume of primary healthcare visits and prescriptions increased every year, except 2020, the first year of Covid-19 in Sudan. Specialty healthcare visits decreased over the same period, from 2,461,424 to 1,249,585 (p < 0.01). The ratio of primary to specialty visits increased from 6.0 in 2016 to 15.7 in 2021 (p < 0.001). Conclusion(s): In Sudan, transition to UHC increased utilization of primary care services, but at a slower rate than enrolment growth. The ratio of primary to specialty visits increased and specialty visits declined, suggesting that more primary care may have prevented specialist-requiring disease states and sequelae. Fears of overwhelming the health system were unfounded indicating that other barriers to healthcare might exist.Copyright © 2023

Epidemiological change of influenza virus in hospitalized children with acute respiratory tract infection during 2014-2022 in Hubei Province, China.

PURPOSE: Influenza virus (IFV) causes acute respiratory tract infection (ARTI) and leads to high morbidity and mortality annually. This study explored the epidemiological change of IFV after the implementation of the universal two-child policy and evaluated the impact of coronavirus disease 2019 (COVID-19) pandemic on the detection of IFV. METHODS: Hospitalized children under 18 years with ARTI were recruited from Hubei Maternal and Child Healthcare Hospital of Hubei Province from January 2014 to June 2022. The positive rates of IFV were compared among different periods by the implementation of the universal two-child policy and public health measures against COVID-19 pandemic. RESULTS: Among 75,128 hospitalized children with ARTI, the positive rate of IFV was 1.98% (1486/75128, 95% CI 1.88-2.01). Children aged 6-17 years had the highest positive rate of IFV (166/5504, 3.02%, 95% CI 2.58-3.50). The positive rate of IFV dropped to the lowest in 2015, then increased constantly and peaked in 2019. After the universal two-child policy implementation, the positive rate of IFV among all the hospitalized children increased from 0.40% during 2014-2015 to 2.70% during 2017-2019 (RR 6.72, 95% CI 4.94-9.13, P < 0.001), particularly children under one year shown a violent increasing trend from 0.20 to 2.01% (RR 10.26, 95% CI 5.47-19.23, P < 0.001). During the initial outbreak of COVID-19, the positive rate of IFV decreased sharply compared to that before COVID-19 (0.35% vs. 3.37%, RR 0.10, 95% CI 0.04-0.28, P < 0.001), and then rebounded to 0.91%, lower than the level before COVID-19 (RR 0.26, 95% CI 0.20-0.36, P < 0.001). CONCLUSION: IFV epidemiological pattern has changed after the implementation of the universal two-child policy. More attention should be emphasized to comprehend the health benefits generated by COVID-19 restrictions on IFV transmission in future.

Broad-spectrum pan-genus and pan-family virus vaccines.

Although the development and clinical application of SARS-CoV-2 vaccines during the COVID-19 pandemic demonstrated unprecedented vaccine success in a short time frame, it also revealed a limitation of current vaccines in their inability to provide broad-spectrum or universal protection against emerging variants. Broad-spectrum vaccines, therefore, remain a dream and challenge for vaccinology. This review will focus on current and future efforts in developing universal vaccines targeting different viruses at the genus and/or family levels, with a special focus on henipaviruses, influenza viruses, and coronaviruses. It is evident that strategies for developing broad-spectrum vaccines will be virus-genus or family specific, and it is almost impossible to adopt a universal approach for different viruses. On the other hand, efforts in developing broad-spectrum neutralizing monoclonal antibodies have been more successful and it is worth considering broad-spectrum antibody-mediated immunization, or "universal antibody vaccine," as an alternative approach for early intervention for future disease X outbreaks.

The impact of universal health coverage and COVID-19 pandemic on out-of-pocket expenses in Thailand: an analysis of household survey from 1994 to 2021.

OBJECTIVES: After Thailand achieved Universal Health Coverage (UHC) in 2002, the extent of financial risk protection has not been assessed in the long term, especially after the COVID-19 pandemic. Therefore, this study aims to revisit the impact of UHC on out-of-pocket expenses (OOPE) for health and to descriptively explore the impact of COVID-19 on OOPE. METHODS: This study was a secondary data analysis and used data from the Socio-Economic Survey from 1994 to 2021 in Thailand. The effect of UHC on the percentage of OOPE in total health expenditures (THE) from 1994 to 2019 was investigated with an interrupted time-series analysis. Descriptive analyses of OOPE in absolute value during the COVID-19 were conducted. RESULTS: The percentage of OOPE in THE significantly decreased both before (ß -2.02%; 95% CI: -2.70% to - 1.33%) and during (ß 1.41%; 95% CI: 0.70% to 2.11%) the UHC period. During the pandemic, total household OOPE for medical equipment was found to have rapidly increased from 643 million THB in 2019 to 9.4 billion THB in 2020. CONCLUSIONS: The trend of providing financial risk protection (measured by OOPE/THE) in Thailand continues until 2019. Providing medical equipment in sufficient and equally accessible manners should be prioritized during the future pandemic.

Multisectoral action towards sustainable development goal 3.d and building health systems resilience during and beyond COVID-19: Findings from an INTOSAI development initiative and World Health Organization collaboration.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. As the world faces global health crises such as pandemics, epidemics, climate change and evolving disease burdens and population demographics, building strong and resilient public health systems is of critical importance. The need for an integrated approach to building health system resilience; the widening of inequalities; and fears of vulnerable populations being left behind are critical issues that require Supreme Audit Institutions (SAIs) enquiry as independent public oversight bodies. Each country has a Supreme Audit Institution with a remit to audit public funds as an effective, accountable, and inclusive institution. Government audits are key components of effective public financial management and Good Governance. SAIs contribute to the quality of government engagement and better state-society relations through their work. As SAIs provide independent external oversight and contribute to follow up and review of national targets linked to the Sustainable Development Goals (SDGs) in their respective countries, they can play an important role in national recovery efforts. WHO and INTOSAI Development Initiative (IDI) have been collaborating in facilitating SAIs' audits of strong and resilient national public health systems linked to the national target of SDG 3.d in 40 countries across Africa, Americas, Asia and Oceania between 2021 and 2022. This paper aims to convey key lessons learned from the joint multisectoral collaboration for facilitating the 3.d audits that can contribute to building health systems resilience in ongoing recovery efforts. The collaboration included facilitation of the audits through professional education and audit support using a health systems resilience framework. The 3.d audits are performance audits and follow IDI's SDG Audit Model (ISAM). Following the ISAM implies that the SAI should focus on a whole-of-government approach, policy coherence and integration, and assess both government efforts at 'leaving no one behind' and multi-stakeholder engagement in implementing the chosen national SDG target linked to 3.d. WHO's Health Systems Resilience team has supported IDI and SAIs by delivering training sessions and reviewing working papers and draft reports of the SAIs from a health systems resilience perspective. IDI has provided the technical expertise on performance audits through its technical team and through in-kind contributions from mentors from many SAIs in the regions participating in the audit. In the 3.d audit, SAIs can ask how governments are acting to enhance capacity in some or all of the following, depending on their own national context and risk: forecasting, preventing and preparing for public health emergencies (PHEs) and threatsadapting, absorbing and responding to PHEs and threatsmaintaining essential health services in all contexts (including during emergencies/crises). The audits are expected to highlight current capacities of health systems resilience; the extent to which a whole-of-government approach and policy coherence have been utilised; and government efforts related to multistakeholder engagement and leaving no one behind in building health systems resilience related to progressing towards achieving the national target linked to 3.d by 2030. An overall positive achievement noted was that undertaking a complex health audit in the middle of a pandemic is possible and can contribute to building health systems resilience and recovery efforts. In their review of audit plans, draft summaries, and other work by the SAIs, both WHO and IDI have observed that SAIs have used the training and supplementary materials and applied various parts of it in their audits. This collaboration also demonstrates key considerations needed for successful partnership across multisectoral partners at global, regional and national levels. Such considerations can be applied in different contexts, including socioeconomic and health system recovery, to ensure whole-of-society and whole-of-government action in building health systems resilience and monitoring and evaluation to maintain and accelerate progress towards the national target linked to SDG3.d, health security and universal health coverage (UHC), as well as broader socioeconomic development.

Area-specific covid-19 effects on health services utilization in the Democratic Republic of the Congo using routine health information system data.

BACKGROUND: Since March 2020, the COVID-19 pandemic has shocked health systems worldwide. This analysis investigated the effects of the pandemic on basic health services utilization in the Democratic Republic of the Congo (DRC) and examined the variability of COVID effects in the capital city Kinshasa, in other urban areas, and in rural areas. METHODS: We estimated time trends models using national health information system data to replicate pre-COVID-19 (i.e., January 2017-February 2020) trajectories of health service utilization, and then used those models to estimate what the levels would have been in the absence of COVID-19 during the pandemic period, starting in March 2020 through March 2021. We classified the difference between the observed and predicted levels as the effect of COVID-19 on health services. We estimated 95% confidence intervals and p-values to examine if the effect of the pandemic, nationally and within specific geographies, was statistically significant. RESULTS: Our results indicate that COVID-19 negatively impacted health services and subsequent recovery varied by service type and by geographical area. COVID-19 had a lasting impact on overall service utilization as well as on malaria and pneumonia-related visits among young children in the DRC. We also found that the effects of COVID-19 were even more immediate and stronger in the capital city of Kinshasa compared with the national effect. Both nationally and in Kinshasa, most affected services had slow and incomplete recovery to expected levels. Therefore, our analysis indicates that COVID-19 continued to affect health services in the DRC throughout the first year of the pandemic. CONCLUSIONS: The methodology used in this article allows for examining the variability in magnitude, timing, and duration of the COVID effects within geographical areas of the DRC and nationally. This analytical procedure based on national health information system data could be applied to surveil health service disruptions and better inform rapid responses from health service managers and policymakers.

The disproportionate effect of COVID-19 on the labour market in South Korea

COVID-19 delivered distributional effects on the labour market. Therefore, policymakers concentrated on designing more efficient and effective fiscal supports to alleviate economic damages. To draw more specific pictures, this study estimates who faced harder impacts and how much they experienced economic difficulties in Korea using unconditional quantile regression and separating vulnerable sectors, such as face-to-face industries. The findings suggest that self-employed workers in the vulnerable industries at low-income percentiles presented the most severe damages. Second, self-employed workers in other sectors, temporary workers in the vulnerable industries, and low-income households also had serious impacts. Third, female workers, who have a primary child-care duty, experienced serious negative effects due to the regulation disparity between strict school closure measures and generous workplace restrictions. In this regard, financial supports should aim to target more damaged groups instead of universal benefits. Furthermore, it is also important to improve child-care services to mitigate gender inequality.

Compliance with Standard Precaution Practices During the Early Phase of the Covid-19 Pandemic among Nurses in Nigeria

Background: Nurses serve at the frontline during disease outbreaks. While measures have been adopted to control the rapid spread of the Covid-19 pandemic, little is known about the level of compliance of nurses to standard precaution practices during the early phase of the pandemic. Objective: This study aimed to assess compliance with standard precaution practices (SPPs) among 713 nurses in Nigerian hospitals during the early phase of the pandemic. Method: The study adopted a descriptive cross-sectional design using an anonymous online questionnaire to elicit data from respondents. Data were analysed with the Statistical Package for the Social Sciences, version 25. Chisquare test and multiple regression analyses were also conducted where appropriate. Results: Findings from this study indicated that 448 (62.8%) of the respondents had good knowledge of Covid-19 and 265 (37.2%) had poor knowledge. Also, 529 (74.2%) had good compliance with the practice of standard precautions, and 184 (25.8%) showed non-compliance. A significant association was found between the age of nurses (X-2=14.034 p=0.015), years of experience (X-2=8. 636 p =0.035) and their overall compliance with the practice of standard precautions. Conclusion: During the early phase of the Covid-19 pandemic in Nigeria, although over an average of the nurses had good knowledge of the disease, over one-third had poor knowledge, and one-quarter showed poor compliance with standard precautions. Interventions to improve the knowledge and compliance of health workers during the early phase of disease outbreaks are hereby advocated, as 21.3% had no previous training on Covid-19.

Higher Education for Students with Disabilities. An Overview Through the Lens of Text Min

Inequalities and exclusion from education were exposed and worsened during the COVID-19 pandemic;however, it forced us to recognize the need to make equality, equity, and social inclusion policies effective for all. Scientific and technological solutions to global threats depend on the formation of the maximum number of qualified human resources, which entirely relies on enabling everyone to acquire, update, and improve their knowledge, skills, and competencies through lifelong learning and higher education. To guarantee inclusive and quality education for all (UN Sustainable Development Goal 4) is hard to achieve at higher education or post-secondary levels. This research aims to provide an overview of the achievements and challenges that higher education institutions (HEI) face in fulfilling the requirements of students with disabilities (SWD). We analyzed a database of 104 s from reviews of SWD in HEI published in Scopus-indexed journals between 2018 and August 2022. After data preprocessing, the text mining analysis on the corpus was visualized in word clouds and graphs. From the results, we could identify that providing access to facilities and information still dominates the research on inclusive education, and visual disability is the most frequently analyzed. The graphs reveal published research on undergraduates with disorders like Autism Spectrum (ASD), learning disorders, and visual, hearing, physical, intellectual, and psychosocial disabilities. The authors also evidenced the lack of information on the barriers and needs of SWD in HEI and potential future research to address them. Concerning the strategies to attend and care for SWD inside the classrooms, the graphs highlight Universal Design as a promising trend leading to inclusivity in higher education. The results and analyses in current research provide essential information to educational stakeholders and decision-makers inside institutions so that they can take action to embrace diversity. © 2023 IEEE.

When theory meets praxis – enhancing heritage management through practice-led research at Great Zimbabwe World Heritage property

Purpose: The purpose of this paper is to outline and reflect on the new research agenda for the Great Zimbabwe World Heritage property. This research agenda was jointly developed by academics and practitioners from Great Zimbabwe University (GZU) and the National Museums and Monuments of Zimbabwe (NMMZ) respectively. This Research-Practice Team was put together for the Heritage Place Lab (HPL), a pilot project of the ICCROM-IUCN World Heritage Leadership programme. Design/methodology/approach: A series of steps were undertaken to come up with research priorities and a new research agenda that are presented in this paper. The HPL project involved online workshops, due to the COVID-19 travel restrictions, that were held between September 2021 and April 2022. The HPL methodology involved six assignments that were based on the Enhancing Our Heritage Toolkit 2.0 (EOH) which was being designed by UNESCO and its Advisory Bodies. This toolkit encouraged the team to establish site-specific management issues and research needs. The toolkit helped the team to have a detailed appreciation of the site's Outstanding Universal Value as well as other heritage values of national and local importance. The toolkit also involved the mapping of site attributes and multiple actors as well as the analysis of governance and legal frameworks. The toolkit also required the team to identify factors affecting the heritage property. Findings: The Research-Practice Team highlighted challenges that resulted from the legacy of ill-informed research activities and conservation efforts at the World Heritage property. It became more apparent that the site managers were prioritizing the physical fabric of the site at the expense of the spiritual aspects. Lack of coordination among the actors was also undermining the governance structure. Four thematic strands which included local values and intangible cultural heritage elements;heritage governance;climate change and environmental sustainability and incorporation of local knowledge systems were identified for further research. Originality/value: The paper is an outcome of collaborative efforts that were done by academics and practitioners. Researchers and site managers at Great Zimbabwe had hitherto worked in silos. The majority of previous and ongoing research on the World Heritage property falls short of addressing the dire management challenges. The paper is an attempt to broaden the scope in terms of the management of the site. In the past focus has been on the monumental aspects of the site with specific reference to the dry-stone walled structures. However, in this instance, the Research-Practice Team has integrated new interests such as the intangible aspects of Great Zimbabwe, spirituality and community beneficiation. © 2023, Emerald Publishing Limited.

Come together? The unusual combination of precariat materialist and educated post-materialist support for an Australian Universal Basic Income

International studies using the European Social Survey (ESS) reveal higher support for Universal Basic Income (UBI) in poorer countries with less generous welfare systems, and among individuals with lower income and education, and leftist political leanings. We present data from the 2019-20 Australian Survey of Social Attitudes mirroring the ESS question. Australia falls in the middle of European opinion, with 51% supporting a UBI, increasing slightly during the onset of Covid-19. We also find higher support among two different groups: (1) those facing greater 'material' precarity, including younger, low-income, unemployed, suburban renters, and (2) those who have more post-materialist concerns, including Green-left voters and those favouring redistributive values. Unlike in other countries, higher education predicts more support, while homeownership predicts less. The article concludes with challenges to introducing UBI to Australia, including potentially contradictory strategies for different support bases (material vs post-material), ongoing commitments to means-testing, and negative framing in the media.

Impact of the Coronavirus Disease 2019 Pandemic on Dental Visits in Japan.

PURPOSE: This study aimed to clarify the impact of the coronavirus disease 2019 (COVID-19) pandemic on individual dental-visit behaviour and examine the difference between elderly and other individuals regarding the impact on dental visits. MATERIALS AND METHODS: An interrupted time-series analysis was performed to examine the change in data from the national database before and after the first declaration of a state of emergency. RESULTS: The number of patients visiting a dental clinic (NPVDC), number of dental treatment days (NDTD) and dental expenses (DE) during the first declaration of a state of emergency decreased by 22.1%, 17.9%, and 12.5% in the group under 64 years of age and 26.1%, 26.3%, and 20.1% in the group over 65 years of age, respectively, compared with those in the same month of the previous year. Between March and June 2020, the monthly NPVDC and NDTD were significantly reduced (p < 0.001, p = 0.013) in those over 65 years of age. The DE did not change statistically significantly in either the under 64 group or the over 65 group. There was no statistically significant change in the slope of the regression line in the NPVDC, NDTD, and DE before and after the first state-of-emergency declaration. CONCLUSION: The first state of emergency greatly reduced the NPVDC, NDTD, and DE compared to those in the previous year. In people aged over 65 years, it might still be unresolved 2 years after the postponement of dental treatment owing to the first declaration of a state of emergency.

Potential of conserved antigenic sites in development of universal SARS-like coronavirus vaccines.

Given pandemic risks of zoonotic SARS-CoV-2 variants and other SARS-like coronaviruses in the future, it is valuable to perform studies on conserved antigenic sites to design universal SARS-like coronavirus vaccines. By using antibodies obtained from convalescent COVID-19 patients, we succeeded in functional comparison of conserved antigenic sites at multiple aspects with each other, and even with SARS-CoV-2 unique antigenic sites, which promotes the cognition of process of humoral immune response to the conserved antigenic sites. The conserved antigenic sites between SARS-CoV-2 and SARS-CoV can effectively induce affinity maturation of cross-binding antibodies, finally resulting in broadly neutralizing antibodies against multiple variants of concern, which provides an important basis for universal vaccine design, however they are subdominant, putatively due to their lower accessibility relative to SARS-CoV-2 unique antigenic sites. Furthermore, we preliminarily design RBDs to improve the immunogenicity of these conserved antigenic sites. Our study focusing on conserved antigenic sites provides insights for promoting the development of universal SARS-like coronavirus vaccines, thereby enhancing our pandemic preparedness.

Strengthening Health Systems Using Innovative Digital Health Technologies in Africa.

While effective health systems are needed to advance Universal Health Coverage and actualize the health Sustainable Development Goals, information system verticalization remains a challenge among African health systems. Most investments are vertical, partner-driven and program-specific with limited system-wide impacts. Poor linkages exist amongst different solutions as they are not designed to capture robust data across multiple programmatic areas. To address these challenges, the World Health Organization Africa Regional Office has proposed the adoption of a Digital Health Platform (DHP) to streamline different solutions to a cohesive whole. The DHP presents a pragmatic approach of bringing multiple platforms together using recognized standards to create a national infostructure, which bridges information solutions toward healthy and sustainable outcomes. It has capacities to curate accurate, high fidelity and timely data feedback loops needed to strengthen and continuously improve program delivery, monitoring, management, and informed decision-making at every level of the health system regardless of location. This paper contributes to the ongoing regional conversations on the need to harness innovative digital solutions to improve healthcare delivery in Africa.

Parenting in the pandemic: exploring the experiences of families with children on Universal Credit before and during the COVID-19 pandemic

The expansion of the UK's support for families with children from the late 1990s was put into reverse over the decade from 2010. Even prior to the COVID-19 pandemic, therefore, parents may have felt that they had less support from the government and increased private responsibility in bringing up the next generation. Drawing on qualitative interviews with parents in England and Scotland claiming Universal Credit, this article analyses parenting experiences for low-income families during the COVID-19 pandemic, in particular concerning the costs of looking after children, caring for children, and family relationships/mental health. Our findings suggest that the privatisation of parenting in the UK has been further reinforced during the pandemic, with largely negative implications for families with children. The positive experiences for some with families must be supported by public policy change to persist.