Building a virtual summer research experience in cancer for high school and early undergraduate students: lessons from the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic posed a unique challenge for summer research programs in 2020, particularly for programs aimed at hands-on experience for younger trainees. The Indiana University Melvin and Bren Simon Comprehensive Cancer Center supports two pipeline programs, which traditionally immerse high school juniors, seniors, and early undergraduate students from underrepresented populations in science in hands-on projects in cancer biology labs. However, due to social distancing policies during the pandemic and reduction of research operations, these students were not physically allowed on campus. Thus, the authors set out to strategically pivot to a wholly virtual curriculum and evaluate the Virtual Summer Research Experience in Cancer outcomes. METHODS: The virtual program included four components: 1. a core science and professional development curriculum led by high school teachers and senior undergraduates; 2. faculty-delivered didactic sessions on cancer science; 3. mentored, virtual research projects with research faculty; and 4. online networking events to encourage vertical mentoring. Outcomes data were measured using a locally created 11-item Research Preparation Scale, daily electronic feedback, and weekly structured evaluation and feedback via Zoom. RESULTS: Outcome data suggested high self-reported satisfaction with the virtual program. Outcome data also revealed the importance of coordination between multiple entities for seamless program implementation. This includes the active recruitment and participation of high school teachers and further investment in information technology capabilities of institutions. CONCLUSIONS: Findings reveal a path to educate and train high school and early undergraduate students in cancer research when hands-on, in-person training is not feasible. Virtual research experiences are not only useful to engage students during public health crises but can provide an avenue for cancer centers to expand their cancer education footprints to remotely located schools and universities with limited resources to provide such experiences to their students.

Social Determinants of Health Are Associated with Markers of Renal Injury in Adolescents with Type 1 Diabetes.

OBJECTIVE: To examine the relationship between the social determinants of health and markers of early renal injury in adolescent patients with type 1 diabetes (T1D). STUDY DESIGN: Renal outcomes included estimated glomerular filtration rate (eGFR) and albumin-creatinine excretion ratio (ACR). Differences in urinary and serum inflammatory markers also were assessed in relation to social determinants of health. Regression analysis was used to evaluate the association between the Ontario Marginalization Index (ON-Marg) as a measure of the social determinants of health, patient characteristics, ACR, eGFR, and renal filtration status (hyperfiltration vs normofiltration). RESULTS: Participants with T1D (n = 199) with a mean age of 14.4 ± 1.7 years and diabetes duration of 7.2 ± 3.1 years were studied. Mean eGFR was 122.0 ± 19.4 mL/min/1.73 m2. Increasing marginalization was positively associated with eGFR (P < .0001) but not with ACR (P = .605). Greater marginalization was associated with greater median levels of urinary interleukin (IL)-2, IL-12 (p40), macrophage-derived chemokine, monocyte chemoattractant protein-3, and tumor necrosis factor-ß and serum IL-2. ON-Marg was significantly associated with eGFR after we controlled for age, sex, body mass index z score, ethnicity, serum glucose, and hemoglobin A1c in linear regression. A similar association between hyperfiltration and ON-Marg score was observed in multivariable logistic regression. CONCLUSION: Increasing marginalization is significantly associated with both eGFR and hyperfiltration in adolescents with T1D and is associated with significant changes in urinary inflammatory biomarkers. These findings highlight a potentially important interaction between social and biological determinants of health in adolescents with T1D.

Physician-facilitated designation of proxy decision maker.

With vast improvements in healthcare in recent decades, people are living longer but often with higher rates of morbidity and chronic illnesses. This has resulted in a higher proportion of the population who may benefit from early end-of-life 'conversation and planning', but also gives healthcare professionals more time during which these discussions are relevant, as people live longer with their chronic diseases. A survey conducted by Lifshitz et al (Isr J Health Policy Res 5:6, 2016) sought to assess physician awareness and willingness to discuss designating a proxy decision-maker with patients, in order to aid end-of-life care in the event that the patient is rendered unable to make or communicate these decisions later in life. Their article suggests that proxy decision-maker designation is only one aspect of end-of-life care; a challenging area littered with ethical and moral dilemmas. Without early, open and frank discussions with patients regarding their wishes at the end of life, proxy decision-makers may be in no better position than physicians or a court appointed proxy to make decisions in the patients' best interests/benefits. This commentary also touches upon the use of health and care passports being developed or in early phases in the United Kingdom, and whether these may be utilised in the field of palliative care in Israel.

Examining Relative Age Effects in Fundamental Skill Proficiency in British Children Aged 6-11 Years.

Birch, S, Cummings, L, Oxford, SW, and Duncan, MJ. Examining relative age effects in fundamental skill proficiency in British children aged 6-11 years. J Strength Cond Res 30(10): 2809-2815, 2016-The relative age effect (RAE) suggests that there is a clustering of birth dates just after the cutoff used for sports selection in age-grouped sports and that in such circumstances, relatively older sportspeople may enjoy maturational and physical advantages over their younger peers. Few studies have examined this issue in nonselective groups of children, and none have examined whether there is evidence of any RAE in skill performance. The aim of this study was to assess whether there were differences in fundamental movement skill (FMS) proficiency within children placed in age groups according to the school year. Six FMS (sprint, side gallop, balance, jump, catch, and throw) were assessed in 539 school children (258 boys and 281 girls) aged 6-11 years (mean age ± SD = 7.7 ± 1.7 years). We examined differences in these FMS between gender groups and children born in different quarters of the year after controlling for age and body mass index (BMI). For balance, chronological age was significant as a covariate (p = 0.0001) with increases in age associated with increases in balance. Boys had significantly higher sprint mastery compared with girls (p = 0.012), and increased BMI was associated with poorer sprint mastery (p = 0.001). Boys had higher catching mastery than girls (p = 0.003), and children born in Q1 had significantly greater catching mastery than those born in Q2 (p = 0.015), Q3 (p = 0.019), and Q4 (p = 0.01). Results for throwing mastery also indicated higher mastery in boys compared with girls (p = 0.013) and that children born in Q1 had higher throwing proficiency than those born in Q4 (p = 0.038). These results are important if coaches are basing sport selection on measures of skilled performance, particularly in object-control skills. Categorizing children's skilled performance based on rounded down values of whole-year age may disadvantage children born relatively later in the selection year, whereas children born earlier in the selection year will likely evidence greater skill mastery and subsequent advantage for selection purposes.