The Health Justice Policy Tracker: COVID-19 Policies To Advance Health Justice For Vulnerable Populations

The rapid spread of COVID-19 throughout the world in early 2020 created unprecedented challenges for national governments. Policies developed during the early months of the pandemic, before the first mRNA vaccines were authorized for emergency use, provide a window into national governments' prioritization of populations that were particularly vulnerable. We developed the COVID-19 Health Justice Policy Tracker to capture and categorize these policies using a health justice lens. In this article we present the results of a preliminary analysis of the tracker data. The tracker focuses on policies for six population groups: children, the elderly, people with disabilities, migrant workers, incarcerated people, and people who were refugees or were seeking political asylum. It includes 610 policies, most targeting children and the elderly and providing financial support. National governments also prioritized measures such as policies to ensure access to mental health care and social services, digital and teleservices, continuity of children's education, and food security. The tracker provides a resource for researchers and policy makers seeking model language and tested policy approaches to advance health justice during future crises.

Genetic diversity analysis of cattle genetic groups of Kerala state using microsatellite data

Cattle belonging to seven different genetic groups in Kerala state, India were chosen for the study to find out the genetic diversity between the groups, which would aid in their sustainable improvement and conservation of native cattle. They included the native groups namely, Vechur, Kasaragod, Vadakara dwarf and Vilwadri, along with three different grades of crossbred cattle, based on milk production. Genomic DNA was isolated from 20 to 30 unrelated animals of each group and a panel of 25 microsatellite markers as suggested by FAO-ISAG, were amplified by multiplex PCR. The PCR amplicons were genotyped and the allelic data analyzed using suitable Bioinformatics softwares. The present study showed that the observed number of alleles was much more than the expected, in all populations. The mean PIC value obtained for the present study was 0.8912 and increased number of private alleles were observed, especially in Vilwadri and Kasaragod groups. Negative value of FIS (-0.055) indicated that the level of inbreeding was less. The FST value was 0.1442 indicating that the populations showed good genetic differentiation. The results of Structure analysis revealed admixture only in Vadakara population. The results obtained from the present study showed that Vilwadri and Kasaragod cattle showed distinct differences from other groups.

Understanding resilience, self-reliance and increasing country voice: a clash of ideologies in global health

BACKGROUND

'Resilience', 'self-reliance' and 'increasing country voice' are widely used terms in global health. However, the terms are understood in diverse ways by various global health actors. We analyse how these terms are understood and why differences in understanding exist.

METHODS

Drawing on scholarship concerning ideology, framing and power, we employ a case study of a USAID-sponsored suite of awards called MOMENTUM. Applying a meta-ethnographic approach, we triangulate data from peer-reviewed and grey literature, as well as 27 key informant interviews with actors at the forefront of shaping these discourses and those associated with MOMENTUM, working in development agencies, implementing organisations, low-income and middle-income country governments, and academia.

RESULTS

The lack of common understanding of these three terms is in part a result of differences in two perspectives in global health-reformist and transformational-which are animated by fundamentally different ideologies. Reformists, reflecting neoliberal and liberal democratic ideologies, largely take a technocratic approach to understanding health problems and advance incremental solutions, working within existing global and local health systems to effect change. Transformationalists, reflecting threads of neo-Marxist ideology, see the problems as inherently political and seek to overhaul national and global systems and power relations. These ideologies shape differences in how actors define the problem, its solutions and attribute responsibility, resulting in nuanced differences among global health actors in their understanding of resilience, self-reliance and increasing country voice.

CONCLUSIONS

Differences in how these terms are employed and framed are not just linguistic; the language that is used is reflective of underlying ideological differences among global health actors, with implications for the way programmes are designed and implemented, the knowledge that is produced and engagement with stakeholders. Laying these distinct ideologies bare may be crucial for managing actor differences and advancing more productive discussions and actions towards achieving global health equity.

Why 'elevating country voice' is not decolonizing global health: A frame analysis of in-depth interviews

Recent calls for global health decolonization suggest that addressing the problems of global health may require more than 'elevating country voice'. We employed a frame analysis of the diagnostic, prognostic, and motivational framings of both discourses and analyzed the implications of convergence or divergence of these frames for global health practice and scholarship. We used two major sources of data-a review of literature and in-depth interviews with actors in global health practice and shapers of discourse around elevating country voice and decolonizing global health. Using NVivo 12, a deductive analysis approach was applied to the literature and interview transcripts using diagnostic, prognostic and motivational framings as themes. We found that calls for elevating country voice consider suppressed low- and middle-income country (LMIC) voice in global health agenda-setting and lack of country ownership of health initiatives as major problems; advancing better LMIC representation in decision making positions, and local ownership of development initiatives as solutions. The rationale for action is greater aid impact. In contrast, calls for decolonizing global health characterize colonialityas the problem. Its prognostic framing, though still in a formative stage, includes greater acceptance of diversity in approaches to knowledge creation and health systems, and a structural transformation of global health governance. Its motivational framing is justice. Conceptually and in terms of possible outcomes, the frames underlying these discourses differ. Actors' origin and nature of involvement with global health work are markers of the frames they align with. In response to calls for country voice elevation, global health institutions working in LMICs may prioritize country representation in rooms near or where power resides, but this falls short of expectations of decolonizing global health advocates. Whether governments, organizations, and communities will sufficiently invest in public health to achieve decolonization remains unknown and will determine the future of the call for decolonization and global health practice at large.

Transforming global health education during the COVID-19 era: perspectives from a transnational collective of global health students and recent graduates

Inspired by the 2021 BMJ Global Health Editorial by Atkinset alon global health (GH) teaching during the COVID-19 pandemic, a group of GH students and recent graduates from around the world convened to discuss our experiences in GH education during multiple global crises. Through weekly meetings over the course of several months, we reflected on the impact the COVID-19 pandemic and broader systemic inequities and injustices in GH education and practice have had on us over the past 2 years. Despite our geographical and disciplinary diversity, our collective experience suggests that while the pandemic provided an opportunity for changing GH education, that opportunity was not seized by most of our institutions. In light of the mounting health crises that loom over our generation, emerging GH professionals have a unique role in critiquing, deconstructing and reconstructing GH education to better address the needs of our time. By using our experiences learning GH during the pandemic as an entry point, and by using this collective as an incubator for dialogue and re-imagination, we offer our insights outlining successes and barriers we have faced with GH and its education and training. Furthermore, we identify autonomous collectives as a potential viable alternative to encourage pluriversality of knowledge and action systems and to move beyond Western universalism that frames most of traditional academia.

Impacts of COVID-19 lockdown on time allocation for sedentary and physical activities - The context of Indian university students

Introduction

Covid-19 pandemic has impacted individuals' time allocation decisions. As it is known that university students display behaviors different from the general population, very few studies have examined their activity participation and time allocation behavior during the pandemic. The present study investigates the changes in time allocations to sedentary, physically active, and eat-sleep activities before and during the pandemic.

Methods

The study hypothesizes that active mode (walk, bicycle) and transit users would compensate for the physical efforts by increasing physical activities at home during the lockdown. Students' perception of personal well-being, anxiety, and individual leisure during the pandemic and their impacts on time allocation decisions after controlling for demographic variables and temporal effects are also explored. A pan India behavioral data of 203 samples collected using an online survey conducted between May to July 2020, during India's lockdown phase, is used for analysis. A series of segmented analyses (using ANOVA's and Kruskal-Wallis Test) and empirical modeling (linear mixed-effect regression) were conducted based on the time use distribution.

Results

Findings showed that university students from low-income households and students who own a bicycle show a higher tendency to spend time in physical activities during lockdown periods. Students accessing college using active modes (before lockdown) allocate less time to sedentary and eat-sleep activities than physical activities during the lockdown period. Students' perception of Leisure items among those who use active modes is significantly different from those of private and public mode users.

Conclusions

From a policy viewpoint, such investigation would help implicitly understand and publicize the health benefits of active modes and transit and encourage their use. For instance, policymakers and transport planners can temporarily allocate less-used motorized streets (due to the pandemic) to students who prefer walking and cycling as universities still function online in India.

Phylogenetic analysis of Nilgiri langur using mitochondrial cytochrome B gene

Old world monkeys comprise 28 Langur species which belong to subfamily Colobinae under family Cercopithecidae. Nilgiri Langurs (Trachypithecus johnii) are endemic to the rain forests of the Western Ghats. The current study is an attempt at comparative phylogeny based on mitochondrial CYTB (mtCYTB) gene of Nilgiri Langur with other langurs. Faecal sample was collected from Nilgiri langur and the genomic DNA was isolated. The 1140 bp mitochondrial CYTB was amplified and sequenced using Sanger’s di-deoxy method. The amplified sequence along with the 27 sequences of Trachypithecus and Semnopithecus that were retrieved from the GenBank database were used for analysis. The phylogenetic tree was constructed by the maximum likelihood method in MEGA X. The analysis showed the clustering of Nilgiri langur with other langurs of the Semnopithecus sp. as a single clade.

Nanomixture of 0-D ternary metal oxides (TiO2- SnO2-Al2O3) cooperating with 1-D hydroxyapatite (HAp) nanorods for RhB removal from synthetic wastewater and hydrogen evolution via water splitting

This work was carried out to devise a feasible alternative to remove cationic dyes from industrial wastewater. A nanomixture of (TiO₂-SnO₂-Al₂O₃) cooperating with Hydroxyapatite (HAp) nanorods was synthesized in this regard as a catalyst to degrade Rhodamine B (RhB) dye from aqueous medium. The physicochemical properties of the hydrothermally prepared Hydroxyapatite Nano Mixture (HNM) were revealed through XRD, FESEM, TEM, XPS, FTIR, BET-BHJ, UV-Vis, and Raman spectroscopy techniques. The synthesized material which was found to be nanorods of average crystallite size 12.53 nm and BET Specific Surface area 60.81 m² g^-1 proved to be very effective for the removal of RhB at various pH conditions (acid, basic, and neutral). Maximum removal of 97% was achieved within 30 min of UV irradiation using 5 ppm RhB in acidic medium while at a higher concentration (20 ppm), it takes just 90 min to achieve 98% degradation of RhB under the same reaction conditions. A further catalytic potential of the prepared nanomixture for hydrogen (H₂) evolution via water splitting was explored where 129.45 μmol g^-1 of H₂ was evolved within 60 min. Our findings suggest that the prepared nanomixture could be used as an efficient catalyst for removing spent dyes used in industrial processes and also as a catalyst for hydrogen gas production.

A plant-mediated synthesis of nanostructured hydroxyapatite for biomedical applications: a review

The engineering of calcium-based phosphate materials at the nanoscale gains several unique properties compared to the bulky state. The effort to scale down, e.g., from bulky state to nanoscale in order to control the morphology and improve structural properties requires the use of varying reagents that can be detrimental to the environment. A typical example of these materials is hydroxyapatite (HAp), one of the well-known calcium phosphate materials, which has a close resemblance to human bone tissue. HAp has valuable applications in catalysis, drug delivery, bone and dental implant formation, and adsorption. Hydroxyapatite-based nanomaterials synthesized through conventional routes make use of reagents that are not environmental friendly and are very costly. Since the current research trends are geared towards producing/synthesizing nanomaterials through an eco-friendly approach, there is the need to consider the techniques and reagents involved in the synthesis of HAp. This review touches on the possible replacement of such synthetic chemical reagents, synthesis routes, and toxic capping agents with plant extracts for synthesizing HAp-based nanomaterials for multi-functional applications. The influence of biomolecules from plants on synthesized HAps and the attainable mechanism during these green approaches are discussed. Viable future modifications of the methods used to obtain extracts from plants are also studied.

Temporomandibular joint alloplastic reconstruction of post-traumatic joint degeneration with Sawhney Type I ankylosis using 3D-custom GD-condylar cap prosthesis to restore condylar form and function

Temporomandibular Joint (TMJ) ankylosis as a sequelae following hemarthrosis from trauma, middle ear infection and progressive debilitating arthritis of various etiologies has been well understood, but challenges always arise in terms of choosing least morbid procedure with maximum functional outcome. Total joint replacement (TJR) is the common final stage correction mandating extensive surgical exposure with good technical expertise with its limitations of risk of failure and complications. A case of post-traumatic TMJ degeneration with ankylosis reconstructed using a customised GD-condylar cap prosthesis is described. The patient had an uneventful post-operative period with an acceptable functional outcome. CONCLUSION: The condylar cap prosthesis is a bio-compatible and biomechanically designed in such a way that it can be used for indicated cases by performing minimally invasive surgical technique to achieve an optimal functional and aesthetic outcome.

Core–shell hydroxyapatite/Mg nanostructures: surfactant free facile synthesis, characterization and their in vitro cell viability studies against leukaemia cancer cells (K562)

Hydroxyapatite/magnesium core–shell nanostructures were synthesized by a simple and cost effective precipitation method without a surfactant or ligand/chelating agent.

In vivo anti-diabetic, antioxidant and molecular docking studies of 1, 2, 8-trihydroxy-6-methoxy xanthone and 1, 2-dihydroxy-6-methoxyxanthone-8-O-β-D-xylopyranosyl isolated from Swertia corymbosa

1, 2, 8-trihydroxy-6-methoxy xanthone (1) and 1, 2- dihydroxy-6-methoxyxanthone-8-O-β-d-xylopyranosyl (2) are the main constituents of petroleum ether and ethyl acetate extracts from Swertia corymbosa (Gentinaceae), a medicinal plant used in Indian traditional system for the treatment of diabetes. The present study was designed to examine the antihypoglycemic, antihyperlipidemic and antioxidant effect of compounds 1 and 2 in streptozotocin (STZ) induced diabetic rats. Diabetes was induced in male Wistar rats by a single intraperitoneal injection of STZ (60 mg/kg b.w.). The isolated compounds 1 and 2 at a dose of 50 mg/kg b.w., produced the maximum fall of 83% in the blood glucose level in the diabetic rats after 3h of the treatment. The administration of 1 and 2 (50 mg/kgb.w.) daily for 28 days in STZ induced diabetic rats, resulted in a significant decrease in blood glucose, glycosylated hemoglobin, SGOT, SGPT, ALP serum urea and creatinine with significant rise in plasma insulin level. Test compounds 1 and 2 showed antihyperlipidemic activities as evidenced by significant decrease in serum TC, TG, LDL-C, VLDL-C levels coupled together with elevation of HDL-C level in diabetic treated rats when compared to diabetic untreated rats, indicate the protective role against liver and kidney damage. The results of histopathology also showed 1 and 2 protected tissues (pancreas, liver and kidney) against peroxidation damage and maintained tissue integrity. Further, the molecular interaction study of the ligands 1, 2 and glibenclamide with various diabetes mellitus related protein targets like glucokinase (PDB ID: 1V4S), fructose-1, 6-bisphosphatase 1 (PDB ID: 2JJK) 11-β-hydroxysteroid dehydrogenase (PDB ID: 2BEL) and modeled protein sulfonylurea receptor 1 (SUR1) showed that ligand 1 and 2 possess binding affinity with all protein targets except for 2BEL target protein for which ligand 1 has no interaction. The ligand pose with 2BEL and SUR1 protein target of ligand 2 gave the best binding conformation. Hence 1 and 2 can be considered for developing into a potent antidiabetic drug.

4-Chloro-6-methyl-N-(4-methyl-phen-yl)quinolin-2-amine

In the title compound C(17)H(15)ClN(2), the dihedral angle between the quinoline ring system and the phenyl ring is 50.18 (6)°. In the crystal, mol-ecules are linked into chains running along the c axis by N-H⋯N hydrogen bonds.

2,9-Dimethyl-7-phenyl-N-(4-methylphenyl)dibenzo[b,h][1,6]naphthyridin-6-amine

The title compound, C₃₁H₂₅N₃, was synthesized from 6,4′,4′′-trimethyl-2,4-bis­(N-phenyl­amino)­quinoline and is the first structural example containing a phenyl and phenyl­amino fragment attached to a fused dibenzo[1,6]naphthyridine moiety. The fused tetra­cyclic ring system is essentially planar [r.m.s. deviation = 0.08 (3) Å]. The phenyl ring and the phenyl­amino group are inclined by 82.68 (6) and 35.31 (5)°, respectively, to the mean plane of the fused tetra­cyclic ring system. A weak intra­molecular N—H⋯π(arene) inter­action may in part influence the conformation of the mol­ecule. In the crystal, mol­ecules are linked by weak inter­molecular C—H⋯N hydrogen bonds into centrosymmetric dimers. Additional stabilization is provided by weak C—H⋯π and π–π stacking inter­actions [centroid–centroid distances = 3.834 (2) and 3.898 (1) Å].

7-(2-Chloro-phen-yl)-2,6,9-trimethyl-dibenzo[b,h][1,6]naphthyridine

In the title compound, C(25)H(19)ClN(2), the dibenzo[b,h][1,6]naphthyridine system is planar to within 0.16 (2) Å, and the chloro-phenyl ring is inclined to it by 82.53 (7)°. In the crystal, mol-ecules are linked by C-H⋯N hydrogen bonds, forming chains propagating in [100]. There are also a number of weak π-π stacking inter-actions present [centroid-centroid distances = 3.8531 (1) and 3.7631 (1) Å].

2-Chloro-7-methyl-12-phenyldibenzo[b,g][1,8]naphthyridin-11(6H)-one

In the title compound, C₂₃H₁₅ClN₂O, the fused ring system is planar: the deviation of all the non-H atoms from the plane through all four fused rings is less than 0.31 Å. The plane of the phenyl ring is inclined at 71.78 (5)° to the mean plane of the 1,8-naphthrydine ring system. The crystal structure is devoid of any classical hydrogen bonds but π–π inter­actions are present.

Maternal mortality--an avoidable catastrophe

A retrospective study of work-load and maternal mortality over the past 10 years (1976-1985) at the Women's Hospital, Doha was conducted. 68,540 mothers delivered out of which 4,296 through C-section. The maternal mortality rate, although accounts for 17.59 per 100,000 during the first half of the 10 years period, has fallen to 9.96 in the second half. There are no deaths directly or indirectly related to anesthesia. Anesthetic practice and set-up at the Women's Hospital is discussed.