Toward Pay Equity: A Case Study of Washington DCs Wage Boost for Early Childhood Educators

This short report presents findings from interviews—with key informants, including DC early childhood education leaders, advocates, and implementation partners; parents and legal guardians of young children enrolled in licensed DC child care facilities; and child care center directors and home and expanded home providers—on the nation's first early childhood educator wage supplement with dedicated public funding

Predictors of Comorbid Eating Disorders and Association with Other Obsessive-Compulsive Spectrum Disorders in Trichotillomania

Trichotillomania (TTM) and eating disorders (ED) share many phenomenological similarities, including ritualized compulsive behaviors. Given this, and that comorbid EDs may represent additional functional burden to hair pullers, we sought to identify factors that predict diagnosis of an ED in a TTM population. Subjects included 555 adult females (age range 18–65) with DSM-IV-TR TTM or chronic hair pullers recruited from multiple sites. 7.2% (N = 40) of our TTM subjects met criteria for an ED in their lifetime. In univariable regression analysis, obsessive-compulsive disorder (OCD), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) worst-ever compulsion and total scores, certain obsessive-compulsive spectrum disorders, anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), and substance disorder all met the pre-specified criteria for inclusion in the multivariable analysis. In the final multivariable model, diagnosis of OCD (OR: 5.68, 95% CI: 2.2–15.0) and diagnosis of an additional body-focused repetitive behavior disorder (BFRB) (OR: 2.69, 95% CI: 1.1–6.8) were both associated with increased risk of ED in TTM. Overall, our results provide further support of the relatedness between ED and TTM. This finding highlights the importance of assessing for comorbid OCD and additional BFRBs in those with TTM. Future research is needed to identify additional predictors of comorbid disorders and to better understand the complex relationships between BFRBs, OCD and EDs

Study of access and outcomes from advanced computer science coursework in the Chicago Public Schools\u27\u27 poster in Structured Poster Session CS for All: An intersectional approach to unpacking equity in computer science education

The Chicago Public Schools (CPS) has taken a unique approach to broadening participation of low-income students, students of color, and girls by establishing Computer Science (CS) as a high school graduation requirement. This policy ensures that all CPS high school students will take a CS course, starting with the class of 2020. However, equity is more than just access. We define equity as equivalence in both the quality and outcomes of CS experiences. Exploring Computer Science (ECS) is the foundational course that fulfills the CPS requirement. Through ECS professional development, the number of qualified ECS teachers has grown. Two years into policy implementation, three-fourths of the schools offered ECS. Our prior research has shown that ECS participation rates by race, gender, and income closely reflect representation of the corresponding populations in CPS. In addition, student performance on the ECS end-of-course assessment was equivalent by race, gender, and income level. This evidence suggests that the CPS graduation policy is contributing towards equitable access to introductory CS with equitable course outcomes. Another outcome of interest is the equitable pursuit of advanced CS. Our primary research question for this poster is the extent to which there is equitable representation and outcomes of students who pursue advanced CS coursework in CPS. In particular, we focused on enrollment in the AP Computer Science A (CSA) and AP Computer Science Principles (CSP) courses from the 2014--15 to the 2017--18 school year. The 2014--15 school year was the first year that the CSP course was pilot tested in CPS, and the 2016--17 school year was the first year that the CSP exam was available. For every student enrolled in either AP CS course, the dataset included race, gender, special education status, English language learner status, free and reduced lunch status, overall GPA, AP course grade, and AP exam score. During the target period, enrollment in CSA declined from a high of 220 to a low of 136 students, while CSP enrollment increased from a pilot of 29 students to 693 students. The combined representation of students by race and gender in both courses was not reflective of the district\u27s student demographics. However, student representation by race and gender was closer to the district representation for CSP than for CSA. We conducted a multiple regression of the factors that correlated with the AP exam performance. The students\u27 overall GPA and the grade in the course were significantly correlated with exam scores. Girls scored statistically lower than boys and Latinx students scored statistically lower than Caucasian, Asian, and African-American students. Students who took ECS prior to CSP scored statistically higher on the CSP exam. These results show promise that using ECS as a foundation course is helpful for students who go on to pursue AP CSP. However, more work needs to be done to capitalize on the success of ECS to encourage CPS schools to offer AP CS courses and to encourage girls and students from underrepresented minority groups to pursue advanced CS coursework

An examination of the factors correlating with course failure in a high school computer science course

Across the United States, enrollment in high school computer science (CS) courses is increasing. These increases, however, are not spread evenly across race and gender. CS remains largely an elective class, and fewer than three-fourths of the states allow it to count towards graduation. The Chicago Public Schools has sought to ensure access for all students by recently enacting computer science as a high school graduation requirement. The primary class that fulfills the graduation requirement is Exploring Computer Science (ECS), a high school introductory course and professional development program designed to foster deep engagement through equitable inquiry around CS concepts. The number of students taking CS in the district increased significantly and these increases are distributed equitably across demographic characteristics. With ECS serving as a core class, it becomes critical to ensure success for all students independent of demographic characteristics, as success in the course directly affects a student\u27s ability to graduate from high school. In this paper, we examine the factors that correlate with student failure in the course. At the student level, attendance and prior general academic performance correlate with passing the class. After controlling for student characteristics, whether or not teachers participated in the professional development program associated with ECS correlates with student success in passing the course. These results provide evidence for the importance of engaging teachers in professional development, in conjunction with requiring a course specifically designed to provide an equitable computer science experience, in order to broaden participation in computing

Does a Computer Science Graduation Requirement Contribute to Increased Enrollment in Advanced Computer Science Coursework?

Prior research has shown that students pursuing Exploring Computer Science (ECS) as their first elective course were more likely to pursue another computer science course in high school, as compared to students who took a traditional course as the first course. This study investigated whether the results are consistent when students are pursuing ECS to fulfill the Chicago Public Schools\u27 graduation requirement. ECS is designed to foster deep engagement through equitable inquiry around computer science concepts. It is hypothesized that students who are fulfilling a graduation requirement will pursue additional computer science coursework at rates similar to students who were pursuing ECS as an elective course

Understanding ownership of patient care: A dual-site qualitative study of faculty and residents from medicine and psychiatry

Introduction: With changes in duty hours and supervision requirements, educators have raised concerns about erosion of patient care ownership by resident physicians. However, the definition of ownership is unclear. This qualitative study investigated definitions of ownership in medicine and psychiatry faculty and residents. Methods: The authors distributed an anonymous online survey regarding definitions of ownership to faculty and residents at the psychiatry and internal medicine residency programs at the University of Washington and the Harvard Longwood psychiatry residency and conducted a qualitative analysis of free-text responses to identify emergent themes. Results: 225 faculty (48.6%) and 131 residents (43.8%) across the three programs responded. Responses yielded themes in five domains: Physician Actions, Physician Attitudes, Physician Identity, Physician Qualities, and Quality of Patient Care. All groups identified themes of advocacy, communication and care coordination, decision-making, follow through, knowledge, leadership, attitudes of going ‘above and beyond’ and ‘the buck stops here’, responsibility, serving as primary provider, demonstrating initiative, and providing the best care as central to ownership. Residents and faculty had differing perspectives on ‘shift work’ and transitions of care and on resident decision-making as elements of ownership. Discussion This study expanded and enriched the definition of patient care ownership. There were more similarities than differences across groups, a reassuring finding for those concerned about a decreasing understanding of ownership in trainees. Findings regarding shared values, shift work, and the decision-making role can inform educators in setting clear expectations and fostering ownership despite changing educational and care models

Diagnosis and management of functional tic-like phenomena

Over the past 3 years, a global phenomenon has emerged characterized by the sudden onset and frequently rapid escalation of tics and tic-like movements and phonations. These symptoms have occurred not only in youth known to have tics or Tourette syndrome (TS), but also, and more notably, in youth with no prior history of tics. The Tourette Association of America (TAA) convened an international, multidisciplinary working group to better understand this apparent presentation of functional neurological disorder (FND) and its relationship to TS. Here, we review and summarize the literature relevant to distinguish the two, with recommendations to clinicians for diagnosis and management. Finally, we highlight areas for future emphasis and research

A human STAT3 gain-of-function variant confers T cell dysregulation without predominant Treg dysfunction in mice

Primary immune regulatory disorders (PIRD) represent a group of disorders characterized by immune dysregulation, presenting with a wide range of clinical disease, including autoimmunity, autoinflammation, or lymphoproliferation. Autosomal dominant germline gain-of-function (GOF) variants in STAT3 result in a PIRD with a broad clinical spectrum. Studies in patients have documented a decreased frequency of FOXP3+ Tregs and an increased frequency of Th17 cells in some patients with active disease. However, the mechanisms of disease pathogenesis in STAT3 GOF syndrome remain largely unknown, and treatment is challenging. We developed a knock-in mouse model harboring a de novo pathogenic human STAT3 variant (p.G421R) and found these mice developed T cell dysregulation, lymphoproliferation, and CD4+ Th1 cell skewing. Surprisingly, Treg numbers, phenotype, and function remained largely intact; however, mice had a selective deficiency in the generation of iTregs. In parallel, we performed single-cell RNA-Seq on T cells from STAT3 GOF patients. We demonstrate only minor changes in the Treg transcriptional signature and an expanded, effector CD8+ T cell population. Together, these findings suggest that Tregs are not the primary driver of disease and highlight the importance of preclinical models in the study of disease mechanisms in rare PIRD

CRISPR/Cas9-Assisted Transformation-Efficient Reaction (CRATER) for Near-Perfect Selective Transformation

The CRISPR (Clustered, Regularly Interspaced, Short Palindromic Repeats)/Cas9 system has revolutionized genome editing by providing unprecedented DNA-targeting specificity. Here we demonstrate that this system can be also applied in vitro to fundamental cloning steps to facilitate efficient plasmid selection for transformation and selective gene insertion into plasmid vectors by cleaving unwanted plasmid byproducts with a single-guide RNA (sgRNA)-Cas9 nuclease complex. Using fluorescent and chromogenic proteins as reporters, we demonstrate that CRISPR/Cas9 cleavage excludes multiple plasmids as well as unwanted ligation byproducts resulting in an unprecedented increase in the transformation success rate from approximately 20% to nearly 100%. Thus, this CRISPR/Cas9-Assisted Transformation-Efficient Reaction (CRATER) protocol is a novel, inexpensive, and convenient application to conventional molecular cloning to achieve near-perfect selective transformation

Synaptic processes and immune-related pathways implicated in Tourette syndrome

Tourette syndrome (TS) is a neuropsychiatric disorder of complex genetic architecture involving multiple interacting genes. Here, we sought to elucidate the pathways that underlie the neurobiology of the disorder through genome-wide analysis. We analyzed genome-wide genotypic data of 3581 individuals with TS and 7682 ancestry-matched controls and investigated associations of TS with sets of genes that are expressed in particular cell types and operate in specific neuronal and glial functions. We employed a self-contained, set-based association method (SBA) as well as a competitive gene set method (MAGMA) using individual-level genotype data to perform a comprehensive investigation of the biological background of TS. Our SBA analysis identified three significant gene sets after Bonferroni correction, implicating ligand-gated ion channel signaling, lymphocytic, and cell adhesion and transsynaptic signaling processes. MAGMA analysis further supported the involvement of the cell adhesion and trans-synaptic signaling gene set. The lymphocytic gene set was driven by variants in FLT3, raising an intriguing hypothesis for the involvement of a neuroinflammatory element in TS pathogenesis. The indications of involvement of ligand-gated ion channel signaling reinforce the role of GABA in TS, while the association of cell adhesion and trans-synaptic signaling gene set provides additional support for the role of adhesion molecules in neuropsychiatric disorders. This study reinforces previous findings but also provides new insights into the neurobiology of TS