Search

INTRODUCTION: Drug development for neurodegenerative diseases such as Friedreich's ataxia (FRDA) is limited by a lack of validated, sensitive biomarkers of pharmacodynamic response in affected tissue and disease progression. Studies employing neuroimaging measures to track FRDA have thus far been limited by their small sample sizes and limited follow up. TRACK-FA, a longitudinal, multi-site, and multi-modal neuroimaging natural history study, aims to address these shortcomings by enabling better understanding of underlying pathology and identifying sensitive, clinical trial ready, neuroimaging biomarkers for FRDA. METHODS: 200 individuals with FRDA and 104 control participants will be recruited across seven international study sites. Inclusion criteria for participants with genetically confirmed FRDA involves, age of disease onset ≤ 25 years, Friedreich's Ataxia Rating Scale (FARS) functional staging score of ≤ 5, and a total modified FARS (mFARS) score of ≤ 65 upon enrolment. The control cohort is matched to the FRDA cohort for age, sex, handedness, and years of education. Participants will be evaluated at three study visits over two years. Each visit comprises of a harmonized multimodal Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) scan of the brain and spinal cord; clinical, cognitive, mood and speech assessments and collection of a blood sample. Primary outcome measures, informed by previous neuroimaging studies, include measures of: spinal cord and brain morphometry, spinal cord and brain microstructure (measured using diffusion MRI), brain iron accumulation (using Quantitative Susceptibility Mapping) and spinal cord biochemistry (using MRS). Secondary and exploratory outcome measures include clinical, cognitive assessments and blood biomarkers. DISCUSSION: Prioritising immediate areas of need, TRACK-FA aims to deliver a set of sensitive, clinical trial-ready neuroimaging biomarkers to accelerate drug discovery efforts and better understand disease tr

Radiative cooling forms an emerging direction in which objects are passively cooled via thermal radiation to cold space. Cooling materials should provide high thermal emissivity (infrared absorptance) and low solar absorptance, making cellulose an ideal and sustainable candidate. Broadband solar-reflective or transparent coolers are not the only systems of interest, but also more pleasingly looking colored systems. However, solutions based on wavelength-selective absorption generate not only color but also heat and thereby counteract the cooling function. Intended as coatings for solar cells, we demonstrate a transreflective cellulose material with minimal solar absorption that generates color by wavelength-selective reflection, while it transmits other parts of the solar spectrum. Our solution takes advantage of the ability of cellulose nanocrystals to self-assemble into helical periodic structures, providing nonabsorptive films with structurally colored reflection. Application of violet-blue, green, and red cellulose films on silicon substrates reduced the temperature by up to 9 °C under solar illumination, as result of a combination of radiative cooling and reduced solar absorption due to the wavelength-selective reflection by the colored coating. The present work establishes self-assembled cellulose nanocrystal photonic films as a scalable photonic platform for colored radiative cooling., QC 20230404

Background: Setting public health policies and effectively monitoring the impact of health interventions requires accurate, timely and complete cause of death (CoD) data for populations. In Sri Lanka, almost half of all deaths occur outside hospitals, with questionable diagnostic accuracy, thus limiting their information content for policy. Objectives: To ascertain whether SmartVA is applicable in improving the specificity of cause of death data for out-of-hospital deaths in Sri Lanka, and hence enhance the value of these routinely collected data for informing public policy debates. Methods: SmartVA was applied to 2610 VAs collected between January 2017 and March 2019 in 22 health-unit-areas clustered in six districts. Around 350 community-health-workers and 50 supervisory-staffs were trained. The resulting distribution of Cause-Specific-Mortality-Fractions (CSMFs) was compared to data from the Registrar-General's-Department (RGD) for out-of-hospital deaths for the same areas, and to the Global-Burden-of-Disease (GBD) estimates for Sri Lanka. Results: Using SmartVA, for only 15% of deaths could a specific-cause not be assigned, compared with around 40% of out-of-hospital deaths currently assigned garbage codes with "very high" or "high" severity. Stroke (M: 31.6%, F: 35.4%), Ischaemic Heart Disease (M: 13.5%, F: 13.0%) and Chronic Respiratory Diseases (M: 15.4%, F: 10.8%) were identified as the three leading causes of home deaths, consistent with the ranking of GBD-Study for Sri Lanka for all deaths, but with a notably higher CSMF for stroke. Conclusions: SmartVA showed greater diagnostic specificity, applicability, acceptability in the Sri Lankan context. Policy formulation in Sri Lanka would benefit substantially with national-wide implementation of VAs.

BACKGROUND: Accurate and timely cause of death (COD) data are essential for informed public health policymaking. Medical certification of COD generally provides the majority of COD data in a population and is an essential component of civil registration and vital statistics (CRVS) systems. Accurate completion of the medical certificate of cause of death (MCCOD) should be a relatively straightforward procedure for physicians, but mistakes are common. Here, we present three training strategies implemented in five countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne (UoM) and evaluate the impact on the quality of certification. METHODS: The three training strategies evaluated were (1) training of trainers (TOT) in the Philippines, Myanmar, and Sri Lanka; (2) direct training of physicians by the UoM D4H in Papua New Guinea (PNG); and (3) the implementation of an online and basic training strategy in Peru. The evaluation involved an assessment of MCCODs before and after training using an assessment tool developed by the University of Melbourne. RESULTS: The TOT strategy led to reductions in incorrectly completed certificates of between 28% in Sri Lanka and 40% in the Philippines. Following direct training of physicians in PNG, the reduction in incorrectly completed certificates was 30%. In Peru, the reduction in incorrect certificates was 30% after implementation and training on an online system only and 43% after training on both the online system and basic medical certification principles. CONCLUSIONS: The results of this study indicate that a variety of training strategies can produce benefits in the quality of certification, but further improvements are possible. The experiences of D4H suggest several aspects of the strategies that should be further developed to improve outcomes, particularly key stakeholder engagement from early in the intervention and local committees to oversee activities and support a

See attached

There has been a recent trend towards the use of performance indicators – often predicated on financial data – to enhance accountability and transparency of local government both in Australia and abroad. However, performance management also brings with it a range of risks including inter alia unintended performance distortion, synecdochal gap and intended distortions. This chapter reviews the substantial scholarly literature on government performance management before applying the concepts to a particular instance of high stakes performance management: the New South Wales Fit for the Future program. Fit for the Future required councils to self-assess against seven ratios drawn from financial statement data. Councils which failed to achieve the prescribed benchmarks were subject to forced amalgamations. Empirical evidence is provided which suggests significant levels of distortion in the performance management data. It is argued that careful design and testing of ratios – in order to avoid deleterious outcomes – is extremely important in any performance management regime, irrespective of whether accounting data from audited financial statements is used.

There has been a recent trend towards the use of performance indicators-often predicated on financial data-to enhance accountability and transparency of local government both in Australia and abroad. However, performance management also brings with it a range of risks including unintended and intended performance distortions. This chapter reviews the substantial scholarly literature on government performance management before applying the concepts to a particular instance of high stakes performance management: the New South Wales Fit for the Future programme. Fit for the Future required councils to self-assess against seven ratios drawn from financial statement data. Councils which failed to achieve the prescribed benchmarks were subject to forced amalgamations. Empirical evidence is provided which suggests significant levels of distortion in the performance management data. It is argued that careful design and testing of ratios-in order to avoid deleterious outcomes-is extremely important in any performance management regime, irrespective of whether accounting data from audited financial statements is used.

BACKGROUND: More countries are using verbal autopsy as a part of routine mortality surveillance. The length of time required to complete a verbal autopsy interview is a key logistical consideration for planning large-scale surveillance. METHODS: We use the PHMRC shortened questionnaire to conduct verbal autopsy interviews at three sites and collect data on the length of time required to complete the interview. This instrument uses a novel checklist of keywords to capture relevant information from the open response. The open response section is timed separately from the section consisting of closed questions. RESULTS: We found the median time to complete the entire interview was approximately 25 minutes and did not vary substantially by age-specific module. The median time for the open response section was approximately 4 minutes and 60% of interviewees mentioned at least one keyword within the open response section. CONCLUSIONS: The length of time required to complete the interview was short enough for large-scale routine use. The open-response section did not add a substantial amount of time and provided useful information which can be used to increase the accuracy of the predictions of the cause of death. The novel checklist approach further reduces the burden of transcribing and translating a large amount of free text. This makes the PHMRC instrument ideal for national mortality surveillance.

NSW Department of Primary Industries (NSW DPI) launched the Right to Farm Policy in 2015. The policy is a comprehensive, state-wide approach to deal with the issues of ‘right to farm’ - defined as a desire by farmers to undertake lawful agricultural practices without conflict or interference arising from complaints from neighbours and other land users. The University of Technology Sydney (UTS) and the NSW Department of Primary Industries (NSW DPI) are investigating the type and extent of agricultural land use conflict across NSW, how councils are managing this conflict, and how councils can best be supported in conflict management. The research will be completed in three stages: • Stage 1 (2016) – Preliminary council interviews and benchmarking survey • Stage 2 (2017) – Follow up survey and eight in-depth interviews with local governments • Stage 3 (2018) – Final survey. This project undertaken by UTS will advance the purpose of the Right to Farm Policy and assist NSW DPI in supporting local councils in managing and responding to agricultural land use conflict. This report presents the findings from Stage 2 survey which 58 local governments responded to (56% response rate), and findings from the eight in-depth interviews with local governments which were selected based on their patterns of agricultural land use conflict.