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Histo-blood group antigens are inherited polymorphic glycans expressed on mucosal epithelial cell surfaces and shed in secretions. They act as receptors for gastrointestinal pathogens. Those expressing these antigens are categorized as secretors and have an increased susceptibility to gastrointestinal infections, particularly from some norovirus and rotavirus genotypes. However, high-level evidence of association between secretor status and susceptibility is lacking for many other gastrointestinal pathogens. We compared differences in detection rates for 8 viruses, 5 bacteria, and 4 protozoa in children under 2 years of age enrolled in the Australian Observational Research in Childhood Infectious Diseases birth cohort study. Their secretor status was determined by phenotyping (ABO, Lewis, UEA-I) and genotyping test results. Data from polymerase chain reaction assay testing of weekly stool samples collected from birth as well as daily symptom and illness diaries were analyzed. Incidence rates were calculated by secretor status and compared using incidence rate ratios for each pathogen. Additional comparisons included symptomatic/asymptomatic detections, illness severity, and healthcare utilization by secretor status. Eighty-four children (77% secretors) participated for an exposure period of 157 child-years. The incidence rates of norovirus GI, GII, wild-type rotavirus, and Campylobacter detections were more than 50% higher in secretors than non-secretors, but lower for Blastocystis. For these pathogens, secretor status was not associated with symptomatic illness, severity, or healthcare use. Our results confirmed the previously known higher susceptibility to norovirus GII infections in secretors but displayed variations in susceptibility to other pathogens. This study strengthens the evidence for norovirus susceptibility in Australian children.

Although services are critical for many transition-aged youth, it is unclear the extent to which autistic youth participate in decisions about their services. By exploring the perceptions of autistic youth about their role in services, interventions can be developed to improve their participation. In this study, we interviewed 43 transition-aged youth with autism to explore their involvement in decisions about services. Most youth reported not being involved in decision making about the types and modalities of disability services. When youth were involved in decisions, the services were often related to education. Although youth reported that their parents typically spearheaded decisions about services, youth also reported that their parents often listened to their input. Implications for research, policy, and practice are discussed.

Parents of individuals with autism face many challenges in accessing appropriate services and supports for their offspring. Parents also play vital roles in advocating for their offspring's rights and needs. Furthermore, despite advocacy programs becoming increasingly common, it remains unclear how to best foster advocacy among parents of individuals with autism. To this end, we examined the associations among knowledge, empowerment, and three types of advocacy activities (i.e. individual, peer, and systemic) among 185 parents of transition-aged youth with autism using structural equation modeling. Results show that empowerment has a greater impact on advocacy than knowledge. Significant direct and indirect effects of individual advocacy activities on peer advocacy activities, and peer advocacy activities on systemic advocacy activities were also confirmed. Implications for research and practice are discussed.

Going down a slide, dancing to music, and pushing someone on a tire swing are more than simply "play activities" or a means to staying physically fit. Engagement in motor play provides important opportunities for preschoolers to develop a variety of skills, including gross motor, social, communication, and cognitive skills. However, during the past several years, since the identification of the COVID-19 virus, no guidelines have been available to ensure that gross motor content is addressed while simultaneously meeting the educational needs of preschoolers with and without disabilities during virtual learning. The purpose of this study was to understand the benefits and challenges that 26 preschool teachers faced as they attempted to embed motor play into their curriculum during virtual learning. All teachers worked in inclusive preschool settings and interviews were conducted between March-June 2021. Constant comparative analysis and emergent coding were used to interpret the data. Findings revealed that school readiness skills were the primary focus of virtual learning. Teachers indicated that motor play can help expand students' pre-academic skills, be fun and motivating for children, and help students be more focused and attentive. Some logistical barriers (e.g., technology, limited physical spaces, limited resources) need to be addressed in order to successfully teach motor play in a virtual format. Study findings suggest policies and guidelines need to be established to provide young children with high quality and accessible virtual instruction. Implications for research and practice are discussed.

Services are important for many individuals with autism to achieve meaningful post-school outcomes. To understand how to improve service access, it is important to measure services in ways that capture whether an individual's needs are truly being met. Yet, most measures of service access are simplistic, without fully taking into account the vast heterogeneity among those on the autism spectrum. In this manuscript, we highlight the key issues, challenges, and considerations in measuring service access. We provide ways a service access measure can address some of these issues while also suggesting further ways to improve the measurement of services. We conclude with implications for research, policy, and practice.

Family navigator programs are becoming increasingly common among families of children with autism. Yet, it is unclear how family navigators are developed; by exploring the input of families of children with autism, such programs can be responsive to family needs. In this study, 12 parents of autistic children from low-resourced communities were interviewed to inform the development of a family navigator program. Findings demonstrated that programs need to prepare navigators to address barriers such as limited knowledge and difficulty accepting an autism diagnosis. Programs should teach navigators to use strategies with families including educating families about services and connecting families with peer support. Program content should reflect direct services, government services, and advocacy strategies. Implications are discussed.

Background: Breast conserving surgery (BCS) is preferred for suitable candidates, while mastectomy (MTX) with reconstruction (MTX + R) is considered a better option for patients requiring MTX. In Hong Kong, the rates of BCS and breast reconstruction are relatively low. This paper aims to study the surgical options and their predictors among Hong Kong breast cancer patients. Methods: Data is retrieved from the Hong Kong Breast Cancer Registry (HKBCR) from 2007 to 2013. A total of 4519 Stage I–II breast cancer patients who had surgical treatments were included in this retrospective study. Results: Our multivariate logistic regression shows that people who were younger (age

A semistructured preschool motor program was developed in response to the paucity of evidence-based motor programs for preschoolers with disabilities in inclusive classrooms. A randomized controlled trial (RCT) was undertaken to examine the impact of the "CHildren in Action: Motor Program for PreschoolerS (CHAMPPS)," a 21-week intervention that includes 42 Universal Design for Learning--embedded lessons with suggestions for supporting school readiness skills. Eight intervention and 8 control classrooms across 2 states participated in the RCT. Data on 51 children with disabilities provide initial evidence on how "CHAMPPS" positively impacted children's active engagement, motor, and social development. The promising results include gains in motor skills, sustained physical activity levels during motor play, increased on-task behavior, and high feasibility and usability ratings by teachers. Implications for practice and future research are discussed.

A variety of intermediate- and low-level liquid and solid wastes are produced from reactor production of 99Mo using UAl alloy or UO2 targets and in principle can be collectively or individually converted into waste forms. At ANSTO, we have legacy acidic uranyl-nitrate-rich intermediate level waste (ILW) from the latter, and an alkaline liquid ILW, a U-rich filter cake, plus a shorter lived liquid stream that rapidly decays to low-level waste (LLW) standards, from the former. The options considered consist of cementitious products, glasses, glass-ceramics, or ceramics produced by vitrification or hot isostatic pressing for intermediate-level wastes. This paper discusses the progress in waste form development and processing to treat ANSTO’s ILW streams arising from 99Mo. The various waste forms and the reason for the process option chosen will be reviewed. We also address the concerns over adapting our chosen process for use in a hot-cell environment.

Systems navigation can be difficult, especially for low-resourced families (i.e., families who are "low income" or meet one of the following indicators: mother has a high school diploma or less; primary caregiver is unemployed; or the family receives governmental assistance). Navigators may help families access services; however, the training of navigators is unclear. The purpose of this study was to determine the effectiveness and feasibility of Supporting Parents to Access and Navigate Services (SPANS), a program to develop navigators. Altogether, 19 low-resourced parents of children with autism participated in SPANS. Participants demonstrated significantly improved knowledge about autism services and perceived advocacy for other families and systemic change. There was high attendance, low attrition, high acceptability, and high fidelity. Implications are discussed.

Preschoolers and kindergarteners demonstrate rapid growth and change in motor skills, socio-emotional (SE) skills, and academic performance. Data on 250 children with disabilities (CWD) and 250 typically developing children (TDC) from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) data set were analyzed to explore the relation between motor skills, SE skills and academic performance for children with and without disabilities. The ECLS-B data set is the first study to follow children from birth through kindergarten entry, collecting data on thier early development. The current study utilized descriptive and regression analyses (survey frequency, mean, and regression) were conducted using Statistical Analysis Software (SAS) version 9.2 (SAS Institute, 2008). Results indicated that both fine and gross motor skills make significant contributions to SE skills in CWD at both preschool and kindergarten and in TDC at preschool only. A significant correlation between fine and gross motor skills and academic performance was found for CWD and TDC in preschool and kindergarten. These findings indicated that an increased emphasis on the development of fine and gross motor skills during the preschool years may benefit the development of SE skills and academic performance for CWD. Results sheds light on the importance of including motor interventions as part of early childhood education programs delivered to CWD to narrow the achievement gap and ideally result in early learning success.

Pediatric obstructive sleep apnea has significant negative effects on health and behavior in childhood including depression, failure to thrive, neurocognitive impairment, and behavioral issues. It is strongly associated with an increased risk for chronic adult disease such as obesity and diabetes, accelerated atherosclerosis, and endothelial dysfunction. Accumulating evidence suggests that adult-onset non-communicable diseases may originate from early life through a process by which an insult applied at a critical developmental window causes long-term effects on the structure or function of an organism. In recent years, there has been increased interest in the role of epigenetic mechanisms in the pathogenesis of adult disease susceptibility. Epigenetic mechanisms that influence adaptive variability include histone modifications, non-coding RNAs, and DNA methylation. This review will highlight what is currently known about the phenotypic associations of epigenetic modifications in pediatric obstructive sleep apnea and will emphasize the importance of epigenetic changes as both modulators of chronic disease and potential therapeutic targets.

This paper is about the position of workforce and employment considerations within the sustainable tourism narrative. The paper aims to address the relative neglect of this area within the discourse of sustainable tourism and highlights references to the workforce within the United Nations' 2030 Agenda for Sustainable Development. The discussion follows the emerging field of sustainable human resource management and the contribution that this can make to meeting both the UN Sustainable Development Goals and to enhancing the recognition of workforce and employment issues within the related debate in tourism. The body of the paper highlights examples of key dimensions of work and employment across varied tourism contexts, where sustainability is of increasing consequence and significance. The paper concludes by drawing together the implications of these "mini-cases" and locating them within key principles of the 2030 Agenda for Sustainable Development. [ABSTRACT FROM AUTHOR]

Hospitality higher education traditionally seems to focus more on disseminating knowledge and conducting research. There are criticisms on undergraduate students who have little understanding on how to apply the knowledge learnt from classrooms and what practical skills to obtain upon graduation. This issue is debated and discussed among hospitality academics in the Chinese Mainland. As the use of experiential learning is increasingly recognized to be beneficial in engaging students, hospitality schools in China started to introduce this teaching method in hospitality education which aims to promote vocation-oriented education. Hence, the current study aims to identify currently how experiential learning is implemented to effectively engage hospitality students in China. [ABSTRACT FROM AUTHOR]

This study, for the first time, attempts to explore the factors affecting tourist satisfaction with a theatrical performance, The Romance of the Song Dynasty in Hangzhou, China. Four factors are identified to have affected tourist satisfaction: 'Performance,' 'Venue Environment,' 'Service,' and 'Stage Facilities.' These theatrical performance factors are examined to assess the relative influence on tourist overall satisfaction. Tourists have the highest satisfaction with 'Stage Facilities' among all factors; however, 'Service' is the most influential predictor of tourist overall satisfaction. Tourist demographic and travel characteristics toward these four theatrical performance factors reveal several significant differences. Discussions and implications are provided to theater operators to improve tourist satisfaction with theatrical performance not only in Hangzhou, but also in the whole of China. [ABSTRACT FROM AUTHOR]

Background. Erythropoietin (EPO) has recently been shown to exert important cytoprotective and anti-apoptotic effects in experimental brain injury and cisplatin-induced nephrotoxicity. The aim of the present study was to determine whether EPO administration is also renoprotective in both in vitro and in vivo models of ischaemic acute renal failure. Methods. Primary cultures of human proximal tubule cells (PTCs) were exposed to either vehicle or EPO (6.25-400 IU/ml) in the presence of hypoxia (1% O2), normoxia (21% O2) or hypoxia followed by normoxia for up to 24 h. The end-points evaluated included cell apoptosis (morphology and in situ end labelling [ISEL], viability [lactate dehydrogenase (LDH release)], cell proliferation [proliferating cell nuclear antigen (PCNA)] and DNA synthesis (thymidine incorporation). The effects of EPO pre-treatment (5000 U/kg) on renal morphology and function were also studied in rat models of unilateral and bilateral ischaemia-reperfusion (IR) injury. Results. In the in vitro model, hypoxia (1% O2) induced a significant degree of PTC apoptosis, which was substantially reduced by co-incubation with EPO at 24 h (vehicle 2.5±0.5% vs 25 IU/ml EPO 1.8±0.4% vs 200 IU/ml EPO 0.9±0.2%, n = 9, P<0.05). At high concentrations (400 IU/ml), EPO also stimulated thymidine incorporation in cells exposed to hypoxia with or without subsequent normoxia. LDH release was not significantly affected. In the unilateral IR model, EPO pre-treatment significantly attenuated outer medullary thick ascending limb (TAL) apoptosis (EPO 2.2±1.0% of cells vs vehicle 6.5±2.2%, P<0.05, n = 5) and potentiated mitosis (EPO 1.1±0.3% vs vehicle 0.5±0.3%, respectively, P<0.05) within 24 h. EPO-treated rats exhibited enhanced PCNA staining within the proximal straight tubule (6.9±0.7% vs vehicle 2.4±0.5% vs sham 0.3±0.2%, P<0.05), proximal convoluted tubule (2.3±0.6% vs vehicle 1.1±0.3% vs sham 1.2±0.3%, P<0.05) and TAL (4.7±0.9% vs vehicle 0.6±0.3% vs sham 0.3±0.2%, P<0.05). The frequency of tubular profiles with luminal cast material was also reduced (32.0±1.6 vs vehicle 37.0±1.3%, P = 0.05). EPO-treated rats subjected to bilateral IR injury exhibited similar histological improvements to the unilateral IR injury model, as well as significantly lower peak plasma creatinine concentrations than their vehicle-treated controls (0.04±0.01 vs 0.21±0.08 mmol/l, respectively, P<0.05). EPO had no effect on renal function in sham-operated controls. Conclusions. The results suggest that, in addition to its well-known erythropoietic effects, EPO inhibits apoptotic cell death, enhances tubular epithelial regeneration and promotes renal functional recovery in hypoxic or ischaemic acute renal injury. [ABSTRACT FROM AUTHOR]

This paper reports on a study about applying regression techniques to identify the determinants and functional forms of tourism hotel expenditure in Hong Kong. Annual time series data from 1983 to 1997 of average room rate, the number of visitor arrivals, the service price index, and hotel accommodation rates were hypothesised to affect tourism hotel expenditure. Seven exogenous variables were selected for regression model development in both linear and log-linear forms. In view of the potential problems of multicollinearity between the independent variables, and therefore the associated instability of the regression coefficients, stepwise regression analyses were employed to improve the initial model. Final empirical results showed that the hotel expenditure in Hong Kong could be explained by four of the seven exogenous variables. A log-linear form of the regression model appeared to slightly outperform the linear form. [ABSTRACT FROM AUTHOR]

BackgroundIt is difficult for families to navigate and access services for their children with autism. Barriers to service access are compounded among families from low-resourced backgrounds. ObjectiveThe purpose of our study was to explore the development of an app to facilitate access to services among families of children with autism from low-resourced backgrounds. Our specific aims were to explore feedback from an advisory board about the app and to explore feedback from navigators about the app. MethodsVia a multistage codevelopment process, we elicited feedback from 5 key parties: the research team, a community organization, the app development team, the advisory board, and family navigators. Collectively, 36 individuals provided feedback about the development of the app via individual interviews, focus groups, observations, and surveys. The key features of the app included a dashboard showing the service needs of the family and related resources, a messaging feature between the family, the navigator, and the supervisor, and a fidelity checklist and evaluation feature. ResultsThe advisory board provided feedback about the app to increase its user-friendliness, include the ability to develop an action plan, improve the identification of needed services, and add information about service providers. Navigators suggested that the app should connect navigators to one another, have a clearer purpose for the notes section, and reflect an easier log-in process. Navigators also wanted training to role-play using the app. After participating in a role play using the app, navigators reported significantly more satisfaction with the app and greater usefulness (P

Although services are critical for many transition-aged youth, it is unclear the extent to which autistic youth participate in decisions about their services. By exploring the perceptions of autistic youth about their role in services, interventions can be developed to improve their participation. In this study, we interviewed 43 transition-aged youth with autism to explore their involvement in decisions about services. Most youth reported not being involved in decision making about the types and modalities of disability services. When youth were involved in decisions, the services were often related to education. Although youth reported that their parents typically spearheaded decisions about services, youth also reported that their parents often listened to their input. Implications for research, policy, and practice are discussed., (©AAIDD.)

Systems navigation can be difficult, especially for low-resourced families (i.e., families who are "low income" or meet one of the following indicators: mother has a high school diploma or less; primary caregiver is unemployed; or the family receives governmental assistance). Navigators may help families access services; however, the training of navigators is unclear. The purpose of this study was to determine the effectiveness and feasibility of Supporting Parents to Access and Navigate Services (SPANS), a program to develop navigators. Altogether, 19 low-resourced parents of children with autism participated in SPANS. Participants demonstrated significantly improved knowledge about autism services and perceived advocacy for other families and systemic change. There was high attendance, low attrition, high acceptability, and high fidelity. Implications are discussed., (©AAIDD.)

Research related to the developmental disability (DD) community should include collaboration with individuals with DD. Unfortunately, people with DD are infrequently involved in research projects in meaningful ways, and there is little guidance about how to collaborate equitably with researchers with DD. The purpose of this article is to share lessons learned from a collaborative research study among researchers with and without DD using both qualitative and quantitative methods to develop and examine the effectiveness of a civic engagement intervention for transition-aged youth with disabilities. It includes how our research team compensated researchers with DD, clarified team member roles, leveraged the expertise of researchers with DD in using both qualitative and quantitative methods, and integrated technology throughout the research process., (©AAIDD.)

Services are critical for youth with autism spectrum disorder (ASD), especially during the transition to adulthood. Under the best of circumstances, though, it can be difficult to access needed adult services. With COVID-19, services were more difficult to obtain and retain. In this study, we explored parent perceptions of accessing new services and maintaining current services during the first year of the COVID-19 pandemic. Structured interviews were conducted with 65 parents of transition-aged youth (aged 16-26) with ASD living in three states (IL, TN, and WI) in the United States. None of the participants reported receiving new services during the pandemic, and many struggled to access services via online applications. In addition, participants reported that service suspensions and changes in modality (e.g., from in-person to telehealth) were spearheaded by professionals and not families. Participants, especially those in TN, were more likely to pay out-of-pocket for services during the COVID-19 pandemic to compensate for service disruptions. Implications for research and practice are discussed., (©AAIDD.)

General Purpose: To provide an overview of the assessment and management of risk factors for falls in older adults., Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care., Learning Objectives/outcomes: After participating in this educational activity, the participant should be better able to:1. Outline the components of an evidence-based falls assessment and identify risk factors for falls.2. Specify strategies to reduce falls in older adults, especially as related to maintaining skin integrity., Abstract: Older adult patients may present to skin and wound care clinicians with skin injuries as a result of falls. In addition, chronic wounds associated with the patient's conditions may also increase his/her falls risk. Hence, appropriate assessment and management of the risk of falls in older adult patients are key elements of patient-centered care.