Racial Socialization and Black Adolescent Mental Health and Developmental Outcomes: A Critical Review and Future Directions.

OBJECTIVE: Black American adolescents are beleaguered with the most frequent and severe experiences of racial discrimination (RD) among their peers. To protect Black adolescents' mental health and developmental outcomes from the pernicious impact of discrimination, parents and other proximal adults and peers often utilize racial socialization (RS), or communications and behaviors emphasizing the importance of race and the harms of racism. While several recent RS reviews have been conducted across ethnicity, a modern review investigating RS practices related to and predictive of Black adolescent psychosocial outcomes is needed. METHOD: To ground our critical systematic review of 45 articles, we first highlighted the ways RD impacts the lives of Black adolescents. Then, drawing from integrative models for Black youth development, we synthesized recent psychological, academic, and sociocultural literatures to describe the role of RS in Black adolescents' wellness. RESULTS: The impact of various tenets of RS was seen most clearly as a protective factor against RD with respect to adolescents' mental health (e.g. depression), academic achievement (e.g. GPA), and sociocultural identity (e.g. public and private racial regard) development. Cultural socialization, a strategy related to extolling pride for one's race, was the most consistent RS protective factor, with novel RS constructs (e.g. parental competency) emerging as a method to buffer youth internalizing and externalizing problems. CONCLUSIONS: Recommendations are made for future research on understudied components of RS and multiple methods and reporters to capture a more holistic depiction of RS practices. We emphasize preventative and intervening approaches to reduce the impetus for RS and its impact, including burgeoning clinical and community-level programs and the importance for provider training to yield positive mental health outcomes for Black adolescents.

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Patients with Myeloproliferative Neoplasms.

Myeloproliferative neoplasms (MPNs) are a group of rare chronic progressive blood cancers that vary widely in clinical presentation, yet all patients have a risk of disease progression and thrombotic complications. Diseases include primary myelofibrosis, polycythemia vera, and essential thrombocythemia. With current treatment approaches, most patients live a prolonged life, but many experience a complex of symptoms that negatively influence their functional status and quality of life. Although significant advances have been made in preventing arterial and venous complications while mitigating inflammatory processes, comprehensive palliative care can help address unmet complex physical and psychosocial needs on a long-term basis. This article, created by a multidisciplinary group of providers, offers an overview of MPNs so palliative care clinicians can better support patients with these hematologic cancers.

QTc Interval Prolongation and Its Association With Electrolyte Abnormalities and Psychotropic Drug Use Among Patients With Eating Disorders.

Background: Eating disorders (EDs) often develop during adolescence with high mortality rates. Sudden cardiac death in these patients has been associated with corrected QT (QTc) interval prolongation. The significance of extrinsic factors on QTc prolongation in populations with EDs remains controversial. This study assessed the relationship between QTc prolongation in paediatric patients with EDs and extrinsic factors, such as QTc-prolonging medications and electrolyte abnormalities to investigate whether an ED alone is associated with an increased prevalence of QTc prolongation. Methods: Electrocardiograms, electrolytes, and psychopharmaceutical usage were retrospectively analysed from the charts of 264 paediatric patients with EDs. Descriptive statistics were used to assess QTc prolongation and its relationship with electrolyte abnormalities and psychopharmaceuticals. Results: Of 264 patients, 227 had normal QTc intervals (<440 ms), whereas 37 had borderline prolonged (440-460 ms) or prolonged (>460 ms) intervals. The prevalence of QTc intervals exceeding 440 ms in patients with normal electrolytes and not using QTc-prolonging psychotropics mirrored that of the general population (P = 0.59). Of the 23 patients taking psychotropics, 8 had abnormal QTc intervals. The average QTc was greater for patients using QTc-prolonging psychotropics (P = 0.05) with a correlation between interval length and psychotropic usage (P < 0.01). Average potassium (P = 0.08), calcium (P = 0.18), and magnesium (P = 0.08) levels did not significantly differ between those with normal and abnormal QTc intervals. Conclusions: This study suggests that EDs alone may not prolong QTc intervals in paediatric patients with EDs, but psychotropics appear to be a salient external factor in QTc prolongation.

Contexte: Les troubles des conduites alimentaires (TCA) surviennent surtout au cours de l'adolescence et entraînent un taux de mortalité élevé. Chez ces patients, la mort subite d'origine cardiaque a été associée à un allongement de l'intervalle QT corrigé (QTc). La portée des facteurs extrinsèques sur l'allongement de cet intervalle chez les patients atteints de TCA demeure un sujet controversé. La présente étude visait à évaluer la relation entre l'allongement de l'intervalle QTc chez les enfants atteints de TCA et des facteurs extrinsèques, comme la prise de médicaments causant l'allongement de l'intervalle QTc et les anomalies électrolytiques, pour déterminer si la présence d'un TCA est à elle seule associée à une prévalence élevée d'allongement de l'intervalle QTc. Méthodologie: Nous avons analysé rétrospectivement les électrocardiogrammes, les valeurs d'électrolytes et l'utilisation de médicaments psychotropes dans les dossiers de 264 enfants atteints de TCA. Des techniques de statistique descriptive ont été utilisées pour analyser l'allongement de l'intervalle QTc et les liens avec les anomalies électrolytiques et les médicaments psychotropes. Résultats: Parmi les 264 patients, 227 présentaient un intervalle QTc normal (< 440 ms) et 37 présentaient des résultats limites (440 à 460 ms) ou un allongement de l'intervalle (> 460 ms). La prévalence d'un intervalle QTc de 440 ms ou plus chez les patients présentant des taux d'électrolytes normaux et non traités par des médicaments psychotropes causant l'allongement de l'intervalle QTc était semblable à la prévalence dans la population générale (p = 0,59). Huit des 23 patients traités par des médicaments psychotropes présentaient un intervalle QTc anormal. La moyenne des intervalles QTc était supérieure dans le groupe des patients recevant des médicaments psychotropes causant un allongement de l'intervalle QTc (p = 0,05), et il existait une corrélation entre la durée de l'intervalle et de l'usage de médicaments psychotropes (p < 0,01). Les taux moyens de potassium (p = 0,08), de calcium (p = 0,18) et de magnésium (p = 0,08) ne différaient pas de façon significative entre les groupes présentant des intervalles QTc normaux et anormaux. Conclusions: Les résultats de notre étude donnent à penser que le TCA à lui seul ne provoque pas l'allongement de l'intervalle QTc chez les enfants qui en sont atteints, mais que l'utilisation de médicaments psychotropes constitue un facteur externe important dans l'allongement de l'intervalle QTc.

Directionality explored: Black Adolescents' awareness of systemic racism and race-based experiences.

Increases in conversations about race and racial discrimination experiences during adolescence make this a critical developmental period to investigate adolescents' awareness of racism. We examined bidirectional associations between race-based experiences and awareness of systemic racism-operationalized as understanding systemic causes of racial disparities in education. Adolescents who self-identified as African American/Black were surveyed in Grade 6 (n = 317; Mage = 11.12; 48% girls) and Grade 8 (n = 247; Mage = 13.15; 56% girls). Cross-lagged panel analyses revealed that racial barrier messages, but not racial discrimination experiences, in Grade 6 positively predicted awareness of systemic racism in Grade 8. Adolescents' awareness of systemic racism in Grade 6 did not predict racial socialization or racial discrimination experiences in Grade 8.

A study protocol for implementing Canadian Practice Guidelines for Treating Children and Adolescents with Eating Disorders.

BACKGROUND: Eating disorders have one of the highest mortality rates among psychiatric illnesses. Timely intervention is crucial for effective treatment, as eating disorders tend to be chronic and difficult to manage if left untreated. Clinical practice guidelines play a vital role in improving healthcare delivery, aiming to minimize variations in care and bridge the gap between research and practice. However, research indicates an active guideline implementation approach is crucial to effective uptake. METHODS: Mixed methods will be used to inform and evaluate our guideline implementation approach. Semi-structured focus groups will be conducted in each of the eight provinces in Canada. Each focus group will comprise 8-10 key stakeholders, including clinicians, program administrators, and individuals with lived experience or caregivers. Qualitative data will be analyzed using conventional content analysis and the constant comparison technique and the results will be used to inform our implementation strategy. The study will then evaluate the effectiveness of our implementation approach through pre- and post-surveys, comparing changes in awareness, use, and impact of the guidelines in various stakeholder groups. DISCUSSION: Through a multifaceted implementation strategy, involving the co-creation of educational materials, tailored training, and context-specific strategies, this study intends to enhance guideline uptake and promote adherence to evidence-based practices. Our study will also contribute valuable information on the impact of our implementation strategies.

Popular contraception videos on TikTok: An assessment of content topics.

OBJECTIVES: This study aimed to explore the contraception content topics on the highly popular social media platform TikTok to understand this influential information source patients may bring into birth control counseling visits. STUDY DESIGN: Utilizing a snapshot method, we collected the 100 most popular TikTok English-language videos for each of the eight contraception-specific search terms. We abstracted video content topics addressed and creator attributes. Two independent abstractors coded each video with high agreement, with a third coder adjudicating discrepancies. RESULTS: The final data set included 700 unique videos, with a total of 1.18 billion views, 131 million likes, 1.5 million comments, and 4.1 million shares. In these videos, the most common topics addressed were patient experience (n = 365, 52.1%) and logistics of use (n = 351, 50.1%). Health care professionals created only 19.3% of videos (n = 135), but these videos accounted for a larger portion of the total video views (41.3%). Health care professionals largely made educational videos (92.6%) compared to 22.5% of videos coded as educational videos when made by perceived non-health care professionals. A small number of prolific video creators developed the majority of videos made by health care professionals, with 91 (67.4%) made by six TikTok creators. CONCLUSIONS: TikTok contains highly accessible contraception content, which garners high viewership, especially when created by health care providers. Clinicians should be aware of TikTok's potential to influence patients prior to contraceptive counseling visits and recognize this platform as a public health instrument to disseminate contraceptive information to a key demographic. IMPLICATIONS: Few previous studies have examined the presence and popularity of contraception content topics on TikTok; little is known about the health content on this highly popular platform. Providers should be aware of the contraceptive topics on TikTok for understanding both patient perceptions and the potential for health education through this media.

Consent Policies for Pelvic Exams Under Anesthesia Performed by Medical Students: A National Assessment.

Background: Medical students report low confidence in their ability to perform pelvic exams. Pelvic exams under anesthesia (EUA) are one way for students to practice the exam, but this needs to be balanced with patients' bodily autonomy through explicit disclosure and consent. This study seeks to characterize U.S. medical schools' policies regarding the consent process for students to perform pelvic EUA. Materials and Methods: Obstetrics and gynecology clerkship directors were anonymously surveyed about their medical school affiliated hospitals' (MSAH) consent policies for pelvic EUA in general and explicitly for medical students. Chi-square and Fisher's exact test were used to test for differences between categorical variables and thematic analysis was used to review qualitative responses. Results: A total of 87 clerkship directors completed the survey (44.4% response rate). Most MSAH explicitly consent patients for pelvic EUA (80.2%), and specifically for performance by medical students (79.1%). Sixty-nine respondents (79.3%) stated that performing pelvic EUA is important for medical student education. Five themes were identified from review of qualitative responses, including consent policy details, the importance of pelvic EUA, other opportunities for pelvic exam teaching, barriers to standardization, and outside guidance. Conclusions: The pelvic EUA is a necessary part of both surgical care and medical education but patient dignity must be protected too. Most MSAH have consent policies for students to perform pelvic EUA. Still, these policies need to be further strengthened and standardized across institutions to protect patients' rights while continuing to teach students the pelvic exam.

Significant vomiting and weight loss in a pediatric epilepsy patient secondary to vagus nerve stimulation: A case report and review of the literature.

Vagus nerve stimulation is a neuromodulatory treatment option for individuals with drug resistant epilepsy who are not resective surgical candidates. As the vagus nerve has widespread neural connections, stimulation can lead to an array of adverse effects. While vomiting and weight loss are known side effects of vagus nerve stimulation, these are typically transient, mild, and do not limit the ability to continue treatment. We describe a 17-year-old female with drug resistant focal epilepsy secondary to tuberous sclerosis complex, who began to experience daily emesis and significant weight loss approximately 2.5 years after VNS device insertion. Her body mass index progressively fell from between the 75th-85th percentiles to less than the first percentile. She underwent extensive workup by neurology, gastroenterology, and adolescent medicine services with no obvious cause identified. Prior to the insertion of an enteral tube for feeding support and urgent weight restoration, her vagus nerve stimulator was switched off, resulting in immediate cessation of her vomiting and a dramatically rapid recovery of weight over the ensuing few months. This case emphasizes the need to consider adverse effects of vagus nerve stimulation in the differential diagnosis of patients with otherwise unexplained new medical sequelae, and provides evidence potentially linking vagal stimulation to significant malnutrition-related complications. Outside of GI-related effects, few studies have shown late-onset adverse effects from VNS, including laryngeal and facial pain as well as bradyarrhythmia. Further research is needed to elucidate the exact mechanisms of vagus nerve stimulation to better anticipate and mitigate adverse effects, and to understand the pathophysiology of late-onset adverse effects in previously tolerant VNS patients.

Reflecting on change: Critical consciousness as a protective factor for Black youth.

OBJECTIVES: The previous decade has seen an abundance of scholarship on the benefits of critical consciousness (CC) for racial and ethnic minority youth. However, it is unclear whether CC is a buffer against the negative effects of racial discrimination on Black adolescents' outcomes. The present study examined whether three CC dimensions buffered against the negative effects of racial discrimination on academic attitudes. METHOD: A total of 205 Black adolescents (Mage = 15.10) reported racial discrimination and CC. We conducted multiple regression analyses for each component of CC to test for their direct and protective effects on academic attitudes. RESULTS: Our results revealed associations between CC dimensions and academic attitudes. Critical reflection and critical action also buffered against racial discrimination's negative effects. CONCLUSIONS: Implications for research on the nature and impact of CC dimensions on racial discrimination and academic attitudes are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Health state utility values in patients undergoing chest masculinization surgery.

BACKGROUND: Chest masculinization surgery is the most common gender-affirming procedure performed in transgender and gender-diverse individuals. While evidence on the health-related quality of life (HRQL) impact of chest masculinization is starting to emerge, data on health state utility values (HSUVs) associated with the surgery is largely missing. The objectives of this study were to estimate the HSUVs using EQ-5D for patients seeking chest masculinization surgery and assess the determinants of EQ-5D score at 6 months postoperatively. METHODS: Patients seeking chest masculinization at a single community plastic surgery clinic by 2 surgeons completed 3 patient-reported outcome measures - EQ-5D-3L, Patient Health Questionnaire (PHQ)-9, and BODY-Q Chest module - preoperatively and postoperatively at 6 weeks and 6-months. Friedman test was used to assess the differences in PROM scores at the 3 timepoints. Simple and backward stepwise regression analyses of 6-month postoperative EQ-5D scores were performed. RESULTS: A total of 113 patients (mean [SD] age, 25.7 [6.9] years) were included. The mean [SD] EQ-5D scores at preoperative, postoperative 6 weeks and 6 months were 0.81 [0.15], 0.84 [0.15] and 0.87 [0.12], respectively. Postoperatively, problems were most frequently reported in the dimensions "pain/discomfort" and "anxiety/depression". Preoperative PHQ-9 score was a predictor of 6-month postoperative EQ-5D scores following simple (p < 0.01) and backward stepwise linear regression analysis (p < 0.01). CONCLUSION: Chest masculinization was associated with an improvement in overall HRL at 6 months postoperatively; however, this did not achieve statistical significance. Preoperative depression severity was a significant determinant of postoperative HRL. Consequently, additional support must be offered to patients who have a higher level of preoperative depression.

Rural healthy people 2030: New decade, new challenges.

Rural Healthy People is a companion piece to the federal Healthy People initiative released once a decade to identify the most important Healthy People priorities for rural America, as identified by rural stakeholders, for the current decade. This study reports on the findings of Rural Healthy People 2030. The study relied on a survey of rural health stakeholders collected from July 12, 2021, to February 14, 2022, and: 1) identified the 20 Healthy People priorities most frequently selected as priorities for rural America, 2) studied the priorities that were most frequently selected as a "top 3" priority within each Healthy People 2030 category, and 3) investigated Healthy People 2030 priorities in terms of ranked importance for rural Americans. The analysis finds that for the first time across 3 decades of Rural Healthy People, a greater proportion of respondents selected "Mental Health and Mental Disorders" and "Addiction" as Healthy People priorities for rural America, than did "Health Care Access and Quality". Even still, respondents ranked "Health Care Access and Quality" as the single-most important rural priority. "Economic Stability," a new priority within the Social Determinant of Health category, debuted within the 10 most frequently selected priorities for rural America for the coming decade. As public health practitioners, researchers, and policymakers work toward closing the urban-rural divide, the most important rural priorities to address in the coming decade are mental health and substance use disorders, access to high quality health care services, and social determinants of health, such as economic stability.

Allergic and infectious complications of Etonogestrel implant placements: A case series.

Patients rarely experience complications at the time of Etonogestrel subdermal contraceptive implant placement. Few case reports describe infection or allergy as a complication at the time of implant insertion. In this case series, we discuss three infections and one allergic reaction following Etonogestrel implant placement, review six previous case reports of eight cases of infection or allergy, and discuss management of these complications. We highlight differential diagnosis when encountering a placement complication, considerations of dermatologic conditions when placing Etonogestrel implants, and discuss when to consider removal of the implant when a complication occurs.

Place, Race, and Case: Examining Racialized Economic Segregation and COVID-19 in Louisiana.

Early COVID-19 pandemic data suggested racial/ethnic minority and low-income earning people bore the greatest burden of infection. Structural racism, the reinforcement of racial and ethnic discrimination via policy, provides a framework for understanding disparities in health outcomes like COVID-19 infection. Residential racial and economic segregation is one indicator of structural racism. Little attention has been paid to the relationship of infection to relative overall concentrations of risk (i.e., segregation of the most privileged from the most disadvantaged). We used ordinary least squares and geographically weighted regression models to evaluate the relationship between racial and economic segregation, measured by the Index of Concentration at the Extremes, and COVID-19 cases in Louisiana. We found a significant global association between racial segregation and cumulative COVID-19 case rate in Louisiana and variation across the state during the study period. The northwest and central regions exhibited a strong negative relationship indicating greater risk in areas with high concentrations of Black residents. On the other hand, the southeastern part of the state exhibited more neutral or positive relationships indicating greater risk in areas with high concentrations of White residents. Our findings that the relationship between racial segregation and COVID-19 cases varied within a state further support evidence that social and political determinants, not biological, drive racial disparities. Small area measures and measures of polarization provide localized information better suited to tailoring public health policy according to the dynamics of communities at the census tract level, which may lead to better health outcomes.

Examining the feasibility of a parental self-help intervention for families awaiting pediatric eating disorder services.

OBJECTIVE: Waitlists for eating disorder (ED) services grew immensely during the COVID-19 pandemic. To address this, we studied the feasibility of a novel parental self-help waitlist intervention. METHOD: Parents of a child/adolescent (7-17 years) awaiting pediatric ED services were provided with our intervention, adapted from the family-based treatment model, and consisting of videos and reading material with no therapist involvement. Parent-reported child/adolescent weight was collected weekly 6 weeks pre-intervention, 2 weeks during the intervention, and 6-week post-intervention. Recruitment and retention rates were calculated. Regression-based interrupted time series analyses were completed to measure changes in the rate of weight gain. RESULTS: Ninety-seven parents were approached, and 30 agreed to participate (31% recruitment rate). All but one completed end-of-study measures (97% retention rate). The average rate of weight gain was 0.24 lbs/week pre-intervention, which increased significantly to 0.78 lbs/week post-intervention (p < .034). DISCUSSION: Our findings provide preliminary evidence that this intervention is feasible. Future research is needed to confirm the efficacy of this intervention on a larger scale. PUBLIC SIGNIFICANCE: The COVID-19 pandemic has resulted in several challenges in providing care for children and adolescents with eating disorders, including long waiting lists and delays in treatment. This study suggests that providing parents on a waitlist with educational videos and reading material is acceptable to parents, and may even help in improving the child's symptoms of an eating disorder.

We Must Address the Antiobesity Biases We Espouse in Our Operating Rooms.

OBJECTIVE: To describe anti-obesity bias in medical education including impact on patients, growth of biases over time, and education-based initiatives aimed at reducing bias. DESIGN: We reviewed available literature on anti-obesity bias in medical education and initiatives to address this bias. SETTING: Information from a wide variety of medical educational settings was included. PARTICIPANTS: N/A RESULTS: Anti-obesity bias in healthcare is an independent risk factor for poor health outcomes and is pervasive throughout the culture of medicine. Medical students identify operating rooms as the number one location for anti-obesity comments, and students' biases increase throughout medical school. We propose several interventions (the 6 I's) as the next step in addressing this bias.

Medical Students' Intention to Change After Receiving Formative Feedback: Employing Social Cognitive Theories of Behavior.

Introduction: We applied Azjen's theory of planned behavior (TPB) and Triandis' theory of interpersonal behavior (TIB) to understand medical students' intention to change behavior based on feedback received during an obstetrics and gynecology clerkship. Both models presume that behavioral intention is strongly related to actual behavior. Materials and Methods: We collected free-text responses from students during a year-long Feedback Focused initiative on the obstetrics and gynecology clerkship at Harvard Medical School. Students reported feedback daily and what they would change based on that feedback. We applied TPB and TIB to identify students' motivation to change. We analyzed data using directed content analysis. Results: We reviewed 1,443 feedback entries from 122 students between July 2, 2018, and May 31, 2019. Self-efficacy was the most commonly represented component, related to a student expressing their own role, ability, or skill integrating the feedback (85%). Some entries (11%) focused on students' attitudes or beliefs about the outcome of the implemented feedback, usually patient focused but sometimes about the learner's outcome. Intentions motivated by social norms and expectations focused on the perceived or stated expectations of others, usually a superior or a team (11%). A small number of entries (1.7%) indicated that students had an emotional response to challenging or meaningful feedback. Conclusions: While self-efficacy is an important change motivator, faculty development geared toward improving the provision of meaningful feedback that bridges a desired behavior change to an outcome of interest, framed through the attitudes and beliefs or social norms lens, may improve trainee performance.

Abortion as Essential Health Care and the Critical Role Your Practice Can Play in Protecting Abortion Access.

Few obstetrician-gynecologists (ob-gyns) provide abortion care, resulting in abortion being separated from other reproductive health care. This segregation of services disrupts the ob-gyn patient-clinician relationship, generates needless costs, delays access to abortion care, and contributes to stigma. General ob-gyns have both the skills and the knowledge to incorporate abortion into their clinical practices. In this way, they can actively contribute to the protection of abortion access now with the loss of federal protection for abortion under Roe v Wade . For those who live where abortion remains legal, now is the time to start providing abortions and enhancing your abortion-referral process. For all, regardless of state legislation, ob-gyns must be leaders in advocacy by facilitating abortion care-across state lines, using telehealth, or with self-managed abortion-and avoiding any contribution to the criminalization of those who seek or obtain essential abortion care. Our patients deserve a specialty-wide concerted effort to deliver comprehensive reproductive health care to the fullest extent.

Insights About Cannabis and Psychosis Using Video Games for Young People With a First Episode of Psychosis, Particularly Those From Black Racialized Communities: Protocol for a Mixed Methods Study.

BACKGROUND: Cannabis use disorder among young people with a first episode of psychosis contributes to relapse, hospitalization, and impaired functioning. However, few studies have examined what young people with early phase psychosis, particularly those from Black racialized communities, understand or appreciate about this relationship, even though they may be at risk. There are no formally tested knowledge translation strategies that disseminate these research findings for young people with emerging psychosis from Black racialized communities. OBJECTIVE: This study aims to conceptualize what young people with early phase psychosis/cannabis use disorder understand about the relationship between cannabis and psychosis, focusing on people from racialized backgrounds. This study also aims to assess whether the knowledge translation product, the "Back to Reality Series," increases awareness of the impact of cannabis use on psychosis from the perspectives of young people with emerging psychosis and cannabis use disorder from Black African and Caribbean communities. METHODS: Qualitative analysis will reveal themes from qualitative interviews about cannabis and psychosis from the perspectives of young people with emerging psychosis and cannabis use disorder from Black African and Caribbean communities. Perceptions before and after exposure to the Back to Reality Series will be qualitatively analyzed. A control game will be used for comparison, and scores on a quiz after playing the Back to Reality Series will be quantitatively analyzed to establish whether the Back to Reality Series raises awareness of the effects of cannabis on psychosis. An advisory council involving young people from Black communities, family members, and clinicians will bring community perspectives to this research. RESULTS: We began recruiting participants for this study in September 2021. We will complete data collection on demographic and clinical factors, qualitative interviews, and quantitative assessments of the Back to Reality Series. CONCLUSIONS: The voices of young people from racialized backgrounds will generate preliminary data to inform early psychosis programs, addressing cannabis use in this population. The findings may advance the use of a new knowledge translation product that deals with gaps in knowledge about cannabis use for people experiencing early phase psychosis, particularly those from racialized communities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36758.

Service learning and the medical student affective domain.

BACKGROUND: The Association of American Medical College (AAMC) requires all students to demonstrate four core attributes: knowledge, skills, altruism and dutifulness. A formal service-learning curriculum may serve to explicitly foster altruism and dutifulness in the affective domain of Bloom's taxonomy as well as proactively improve student well-being. APPROACH: All Harvard Medical School students enrolled in the Principal Clinical Experience (PCE) programme in the 2018-2019 academic year at Brigham and Women's Hospital were excused from clerkship responsibilities and given the opportunity to participate in a half-day team-based community-service intervention at a not-for-profit organisation in Boston, MA. Following the service-learning initiative, we examined student compassion, civic responsibility, well-being and team cooperativeness using validated survey questions, supplemented by free-text feedback. EVALUATION: Forty-five of the 55 PCE students (82%) attended the outing. Overall, 68% of students found the outing to be valuable and 23% somewhat valuable. On a scale of 0-20, students reported very high self-perception of compassion (mean = 19.9), civic responsibility (mean = 19.7) and team development and composition (mean = 19.1), after the event. Students reported lower perceptions of personal well-being (mean = 17.5), but emotional wellness was the most frequently mentioned theme in open response. IMPLICATIONS: Incorporation of a team-based service-learning activity contributes to the students' community understanding, empathy and class team building. Utilisation of a published framework in the development of this initiative likely contributed to its success. Given our findings, we plan further expansion of this service learning longitudinally through the 4-year curriculum to potentially strengthen the affective domain for students further.

Global analysis of protein-RNA interactions in SARS-CoV-2-infected cells reveals key regulators of infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). SARS-CoV-2 relies on cellular RNA-binding proteins (RBPs) to replicate and spread, although which RBPs control its life cycle remains largely unknown. Here, we employ a multi-omic approach to identify systematically and comprehensively the cellular and viral RBPs that are involved in SARS-CoV-2 infection. We reveal that SARS-CoV-2 infection profoundly remodels the cellular RNA-bound proteome, which includes wide-ranging effects on RNA metabolic pathways, non-canonical RBPs, and antiviral factors. Moreover, we apply a new method to identify the proteins that directly interact with viral RNA, uncovering dozens of cellular RBPs and six viral proteins. Among them are several components of the tRNA ligase complex, which we show regulate SARS-CoV-2 infection. Furthermore, we discover that available drugs targeting host RBPs that interact with SARS-CoV-2 RNA inhibit infection. Collectively, our results uncover a new universe of host-virus interactions with potential for new antiviral therapies against COVID-19.