Health of our nation's children

Authors: Mary Jo Coiro, Nicholas Zill, Barbara Bloom.Based on data from the 1988 National Health Interview Survey on Child Health.Shipping list no.: 95-0024-P."December 1994."Also availalbe via the World Wide Web.Includes bibliographical references (p. 16-17)

Increases in Graduate Students’ Interprofessional Competence Associated with Clinical Training Activities

INTRODUCTION Interprofessional education is a critical and recommended element in most allied health training programs as it prepares emerging practitioners to work with professionals in other disciplines. The purpose of this study was to examine graduate students’ interprofessional (IP) attitudes and perceived competence prior to and after they participated in a yearlong IP curriculum consisting of both educational and clinical activities. In addition, the study sought to determine if competence was related to the number or perceived value of the educational or clinical activities and if there was a correlation between attitudes and competence. METHODS Participants were 45 graduate students in speech-language pathology (MS) and clinical psychology (PsyD) who completed self-report questionnaires at three time points during their first year of graduate school. RESULTS Students participated in an average of 4.8 IP educational and 3.6 IP clinical training activities. Across the year, attitudes toward IP practice remained high. Students reported an increase in their IP competence, particularly associated with participation in clinical, rather than educational, activities. Attitudes and competence were only somewhat related, as students with better attitudes toward teamwork and shared roles reported an increase in competence. DISCUSSION Students perceived that clinical training has a more positive impact on their knowledge and skills than didactic training; this pattern is consistent with practice guidelines that emphasize the importance of practical training. CONCLUSION Future research should examine whether particular IP experiences are associated with increases in competence, and whether self-reported competence is associated with IP performance in practice

Assessing and Increasing Graduate Students’ Use of Reflective Practices: An Empirical Study

The Ignatian Pedagogy Paradigm (IPP) has primarily been conceptualized and applied with regards to high school and undergraduate education. However graduate students constitute one-third of the total enrollment at Jesuit universities in the United States. This article describes an initiative to infuse one aspect of the IPP – namely, reflection – into the curricula of three graduate programs, and the development of a brief self-report measure of reflective practices. Self-report data collected from 130 graduate students in three human services programs (pastoral counseling, psychology, and speech/language pathology) indicated that their understanding and use of reflection as a pedagogical tool increased significantly during their first year in their respective programs. This article discusses future plans to continue infusing the IPP into graduate curricula

Personal and Educational Differences in College Students’ Attitudes Toward Social Justice

Many colleges and universities encourage students to engage with social justice issues in their education and career discernment. However, a variety of individual attributes and life experiences may predict how college students develop an awareness of and attitudes toward social justice, perhaps including ways in which students relate to their own challenging life experiences and encounter others’ experiences of injustice. This study explored the relationship between individual attributes, educational experiences and social justice attitudes among a sample of 347 college students who completed self-report surveys. Specifically, this study examined a) help-seeking attitudes, b) self-compassion, c) prior experience receiving mental health support, and d) prior experience participating in service activities as predictors of social justice attitudes. As hypothesized, higher willingness to seek help in times of personal distress and higher levels of self-compassion were positively correlated with awareness and concern for social justice issues, with help-seeking attitudes being the stronger predictor. Significant differences were also observed across gender, help-seeking history, and service experience. Furthermore, the association between help-seeking attitudes and social justice attitudes was moderated by gender and by prior service experience and mental health support. Implications of these findings for social justice education and college student well-being are discussed

An explainable model of host genetic interactions linked to COVID-19 severity

We employed a multifaceted computational strategy to identify the genetic factors contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing (WES) dataset of a cohort of 2000 Italian patients. We coupled a stratified k-fold screening, to rank variants more associated with severity, with the training of multiple supervised classifiers, to predict severity based on screened features. Feature importance analysis from tree-based models allowed us to identify 16 variants with the highest support which, together with age and gender covariates, were found to be most predictive of COVID-19 severity. When tested on a follow-up cohort, our ensemble of models predicted severity with high accuracy (ACC = 81.88%; AUCROC = 96%; MCC = 61.55%). Our model recapitulated a vast literature of emerging molecular mechanisms and genetic factors linked to COVID-19 response and extends previous landmark Genome-Wide Association Studies (GWAS). It revealed a network of interplaying genetic signatures converging on established immune system and inflammatory processes linked to viral infection response. It also identified additional processes cross-talking with immune pathways, such as GPCR signaling, which might offer additional opportunities for therapeutic intervention and patient stratification. Publicly available PheWAS datasets revealed that several variants were significantly associated with phenotypic traits such as "Respiratory or thoracic disease", supporting their link with COVID-19 severity outcome.A multifaceted computational strategy identifies 16 genetic variants contributing to increased risk of severe COVID-19 infection from a Whole Exome Sequencing dataset of a cohort of Italian patients

The polymorphism L412F in TLR3 inhibits autophagy and is a marker of severe COVID-19 in males

The polymorphism L412F in TLR3 has been associated with several infectious diseases. However, the mechanism underlying this association is still unexplored. Here, we show that the L412F polymorphism in TLR3 is a marker of severity in COVID-19. This association increases in the sub-cohort of males. Impaired macroautophagy/autophagy and reduced TNF/TNFα production was demonstrated in HEK293 cells transfected with TLR3L412F-encoding plasmid and stimulated with specific agonist poly(I:C). A statistically significant reduced survival at 28 days was shown in L412F COVID-19 patients treated with the autophagy-inhibitor hydroxychloroquine (p = 0.038). An increased frequency of autoimmune disorders such as co-morbidity was found in L412F COVID-19 males with specific class II HLA haplotypes prone to autoantigen presentation. Our analyses indicate that L412F polymorphism makes males at risk of severe COVID-19 and provides a rationale for reinterpreting clinical trials considering autophagy pathways. Abbreviations: AP: autophagosome; AUC: area under the curve; BafA1: bafilomycin A1; COVID-19: coronavirus disease-2019; HCQ: hydroxychloroquine; RAP: rapamycin; ROC: receiver operating characteristic; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; TLR: toll like receptor; TNF/TNF-α: tumor necrosis factor

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Common, low-frequency, rare, and ultra-rare coding variants contribute to COVID-19 severity

The combined impact of common and rare exonic variants in COVID-19 host genetics is currently insufficiently understood. Here, common and rare variants from whole-exome sequencing data of about 4000 SARS-CoV-2-positive individuals were used to define an interpretable machine-learning model for predicting COVID-19 severity. First, variants were converted into separate sets of Boolean features, depending on the absence or the presence of variants in each gene. An ensemble of LASSO logistic regression models was used to identify the most informative Boolean features with respect to the genetic bases of severity. The Boolean features selected by these logistic models were combined into an Integrated PolyGenic Score that offers a synthetic and interpretable index for describing the contribution of host genetics in COVID-19 severity, as demonstrated through testing in several independent cohorts. Selected features belong to ultra-rare, rare, low-frequency, and common variants, including those in linkage disequilibrium with known GWAS loci. Noteworthily, around one quarter of the selected genes are sex-specific. Pathway analysis of the selected genes associated with COVID-19 severity reflected the multi-organ nature of the disease. The proposed model might provide useful information for developing diagnostics and therapeutics, while also being able to guide bedside disease management. © 2021, The Author(s)

A first update on mapping the human genetic architecture of COVID-19

peer reviewe