COVID-19 Testing and Education at the Allen Family Center

COVID-19 Testing and Education at the Allen Family Center COVID-19 Testing and Education at the Allen Family Center The Mount Baker community is home to many families experiencing homelessness and housing instability. According to the Department of Community and Health Services, there is an estimate of 40,800 people in King County who experienced homelessness in 2020 (King County Department of Community, 2021). The Allen Family Center (AFC) is an inviting community resource, partnered with Mary’s Place and Mercy Housing Northwest, that serves families by providing assistance with housing, medical care, and childcare; recently, the AFC began providing COVID-19 testing available to anyone in the Mount Baker community. After assessing the AFC, our group, which consists of Seattle Pacific University (SPU) nursing students, determined that the AFC staff would benefit from further education regarding COVID-19 testing. Our goal for this project was for the AFC and its staff to be well-equipped with the skills and knowledge to operate a COVID-19 testing location for the surrounding Mount Baker community. Background Throughout the COVID-19 pandemic, there has been an increase in people experiencing homelessness and therefore an increased need for easily accessible COVID-19 testing (King County Department of Health, 2022). According to the King County Department of Health, the homeless population is at a higher risk of becoming infected with COVID-19 and experiencing severe illness related to COVID-19 (King County Department of Health, 2022). Fortunately, the AFC was provided with a large number of Binax COVID-19 testing kits for use in the Mount Baker community. However, the knowledge deficit within the AFC staff regarding safe COVID-19 testing protocol and infection prevention was a barrier to their confidence in facilitating safe COVID-19 testing. In addition to the knowledge deficit, the AFC is also limited in its ability to function fully due to setbacks related to COVID-19. Activities Our project consisted of reviewing current COVID-19 literature and testing protocols in order to create an educational binder for staff and clients. Our initial windshield survey of the AFC revealed the need to tailor the existing Mary’s Place testing protocols to their unique space. These modifications included a streamlined and comprehensive screening tool, adjustments to the Mary’s Place protocol, and details on safe donning and doffing of personal protective equipment (PPE). Our symptom screening tool was developed using the Centers for Disease Control and Prevention (CDC) as a reference with the intention of being simple and comprehensive (CDC, 2020). We included questions relevant for the AFC such as the clients race, ethnicity, and if they were pregnant. For the modified Mary’s Place protocol, we included details on the use of the AFC space and specific testing procedures for the staff to follow. Finally, we provided educational infographics and links to videos regarding PPE donning and doffing; staff were educated to perform hand hygiene, wear a mask, and don gloves in order to promote staff safety. These three elements comprise the core of our project and final deliverables. One of our nursing diagnoses was a staff knowledge deficit regarding COVID-19 testing protocols and safety surrounding hand hygiene, disinfection, and testing flow. This led us to review research around proper testing protocols, sanitation, donning and doffing of PPE, and proper waste disposal to educate staff. We also compiled resources for the surrounding community such as sick day protocols, a vaccine locator, and additional locations to obtain a COVID-19 polymerase chain reaction (PCR) test. After a review of the research, we compiled relevant information into a binder and digital folder intended for use and distribution by the AFC staff. We met with the AFC staff in person to deliver these elements, assess their current testing protocol, and review our planned protocol. At this point, we were able to demonstrate all the necessary education we gathered. Meeting face-to-face provided the opportunity to answer questions directly, collaborate and brainstorm with staff on final edits to the protocol, and demonstrate any hands-on techniques, such as properly donning and doffing gloves. 4 Ultimately, these resources are intended for ongoing use to protect the health and safety of staff and the community they serve. Outcomes Our first outcome goal was to improve staff knowledge of safe COVID-19 testing practices. A limitation to this was the complexity and number of steps required to complete safe and effective COVID-19 testing. To avoid this limitation, we provided a step-by-step document explaining the testing procedures for each person involved in the testing process (See appendix). After visiting the AFC and providing in-person staff training, we found that our goal was met when the staff was able to explain and perform the testing process accurately. The second outcome we achieved was updating the AFC COVID-19 testing protocol to be current with the CDC guidelines for testing. Mary’s Place provided their established protocol for COVID-19 testing. We realized their protocol would need to be adapted to the AFC. We utilized the most up-to-date CDC information in order to update the protocol and make it specific to the AFC. A major limitation to this is the ever-changing nature of COVID-19 protocol as new information comes to light. To combat this limitation, we opted to provide a digital copy of our resources so as information is updated, the AFC can remain equipped with the most current information directly from the provided sources. The final outcome we hoped to achieve is an increased access to efficient, safe testing for the Mount Baker community. At this time, the AFC is testing their staff weekly and any clients who walk up to the building requesting COVID-19 testing. While we were able to meet this goal by facilitating the agency to open a new testing site at the AFC, we recognize that there is a limitation in how many clients can be tested due to COVID-19’s impact on the AFC’s ability to function at full capacity. As the pandemic settles, our hope is that the resources provided to the AFC will be sufficient to support their testing process and reach the greater Mount Baker community. Conclusion The newly established AFC in Mount Baker, Seattle has been providing COVID-19 testing to their staff and the greater community. The staff voiced their concerns about their knowledge deficit related to best practice protocol to keep themselves and clients safe and healthy. To best support both the staff and the Mount Baker community, SPU nursing students developed an evidence-based COVID-19 testing protocol for the AFC and provided educational materials and training. Through these interventions, we equipped the AFC staff with the education needed to facilitate a functioning and safe COVID-19 testing site. The AFC staff reported feeling empowered with the knowledge and confidence to carry out COVID-19 testing in a community facing a higher risk of exposure. A limitation to our project is the short timeline we were granted to work with the AFC because it limits our ability to see the long-term impact of our interventions. Our work to empower the staff with educational material and safe testing protocol proved to be valuable to those we worked with at the AFC and surrounding community. Seeing the staff react positively to our interventions and deliverables proved that establishing a safe and functioning testing site positively affected the community by leading to increased access to testing, community awareness, and improved staff knowledge. References CDC. (2020, June 29). CDC Facilities COVID-19 Screening. Centers for Disease Control and Prevention. https://www.cdc.gov/screening/index.html King County Department of Community and Human Services. (2021). Integrating data to better measure homelessness [Infographic]. Kingcounty.gov. https://kingcounty.gov/~/media/depts/communityhumanservices/department/documents/KC_DCHS_Cross_Systems_Homelessness_Analysis_Brief_12_16_2021_FINAL.ashx?1 King County Department of Health. (2022, January). Homelessness and Covid-19. Homelessness and COVID-19 - King County. Retrieved February 23, 2022, from https://kingcounty.gov/depts/health/covid-19/data/homeless.asp

Epigenome-wide meta-analysis of blood DNA methylation in newborns and children identifies numerous loci related to gestational age

Background Preterm birth and shorter duration of pregnancy are associated with increased morbidity in neonatal and later life. As the epigenome is known to have an important role during fetal development, we investigated associations between gestational age and blood DNA methylation in children. Methods We performed meta-analysis of Illumina's HumanMethylation450-array associations between gestational age and cord blood DNA methylation in 3648 newborns from 17 cohorts without common pregnancy complications, induced delivery or caesarean section. We also explored associations of gestational age with DNA methylation measured at 4-18 years in additional pediatric cohorts. Follow-up analyses of DNA methylation and gene expression correlations were performed in cord blood. DNA methylation profiles were also explored in tissues relevant for gestational age health effects: fetal brain and lung. Results We identified 8899 CpGs in cord blood that were associated with gestational age (range 27-42 weeks), at Bonferroni significance, P <1.06 x 10(- 7), of which 3343 were novel. These were annotated to 4966 genes. After restricting findings to at least three significant adjacent CpGs, we identified 1276 CpGs annotated to 325 genes. Results were generally consistent when analyses were restricted to term births. Cord blood findings tended not to persist into childhood and adolescence. Pathway analyses identified enrichment for biological processes critical to embryonic development. Follow-up of identified genes showed correlations between gestational age and DNA methylation levels in fetal brain and lung tissue, as well as correlation with expression levels. Conclusions We identified numerous CpGs differentially methylated in relation to gestational age at birth that appear to reflect fetal developmental processes across tissues. These findings may contribute to understanding mechanisms linking gestational age to health effects.Peer reviewe

DNA methylation and body mass index from birth to adolescence : meta-analyses of epigenome-wide association studies

Background DNA methylation has been shown to be associated with adiposity in adulthood. However, whether similar DNA methylation patterns are associated with childhood and adolescent body mass index (BMI) is largely unknown. More insight into this relationship at younger ages may have implications for future prevention of obesity and its related traits. Methods We examined whether DNA methylation in cord blood and whole blood in childhood and adolescence was associated with BMI in the age range from 2 to 18 years using both cross-sectional and longitudinal models. We performed meta-analyses of epigenome-wide association studies including up to 4133 children from 23 studies. We examined the overlap of findings reported in previous studies in children and adults with those in our analyses and calculated enrichment. Results DNA methylation at three CpGs (cg05937453, cg25212453, and cg10040131), each in a different age range, was associated with BMI at Bonferroni significance, P <1.06 x 10(-7), with a 0.96 standard deviation score (SDS) (standard error (SE) 0.17), 0.32 SDS (SE 0.06), and 0.32 BMI SDS (SE 0.06) higher BMI per 10% increase in methylation, respectively. DNA methylation at nine additional CpGs in the cross-sectional childhood model was associated with BMI at false discovery rate significance. The strength of the associations of DNA methylation at the 187 CpGs previously identified to be associated with adult BMI, increased with advancing age across childhood and adolescence in our analyses. In addition, correlation coefficients between effect estimates for those CpGs in adults and in children and adolescents also increased. Among the top findings for each age range, we observed increasing enrichment for the CpGs that were previously identified in adults (birth P-enrichment = 1; childhood P-enrichment = 2.00 x 10(-4); adolescence P-enrichment = 2.10 x 10(-7)). Conclusions There were only minimal associations of DNA methylation with childhood and adolescent BMI. With the advancing age of the participants across childhood and adolescence, we observed increasing overlap with altered DNA methylation loci reported in association with adult BMI. These findings may be compatible with the hypothesis that DNA methylation differences are mostly a consequence rather than a cause of obesity.Peer reviewe

Hierarchical Bayesian models for small area estimation of county-level private forest landowner population

The National Woodland Owner Survey (NWOS), administered by the USDA Forest Service, provides estimates of private forest ownership characteristics, and ownersâ attitudes and behaviors at a national-, regional- and state-level. Due to small sample sizes prescribed for inference at the state-level, there are insufficient data to support county-level estimates. However, county-level estimates of NWOS variables are desired because ownership programs and education initiatives often occur at the county-level and such information could help tailor these efforts to better match county-specific needs and demographics. Here, we present and assess methods to estimate the number of private forest ownerships at the county-level for two states, Montana and New Jersey. To assess model performance, true population parameters were derived from cadastral and remote sensing data. Two small area estimation (SAE) models, the Fay-Herriot (FH) and FH with conditional autoregressive random effects (FHCAR), improved estimated county-level population mean squared error (MSE) over that achieved by direct estimates. The proposed SAE models use covariates to improve accuracy and precision of county-level estimates. Results show total forest area and 2010 decennial Census population density covariates explained a significant portion of variability in county-level population size. These and other results suggest the proposed SAE methods yield a statistically robust approach to deliver reliable estimates of private ownership population size and could be extended to additional important NWOS variables at the county-level.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Replication Data for: Hierarchical Bayesian models for small area estimation of county-level private forest landowner population

files containing R data image and associated scripts for running small area estimation models of the number of private forest ownerships at the county-level for Montana and New Jerse

Analytic reproducibility in articles receiving open data badges at the journal Psychological Science: An observational study

For any scientific report, repeating the original analyses upon the original data should yield the original outcomes. We evaluated analytic reproducibility in 25 Psychological Science articles awarded open data badges between 2014 and 2015. Initially, 16 (64%, 95% confidence interval [43,81]) articles contained at least one ‘major numerical discrepancy' (>10% difference) prompting us to request input from original authors. Ultimately, target values were reproducible without author involvement for 9 (36% [20,59]) articles; reproducible with author involvement for 6 (24% [8,47]) articles; not fully reproducible with no substantive author response for 3 (12% [0,35]) articles; and not fully reproducible despite author involvement for 7 (28% [12,51]) articles. Overall, 37 major numerical discrepancies remained out of 789 checked values (5% [3,6]), but original conclusions did not appear affected. Non-reproducibility was primarily caused by unclear reporting of analytic procedures. These results highlight that open data alone is not sufficient to ensure analytic reproducibility. Funding T.E.H.'s contribution was enabled by a general support grant awarded to the Meta-Research Innovation Center at Stanford (METRICS) from the Laura and John Arnold Foundation and a grant from the Einstein Foundation and Stiftung Charité awarded to the Meta-Research Innovation Center Berlin (METRIC-B)

Analytic reproducibility in articles receiving open data badges at the journal Psychological Science: An observational study

For any scientific report, repeating the original analyses upon the original data should yield the original outcomes. We evaluated analytic reproducibility in 25 Psychological Science articles awarded open data badges between 2014 and 2015. Initially, 16 (64%, 95% confidence interval [43,81]) articles contained at least one ‘major numerical discrepancy' (>10% difference) prompting us to request input from original authors. Ultimately, target values were reproducible without author involvement for 9 (36% [20,59]) articles; reproducible with author involvement for 6 (24% [8,47]) articles; not fully reproducible with no substantive author response for 3 (12% [0,35]) articles; and not fully reproducible despite author involvement for 7 (28% [12,51]) articles. Overall, 37 major numerical discrepancies remained out of 789 checked values (5% [3,6]), but original conclusions did not appear affected. Non-reproducibility was primarily caused by unclear reporting of analytic procedures. These results highlight that open data alone is not sufficient to ensure analytic reproducibility. Funding T.E.H.'s contribution was enabled by a general support grant awarded to the Meta-Research Innovation Center at Stanford (METRICS) from the Laura and John Arnold Foundation and a grant from the Einstein Foundation and Stiftung Charité awarded to the Meta-Research Innovation Center Berlin (METRIC-B)