Brief Report: Perspectives of Foster Care Alumni on COVID-19 Vaccination: Key Findings and a Call to Action

The United States recently surpassed 32 million cases and 570 thousand deaths due to COVID-19. Vaccination of the general population is critical to ending the pandemic, and several highly effective vaccines have now received emergency FDA approval. Young adults are a key group to target for vaccination, as they may be asymptomatic carriers of COVID-19 and unknowingly spread the virus to others. However, recent research suggests that young adults have concerns about COVID-19 vaccination, particularly if they belong to racial and ethnic minority groups or other marginalized populations. Young people with foster care backgrounds are predominantly Black, Indigenous, and people of color (BIPOC), and their hesitancy toward COVID-19 vaccination may be exacerbated by public systems mistrust and ineffective messaging channels. To better understand vaccination attitudes among this population, we conducted focus groups and individual interviews with 23 young people ages 18 to 26 who had recently aged out of foster care. All young people in our sample were parents of young children; thus, their attitudes towards COVID-19 vaccination have relevance for their own as well as their children’s likelihood of getting vaccinated. As part of this project, participants described their attitudes towards COVID-19 vaccination and their reasoning for either accepting or declining a vaccine. Interview audio files were transcribed verbatim and rigorously analyzed using a structured approach to thematic analysis.This study was funded by the Annie E. Casey Foundation. The views expressed in this report are the authors’; the Annie E. Casey Foundation bears no responsibility for the analyses or interpretations presented in this report

Familial sources of encouragement and breast-feeding practices among women participating in the US Special Supplemental Nutrition Programme for Women, Infants and Children

Abstract Objective: To explore how sources of familial encouragement are associated with breast-feeding initiation and duration among a national sample participating in the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: This study uses the 2013–2015 WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2) data. Breast-feeding initiation was measured at the first month, while duration was derived from a composite of the first 13 months. The analysis used logistic and linear regression to explore the association between encouragement sources and breast-feeding outcomes. Setting: A nationally representative sample of WIC participants in the USA. Participants: WIC participants who completed the 13-month interview of the WIC ITFPS-2 (n 2807). Results: Encouragement was significantly associated with both initiation and duration. Each source of encouragement was associated with a 3·2 (95 % CI 2·8, 3·8) increase in odds of initiating breast-feeding in the unadjusted model and 3·0 (95 % CI 2·5, 3·6) increased odds, controlling for age, education, nativity, poverty status, race and ethnicity (<0·0001). When predicting log duration, each percent increase in source of encouragement was associated with an increasing duration on average by 0·003 d (95 % CI 0·2, 0·3, <0·0001). When controls were added, it was associated with an increase of an average of 0·002 d (95 % CI 0·2, 0·3) per percent increase in encouragement source (<0·0001). Conclusions: Women who receive encouragement appear to be more likely to breastfeed. Additional work is needed to explore sources of encouragement and how to include them in intervention work

What motivates community mental and behavioral health organizations to participate in LGBTQ+ cultural competency trainings?

LGBTQ+ populations show elevated rates of poor mental health and substance use relative to their heterosexual and cisgender counterparts but often experience stigma and marginalization when seeking mental health care. Mental and behavioral health organizations and therapists recognize a need for LGBTQ+ cultural competency training opportunities and are interested in participating in these trainings. Professional organizations and state licensing bodies should consider policies that require accredited graduate programs and continuing education opportunities to include LGBTQ+ training and competencies.The constantly evolving language, understanding, and cultural context regarding the mental health of lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse individuals (LGBTQ+) require mental health providers to obtain LGBTQ+ cultural competency training to be affirmative and effective with this population. Unfortunately, many providers are not obtaining this ongoing training and mental health disparities continue to plague LGBTQ+ populations. Guided by the Consolidation Framework for Implementation Research (CFIR), we conducted eight focus groups with community mental and behavioral health organization (MBHO) administrators (e.g., directors, clinical supervisors) and therapists to explore what factors facilitated or inhibited their adoption and implementation of a multicomponent LGBTQ+ cultural competency training program that required administrator and therapist participation in multiple learning sessions over several months (i.e., workshop, clinical consultation, and organizational technical assistance). Results from template analysis supported CFIR-aligned themes, including characteristics of individuals, inner setting, outer setting, and process, and two additional codes—marketing and other/previous training opportunities—emerged from the focus group data. Findings suggest that therapists are motivated to engage in such a program because they want to feel more efficacious, and administrators see the benefits of LGBTQ+ training programs for their clientele and marketing. Barriers to adoption and implementation include cost and personnel resistance, although participants believed these barriers were surmountable. Emphasizing therapist efficacy, clientele need, and benefits for marketing mental and behavioral health services could motivate MBHOs’ and therapists’ adoption and implementation of LGBTQ+ cultural competency training.This work was supported by the University of Maryland Prevention Research Center cooperative agreement no. U48DP006382 from the Centers for Disease Control and Prevention (CDC). Any interpretations and opinions expressed herein are solely those of the authors and may not reflect those of the CDC

Professional Expectations of Provider LGBTQ Competence: Where We Are and Where We Need to Go

Introduction: Mental and behavioral health professional organizations use their governing documents to set expectations of provider competence in working with LGBTQ+ clients. Method: The codes of ethics and training program accreditation guidelines of nine mental and behavioral health disciplines (n=16) were analyzed using template analysis. Results: Coding resulted in fives themes: mission and values, direct practice, clinician education, culturally competent professional development, and advocacy. Expectations for provider competency vary greatly across disciplines. Conclusion: Having a mental and behavioral health workforce that is uniformly competent in meeting the unique needs of LGBTQ populations is key for supporting the mental and behavioral health of LGBTQ persons.This work was supported by the University of Maryland Prevention Research Center cooperative agreement from the Centers for Disease Control and Prevention (grant U48DP006382). N.D.W. also acknowledges support from the Southern Regional Education Board and the Robert Wood Johnson Foundation Health Policy Research Scholars Program. J.N.F. also acknowledges support from the Maryland Population Research Center, by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant P2CHD041041). This work does not expressly represent the views of the Centers for Disease Control and Prevention, National Institutes of Health, or the Robert Wood Johnson Foundation

Type II glycogenosis in a Rottweiler puppy

Se presentó a la consulta a la FCV un canino macho Rottweiler de 4 meses de edad debido a intolerancia al ejercicio, anormalidad en la marcha y dificultad para incorporarse, de 20 días de evolución. Se percibieron intenso dolor en los músculos apendiculares y troncales y hepatomegalia. La ejecución de los reflejos espinales fue anormal, con persistencia de los mismos y temblores de los grupos musculares involucrados. El pulso era débil. Mediante Rx se pusieron en evidencia cardio y hepatomegalia. Se constataron hipercolesterolemia (4.16 g/l) y CPK elevada (125 Un/L). El frotis sanguíneo resultó negativo para Hepatozoon La titulación de anticuerpos contra Toxoplasma y Neospora resultó negativa. Se remitieron muestras de músculos isquiotibiales y psoas para estudios histopatológico y ultraestructural.Facultad de Ciencias Veterinaria

A comprehensive collection of chicken cDNAs

AbstractBirds have played a central role in many biological disciplines, particularly ecology, evolution, and behavior. The chicken, as a model vertebrate, also represents an important experimental system for developmental biologists, immunologists, cell biologists, and geneticists. However, genomic resources for the chicken have lagged behind those for other model organisms, with only 1845 nonredundant full-length chicken cDNA sequences currently deposited in the EMBL databank. We describe a large-scale expressed-sequence-tag (EST) project aimed at gene discovery in chickens (http://www.chick.umist.ac.uk). In total, 339,314 ESTs have been sequenced from 64 cDNA libraries generated from 21 different embryonic and adult tissues. These were clustered and assembled into 85,486 contiguous sequences (contigs). We find that a minimum of 38% of the contigs have orthologs in other organisms and define an upper limit of 13,000 new chicken genes. The remaining contigs may include novel avian specific or rapidly evolving genes. Comparison of the contigs with known chicken genes and orthologs indicates that 30% include cDNAs that contain the start codon and 20% of the contigs represent full-length cDNA sequences. Using this dataset, we estimate that chickens have approximately 35,000 genes in total, suggesting that this number may be a characteristic feature of vertebrates

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead.

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety 'Mode of Action' framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

Plant ecology meets animal cognition: impacts of animal memory on seed dispersal

We propose that an understanding of animal learning and memory is critical to predicting the impacts of animals on plant populations through processes such as seed dispersal, pollination and herbivory. Focussing on endozoochory, we review the evidence that animal memory plays a role in seed dispersal, and present a model which allows us to explore the fundamental consequences of memory for this process. We demonstrate that decision-making by animals based on their previous experiences has the potential to determine which plants are visited, which fruits are selected to be eaten from the plant and where seeds are subsequently deposited, as well as being an important determinant of animal survival. Collectively, these results suggest that the impact of animal learning and memory on seed dispersal is likely to be extremely important, although to date our understanding of these processes suffers from a conspicuous lack of empirical support. This is partly because of the difficulty of conducting appropriate experiments but is also the result of limited interaction between plant ecologists and those who work on animal cognition

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707