Background: Fecal microbiota transplantation (FMT) is a widely used modality for safe and effective treatment of recurrent Clostridium difficile infections, and FMT is being explored for the treatment of additional indications including gastrointestinal diseases and neurological disorders. Although microbiota-based therapies like FMT utilize rigorous donor screening procedures, these procedures are limited in resolution and scope, and there remains a risk of transmission of FMT-associated infectious agents from donor stool to a FMT recipient. Critically, these health concerns led the FDA to issue a 2019 safety alert for the transmission risks associated with FMT and to update its guidelines for screening and reporting. In a suspected transmission event, there is uncertainty around the source of infection; thus, methods are needed to rapidly determine whether a patient’s infection is linked to the donor stool product. Methods: Here, we developed a laboratory service sequencing and bioinformatics pipeline within our CLIA-certified laboratory for investigating suspected FMT infection transmission by measuring genomic relatedness. Our pipeline performs deep sequencing of a metagenomic sample, whole-genome sequencing (WGS) of an isolate derived from the implicated patient infection and determines the genomic relatedness between the 2 using a SNP-based analysis. The workflow was validated in silico with synthetic metagenomic samples spiked-in with WGS of clinically relevant isolate strains at varying abundance. Results: The sample and sequencing library preparation workflow was optimized across a panel of metagenomic and mock fecal microbiome samples demonstrating reproducible and reduced-bias sequencing of metagenomic samples. Our pipeline demonstrates high sensitivity and specificity for clonality calls when a spiked in isolate genome achieves 5× depth for >50% of the genome. We also demonstrated an interplay between abundance rate and sequencing depth for determining a clonality limit of detection. Conclusions: Taken together, our pipeline represents a new method that can support the clinical efforts of FMT and other microbiota-based therapies. References: US Food and Drug Administration. Important safety alert regarding use of fecal microbiota for transplantation and risk of serious adverse reactions due to transmission of multidrug-resistant organisms. Rockville, MD: Food and Drug Administration, 2019. DeFilipp Z, Bloom PP, Torres Soto M, et al. Drug-resistant E. coli bacteremia transmitted by fecal microbiota transplant. N Engl J Med 2019;381:2043–2050.

Financial support: This study was funded by Day Zero Diagnostics.

Disclosures: None

This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.

Current understanding of word-finding (WF) difficulties in children and their underlying language processing deficit is poor. Authors have proposed that different underlying deficits may result in different profiles. The current study aimed to better understand WF difficulties by identifying difficult tasks for children with WF difficulties and by focusing on semantic vs. phonological profiles. Twenty-four French-speaking children with WF difficulties and 22 children without WF difficulties, all aged 7- to 12-years-old, participated. They were compared on a range of measures to cover the overall mechanism of WF and the quality of semantic and phonological representations. The largest differences were found on a parent questionnaire and a word definition task. Cluster analyses revealed “high performance” and “low performance” clusters, with intermediary groups. These clusters did not match the expected semantic vs. phonological profiles derived from models of lexical access, suggesting that WF difficulties may be linked to both semantic and phonological deficits.

White monolingual Anglo-American values permeate language acquisition research, which extends into public health and educational policies. “Quality of language” in parent-child interactions is often called upon to explain weaknesses in the language development of children who are racialized, experiencing poverty, or bilingual. Indeed, many early intervention approaches build on this premise by aiming to improve the “quality of language” used by parents. We aimed to understand the conceptualizations of “quality of language” in studies of parent-child interaction through the critical lens of Community Cultural Wealth Theory and perspectives from development research across cultures. We completed a Systematic Concept Analysis of articles published from 2010 to 2022 and focused on parent-child interactions in the home environment. Our search identified 972 articles and 78 met the inclusion criteria, but only 45 papers provided a definition. These definitions covered eight conceptualizations but only three were previously described. We also found inequity in the use of this terminology, which focused on children who were bilingual, had disability, or experiencing poverty. Informed by a critical lens, we recommend the use of four new terms to encompass “quality of language.” We also recommend refraining from using this term as it is value-laden, poorly defined, and diminishes culturally sustaining language transmission practices.