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BackgroundThe coronavirus disease (COVID-19) pandemic has resulted in significant morbidity and mortality; large numbers of patients require intensive care, which is placing strain on health care systems worldwide. There is an urgent need for a COVID-19 disease severity assessment that can assist in patient triage and resource allocation for patients at risk for severe disease. ObjectiveThe goal of this study was to develop, validate, and scale a clinical decision support system and mobile app to assist in COVID-19 severity assessment, management, and care. MethodsModel training data from 701 patients with COVID-19 were collected across practices within the Family Health Centers network at New York University Langone Health. A two-tiered model was developed. Tier 1 uses easily available, nonlaboratory data to help determine whether biomarker-based testing and/or hospitalization is necessary. Tier 2 predicts the probability of mortality using biomarker measurements (C-reactive protein, procalcitonin, D-dimer) and age. Both the Tier 1 and Tier 2 models were validated using two external datasets from hospitals in Wuhan, China, comprising 160 and 375 patients, respectively. ResultsAll biomarkers were measured at significantly higher levels in patients who died vs those who were not hospitalized or discharged (P

Displacing the largest number of refugees in recent time is one of the devastating impacts of the Syrian war. Turkey hosts over 3.6 million Syrian refugees. Almost half of them are children in the preschool or primary school stage. Because refugee children are five times more likely to miss schooling than nonrefugee children, the provision of high-quality education in refugee settings is emphasized in the literature, as it offers children and their community protection, security, social cohesion, and it also prevents conflicts. Therefore, the purpose of this paper is to report some key findings of a qualitative study that primarily examined Syrian refugee teachers' perceptions of quality education and their experiences of pedagogical change, which included adoption of more learner-centered practices in line with the standards set by the International Network for Education in Emergencies (INEE), an organization that guides the delivery of quality education in emergencies. This paper explores teachers' beliefs about learning, their education, training, and their perceptions of learner-centered education (LCE) and the implementation of LCE in an urban Syrian refugee school in Turkey. In addition, the paper investigates teachers' vision of good pedagogy within their realities and capacities. The findings from this study showed complex contextual influences affecting the educational provision for Syrian refugees and LCE implementation challenges. A key implication that arises from this study relates to the suitability of LCE as "best practice" in the refugee context.

Asthma represents the leading medical cause of school absenteeism. (1) National guidelines recommend anti-inflammatory agents for treating persistent asthma, but inner-city school children may not be correctly classified or treated [...]

Background: Low health literacy affects one-third of adults in the United States and can have a negative effect on health behavior and outcomes., Objective: The goal of this study was to examine attitudes and knowledge of health literacy among pediatric residents and faculty in pediatric resident continuity clinics across the country., Methods: An online mixed-methods survey was distributed to pediatric faculty and residents through the Academic Pediatric Association's Continuity Research Network. The 20-question survey included questions about the participants' health literacy knowledge and health literacy practices in continuity clinics, such as use of universal health literacy precautions. Categorical answer choices were dichotomized into positive and negative groupings and resident and faculty responses were compared using the Chi-squared test (significance p < .05). Qualitative data were analyzed using emergent coding and grounded theory to determine themes., Key Results: Responses were received from 402 individuals at 24 pediatric residency programs. Most participants agreed or strongly agreed that they could correctly identify participants with low health literacy (76% residents vs. 53% faculty). Only 19% of residents and 26% of faculty were familiar with universal health literacy precautions. Many residents and faculty had received no training in health literacy (37% residents vs. 38% faculty). Barriers and challenges around health literacy included time, language, limited training or resources, low literacy, disease mismanagement, and fixed misconceptions., Conclusion: Despite ample evidence in the literature to the contrary, most respondents believed they could correctly identify individuals with low health literacy. Additionally, most participants had not heard of universal health literacy precautions and were unaware of their usage in their practice setting. This is not consistent with current expert recommendations. These findings are troubling as they are from academic residency programs, indicating an educational deficit. These findings point toward a next step in health literacy education for pediatric residents. [ HLRP: Health Literacy Research and Practice . 2022;6(1):e51-e60. ] Plain Language Summary: Pediatric residents and faculty in continuity clinics were surveyed about their opinions, health literacy knowledge, ability, and practices in continuity clinics. Despite evidence to the contrary, most respondents believed they could correctly identify individuals with low health literacy and had not heard of universal health literacy precautions. These findings highlight the need for more health literacy education for pediatric residents.

To examine the association between exposure to Reach Out and Read and vocabulary outcomes in children, a consecutive sample of 200 parent/child pairs was studied at two inner-city health centers. Children at clinic A were exposed to Reach Out and Read, a clinic-based literacy intervention, for 3 years at the time of the study; children at clinic B were unexposed. Main outcome measures were the "Expressive and Receptive One Word Picture Vocabulary Tests" to measure vocabulary in the children and the "Home Literacy Orientation" scale and "READ" subscale of the STIMQ, to measure book-sharing activities. A total of 200 subjects participated, and the mean age of children was 3.8 years. Demographic characteristics were comparable for both clinics at baseline. Exposed children scored higher on receptive vocabulary (81.5 vs. 74.3; p = 0.005). They also scored higher on both the Home Literacy Orientation scale (4.3 vs. 3.3; p = 0.002) and the STIMQ-READ (12.6 vs. 11.0; p = 0.056). There were no differences in expressive vocabulary scores between the two sites (79.5 vs. 77.5; p = 0.26). In conclusion, we found a positive association between exposure to Reach Out and Read and better receptive vocabulary scores. We also found higher scores for Reach Out and Read-exposed children on measures of home reading activities.