Social determinants of health in the setting of hypertrophic cardiomyopathy.

Social determinants of health play an important role in explaining poor health outcomes across many chronic disease states. The impact of the social gradient in the setting of an inherited heart disease, hypertrophic cardiomyopathy (HCM), has not been investigated. This study sought to profile the socioeconomic status of patients attending a specialized multidisciplinary clinic and to determine the impact on clinical factors, psychosocial wellbeing and adherence to medical advice

Why Tenth Graders Fail to Finish High School: A Dropout Typology Latent Class Analysis

A large percentage of the students who drop out of K-12 schools in the United States do so at the end of high school, at some point after grade 10. Yet we know little about the differences between different types of students who drop out of the end of high school. The purpose of this study is to examine a typology of high school dropouts from a large nationally representative dataset (ELS:2002) using latent class analysis (LCA). We found three significantly different types of dropouts; Quiet, Jaded, and Involved. Based on this typology of three subgroups, we discuss implications for future dropout intervention research, policy, and practice

What's in a grade? The multidimensional nature of what teacher-assigned grades assess in high school

Historically, teacher-assigned grades have been seen as unreliable subjective measures of academic knowledge, since grades and standardized tests have traditionally correlated at about the 0.5 to 0.6 level, and thus explain about 25–35% of each other. However, emerging literature indicates that grades may be a multidimensional assessment of both student academic knowledge and a student's ability to negotiate the social processes of schooling, such as behavior, participation, and effort. This study analyzed the high school transcript component of the Education Longitudinal Study of 2002 (ELS:2002) using multidimensional scaling (MDS) to describe the relationships between core subject grades, non-core subject grades, and standardized test scores in mathematics and reading. The results indicate that when accounting for the academic knowledge component assessed through standardized tests, teacher-assigned grades may be a useful assessment of a student's ability at the non-cognitive aspects of school. Implications for practice, research, and policy are discussed

A systematic review investigating fatigue, psychological and cognitive impairment following TIA and minor stroke:protocol paper

Approximately 20,000 people have a transient ischemic attack (TIA) and 23,375 have a minor stroke in England each year. Fatigue, psychological and cognitive impairments are well documented post-stroke. Evidence suggests that TIA and minor stroke patients also experience these impairments; however, they are not routinely offered relevant treatment. This systematic review aims to: (1) establish the prevalence of fatigue, anxiety, depression, post-traumatic stress disorder (PTSD) and cognitive impairment following TIA and minor stroke and to investigate the temporal course of these impairments; (2) explore impact on quality of life (QoL), change in emotions and return to work; (3) identify where further research is required and to potentially inform an intervention study

The role of the genetic counsellor: a systematic review of research evidence

In Europe, genetic counsellors are employed in specialist genetic centres or other specialist units. According to the European Board of Medical Genetics, the genetic counsellor must fulfil a range of roles, including provision of information and facilitation of psychosocial adjustment of the client to their genetic status and situation. To evaluate the extent to which genetic counsellors fulfil their prescribed roles, we conducted a systematic review of the published relevant scientific evidence. We searched five relevant electronic databases (Medline, CINAHL, SocIndex, AMED and PsychInfo) using relevant search terms and handsearched four subject-specific journals for research-based papers published in English between 1 January 2000 and 30 June 2013. Of 419 potential papers identified initially, seven satisfied the inclusion criteria for the review. Themes derived from the thematic analysis of the data were: (i) rationale for genetic counsellors to provide care, (ii) appropriate roles and responsibilities and (iii) the types of conditions included in the genetic counsellor caseload. The findings of this systematic review indicate that where genetic counsellors are utilised in specialist genetic settings, they undertake a significant workload associated with direct patient care and this appears to be acceptable to patients. With the burden on genetic services, there is an argument for the increased use of genetic counsellors in countries where they are under-utilised. In addition, roles undertaken by genetic counsellors in specialist genetic settings could be adapted to integrate genetic counsellors into multi-disciplinary teams in other specialisms

Leveraging population admixture to characterize the heritability of complex traits.

Despite recent progress on estimating the heritability explained by genotyped SNPs (h(2)g), a large gap between h(2)g and estimates of total narrow-sense heritability (h(2)) remains. Explanations for this gap include rare variants or upward bias in family-based estimates of h(2) due to shared environment or epistasis. We estimate h(2) from unrelated individuals in admixed populations by first estimating the heritability explained by local ancestry (h(2)γ). We show that h(2)γ = 2FSTCθ(1 - θ)h(2), where FSTC measures frequency differences between populations at causal loci and θ is the genome-wide ancestry proportion. Our approach is not susceptible to biases caused by epistasis or shared environment. We applied this approach to the analysis of 13 phenotypes in 21,497 African-American individuals from 3 cohorts. For height and body mass index (BMI), we obtained h(2) estimates of 0.55 ± 0.09 and 0.23 ± 0.06, respectively, which are larger than estimates of h(2)g in these and other data but smaller than family-based estimates of h(2)