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The complex nature of human cognition has resulted in cognitive genomics lagging behind many other fields in terms of gene discovery using genome-wide association study (GWAS) methods. In an attempt to overcome these barriers, the current study utilized GWAS meta-analysis to examine the association of common genetic variation (~8M single-nucleotide polymorphisms (SNP) with minor allele frequency ⩾1%) to general cognitive function in a sample of 35 298 healthy individuals of European ancestry across 24 cohorts in the Cognitive Genomics Consortium (COGENT). In addition, we utilized individual SNP lookups and polygenic score analyses to identify genetic overlap with other relevant neurobehavioral phenotypes. Our primary GWAS meta-analysis identified two novel SNP loci (top SNPs: rs76114856 in the CENPO gene on chromosome 2 and rs6669072 near LOC105378853 on chromosome 1) associated with cognitive performance at the genome-wide significance level (P<5 × 10^−8). Gene-based analysis identified an additional three Bonferroni-corrected significant loci at chromosomes 17q21.31, 17p13.1 and 1p13.3. Altogether, common variation across the genome resulted in a conservatively estimated SNP heritability of 21.5% (s.e.=0.01%) for general cognitive function. Integration with prior GWAS of cognitive performance and educational attainment yielded several additional significant loci. Finally, we found robust polygenic correlations between cognitive performance and educational attainment, several psychiatric disorders, birth length/weight and smoking behavior, as well as a novel genetic association to the personality trait of openness. These data provide new insight into the genetics of neurocognitive function with relevance to understanding the pathophysiology of neuropsychiatric illness.

The harms of youth homelessness are well described in the academic literature, but less is known about transitions into homelessness among at risk youth. Given the importance of preventing youth homelessness, and in particular, the first incidence of homelessness, quantitative and qualitative data from street involved youth in Vancouver were analyzed in order to determine significant factors associated with this transition and generate policy options for addressing this issue. Ultimately, this study recommends placing youth workers in secondary schools to support the academic and social development of at risk youth, as well as provide connections to appropriate community supports such as housing. This is the first known study to directly ask youth for their thoughts on how to prevent the first incidence of homelessness, and the results from this Capstone provides policy makers with opportunities for targeted interventions to address youth homelessness in Vancouver.

Children and youth exposed to the child welfare system represent one of society’s most vulnerable populations. Compared to their peer group, too many youth exposed to the child welfare system in British Columbia experience elevated rates of homelessness, substance use, incarceration, unplanned pregnancies, poverty and underemployment, and both mental and physical health issues in early adulthood. Given these disparities, child welfare policy reform is needed to better assist youth in care, rectify lagging outcomes and facilitate successful transitions to independence throughout the province. This study employed a mixed methodology using quantitative data from a prospective cohort of illicit substance-using street youth, semi-structured qualitative interviews and a literature review. Findings from the quantitative analysis found that youth with a history of being in care were more likely to: be of Aboriginal ancestry; have been physically abused; have a parent that drank heavily or used illicit substances; not have completed high school; and have initiated hard drug-use at an earlier age. A range of policy options were developed and informed by various stakeholder groups and evaluated against a set of criteria. The outcome of these evaluations indicate that a portfolio of policies, including the provision of greater resources to kinship caregivers and extending foster care to 21 years old will have the greatest impact on improving outcomes for former government care youth. Moving towards expanding and extending independent living programs was also identified as a promising policy approach to improve outcomes for youth transitioning out of care.

Background. Hepatitis C virus (HCV) coinfection occurs in 20–30% of Canadians living with HIV and is responsible for a heavy burden of morbidity and mortality. Purpose. To update national standards for management of HCV-HIV coinfected adults in the Canadian context with evolving evidence for and accessibility of effective and tolerable DAA therapies. The document addresses patient workup and treatment preparation, antiviral recommendations overall and in specific populations, and drug-drug interactions. Methods. A standing working group with HIV-HCV expertise was convened by The Canadian Institute of Health Research HIV Trials Network to review recently published HCV antiviral data and update Canadian HIV-HCV Coinfection Guidelines. Results. The gap in sustained virologic response between HCV monoinfection and HIV-HCV coinfection has been eliminated with newer HCV antiviral regimens. All coinfected individuals should be assessed for interferon-free, Direct Acting Antiviral HCV therapy. Regimens vary in content, duration, and success based largely on genotype. Reimbursement restrictions forcing the use of pegylated interferon is not acceptable if optimal patient care is to be provided. Discussion. Recommendations may not supersede individual clinical judgement. Treatment advances published since December 2015 are not considered in this document.