Vulnerability and One Health assessment approaches for infectious threats from a social science perspective: a systematic scoping review.

Vulnerability assessments identify vulnerable groups and can promote effective community engagement in responding to and mitigating destabilising events. This scoping review maps assessments for local-level vulnerabilities in the context of infectious threats. We searched various databases for articles written between 1978 and 2019. Eligible documents assessed local-level vulnerability, focusing on infectious threats and antimicrobial resistance. Since few studies provided this dual focus, we included tools from climate change and disaster risk reduction literature that engaged the community in the assessment. We considered studies using a One Health approach as essential for identifying vulnerability risk factors for zoonotic disease affecting humans. Of the 5390 records, we selected 36 articles for review. This scoping review fills a gap regarding vulnerability assessments by combining insights from various approaches: local-level understandings of vulnerability involving community perspectives; studies of social and ecological factors relevant to exposure; and integrated quantitative and qualitative methods that make generalisations based on direct observation. The findings inform the development of new tools to identify vulnerabilities and their relation to social and natural environments.

Rethinking vulnerability through Covid-19.

In times of crisis, inequalities are more commonly exaggerated than ameliorated - meaning both that vulnerable populations are often forced to make do with what resources are at hand and that many of those who barely manage in 'normal' times are pushed beyond capability and opportunity thresholds. Indeed, new case definitions of vulnerability that emerge in a crisis may push previously unrecognized groups (e.g. service employees, 'care' facility residents) into extreme vulnerability, as borderline coping quickly becomes calamity coping. To understand emerging vulnerability, it is therefore critical for social scientists to have a seat at the table where scarce resources are being allocated - before, during and after a crisis.

I heard it through the grapevine: On herd immunity and why it is important.

A. David Napier has been studying immunology and immunologists for more than three decades. In this article, he argues that the medicalization of viral epidemics has distracted us from the importance of their true social drivers: that is, the behaviour of people when they are together - what epidemiologists call human herds. On their own, viruses cannot 'invade' us. Our cells bring them to life and make them infectious through our social actions. Confusing viruses with invasive microbes not only leads us to misuse antibiotics, but fosters xenophobic responses towards outside carriers - as even our neighbours become categorical 'others' in the face of a foreign threat. Indeed, new work in viral epidemiology indicates that many viruses have infectious potential long before an epidemic develops. It is not only changes within viruses that cause epidemics, but also the condition of human herds - how we behave socially - that ignites the rapid circulation of viral information.

Vulnerability assessment tools for infectious threats and antimicrobial resistance: a scoping review protocol.

INTRODUCTION: This protocol will guide and explain the working process of a systematic scoping review on vulnerability assessment tools in the field of infectious disease outbreaks and antimicrobial resistance (AMR) crises. The scoping review will appraise existing tools or methodologies to identify local level vulnerabilities in the context of infectious disease outbreaks and AMR. Due to this focus on infectious threats and AMR, the review also considers articles using a 'One Health' approach to assess the vulnerability of individuals, groups and practices in human-animal-environment interactions. Given the broad nature of vulnerability, we aim to allocate studies discerning the process of identifying vulnerable or at-risk groups during a crisis, instead of studies taking vulnerability only as a starting point. Because considerable research has been conducted on vulnerability, disasters and climate change, we will also assemble tools developed from these fields. To our knowledge, this is the first planned systematic scoping review of vulnerability assessment tools for disease outbreaks and AMR, taking into account practices at the human-animal-environment interface that can lead to increased risk of exposure of individuals to infections, pathogen spillovers or epidemics. METHODS AND ANALYSIS: To develop the protocol, we used the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist (PRISMA-P 2015) in compliance with the PRISMA Extension for Scoping Reviews Explanation and Elaboration. With the assistance of an experienced research librarian, we developed the search strategy, which targeted the following databases: Medline, Global Health database, Web of Science and Embase. A second strategy was developed for Epistemonikos, African Journals Online and Global Index Medicus because these databases do not provide the infrastructure for an advanced search. We consider studies published between 1978 and 2019 and include articles, book chapters, websites and grey literature from selected non-governmental organisations and non-profit organisations working in the health field. We contact them directly regarding whether they are working with or have developed a vulnerability assessment tool. To address the dynamic nature of our investigation, we develop a flow diagram which we continually update to reflect the selection process. Two reviewers (MJ and LL) independently screen the literature and resolve conflicts through discussion rounds. Data extraction will be conducted by four researchers (MJ, LL, EJ and RK) through inductive and deductive coding. Extracted data will be systematically compared and divergences highlighted. ETHICS AND DISSEMINATION: Ethical approval is not required because this study does not involve collection of primary data. The purpose of this review is to disseminate a catalogue of vulnerability assessment tools and a brief summary of key results and recommendations for SoNAR-Global partners in Bangladesh, Ukraine and Uganda. The catalogue will be made publicly available. On the basis of our results, SoNAR-Global partners will pilot one of these tools.

Study protocol for the Cities Changing Diabetes programme: a global mixed-methods approach.

INTRODUCTION: Urban living has been shown to affect health in various ways. As the world is becoming more urbanised and almost two-thirds of people with diabetes now live in cities, research into the relationship between urban living, health and diabetes is key to improving the lives of many. The majority of people with diabetes have type 2 diabetes, a subset linked to overweight and obesity, decreased physical activity and unhealthy diets. Diabetes has significant consequences for those living with the condition as well as their families, relationships and wider society. Although care and management are improving, complications remain common, and diabetes is among the leading causes of vision loss, amputation, neuropathy and renal and cardiovascular disease worldwide. We present a research protocol for exploring the drivers of type 2 diabetes and its complications in urban settings through the Cities Changing Diabetes (CCD) partnership programme. METHODS AND ANALYSIS: A global study protocol is implemented in eight collaborating CCD partner cities. In each city, academic institutions, municipal representatives and local stakeholders collaborate to set research priorities and plan implementation of findings. Local academic teams execute the study following the global study protocol presented here. A quantitative Rule of Halves analysis obtains measures of the magnitude of the diabetes burden, the diagnosis rates in each city and the outcomes of care. A qualitative Diabetes Vulnerability Assessment explores the urban context in vulnerability to type 2 diabetes and identifies social factors and cultural determinants relevant to health, well-being and diabetes. ETHICS AND DISSEMINATION: The protocol steers the collection of primary and secondary data across the study sites. Research ethics board approval has been sought and obtained in each site. Findings from each of the local studies as well as the result from combined multisite (global) analyses will be reported in a series of core scientific journal papers.

Культура имеет значение: учет культурных контекстов здоровья при выработке политики

Данный аналитический обзор подготовлен в связи с растущей осведомленностью лиц, формирующих политику, и специалистов общественного здравоохранения о важной связи, которая существует между культурой и здоровьем. Отражение осведомленности в вопросах культуры в выработке политики имеет огромное значение для формирования адаптивных, справедливых и устойчивых систем медико-санитарной помощи, а также для общего прогресса во многих вопросах здоровья и благополучия населения. В обзоре рассматриваются три ключевые сферы общественного здравоохранения – питание, миграция и окружающая среда – и демонстрируется, насколько важную роль осведомленность в вопросах культуры играет в понимании концепций здоровья и благополучия и в выработке более эффективных и справедливых стратегий здравоохранения. В нем утверждается, что научные исследования в сфере гуманитарных и социальных дисциплин, имеющих отношение к здоровью, способны внести немалый вклад в выработку политики в области общественного здравоохранения.

Culture matters: using a cultural contexts of health approach to enhance policy making

This policy brief has been developed in response to the increasing awareness among policy-makers and the public health community of the important relationship between culture and health. Incorporating cultural awareness into policy-making is critical to the development of adaptive, equitable and sustainable health care systems, and to making general improvements in many areas of population health and well-being. By exploring the three key public health areas of nutrition, migration and environment, the policy brief demonstrates how cultural awareness is central to understanding health and well-being and to developing more effective and equitable health policies. Consequently, it argues that public health policy-making has much to gain from applying research from the health-related humanities and social sciences.

Nonself help: how immunology might reframe the Enlightenment.

The classical immunological paradigm is predicated on the body's ability to recognize and eliminate "nonself." However, the "self­nonself" model has yet to facilitate any resolution of the field's major concerns, and may thus prove to be of limited use. Merely discarding it is no solution, as the juxtaposition of "self" and "nonself" persists in research, in clinical settings, and in everyday practice despite the best efforts of theoretical immunologists. Instead, the very conception of "selfhood" may prove to be key. Replacing immunology's prior and persistent "self" with less static concepts derived from non-Western contexts not only resolves immunology's famous paradoxes but also offers a new and more accurate model that allows immunology to reframe what may become an outmoded Enlightenment construct of "self." In such a new paradigm, immunology's well-known system of protection and defense is replaced with a view in which nonself becomes less the body's enemy than its primary mechanism for the creative assimilation of difference. This incorporative model­in which the "immune system" functions more as a search engine than as an expeller of difference­both resolves outstanding paradoxes, and complies more accurately with contemporary knowledge and research practice.

Jinn, psychiatry and contested notions of misfortune among east London Bangladeshis.

This study examines understandings of misfortune among east London Bangladeshis, particularly with respect to the role of jinn spirits. It reports on the findings of ethnographic interviews among 40 members of this community. Appeal to jinn explanations is commonplace at times of psychological disturbance and unexplained physical symptoms. Resort to traditional healers is frequent. These explanations are contested by different groups in the community. The findings are examined within the context of a discourse on tradition and modernity with particular emphasis on Islam and modernity.

A visual skills inventory for children with neurological impairments.

Children with neurological impairments often have visual deficits that are difficult to quantify. We have compared visual skills evaluated by carers with results of a comprehensive visual assessment. Participants were 76 children with mild to profound intellectual and/or motor impairment (33 males, 43 females; age range 7mo-16y; mean age 5y 1mo [SD 4y 2mo]) who completed a visual skills inventory before attending a special vision clinic. The inventory included 16 questions about visual skills and responses to familiar situations. Responses were augmented by taking a structured clinical history, compared with visual evoked potential (VEP) and/or acuity card measures of visual acuity, and examined using exploratory factor analysis. Acuity ranged from normal to no light perception, and was positively associated with responses to individual questions. After excluding four uninformative questions, an association between the remaining questions and two significant independent factors was found. Factor 1 was associated with questions about visual recognition (e.g. 'Does your child see a small silent toy?') and these items were correlated with both the VEP and acuity card thresholds. Factor 2 was associated primarily with questions about visually mediated social interactions (e.g. 'Does he/she return your silent smile?'). Evaluation of visual skills in children with neurological impairment can provide valid information about the quality of children's vision. Questions with the highest validity for predicting vision are identified.

Experimental infection of possums with macropodid herpesvirus 1.

AIM: To determine whether macropodid herpesvirus 1 (MaHV-1) could infect brushtail possums (Trichosurus vulpecula) and whether such infection would lead to latency in possums. METHODS: Possums (n=9) were instilled with 1.9 x 10(8) TCID50 of MaHV-1 into the conjunctivae and nostrils, while controls (n=3) were administrated with sterile saline. For virus isolation, all possums were swabbed from the conjunctivae and nasal cavities prior to inoculation, and on Days 1, 3, 7, 10 and 14 post-inoculation (p.i.), and then at weekly intervals for up to a further 6 weeks. Sera were collected on Day 0 immediately prior to inoculation and fortnightly thereafter, for the measurement of antibody. Corticosteroids were administrated to 4/9 virus-inoculated possums on Days 36 and 41 p.i. to determine whether latent MaHV-1 infection could be reactivated. Trigeminal ganglia and other tissues were collected at necropsy for viral detection. A nested polymerase chain reaction (PCR) targeting the DNA-dependent DNA polymerase (DNA pol) gene of the herpesviruses using degenerate primers was conducted on DNA samples isolated from the ganglia and livers from the possums, and blind-passaged cell cultures, for viral detection. RESULTS: A mild conjunctivitis was observed in the majority of the virus-inoculated possums between Days 3 and 21 p.i. Virus was recovered from the conjunctiva and/or nasal swabs from 8/9 virus-inoculated possums on Days 1 and 3 p.i. and from 3/9 on Day 7 p.i., but not following administration of corticosteroids. No virus was recovered from the trigeminal ganglia of the virus inoculated possums and possum DNA samples were negative for viral DNA following nested PCR. All of the virus-inoculated possums produced a virus neutralisation antibody response by Day 28 p.i., and five had a titre >/=512. The sequence of a 133 base pair (bp) segment of the MaHV-1 DNA pol gene was considerably different from that of other published data. CONCLUSION: This study demonstrated that MaHV-1 might have established a transient infection at the inoculation sites, and the inoculation of MaHV-1 via intranasal and conjunctival routes could elicit MaHV-1-specific antibody responses in possums. However, systemic and latent infection of MaHV-1 in possums was not demonstrated.

No virus replication in domestic cats fed with RHDV-infected rabbit livers.

Previous studies have shown that feral cats (Felis catus) from rabbit haemorrhagic disease (RHD) epidemic areas in New Zealand had antibodies against RHD Virus (RHDV) and RHDV RNA was identified by nested RT-PCR from one seropositive feral cat liver. To assess whether RHDV replicates and produces clinical consequences in cats following the consumption of RHDV-infected rabbit, a challenge trial was conducted by feeding cats RHDV-infected rabbit livers. Antibodies against RHDV were detected by immunoassay from sera of cats collected 10 days after the consumption of RHDV-infected livers. Animals fed four times with RHDV-infected livers, had higher antibody titres than animals fed only once. RHDV RNA was detected by nested RT-PCR from mesenteric lymph nodes, tonsil, spleen and liver of cats fed with RHDV-infected livers. RHDV anti-genomic RNA was also detected by nested RT-PCR from mesenteric lymph nodes collected from one animal 2 days after the fourth feed. RHDV was detected by antigen ELISA from cat faeces 1-2 days after the consumption of RHDV-infected livers. Even though a large amount of RHDV has been used, cats did not show any signs of disease. Although abortive RHDV replication could not be ruled out, active RHDV replication was not demonstrated.

Dalitz plot analysis of the decay D(+)-->K(-)pi(+)pi(+) and indication of a low-mass scalar Kpi resonance.

We study the Dalitz plot of the decay D(+)-->K(-)pi(+)pi(+) with a sample of 15090 events from Fermilab experiment E791. Modeling the decay amplitude as the coherent sum of known Kpi resonances and a uniform nonresonant term, we do not obtain an acceptable fit. If we allow the mass and width of the K(*)(0)(1430) to float, we obtain values consistent with those from PDG but the chi(2) per degree of freedom of the fit is still unsatisfactory. A good fit is found when we allow for the presence of an additional scalar resonance, with mass 797+/-19+/-43 MeV/c(2) and width 410+/-43+/-87 MeV/c(2). The mass and width of the K(*)(0)(1430) become 1459+/-7+/-5 MeV/c(2) and 175+/-12+/-12 MeV/c(2), respectively. Our results provide new information on the scalar sector in hadron spectroscopy.

Hoxa3 and pax1 regulate epithelial cell death and proliferation during thymus and parathyroid organogenesis.

The thymus and parathyroid glands in mice develop from a thymus/parathyroid primordium that forms from the endoderm of the third pharyngeal pouch. We investigated the molecular mechanisms that promote this unique process in which two distinct organs form from a single primordium, using mice mutant for Hoxa3 and Pax1. Thymic ectopia in Hoxa3(+/-)Pax1(-/-) compound mutants is due to delayed separation of the thymus/parathyroid primordium from the pharynx. The primordium is hypoplastic at its formation, and has increased levels of apoptosis. The developing third pouch in Hoxa3(+/-)Pax1(-/-) compound mutants initiates normal expression of the parathyroid-specific Gcm2 and thymus-specific Foxn1 genes. However, Gcm2 expression is reduced at E11.5 in Pax1(-/-) single mutants, and further reduced or absent in Hoxa3(+/-)Pax1(-/-) compound mutants. Subsequent to organ-specific differentiation from the shared primordium, both the parathyroids and thymus developed defects. Parathyroids in compound mutants were smaller at their formation, and absent at later stages. Parathyroids were also reduced in Pax1(-/-) mutants, revealing a new function for Pax1 in parathyroid organogenesis. Thymic hypoplasia at later fetal stages in compound mutants was associated with increased death and decreased proliferation of thymic epithelial cells. Our results suggest that a Hoxa3-Pax1 genetic pathway is required for both epithelial cell growth and differentiation throughout thymus and parathyroid organogenesis.

Direct measurement of the pion valence-quark momentum distribution, the pion light-cone wave function squared.

We present the first direct measurements of the pion valence-quark momentum distribution which is related to the square of the pion light-cone wave function. The measurements were carried out using data on diffractive dissociation of 500 GeV/c pi(-) into dijets from a platinum target at Fermilab experiment E791. The results show that the /q&q> light-cone asymptotic wave function describes the data well for Q2 approximately 10 (GeV/c)(2) or more. We also measured the transverse momentum distribution of the diffractive dijets.

Observation of color-transparency in diffractive dissociation of pions.

We have studied the diffractive dissociation into dijets of 500 GeV/c pions scattering coherently from carbon and platinum targets. Extrapolating to asymptotically high energies (where t(min)-->0), we find that when the per-nucleus cross section for this process is parametrized as sigma = sigma0Aalpha, alpha has values near 1.6, the exact result depending on jet transverse momentum. These values are in agreement with those predicted by theoretical calculations of color-transparency.

Search for rare and forbidden Charm Meson decays D0 --> Vl+l- and hhll.

We report results of a search for flavor-changing neutral current (FCNC), lepton flavor, and lepton-number violating decays of the D0 (and its antiparticle) into three and four bodies. Using data from Fermilab charm hadroproduction experiment E791, we examine modes with two leptons (muons or electrons) and a rho(0), K( *0), or straight phi vector meson or a nonresonant pi(pi), Kpi, or KK pair of pseudoscalar mesons. No evidence for any of these decays is found. Therefore, we present branching-fraction upper limits at 90% confidence level for the 27 decay modes examined (18 new).