A Pilot Study Exploring the Potential of Improv in Strengthening Youth–Adult Partnerships

This study qualitatively explored the potential of improv for strengthening youth–adult partnerships. Seven members of a youth-adult research collaborative participated in a 2-hour professionally facilitated improv workshop. Participants provided insights about their experiences through a follow-up qualitative interview questionnaire. Participants indicated that improv assisted in dismantling power differentials that often exist in youth–adult partnership contexts, also noting that improv helped them to express their true selves more readily, along with helping them to see new and more “human” sides to their team members. Participants were enthusiastic about accessing further improv opportunities, noting that improv should be embedded into other youth–adult partnership efforts, as such approaches were deemed particularly helpful in building relationships and trust. The further inclusion of improv activities in youthserving intervention and prevention efforts would benefit from additional exploration as ways by which youth–adult collaborations might be innovated and strengthened

Ataxia, Dementia, and Hypogonadotropism Caused by Disordered Ubiquitination

In recent years, we have seen great advances in the elucidation of genetic causes of cerebellar ataxia, with newly identified genes regulating a wide spectrum of cellular functions, including intracellular signaling, tau regulation, and mitochondrial function.1 However, a genetic defect cannot be found in approximately 40% of patients with ataxia,1 including those in whom ataxia is associated with reproductive endocrine failure, a syndrome first reported by Gordon Holmes in 1908.2 Most patients with this syndrome have a hypogonadotropic condition, with defective secretion of gonadotropins by the pituitary gland.3-12 Strikingly, genes associated with ataxia have little functional overlap with genes associated with hypogonadotropic hypogonadism, which encode proteins involved in the biologic function of the neurons that secrete gonadotropin-releasing hormone (GnRH).13 A decade ago, we described a consanguineous family with a syndrome of cerebellar ataxia, dementia, and hypogonadotropic hypogonadism.12 Here we report the results of whole-exome and targeted sequencing performed to identify mutations that underlie the syndrome in this kindred and in unrelated patients

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

John Clare and place

This chapter tackles issues of place in the self-presentation and critical reception of John Clare, and pursues it across a number of axes. The argument centres on the placing of Clare both socio-economically and ‘naturally’, and limitations exerted upon perceptions of his work. Interrogating criticism this chapter finds a pervasive awkwardness especially in relation to issues of class and labour. It assesses the contemporary ‘placing’ of Clare, and seemingly unavoidable insensitivities to labour and poverty in the history industry, place-naming, and polemical ecocriticism. It assesses the ways Clare represents place – in poverty, in buildings, in nature – and, drawing on Michel de Certeau, considers the tactics Clare uses to negotiate his place. It pursues trajectories to ‘un-place’ Clare: the flight of fame in Clare’s response to Byron; and the flight of an early poem in songbooks and beyond, across the nineteenth century

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Back to College Class: “Perseverance and Faith”

Whyte offers a retrospective, humorous look at the role of IWU in an urban youth’s career progression from the famous “Look to your right, look to your left—one of them won’t be here next year” address on the first day of class to graduation to medical school to becoming the first-ever chief health officer for the third largest school district in the nation. Perseverance and faith hallmark Whyte’s reflection on the relationships cultivated, challenges overcome and lessons learned at Illinois Wesleyan

Coaches’ ability to support elite and adolescent soccer players throughout their menstrual cycle

Female soccer players report that the menstrual cycle (MC) can negatively impact sporting performance, with barriers identified in communicating their MC experiences to coaches and support staff. Whilst research is growing, there are few studies exploring the coaching staff perspective in soccer, and none from those at the youth level. The aim was to explore soccer coaches’ awareness, perceptions and experiences of the MC and the perceived impact on performance. Thirteen coaches (female n = 4; male n = 9, aged 33 ± 9 years) from Scottish elite adult and youth soccer participated in individual semi-structured interviews (average interview time 39 ± 11 min). Interviews were audio recorded and transcribed verbatim, with reflexive thematic analysis (RTA) performed. RTA generated three key themes from 232 meaning units: environment and culture, coach–athlete dynamic, and coach support and education. Coaches perceived a societal culture of the MC being hidden, or taboo, with similar barriers noted within the club environment. Coaches were often embarrassed to discuss the MC with players and believed players were embarrassed. Communication differed depending on the coach–athlete relationship, with trust and familiarity cited as improving comfort in communication. Coach awareness and understanding of the MC both generally and within a sporting context influenced their perceived ability to communicate and support players. Findings highlight the need to support coaches by providing MC education, and practical guidance on how to support players’ health and wellbeing. Improved confidence in communication should allow players to feel supported and normalise conversations about the MC