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Introduction. Upper gastrointestinal (UGI) video capsule endoscopy (VCE) provides a possible alternative to conventional oesophago-gastro-duodenoscopy (OGD). In Ireland, the COVID-19 pandemic led to unprecedented change in endoscopy services, accelerating the need for UGI VCE to help reduce patient exposure but allow the continuation of endoscopy services. We report on using UGI VCE as an alternative to OGD throughout all phases of COVID-related endoscopy adjustments. Aims/Background. Prospective observational study to assess identification of relevant UGI anatomical landmarks on UGI VCE as defined in the British Society of Gastroenterology. Method. Inclusion criteria were: patients with dyspepsia under 40 years of age with no alarm symptoms; known cirrhosis for variceal screening; UGI bleeds with the Blatchford score ≤ 2 . A protocol for preparation and a series of positional movements were adapted for the procedure. Landmarks and pathology detection were evaluated by two independent endoscopists. Results. 127 UGI VCE was performed from June 2020 to December 2021, of which 22 required further evaluation with OGD. The most common indications were dyspepsia and abdominal pain, 71% and 19%, respectively. With the use of the dual-facing camera, clear views of the OGJ in 100% of cases, cardia 100%, fundus 97%, greater curve 99%, lesser curve 98%, incisura angularis 95%, antrum 95%, pylorus 94%, D1/bulb 83%, and D2 82% were obtained. The main findings at UGI VCE were reflux oesophagitis and gastritis, with normal mucosa observed in 48% of cases. Findings suggesting a neoplastic lesion at the OG junction were detected in 1 case. Conclusion. Since June 2020, 81% ( N = 103 ) of a selected cohort of patients referred for UGI endoscopy avoided invasive traditional endoscopy and were successfully managed by VCE, thus reducing endoscopy waiting lists. UGI VCE may serve as a clinical diagnostic tool, used alongside OGD in appropriate cases, to help improve patient services and care delivery.

During coronavirus infection, three non-structural proteins, nsp3, nsp4, and nsp6, are of great importance as they induce the formation of double-membrane vesicles where the replication and transcription of viral gRNA takes place, and the interaction of nsp3 and nsp4 lumenal regions triggers membrane pairing. However, their structural states are not well-understood. We investigated the interactions between nsp3 and nsp4 by predicting the structures of their lumenal regions individually and in complex using AlphaFold2 as implemented in ColabFold. The ColabFold prediction accuracy of the nsp3–nsp4 complex was increased compared to nsp3 alone and nsp4 alone. All cysteine residues in both lumenal regions were modelled to be involved in intramolecular disulphide bonds. A linker region in the nsp4 lumenal region emerged as crucial for the interaction, transitioning to a structured state when predicted in complex. The key interactions modelled between nsp3 and nsp4 appeared stable when the transmembrane regions of nsp3 and nsp4 were added to the modelling either alone or together. While molecular dynamics simulations (MD) demonstrated that the proposed model of the nsp3 lumenal region on its own is not stable, key interactions between nsp and nsp4 in the proposed complex model appeared stable after MD. Together, these observations suggest that the interaction is robust to different modelling conditions. Understanding the functional importance of the nsp4 linker region may have implications for the targeting of double membrane vesicle formation in controlling coronavirus infection.

Due to the coronavirus disease 2019 (COVID-19) pandemic, a Swiss university course called “Psychology and Migration” had to move online over the Spring semester 2021. In this course, Psychology and Education students learn about the sociocultural considerations of migration, through a theoretical, personal and artistic exploration of the subjective experience of migration, based on performing arts. As part of the main pedagogical strategies, students are invited to collectively create a short theatre play based on some selected literary texts. Under the conditions imposed by the pandemic, puppetry arts were chosen as a new tool for distance-learning. Collaborating with theatre professionals, the students created a short play, and performed it online using sock puppets, image theatre or object theatre. Using data collected during the course (video recordings of online sessions and students’ diaries), this article explores the critical process of reduction and expansion, and the (potentially) productive tensions that the course creates. It analyses two main appropriation modes for course students: in adaptative appropriation, students aim to reduce these tensions by adapting to the perceived expectations of teachers; in transformative appropriation, students creatively use possibilities offered by the course to conduct a personal exploration, integrating theories with their own experiences and questions.

Background: The ongoing COVID-19 pandemic has shown a crystal-clear warning that nobody will be safe until everybody is safe against the pandemic. However, how everyone is safe when the pandemic’s fat tail risks have broken every nerve of the global economy and healthcare facilities, including vaccine equity. Vaccine inequity has become one of the critical factors for millions of new infections and deaths during this pandemic. Against the backdrop of exponentially growing infected cases of COVID-19 along with vaccine in-equity, this paper will examine how multilateralism could play its role in mitigating vaccine equity through Global Health Diplomacy (GHD). Second, given the most affected developing countries’ lack of participation in multilateralism, could GHD be left as an option in the worst-case scenario?. Methods: In this narrative review, a literature search was conducted in all the popular databases, such as Scopus, Web of Science, PubMed and Google search engines for the keywords in the context of developing countries and the findings are discussed in detail. Results: In this multilateral world, the global governance institutions in health have been monopolized by the global North, leading to COVID-19 vaccine inequities. GHD aids health protection and public health and improves international relations. Besides, GHD facilitates a broad range of stakeholders’ commitment to collaborate in improving healthcare, achieving fair outcomes, achieving equity, and reducing poverty. Conclusion: Vaccine inequity is a major challenge of the present scenario, and GHD has been partly successful in being a panacea for many countries in the global south.

In diesem Beitrag wird der Frage nachgegangen, wie angehende DaF-Lehrende ihre Lernerfahrungen im performativen Online-Workshop bewerten. Zu diesem Zweck wurden verschiedene Drama-Aktivitäten per Videokonferenz mit Studierenden aus Deutschland und Serbien im Rahmen von Lehrveranstaltungen durchgeführt. Am Ende des Sommersemesters 2021 wurden sieben Studierende einzeln interviewt. Die leitfadengestützten Interviews wurden nach der zusammenfassenden Inhaltsanalyse von Mayring (2010) qualitativ ausgewertet. Die Ergebnisse weisen darauf hin, dass durch einen dramapädagogischen Ansatz Unterrichtsatmosphäre, Interaktion, Kommunikation, soziale Distanz und Lernmotivation optimiert sowie Sprechangst und Hemmungen abgebaut werden können.

The COVID-19 pandemic has been linked with increased reports of depression, anxiety, and stress. Stay-at-home directives during the pandemic-imposed lifestyle changes, including eating and sedentary behaviors that can further undermine mental health outcomes. Physical activity is a vital component for metabolic health, as well as for mental health by serving as an active coping strategy to manage stress and promote resilience. Global reports of increased sedentary leisure behaviors have been associated with feelings of depression and anxiety, but it unclear whether the relationship between physical activity and depression or anxiety persists over time. In this longitudinal study, we investigated (i) whether physical activity at the onset of the pandemic was related to feelings of depression or anxiety over time and (ii) whether this relationship was mediated by stress appraisals during the pandemic. We surveyed 319 adults living in Canada or the United States to assess physical activity, stress appraisals, and mental health outcomes at two time points over a 6-month period. We found a reduction in leisure-time physical activity that was linked to subsequent feelings of depression. Furthermore, individuals with lower levels of physical activity were more likely to appraise their COVID-19 situation to be uncontrollable at pandemic onset and as the pandemic continued. Stress appraisals of threat and uncontrollability were also positively related to feelings of depression. Modelling these three factors together showed that appraising a situation as uncontrollable mediated the relationship between initial physical activity and subsequent depressive feelings. Although correlational, these data highlight the protective role of leisure-time physical activity against worsened mental health outcomes during periods of prolonged stress.

Globally, the COVID-19 pandemic seriously affected both physical and mental health conditions. This study aims to assess changes in the prevalence of depression among older adults during the COVID-19 pandemic in Bangladesh and explore the correlates of depression in pooled data.This study followed a repeated cross-sectional design and was conducted through telephone interviews on two successive occasions during the COVID-19 pandemic (October 2020 and September 2021) among 2077 (1032 in 2020-survey and 1045 in 2021-survey) older Bangladeshi adults aged 60 years and above. Depression was measured using the 15-item Geriatric Depression Scale (GDS-15). The binary logistic regression model was used to identify the factors associated with depression in pooled data.A significant increase in the prevalence of depression was noted in the 2021 survey compared to the 2020 survey (47.2% versus 40.3%; adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.11-1.75). Depression was significantly higher among participants without a partner (aOR 1.92, 95% CI 1.45-2.53), with a monthly family income of5000 BDT (aOR: 2.65, 95% CI 1.82-3.86) or 5000-10 000 BDT (aOR: 1.30, 95% CI 1.03-1.65), living alone (aOR 2.24, 95% CI 1.40-3.61), feeling isolated (aOR 3.15, 95% CI 2.49-3.98), with poor memory/concentration (aOR 2.02, 95% CI 1.58-2.57), with non-communicable chronic conditions (aOR 1.34, 95% CI 1.06-1.69), overwhelmed by COVID-19 (aOR 1.54, 95% CI 1.18-2.00), having difficulty earning (aOR 1.49, 95% CI 1.15-1.92) or obtaining food (aOR 1.56, 95% CI 1.17-2.09) during COVID-19 pandemic, communicating less frequently (aOR 1.35, 95% CI 1.07-1.70) and needing extra care (aOR 2.28, 95% CI 1.75-2.96) during the pandemic.Policymakers and public health practitioners should provide immediate mental health support initiatives for this vulnerable population during the COVID-19 pandemic and beyond. Policymakers should also invest in creating safe places to practise mindful eating, exercise, or other refuelling activities as a means of preventing and managing depression.

Background The COVID-19 pandemic exacerbated existing health disparities and disproportionately affected vulnerable individuals and communities (e.g., low-income, precariously housed or in institutional settings, racialized, migrant, refugee, 2SLBGTQ+). Despite their higher risk of infection and sub-optimal access to healthcare, Canada’s COVID-19 vaccination strategy focused primarily on age, as well as medical and occupational risk factors. Methods We conducted a mixed-methods constant comparative qualitative analysis of epidemiological data from a national database of COVID-19 cases and vaccine coverage in four Canadian jurisdictions. Jurisdictional policies, policy updates, and associated press releases were collected from government websites, and qualitative data were collected through 34 semi-structured interviews of key informants from nine Canadian jurisdictions. Interviews were coded and analyzed for themes and patterns. Results COVID-19 vaccines were rolled out in Canada in three phases, each accompanied by specific challenges. Vaccine delivery systems typically featured large-venue mass immunization sites that presented a variety of barriers for those from vulnerable communities. The engagement and targeted outreach that featured in the later phases were driven predominantly by the efforts of community organizations and primary care providers, with limited support from provincial governments. Conclusions While COVID-19 vaccine rollout in Canada is largely considered a success, such an interpretation is shaped by the metrics chosen. Vaccine delivery systems across Canada need substantial improvements to ensure optimal uptake and equitable access for all. Our findings suggest a more equitable model for vaccine delivery featuring early establishment of local barrier-free clinics, culturally safe and representative environment, as well as multi-lingual assistance, among other vulnerability-sensitive elements.

Routine childhood vaccination improves health and prevents morbidity and mortality from vaccine-preventable diseases. There are indications that the COVID-19 pandemic has negatively impacted immunization rates globally, but systematic studies on this are still lacking in Canada. This study aims to add knowledge on the pandemic's effect on children's immunization rates with pneumococcal vaccine using self-reported immunization data from CANImmunize. An interrupted time series analysis was conducted on aggregated monthly enrollment of children on the platform (2016-2021) and their pneumococcal immunization series completion rates (2016-2020). Predicted trends before and after the onset of the COVID19-related restriction (March 1, 2020) were compared by means of an Autoregressive Integrated Moving Average (ARIMA). The highest monthly enrollment was 3,474 new infant records observed in January 2020, and the lowest was 100 records in December 2021. The highest Self-reported pneumococcal immunization series completion rate was 78.89%, observed in February 2017, and the lowest was 6.94% in December 2021. Enrollment decreased by 1177.52 records (95% CI: -1865.47, -489.57), with a continued decrease of 80.84 records each month. Completion rates had an immediate increase of 14.57% (95% CI 4.64, 24.51), followed by a decrease of 3.54% each month. The onset of the COVID-19 related restrictions impacted the enrollment of children in the CANImmunize digital immunization platform and an overall decrease in self-reported pneumococcal immunization series completion rates. Our findings support efforts to increase catch-up immunization campaigns so that children who could not get scheduled immunization during the pandemic are not missed.