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COVID-19 vaccine uptake among healthcare workers (HCWs) remains of significant public health concern due to the ongoing COVID-19 pandemic. As a result, many healthcare institutions are considering or have implemented COVID-19 vaccine mandates for HCWs. We assess defenses of COVID-19 vaccine mandates for HCWs from both public health and professional ethics perspectives. We consider public health values, professional obligations of HCWs, and the institutional failures in healthcare throughout the COVID-19 pandemic which have impacted the lived experiences of HCWs. We argue that, despite the compelling urgency of maximizing COVID-19 vaccine uptake among HCWs, the ethical case for COVID-19 vaccine mandates for HCWs in the United States is complex, and, under current circumstances, inconclusive. Nevertheless, we recognize that COVID-19 vaccine mandates for HCWs have already been and will continue to be implemented across many healthcare institutions. Given such context, we provide suggestions for implementing COVID-19 vaccine mandates for HCWs., (© 2023 John Wiley & Sons Ltd.)

SARS-CoV-2 infection in pregnancy is associated with a greater risk of maternal and newborn morbidity and maternal death. In Kenya, pregnant and lactating women (PLW) were ineligible to receive COVID-19 vaccines until August 2021. How shifts in policy influence vaccine behaviors, such as health worker recommendations and vaccine uptake, is not well documented. We conducted qualitative interviews with PLW, health workers, and policymakers in Kenya to understand how different stakeholders' perceptions of national policy regarding COVID-19 vaccination in pregnancy shaped vaccine behaviors and decision-making. Policymakers and health workers described pervasive uncertainty and lack of communication about the national policy, cited vaccine safety as their primary concern for administering COVID-19 vaccines to PLW, and expressed that PLW were inadequately prioritized in the COVID-19 vaccine program. PLW perceived the restrictive policy as indicative of a safety risk, resulting in vaccine hesitancy and potentially exacerbated inequities in vaccine access. These findings support the need for the development and dissemination of effective vaccine communication guidelines and the prioritization of PLW in COVID-19 vaccination policies and campaigns. To ensure PLW do not face the same inequities in future epidemics, data on infectious disease burdens and vaccine uptake should be collected systematically among pregnant women, and PLW should be included in future vaccine trials.

Pregnant women are at greater risk of adverse outcomes from SARS-CoV-2 infection. There are several factors which can influence the ways in which pregnant women perceive COVID-19 disease and behaviorally respond to the pandemic. This study seeks to understand how three key audiences-pregnant and lactating women (PLW), male community members, and health workers-in Kenya conceptualize COVID-19 to better understand determinants of COVID-19 related behaviors. This study used qualitative methods to conduct 84 in-depth interviews in three counties in Kenya. Data were analyzed using a grounded theory approach. Emerging themes were organized based on common behavioral constructs thought to influence COVID-19 related behaviors and included myths, risk perception, economic implications, stigma, and self-efficacy. Results suggest that risk perception and behavioral attitudes substantially influence the experiences of PLW, male community members, and health workers in Kenya during the COVID-19 pandemic. Public health prevention and communication responses targeting these groups should address potential barriers to preventive health behaviors, such as the spread of misinformation, financial constraints, and fear of social ostracization.

COVID-19 vaccination of children has begun in a number of countries with provisional regulatory approval and public support. This article provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we present three of the strongest arguments that might justify COVID-19 vaccination of children: (a) an argument from paternalism, (b) an argument from indirect protection and altruism, and (c) an argument from global eradication. We offer a series of objections to each of these arguments to show that none of them is currently tenable. Given the minimal direct benefit of COVID-19 vaccination for healthy children, the potential for rare risks to outweigh these benefits and to undermine vaccine confidence, the substantial evidence that COVID-19 vaccination confers adequate protection to risk groups whether or not healthy children are vaccinated and that current vaccines do not provide sterilizing immunity, and given that eradication of the virus is neither feasible nor a high priority for global health, we argue that routine COVID-19 vaccination of healthy children is currently ethically unjustified. Since mandates for children have already been implemented in some places (e.g., California) and may be considered elsewhere, we also present two additional arguments explicitly against making COVID-19 vaccination mandatory for children., (© 2022 The Authors. Bioethics published by John Wiley & Sons Ltd.)

Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people's access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public., Competing Interests: Competing interests: Within the past 2 years, AdF was involved in Vaccine Confidence Project collaborative grants with Janssen Pharmaceutica outside of the submitted work and holds a Merck grant to investigate COVID-19 vaccine attitudes., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Gaps in information about the safety and efficacy of COVID-19 vaccines in pregnancy have led to substantial global variation in public health guidance regarding the use of COVID-19 vaccines in pregnancy over the course of the pandemic., Methods: We conducted systematic screenings of public health authorities' websites across 224 countries and territories every 3 weeks to track the development of policies on COVID-19 vaccine use in pregnancy. Policies were categorised using a 1-5 permissiveness scale, with 1 indicating policies that recommended use, and 5 indicating policies that recommended against use., Results: As of 30 September 2021, 176 countries/territories had issued explicit guidance on COVID-19 vaccine use in pregnancy, with 38% recommending use, 28% permitting use, 15% permitting use with qualifications, 2% not recommending but with exceptions, and 17% not recommending use whatsoever. This represented a significant shift from May 2021, when only 6% of countries/territories with such policies recommended the use of COVID-19 vaccines in pregnancy (p<0.001). However, no policy positions could be found for 21% of all countries and territories, the vast majority being low and middle income. Policy positions also varied widely by vaccine product, with Pfizer/BioNTech and Moderna vaccines being most commonly recommended or permitted., Conclusion: Our study highlights the evolution of policies regarding COVID-19 vaccine use in pregnancy over a 5-month period in 2021, the role of pregnancy-specific data in shaping these policies and how inequities in access for pregnant people persist, both within countries and globally., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Objectives: The purpose of this study was to identify predictors of COVID-19 vaccine intention among Bangladeshi adults., Methods: Secondary data from the COVID-19 Beliefs, Behaviors & Norms Survey conducted by the Massachusetts Institute of Technology (MIT) and Facebook were analyzed. Data were collected from 2,669 adult Facebook users in Bangladesh and was collected between February 15 and February 28, 2021. Binomial logistic regression examined the relationship between COVID-19 vaccination intent and demographic variables, risk perception, preventive behaviors, COVID-19 knowledge, and likelihood of future actions., Results: Seventy-nine percent of respondents reported intent to get the COVID-19 vaccine when it becomes available. Intent to get vaccinated was highest among females, adults aged 71-80, individuals with college or graduate-level degrees, city dwellers, and individuals who perceived that they were in excellent health. Results of the binomial logistic regression indicated that predictors of vaccination intent include age (OR = 1.39), high risk perception of COVID-19 (OR = 1.47), and intent to practice social distancing (OR = 1.22)., Discussion: Findings suggest that age, perceived COVID-19 risk, and non-pharmaceutical COVID-19 interventions may predict COVID-19 vaccination intent among Bangladeshi adults. Findings can be used to create targeted messaging to increase demand for and uptake of COVID-19 vaccines in Bangladesh., Competing Interests: The authors have declared that no competing interests exist.

COVID-19 vaccination of children has begun in various high-income countries with regulatory approval and general public support, but largely without careful ethical consideration. This trend is expected to extend to other COVID-19 vaccines and lower ages as clinical trials progress. This paper provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we argue that it is currently unclear whether routine COVID-19 vaccination of healthy children is ethically justified in most contexts, given the minimal direct benefit that COVID-19 vaccination provides to children, the potential for rare risks to outweigh these benefits and undermine vaccine confidence, and substantial evidence that COVID-19 vaccination confers adequate protection to risk groups, such as older adults, without the need to vaccinate healthy children. We conclude that child COVID-19 vaccination in wealthy communities before adults in poor communities worldwide is ethically unacceptable and consider how policy deliberations might evolve in light of future developments., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Gur-Arie R et al.)

Purpose: To investigate whether coronavirus disease 2019 (COVID-19) vaccination campaigns targeted at health care personnel (HCP) in the United States have addressed the lived experiences of HCP on the frontlines of the COVID-19 pandemic and to analyze policy and legal considerations for improving COVID-19 vaccine uptake among HCP. Methods: We conducted a literature and policy review to explore the lived experiences of different occupational groups of HCP on the frontlines of the COVID-19 pandemic-physicians, nurses, trainees, and nonclinical essential workers-in relation to ongoing COVID-19 vaccination campaigns. Finally, we discuss policy and legal considerations to improve the state of HCP COVID-19 vaccine uptake as the pandemic progresses. Results: COVID-19 vaccination campaigns have not achieved consistent high uptake among HCP for many reasons, including vaccine hesitancy, personal, professional considerations, and equity-rooted challenges. Conclusion: HCPs lived experiences during the COVID-19 pandemic reveal meaningful impediments to their COVID-19 vaccine uptake. We suggest that health care systems minimize inequity inherent in existing vaccination campaigns by providing financial and social support to HCP to raise HCP COVID-19 vaccine uptake., Competing Interests: R.G.A. and Z.B. have no conflicting financial or personal interests or relationships that influenced this article. D.R.R. owns stock in GSK, a vaccine manufacturer that may, at some point, have a COVID-19 vaccine (but does not at present) and served as an unpaid member of Moderna's ethics group, advising on allocating the vaccine. Views and conclusions expressed in this article represent those of the authors alone and do not reflect positions of current or past funders and employers. All authors meet all four criteria for authorship in the International Committee of Medical Journal Editors (ICMJE) Recommendations. All authors confirm that they had full access to all the data in the study and accept responsibility to submit for publication., (© Rachel Gur-Arie et al., 2021; Published by Mary Ann Liebert, Inc.)

Competing Interests: Competing interests: None declared.

Background: Maximizing vaccination uptake is crucial in generating herd immunity and preventing infection incidence (Quach et al., Am J Infect Control 11:1017-23, 2013). Vaccination of healthcare personnel (HCP) against influenza is vital to influenza infection control in healthcare settings, given the consistent exposure of HCP to high-risk patients like: those with compromised immune systems, children, and the elderly (Johnson & Talbot, Curr Opin Infect Dis 24: 363-369, 2011). Influenza vaccination uptake among HCP remains suboptimal: in 2017-18, 47.6% of HCP who worked in settings where influenza vaccination was not mandatory were vaccinated against influenza in United States (Black et al., Morb Mortal Wkly Rep 67: 1050, 2018). Mandatory vaccination policies result in HCP influenza vaccination uptake rates substantially higher than opt-in influenza vaccination campaigns (94.8% vs. 47.6%) (Black et al., Morb Mortal Wkly Rep 67: 1050, 2018)., Goals: The Israel Journal of Health Policy Research has published articles focused on the issues of influenza vaccination (Yamin et al., Isr J Health Policy Res 3: 13, 2014), improving influenza vaccination coverage of HCP (Weber et al., Isr J Health Policy Res 5: 1-5, 2016), influenza vaccination motivators among HCP (Nutman and Yoeli, Isr J Health Policy Res 5: 52, 2016), legal imposition of vaccination (Kamin-Friedman, Isr J Health Policy Res 6:58, 2017), and mandatory vaccination (Gostin, Cell Biosci 8: 1-4, 2018). Each article explores factors influencing disease prevention from different angles within an Israeli context. This article attempts to fuse these topics by investigating how to apply aspects of American mandatory influenza vaccination policy targeted at HCP in an Israeli context., Methods: Critical document analysis was conducted on relevant literature and policy discussing influenza prevention interventions among HCP within the United States. Mandatory vaccination policies were highlighted. A discussion of the professional responsibility of HCP to vaccinate against influenza serves as background. Case studies of hospitals in the United States that implemented mandatory vaccination policies for their employees are analyzed. The article concludes with analysis exploring how qualities of mandatory influenza vaccination policy of HCP could take shape in Israel, giving contextual limitations, urging Israeli health policy makers to reflect on lessons learned from the American case study., Main Findings and Conclusion: Mandatory HCP influenza vaccination policies in comparison to non-mandatory interventions are most effective in obtaining maximum influenza vaccination uptake among HCP (Black et al., Morb Mortal Wkly Rep 67: 1050, 2018). Many HCP cite individual objections to influenza vaccination rooted in personal doubts and ethical concerns. The ethical responsibility of HCP to their patients and work environments to prevent and lower influenza infection incidence arguably overrules such individual objections. Mandatory HCP influenza vaccination policies are an effective method of maximizing HCP influenza vaccine uptake and minimizing the spread of the influenza virus within healthcare settings. Still, cultural, social and political sensitivity must be taken into consideration when implementing both full-on mandatory HCP influenza vaccination policies and/or aspects of mandatory policies, especially within an Israeli context.

Background: In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity., Methods: The study is based on data gathered from the Israeli Ministry of Health's administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013 (the "campaign period"). The analysis was carried out at the municipality level as well as the statistical area level., Results: The higher the SES level of the municipality where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake., Conclusions: Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.

Background: The Study of Healthcare Personnel with Influenza and other Respiratory Viruses in Israel (SHIRI) prospectively follows a cohort of healthcare personnel (HCP) in two hospitals in Israel. SHIRI will describe the frequency of influenza virus infections among HCP, identify predictors of vaccine acceptance, examine how repeated influenza vaccination may modify immunogenicity, and evaluate influenza vaccine effectiveness in preventing influenza illness and missed work., Methods: Cohort enrollment began in October, 2016; a second year of the study and a second wave of cohort enrollment began in June 2017. The study will run for at least 3 years and will follow approximately 2000 HCP (who are both employees and members of Clalit Health Services [CHS]) with routine direct patient contact. Eligible HCP are recruited using a stratified sampling strategy. After informed consent, participants complete a brief enrollment survey with questions about occupational responsibilities and knowledge, attitudes, and practices about influenza vaccines. Blood samples are collected at enrollment and at the end of influenza season; HCP who choose to be vaccinated contribute additional blood one month after vaccination. During the influenza season, participants receive twice-weekly short message service (SMS) messages asking them if they have acute respiratory illness or febrile illness (ARFI) symptoms. Ill participants receive follow-up SMS messages to confirm illness symptoms and duration and are asked to self-collect a nasal swab. Information on socio-economic characteristics, current and past medical conditions, medical care utilization and vaccination history is extracted from the CHS database. Information about missed work due to illness is obtained by self-report and from employee records. Respiratory specimens from self-collected nasal swabs are tested for influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, and coronaviruses using validated multiplex quantitative real-time reverse transcription polymerase chain reaction assays. The hemagglutination inhibition assay will be used to detect the presence of neutralizing influenza antibodies in serum., Discussion: SHIRI will expand our knowledge of the burden of respiratory viral infections among HCP and the effectiveness of current and repeated annual influenza vaccination in preventing influenza illness, medical utilization, and missed workdays among HCP who are in direct contact with patients., Trial Registration: NCT03331991 . Registered on November 6, 2017.

Background: The confused taxonomic classification of Crucigenia is mainly inferred through morphological evidence and few nuclear genes and chloroplast genomic fragments. The phylogenetic status of C. quadrata, as the type species of Crucigenia, remains considerably controversial. Additionally, there are currently no reports on the chloroplast genome of Crucigenia. Results: In this study, we utilize molecular phylogenetics and comparative genomics to show that C. quadrata belongs to Chlorophyceae rather than Trebouxiophyceae. The Bayesian and maximum likelihood (ML) phylogenetic trees support a monophyletic group of C. quadrata and Scenedesmaceae (Chlorophyceae) species. Our study presents the first complete chloroplast genome of C. quadrata, which is 197,184 bp in length and has a GC content of 31%. It has a typical quadripartite structure, and the chloroplast genome codons exhibit usage bias. Nucleotide diversity analysis highlights six genes (ccsA, psbF, chlN, cemA, rps3, rps18) as hotspots for genetic variation. Coding gene sequence divergence analyses indicate that four genes (cemA, clpP, psaA, rps3) are subject to positive selection. Conclusions: The determination of the phylogenetic status and the comparative chloroplast genomic analyses of C. quadrata will not only be useful in enhancing our understanding of the intricacy of Crucigenia taxonomy but also provide the important basis for studying the evolution of the incertae sedis taxa within Trebouxiophyceae. [ABSTRACT FROM AUTHOR]

Background: Mental health and substance use challenges are highly correlated in youth and have been speculated to be associated with COVID-19 vaccine hesitancy. Literature has also suggested that mental health challenges in youth have increased during the COVID-19 pandemic. However, the longitudinal relationship between mental health challenges in youth and COVID-19 vaccine hesitancy is not well established. Objective: We examined the relationship between mental health, substance use and COVID-19 vaccine hesitancy in youth during the COVID-19 pandemic. Methods: Youth ages 14 to 29-years participated in a longitudinal survey study. Participants provided sociodemographic, mental health, and substance use data, as well as qualitative and quantitative information on their vaccine perspectives every two months between February 2021 to August 2021, and on February 2022. Generalized estimating equation logistic regression models were used to analyze the effect of mental health and substance use on vaccine hesitancy over time. Qualitative content area analyses were used to identify trends in vaccine attitudes. Results: Mental health challenges and substance use frequency were associated with vaccine hesitancy, and significantly increased the odds of vaccine hesitancy over time. Additionally, mental health challenges were associated with decreases in vaccine hesitancy (OR: 0.80 (95% CI 0.66, 0.97)) when vaccines first began to emerge, but increases in vaccine hesitancy (OR: 1.72 (95% CI 1.32, 2.26)) one year later. Participants reported perceptions regarding vaccine safety and efficacy were the primary determinants influencing hesitant, uncertain, and acceptant vaccine attitudes. Additionally, changes in vaccine attitudes over time for some participants, were associated with changes in mental health. Conclusions: Increases in mental health challenges and substance use were associated with increases in COVID-19 vaccine hesitancy in youth over the COVID-19 pandemic. Health policy agencies should be aware of the potential impact of mental health challenges and substance use in youth, when developing vaccine policy and programs. [ABSTRACT FROM AUTHOR]

Incorporating infection prevention and control (IPC) is crucial for strengthening global surgery, particularly in low- and middle-income countries (LMICs). This review article highlights the critical role IPC plays in ensuring equitable and sustainable surgical care, aligning with the Sustainable Development Goals (SDG) 3 and 10, which aim to promote health and reduce inequalities. Surgical site infections (SSIs) and other healthcare-associated infections (HAIs) disproportionately affect LMICs, where IPC infrastructure is often underdeveloped. Without robust IPC measures, surgeries in these regions can result in higher morbidity, mortality, and healthcare costs, exacerbating disparities in healthcare access and outcomes. Despite global efforts, such as the World Health Organization (WHO) Guidelines on the Prevention of Surgical Site Infections, IPC integration in surgical practices remains inconsistent, particularly in resource-constrained settings. More widespread adoption and implementation are necessary. By embedding IPC within global surgery frameworks, health systems can improve surgical outcomes, reduce costs, and enhance the resilience of healthcare systems. Effective IPC reduces extended hospital stays, limits the spread of antimicrobial resistance, and increases trust in surgical services. Moreover, the cost savings from preventing SSIs are substantial, benefiting both healthcare systems and patients by reducing the need for prolonged care and antibiotic treatments. This review article calls for greater integration of IPC measures in global surgery initiatives to ensure that surgical interventions are both life-saving and equitable. Strengthening IPC is not optional but essential for achieving the broader goals of universal health coverage and improving public health outcomes globally. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization estimates that currently available vaccines prevent 2 to 3 million deaths worldwide each year. Preventing infectious diseases is an important public health priority to ensure healthy ageing and improve quality of life. This study's aim is to identify the best strategies to increase vaccination coverage in the elderly. Methods: A systematic review and meta-analysis were carried out, including a bibliographic search in the PubMed and Scopus databases. Studies in older people (60 years or older) on any type of intervention aimed at increasing vaccination coverage were included. The effect of the intervention was measured using the odds ratio (OR). Results: After applying the selection criteria, 20 studies were identified: 17 on influenza vaccines and 3 on other vaccines. Educational strategies obtained an OR = 1.63 (95% CI: 1.22–2.19, I 2 = 0.59). Medical counselling obtained an OR = 3.13 (95% CI: 0.60–16.37, I 2 = 0.95). Writing strategies obtained an OR = 1.14 (95% CI: 0.99–1.32, I 2 = 0.93). Few studies reported the effect of free vaccination. Conclusions: The educational strategies proved to be more effective than the others in this study. Free vaccination and age may have important roles. Further studies are needed as research in this area remains limited. [ABSTRACT FROM AUTHOR]

COVID-19 prevention measures and vaccine policies have led to substantial polarization across the world. I investigate whether and how vaccination status and vaccination status identification affect the sympathy and prejudice for vaccinated and unvaccinated individuals. Drawing on a preregistered vignette survey experiment in a large representative sample from Germany (n = 6,100) in December 2021, I show that prejudice was greater among the vaccinated towards the unvaccinated than vice versa. Furthermore, I find that differences in sympathy ratings are strongly subject to vaccination status identification. If individuals do not identify with their vaccination status, there are no differences in the evaluation of the in- and outgroups. Stronger vaccination status identification is, however, associated with greater prejudice among the vaccinated towards the unvaccinated but not for the unvaccinated towards the vaccinated. The results therefore show a stronger polarization on the side of the vaccinated that increases with the identification of one's vaccination status. [ABSTRACT FROM AUTHOR]

Results from multiple recent studies support further evaluation of 3,4-methylenedioxymethamphetamine (MDMA) in conjunction with psychotherapy (i.e., MDMA-Assisted Therapy) in the treatment of post-traumatic stress disorder (PTSD). In two Phase 3 trials, MDMA-Assisted Therapy comprised a short-term, intensive psychotherapy that included three sessions directly facilitated by MDMA (referred to as "experimental sessions"), as well as a number of non-drug psychotherapy sessions. This treatment model aimed to harness the potential of MDMA to facilitate recall and processing of traumatic memories, and to increase learning in a social context, integrating "top-down" and "bottom-up" approaches to trauma-focused care. To date, the conceptual framework for this treatment has not been described in the scientific literature. This omission has contributed to misunderstandings about both the theoretical underpinnings of this modality and the therapeutic approach that emerges from it. This paper delineates the psychotherapeutic concepts, theories, and historical antecedents underlying the inner-directed approach to MDMA-Assisted Therapy for PTSD. Broadly speaking, this therapeutic framework centered the concept of the participant's inner healing intelligence as the primary agent of change, with the therapeutic relationship being the core facilitative condition fostering the participant's self-directed movement toward recovery and growth. Corollaries to this holistic, self-directed, relational, and trauma-informed framework include a non-pathologizing approach to the participant's embodied experience (including the possibility of intense emotional and somatic expression, experiences of multiplicity, suicidal ideation, and multigenerational and transpersonal experiences), as well as the therapists' own psychodynamic, somatic, and transpersonal awareness, empathic attunement, relational skillfulness, and cultural humility. The use of MDMA in conjunction with this psychotherapy platform outperformed the use of placebo with psychotherapy in Phase 2 and 3 trials, as measured by symptom reduction in participants with PTSD. However, within-group comparisons also identified significant symptom reduction in participants who did not receive MDMA, lending empirical support to the psychotherapy model itself. In addition to comparative efficacy trials, future research should investigate which elements of the conceptual framework and therapeutic approach underlie the clinical benefit in individuals with PTSD. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic posed many unprecedented challenges to health care systems and public health efforts worldwide. Policy making and science were deeply intertwined, in particular with regard to the justification of health policy measures. In this context, ethical considerations were often at the core of decision-making trade-offs. However, not much is known about the actual ethical challenges encountered by policy makers and scientists involved in policy advice. With this study, we therefore aim to explore the ethical challenges during COVID-19-related political decision-making in Switzerland as perceived by policy makers and scientists involved in policy making. We also explore the role ethics advice had during the pandemic response and what can be learned for future public health crises. Methods: We conducted thirteen qualitative expert interviews with policy makers and scientists involved in decision-making on COVID-19 policy responses in Switzerland on the regional and national level. We used inductive content analysis to analyse the interviews. Results: Among the multitude of ethical challenges highlighted, interviewees perceived making trade-offs between the common good vs. the individual good and between economic welfare vs. health of the population, as well as proportionality of the policy measures, and the capacity of the public to accept uncertainty as central. Interviewees had diverging opinions on whether ethical considerations were sufficiently raised and discussed on the Swiss policy level during the COVID-19 pandemic. Among the reasons why ethics was not sufficiently discussed, they mentioned a lack of time in the fast-paced dynamic of the pandemic, ethics as a complex subject area, the interconnectedness between ethics and law, too much focus on few topics (mostly on vaccination-related ethical questions), and power relationships, such as dominance of medical professionals over ethicists. They evaluated ethics support to have been adequately present in the decision-making process, but wished for ethics training, involvement of the public in the discourse and for accompanying communication to build trust among the population for the future. Conclusions: The study provides empirical insights into the ethical considerations of COVID-19 policy making in practice in Switzerland. It can help to develop ethics assistance for future crises and inform ethical health policy and decision-making not only in Switzerland, but also in other countries. [ABSTRACT FROM AUTHOR]

Despite the availability of COVID-19 vaccines, Nigeria still faces significant COVID-19 vaccine hesitancy, with only 60.7% of the eligible population fully vaccinated as of 20 March 2023. Our study, part of a community-based effort to improve knowledge and uptake of the COVID-19 vaccine in the Gwagwalada Area Council of Abuja, the Federal Capital Territory (FCT) of Nigeria, utilized the WHO's Behavioral and Social Drivers (BeSDs)-of-vaccination framework to examine the drivers of COVID-19 vaccination among eligible adults. This was a mixed-method study with focus group discussions (FGDs) and in-depth interviews (IDIs) involving 40 purposively sampled participants. We triangulate qualitative findings with data from a household survey of 1512 eligible adults identified using a two-stage systematic cluster sampling approach. All data were collected from the 1–18 November 2022. The household survey showed 46% COVID-19 vaccine uptake, with Pearson chi-square and Fisher's exact test showing significant associations between vaccine uptake and gender, religion, and education. Multivariate logistic regression showed that confidence in vaccine safety, knowing vaccination sites and family/friends' endorsement of COVID-19 vaccination were the strongest items associated with vaccine uptake in the thinking-and-feeling, practical-issue, and social-process domains, respectively. Multiple items measuring these domains aligned with BeSD priority question, demonstrating the robustness of the pared-down framework. Qualitative data corroborated these findings. To address vaccine hesitancy and increase uptake, community-driven approaches to improve trust in vaccine safety and benefits and promote positive vaccination norms are needed. In addition, service delivery strategies to make vaccination services easily accessible and identifiable should be developed and tailored to community needs. [ABSTRACT FROM AUTHOR]

DNA-based methods are increasingly important for bacterial typing. The high number of polymorphic sites present among closely related bacterial genomes is the basis for the presented method. The method identifies multilocus genomic polymorphisms in intergenic regions termed AILP (amplified intergenic locus polymorphism). For each locus, a pair of unique PCR primers was designed to amplify an intergenic sequence from one open reading frame (ORF) to the adjacent ORF. Presence, absence, and size variation of the amplification products were identified and used as genetic markers for rapidly differentiating among strains. Polymorphism was evaluated using 18 AILP sites among 28 strains of Listeria monocytogenes and 6 strains of Listeria spp. and 30 AILP markers among 27 strains of Escherichia coli. Up to four alleles per locus were identified among Listeria strains, and up to six were identified among E. coli strains. In both species, more than half of the AILP sites revealed intraspecies polymorphism. The AILP data were applied to phylogenetic analysis among Listeria and E. coli strains. A clear distinction between L. monocytogenes and Listeria spp. was demonstrated. In addition, the method separated L. monocytogenes into the three known lineages and discriminated the most common virulent serotypic group, 4b. In E. coli, AILP analysis separated the known groups as well as the virulent O157:H7 isolates. These findings for both Listeria and E. coli are in agreement with other phylogenetic studies using molecular markers. The AILP method was found to be rapid, simple, reproducible, and a low-cost method for initial bacterial typing that could serve as a basis for epidemiological investigation.

Multilocus sequencing of housekeeping genes has been used previously for bacterial strain typing and for inferring evolutionary relationships among strains of Escherichia coli. In this study, we used shorter intergenic sequences that contained simple sequence repeats (SSRs) of repeating mononucleotide motifs (mononucleotide repeats [MNRs]) to infer the phylogeny of pathogenic and commensal E. coli strains. Seven noncoding loci (four MNRs and three non-SSRs) were sequenced in 27 strains, including enterohemorrhagic (six isolates of O157:H7), enteropathogenic, enterotoxigenic, B, and K-12 strains. The four MNRs were also sequenced in 20 representative strains of the E. coli reference (ECOR) collection. Sequence polymorphism was significantly higher at the MNR loci, including the flanking sequences, indicating a higher mutation rate in the sequences flanking the MNR tracts. The four MNR loci were amplifiable by PCR in the standard ECOR A, B1, and D groups, but only one (yaiN) in the B2 group was amplified, which is consistent with previous studies that suggested that B2 is the most ancient group. High sequence compatibility was found between the four MNR loci, indicating that they are in the same clonal frame. The phylogenetic trees that were constructed from the sequence data were in good agreement with those of previous studies that used multilocus enzyme electrophoresis. The results demonstrate that MNR loci are useful for inferring phylogenetic relationships and provide much higher sequence variation than housekeeping genes. Therefore, the use of MNR loci for multilocus sequence typing should prove efficient for clinical diagnostics, epidemiology, and evolutionary study of bacteria.

Internally displaced persons (IDPs) are at high risk for COVID-19 transmission because of congested and unsanitary living conditions. COVID-19 vaccination is essential to build population immunity and prevent severe disease among this population. We determined the prevalence and factors associated with intention to accept COVID-19 vaccine among IDPs in Northeast Nigeria. This cross-sectional study, conducted during July–December 2022, included 1,537 unvaccinated IDPs from 18 IDPs camps. We performed a complex sample survey analysis and described participants' characteristics and vaccination intention with weighted descriptive statistics. We fitted weighted logistic regression models and computed adjusted odds ratios with 95% confidence intervals to identify factors associated with intention to accept COVID-19 vaccine. Of 1,537 IDPs, 55.4% were 18–39 years old, 82.6% were females, and 88.6% had no formal education. Among them, 63.5% (95% CI: 59.0–68.1) expressed intention to accept COVID-19 vaccine. Among the IDPs who intended to reject vaccine, 42.8% provided no reason, 35.3% had COVID-19 misconceptions, 9.5% reported vaccine safety concerns, and 7.4% felt no need. IDPs who perceived COVID-19 as severe (Adjusted Odds Ratio (AOR) = 2.31, [95% CI: 1.35–3.96]), perceived COVID-19 vaccine as effective (AOR = 4.28, [95% CI: 2.46–7.44]) and resided in official camps (AOR = 3.29, [95% CI: 1.94–5.56]) were more likely to accept COVID-19 vaccine. However, IDPs who resided 2 kilometers or farther from the nearest health facility (AOR = 0.34, [95% CI: 0.20–0.58]) were less likely to accept vaccine. Intention to accept COVID-19 vaccine among the IDPs was suboptimal. To improve vaccination acceptance among this population, health education and risk communication should be intensified to counter misinformation, strengthen vaccine confidence, and shape perception of COVID-19 severity, focusing on IDPs in unofficial camps. Appropriate interventions to deliver vaccines to remote households should be ramped up. [ABSTRACT FROM AUTHOR]

Introduction: Since the beginning of the COVID-19 pandemic, COVID-19 risk mitigation measures have expanded to include increased rules and surveillance in supportive housing. Yet, in the context of the dual public health emergencies of COVID-19 and the unregulated drug toxicity crisis, we have not evaluated the unintended health and social consequences of such measures, especially on criminalized women. In order to address this dearth of evidence, our aim was to assess the association between increased housing rules and surveillance during COVID-19 and (a) nonfatal overdose, and (b) administration of naloxone for overdose reversal among women sex workers who use drugs in Vancouver, BC. Methods: This study is nested within An Evaluation of Sex Workers Health Access (AESHA), a community-based prospective cohort of women sex workers in Metro Vancouver (2010–present). Using cross-sectional data collected during the first year of COVID-19 (April 2020–2021), we developed separate multivariable logistic regression confounder models to examine the independent associations between experiencing increased housing rules and surveillance during COVID-19 on (a) nonfatal overdose, and (b) administration of naloxone for overdose reversal in the last 6 months. Results: Amongst 166 participants, 10.8% reported experiencing a recent non-fatal overdose and 31.3% recently administered naloxone for overdose reversal. 56.6% reported experiencing increased rules and surveillance within their housing during COVID-19. The prevalence of non-fatal overdose and administering naloxone was significantly elevated among those exposed to increased housing rules and surveillance during COVID-19 versus those who were unexposed (83.3% vs. 52.1%; 75.0% vs. 48.2%, respectively). In separate multivariate confounder models, exposure to increased housing rules and surveillance during COVID-19 was independently associated with increased odds of administering naloxone [AOR: 3.66, CI: 1.63–8.21], and marginally associated with non-fatal overdose [AOR: 3.49, CI: 0.92–13.27]. Conclusion: Efforts to prioritize the right to safe, adequate and affordable housing must avoid reinforcing an overly coercive reliance on surveillance measures which, while often well-intended, can negatively shape residents' well-being. Furthermore, public health responses to pandemics must include criminalized populations so that measures do not exacerbate overdose risk. Implementation of a regulated drug supply is recommended, alongside housing policies that promote residents' rights, safety, and health. [ABSTRACT FROM AUTHOR]

Background: Vaccination has proven to be an essential strategy in combating the COVID-19 pandemic. This study aims to discern the factors influencing both the intentions for and actual behavior regarding COVID-19 vaccination among remote, rural populations in Bangladesh. Methods: The study utilized panel survey data comprising 1,698 randomly selected household heads. These are predominantly illiterate, of Muslim religion, middle-aged, and male, with agriculture or day labor as primary income source. They reside in 36 locations distributed along the whole 250 km length of the Jamuna River in Bangladesh. Data collection occurred through face-to-face and telephone interviews conducted between September 2021 and October 2022. Descriptive statistics and Ordinary Least Squares regression models were employed to assess influence factors for COVID-19 vaccination intentions and uptake. The analyses considered the constructs of the Health Belief Model alongside sociodemographic characteristics such as gender, age, religion, education, and income source. Results: Survey respondents showed a notably high willingness to receive the COVID-19 vaccine promptly upon its availability. However, the effectiveness of the Health Belief Model in elucidating COVID-19 vaccination uptake was limited, except for its availability component. Older individuals, those with higher levels of education, and individuals employed in government or formal sector occupations were prompt in receiving the COVID-19 vaccine as it became available. Gender, religion, and the presence of dependents in the household did not exert a significant influence on vaccination uptake. Conclusions: The results indicate that a strong willingness to receive the COVID-19 vaccine correlated with an increased likelihood of vaccine uptake once it was available. These findings suggest that a widespread distribution of COVID-19 vaccines to low-income and remote areas could have served as a vital strategy in mitigating the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: COVID-19 vaccine hesitancy is a major public health challenge with the potential to prevent communities from achieving the coverage level necessary for herd immunity against the COVID-19 virus. Objective/aim: The study determined COVID-19 vaccine acceptance and associated factors among residents of the Afadzato South District of Ghana. Methods: A descriptive cross-sectional study was conducted among 422 respondents aged 18 years and above using a self-administered and interviewer administered structured questionnaires for persons who could read and with no formal education respectively. The study was conducted and reported in line with the Strobe statement for cross sectional studies. Data analysis was done using the Stata-17.0 software. The association between the dependent and independent variables was examined using a logistic regression analysis, with a p-value of < 0.05 considered statistically significant. Results: More than half of the respondents (n = 291, 68.96%) were below 25 years old. Majority of the respondents were females (n = 218, 51.66%) and had attained secondary education (n = 291, 68.96%). Less than half of the respondents 35.5% (151) indicated acceptance of the COVID-19 vaccine and more than half (n = 271, 64.22%) indicated non-acceptance of the COVID-19 vaccine. The results showed that education level, information source, overall knowledge of COVID-19 vaccine, and misconception of COVID-19 vaccine were significantly associated with acceptance of the COVID-19 vaccine. Conclusion: The study found high vaccine hesitancy among the respondents. Important significant predictors of COVID-19 vaccine hesitancy were education level, information source, overall knowledge of COVID-19 vaccine, and misconception of COVID-19 vaccine. In the attempt to address vaccine hesitancy by health agencies, it is important to take into consideration the varying educational backgrounds of the population in context and their diversified sources of information. This may ensure that everyone in the community is reached with important information on COVID-19 and its vaccines to reduce misconceptions and misinformation. [ABSTRACT FROM AUTHOR]

Immunization through vaccines among children has contributed to improved childhood survival and health outcomes globally. However, vaccine coverage among children is unevenly distributed across settings and populations. The measurement of inequalities is essential for understanding gaps in vaccine coverage affecting certain sub-populations and monitoring progress towards achieving equity. Our study aimed to characterize the methods of reporting inequalities in childhood vaccine coverage, inclusive of the settings, data source types, analytical methods, and reporting modalities used to quantify and communicate inequality. We conducted a scoping review of publications in academic journals which included analyses of inequalities in vaccination among children. Literature searches were conducted in PubMed and Web of Science and included relevant articles published between 8 December 2013 and 7 December 2023. Overall, 242 publications were identified, including 204 assessing inequalities in a single country and 38 assessing inequalities across more than one country. We observed that analyses on inequalities in childhood vaccine coverage rely heavily on Demographic Health Survey (DHS) or Multiple Indicator Cluster Surveys (MICS) data (39.3%), and papers leveraging these data had increased in the last decade. Additionally, about half of the single-country studies were conducted in low- and middle-income countries. We found that few studies analyzed and reported inequalities using summary measures of health inequality and largely used the odds ratio resulting from logistic regression models for analyses. The most analyzed dimensions of inequality were economic status and maternal education, and the most common vaccine outcome indicator was full vaccination with the recommended vaccine schedule. However, the definition and construction of both dimensions of inequality and vaccine coverage measures varied across studies, and a variety of approaches were used to study inequalities in vaccine coverage across contexts. Overall, harmonizing methods for selecting and categorizing dimensions of inequalities as well as methods for analyzing and reporting inequalities can improve our ability to assess the magnitude and patterns of inequality in vaccine coverage and compare those inequalities across settings and time. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has influenced all children's motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. Methods: Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). Results: Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018–6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2–10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. Conclusion: Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children. [ABSTRACT FROM AUTHOR]

Background: As part of the fight against coronavirus disease, Nigeria received nearly 4 million doses of the COVID-19 vaccine via the COVID-19 Vaccines Global Access (COVAX) Facility, marking a historic step towards equitable global distribution of COVID-19 vaccines. Although evidence exists on COVID-19 hesitancy in Nigeria, yet, we are unaware of any study on the optimization of COVID-19 vaccination from the lenses of the mobile teams. Objective: This study seeks to explore the perceptions and experiences of mobile teams in selected communities during the implementation of COVID-19 vaccination in Benue and Niger. Methods: An exploratory approach was adopted, and the study was conducted in Niger and Benue states based on poor performance in COVID-19 vaccination. Focus Group Discussions (FDGs) were conducted among 12 mobile vaccination teams from 12 LGAs. The recorded discussions were transcribed and coded (inductively and deductively) using Dedoose software (v9.0). Four themes and seven sub-themes were generated from the participants' responses. Results: Seventy-two (72) health workers including vaccinators, validators, Electronic Management of Immunization Data (EMID) recorders, social mobilizers, and paper recorders participated in this study. Health workers' perceptions and experiences were thematized using the health building blocks. The mobilization teams in Benue and Niger states perceived that their mobilization efforts contributed to improved coverage, increased accessibility, and reduced hesitancy among the community dwellers. Challenges reported by the teams were vaccine misconceptions, requests for incentives in exchange for vaccine uptake, poor network services, distance to communities, and vaccine stockout. Conclusion: This study concluded that social mobilizers play key roles in vaccine uptake, especially at the community level. Their roles in creating awareness, sensitization, and bringing the vaccine closer to hard-to-reach communities contributed to the success attained in the fight against COVID-19 in both states. [ABSTRACT FROM AUTHOR]

Background: Corona virus disease 2019 (COVID-19) is an extremely contagious viral infection caused by the severe acute respiratory syndrome coronavirus 2. Understanding the willingness of the community to receive the COVID-19 vaccine will help in the development and implementation of effective COVID-19 vaccination promotion programs. Therefore, we aimed to assess the level of COVID-19 vaccine acceptance and associated factors among residents of Dire Dawa Administration, Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among 840 residents in Dire Dawa Administration from May 18th to June 18th, 2021. Multistage cluster sampling followed by systematic random sampling was used to select respondents. A pretested interviewer-administered structured questionnaire was used to collect the data from respondents. Bivariable and multivariable logistic regression were used to identify predictors of COVID-19 vaccine acceptance. The odds ratio (OR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. Results: Out of 840 respondents recruited, the proportion of COVID-19 vaccine acceptance was found to be 54.4% (457/840); (95% CI: 51.0%, 57.7%) Being male [AOR = 1.85, 95% CI: (1.35, 2.54), P < 0.001], not having a current habit of substance use [AOR = 2.38, 95% CI: (1.73, 3.26), P < 0.001], having a monthly income of less than 51.31 USD [AOR = 0.19, 95% CI: (0.04, 0.88), P = 0.001]; and not having a prior history of vaccination experience [AOR = 0.40, 95% CI: (0.29, 0.54), P < 0.001] were significantly associated with COVID-19 vaccine acceptance. Conclusion: This study reveals that the proportion of COVID-19 vaccine acceptance among residents of Dire Dawa Administration, Eastern Ethiopia, was 54.4%. Factors like being male and not having a current habit of substance use were positively associated, whereas having a monthly income of less than 51.31 USD and not having a prior history of vaccination experience were negatively associated with COVID-19 vaccine acceptance. Health information dissemination and economic empowerment are crucial to improving COVID-19 vaccine acceptance among the community. This study provides valuable data for policymakers to plan early vaccination programs and tackle the challenges identified in the study. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are a vulnerable population to COVID-19 given an increased susceptibility to severe SARS-CoV-2 infection and pregnancy complications. However, few SARS-CoV-2 serological surveys have been performed among this population to assess the extent of the infection in sub-Saharan countries. The objectives of this study were to determine SARS-CoV-2 seroprevalence among Beninese pregnant women, to identify spatial seropositivity clusters and to analyse factors associated with the infection. Methods: A cross-sectional study including women in their third trimester of pregnancy attending the antenatal care (ANC) clinics at Allada (south Benin) and Natitingou (north Benin) was conducted. Rapid diagnostic tests (RDT) for detection of IgG/IgM against the SARS-CoV-2 spike protein were performed using capillary blood. Seroprevalence of SARS-CoV-2 antibodies and associations between SARS-CoV-2 serostatus and maternal characteristics were analyzed by multivariate logistic regression. Spatial analyses were performed using the spatial scan statistics to identify spatial clusters of SARS-CoV-2 infection. Results: A total of 861 pregnant women were enrolled between May 4 and June 29, 2022. 58/861 (6.7%) participants reported having received COVID-19 vaccine. None of the participants had been diagnosed with COVID-19 during their pregnancy. SARS-CoV-2 antibodies were detected in 607/802 (75.7%; 95% CI 72.56%–78.62%) of unvaccinated participants. Several urban and rural spatial clusters of SARS-CoV-2 cases were identified in Allada and one urban spatial cluster was identified in Natitingou. Unvaccinated participants from Allada with at least one previous morbidity were at a three-times higher risk of presenting SARS-CoV-2 antibodies (OR = 2.89; 95%CI 1.19%-7.00%). Conclusion: Three out of four pregnant women had SARS-CoV-2 antibodies, suggesting a high virus circulation among pregnant women in Benin, while COVID-19 vaccination coverage was low. Pregnant women with comorbidities may be at increased risk of SARS-CoV-2 infection. This population should be prioritized for COVID-19 diagnosis and vaccination in order to prevent its deleterious effects. Trial registration: NCT06170320 (retrospectively registered on December 21, 2023). [ABSTRACT FROM AUTHOR]

As the COVID-19 global vaccination campaign was launched in December of 2020, vaccination became mandatory for many healthcare workers (HCWs) worldwide. Large minorities resisted the policy, and the responses of authorities to this resistance led to damage d professional reputations, job losses, and suspension or termination of practice licenses. The joint effect of dismissals, early retirements, career changes, and vaccine injuries disabling some compliant HCWs from adequate performance has exacerbated existing crises within health systems. Nevertheless, leading health authorities have maintained that the benefits of a fully vaccinated healthcare labor force--believed to be protecting health systems, vulnerable patient populations, and even HCWs themselves--achieved through mandates, if necessary, outweigh its potential harms. Informed by critical policy and discourse traditions, we examine the expert literature on vaccine mandates for HCWs. We find that this literature neglects evidence that contradicts official claims about the safety and effectiveness of COVID-19 vaccines, dismisses the science supporting the contextual nature of microbial virulence, miscalculates patient and system-level harms of vaccination policies, and ignores or legitimizes the coercive elements built into their design. We discuss the implications of our findings for the sustainability of health systems, for patient care, and for the well-being of HCWs, and suggest directions for ethical clinical and policy practice. [ABSTRACT FROM AUTHOR]

Background: In the first year of roll-out, vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevented almost 20 million deaths from coronavirus disease 2019 (COVID-19). Yet, little is known about the factors influencing access to vaccination at the individual level within rural poor settings of low-income countries. The aim of this study was to examine determinants of vaccine receipt in rural India. Methods: A census of a rural village in Tamil Nadu was undertaken from June 2021 to September 2022. We surveyed 775 participants from 262 households. Household-level data on socioeconomic status (SES), water, sanitation, and hygiene practices, and individual-level demographic information, travel history, and biomedical data, including anthropometry, vital signs, and comorbidities, were collected. Logistic regression models with 5-fold cross-validation were used to identify the biomedical, demographic, and socioeconomic determinants of vaccine receipt and the timing of receipt within the first 30 days of eligibility. Vaccine ineligible participants were excluded leaving 659 eligible participants. There were 650 eligible participants with complete biomedical, demographic, and socioeconomic data. Results: There were 68.0% and 34.0% of individuals (N = 650) who had received one and two vaccine doses, respectively. Participants with household ownership of a permanent account number (PAN) or ration card were 2.15 (95% CI:1.32–3.52) or 3.02 (95% CI:1.72–5.29) times more likely to receive at least one vaccine dose compared to households with no ownership of such cards. Participants employed as housewives or self-employed non-agricultural workers were 65% (95% CI:0.19–0.67) or 59% (95% CI:0.22–0.76) less likely to receive at least one vaccine dose compared to salaried workers. Household PAN card ownership, occupation and age were linked to the timing of vaccine receipt. Participants aged ≤18 and 45–60 years were 17.74 (95% CI:5.07–62.03) and 5.51 (95% CI:2.74–11.10) times more likely to receive a vaccine within 30 days of eligibility compared to 19-44-year-olds. Biomedical factors including BMI, vital signs, comorbidities, and COVID-19 specific symptoms were not consistently associated with vaccine receipt or timing of receipt. No support was found that travel history, contact with COVID-19 cases, and hospital admissions influenced vaccine receipt or timing of receipt. Conclusion: Factors linked to SES were linked to vaccine receipt, more so than biomedical factors which were targeted by vaccine policies. Future research should explore if government interventions including vaccine mandates, barriers to vaccine access, or peer influence linked to workplace or targeted vaccine promotion campaigns underpin these findings. [ABSTRACT FROM AUTHOR]

Equity and health equity are fundamental pillars in fostering a just and inclusive society. While equity underscores fairness in resource allocation and opportunity, health equity aims to eradicate avoidable health disparities among social groups. The concept of harms in interventions—undesirable consequences associated with the use of interventions—often varies across populations due to biological and social factors, necessitating a nuanced understanding. An equity lens reveals disparities in harm distribution, urging researchers and policymakers to address these differences in their decision-making processes. Furthermore, interventions, even well-intentioned ones, can inadvertently exacerbate disparities, emphasizing the need for comprehensive harm assessment. Integrating equity considerations in research practices and trial methodologies, through study design or through practices such as inclusive participant recruitment, is pivotal in advancing health equity. By prioritizing interventions that address disparities and ensuring inclusivity in research, we can foster a more equitable healthcare system. [ABSTRACT FROM AUTHOR]

Background: Tandem repeats are specific sequences in genomic DNA repeated in tandem that are present in all organisms. Among the subcategories of TRs we have Satellite repeats, that is divided into macrosatellites, minisatellites, and microsatellites, being the last two of specific interest because they can identify polymorphisms between organisms due to their instability. Currently, most mining tools focus on Simple Sequence Repeats (SSR) mining, and only a few can identify SSRs in the coding regions. Results: We developed a microsatellite mining software called SATIN (Micro and Mini SATellite IdentificatioN tool) based on a new sliding window algorithm written in C and Python. It represents a new approach to SSR mining by addressing the limitations of existing tools, particularly in coding region SSR mining. SATIN is available at https://github.com/labgm/SATIN.git. It was shown to be the second fastest for perfect and compound SSR mining. It can identify SSRs from coding regions plus SSRs with motif sizes bigger than 6. Besides the SSR mining, SATIN can also analyze SSRs polymorphism on coding-regions from pre-determined groups, and identify SSRs differentially abundant among them on a per-gene basis. To validate, we analyzed SSRs from two groups of Escherichia coli (K12 and O157) and compared the results with 5 known SSRs from coding regions. SATIN identified all 5 SSRs from 237 genes with at least one SSR on it. Conclusions: The SATIN is a novel microsatellite search software that utilizes an innovative sliding window technique based on a numerical list for repeat region search to identify perfect, and composite SSRs while generating comprehensible and analyzable outputs. It is a tool capable of using files in fasta or GenBank format as input for microsatellite mining, also being able to identify SSRs present in coding regions for GenBank files. In conclusion, we expect SATIN to help identify potential SSRs to be used as genetic markers. [ABSTRACT FROM AUTHOR]

Background: As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic. Methods: A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants' self-reported ICP compliance for later comparison. Results: A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p < 0.001). In the self-reported survey, the overall compliance rate for ICPs was 64.6%. Conclusion: The compliance of HCWs in a psychiatric inpatient ward to ICPs during the COVID-19 pandemic ranged from poor to suboptimal. This result was alarming. Revisions of current ICP guidelines and policies that specifically target barriers in psychiatric settings will be necessary. [ABSTRACT FROM AUTHOR]

Among the multiple factors impeding equitable childhood immunization coverage in low- and middle-income countries (LMICs), gender barriers stand out as perhaps the most universal. Despite increasing recognition of the importance of gender considerations in immunization programming, there has not yet been a systematic assessment of the evidence on gender barriers to immunization. We conducted a scoping review to fill that gap, identifying 92 articles that described gender barriers to immunization. Studies documented a range of gender influencers across 43 countries in Africa and South Asia. The barrier to immunization coverage most frequently cited in the literature is women's lack of autonomous decision-making. Access to immunization is significantly impacted by women's time poverty; direct costs are also a barrier, particularly when female caregivers rely on family members to cover costs. Challenges with clinic readiness compound female caregiver's time constraints. Some of the most important gender barriers lie outside of the usual purview of immunization programming but other barriers can be addressed with adaptations to vaccination programming. We can only know how important these barriers are with more research that measures the impact of programming on gender barriers to immunization coverage. [ABSTRACT FROM AUTHOR]

While there is a substantial amount of research on risk perception, there has been less focus on the way medical technologies are perceived by experts as opposed to lay individuals. We investigated the factors that may influence the risk perception of healthcare workers (HCWs) and the general public regarding 3 distinct medical technologies: magnetic resonance imaging (MRI), laser-assisted in situ keratomileusis (LASIK) and the Covid-19 vaccine. Methods: A cross-sectional study conducted in 2021 among 2 populations: HCWs employed at a general public hospital and a sample of outpatients and individuals who are not medical professionals. The participants completed an electronic questionnaire. Results: In total, 739 respondents were included: 197 HCWs (26.7%) and 542 members of the public (73.3%). Most of the respondents (89.4%) reported being vaccinated against Covid-19, 43.8% had previously undergone an MRI but 90% had not undergone LASIK. Overall, all 3 technologies assessed in the study were rated by the respondents as having a high benefit and low risk. HCWs and the public showed statistically significant differences in perceived risk towards MRI and LASIK, as well as in some of the risk perception characteristics of each technology. In contrast, no differences in risk perception towards the Covid-19 vaccine were found between HCWs and the public. Both study populations showed a significant negative correlation between trust in the MoH and the perceived risk towards MRI and the Covid-19 vaccine. Both study populations regarded information provided by medical sources as the most reliable for decision-making. Conclusion: The perceptions and concerns towards medical technologies influence individuals' behavior and acceptance of technologies. They are also essential for risk communication. The study contributes to the understanding of attitudes towards various medical technologies, including risk perception, risk characteristics, trust and sources of information pertaining to each of the technologies, by examining the differences between HCWs and the general public. [ABSTRACT FROM AUTHOR]