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Increasing volumes of mismanaged plastic waste have resulted in millions of tons of plastics entering the environment. While recent research has made substantial progress in determining the fate and transport of microplastics (MP) in river systems and their subsequent discharge to the worlds oceans, much less is known about the subsurface fate of MP as they enter soils, (riverine) sediments and global groundwater resources. Initial studies have identified MP in selected groundwater samples and there is great interest to understand entry pathyways of MPs into soils, in particular through agricultural pathways. The mechanisms of MP release from agricultural sources such as seed and agrochemical encapsulations or sewage sludges as well as the total quantity, spatial distribution, residence time scales as well as the impact of MP on soils and subsequently groundwater ecosystems are completely unknown. There is hence a critical need to study the role of soils and groundwater systems as a long-term sink for plastic pollution, including the development of legacy risks.Here we identify the significance of various entry pathways for MP into subsurface ecosystems, integrating experimental and model based quantifications of MP transport through streambed sediments with quantifications of MP inputs into agricultural soils through irrigation with river water. We present first results of MP impacts on the functioning of subsurface ecosystem services, by the particular example of MP exposure impacts on the behaviour of bioturbating invertebrates and the subsequent consequences for sediment biogeochemical cycling in order to draw attention to the potential risks for vital soil and groundwater ecosystem services.We complement this site specific mechanistic process understanding with global estimates of mismanaged plastic waste accumulation in river basins to quantify MP catchment wide loads available for leakage into soils and present first results of our recently started participatory approach that aims to develop a baseline of MP pollution in aquifers across the world. Such baseline data is imperative to increase our understanding of MP fate and transport processes, MP uptake by groundwater organisms and the interaction of MP with nutrients and potential co-contaminants. Our specifically tailored protocol allows for standardized MP sampling in boreholes, springs or wells across a wide range of geological settings and land cover classes. We invite and encourage the community to contribute to this global effort in order to enable estimates of the magnitude and expected time scales of soil and groundwater MP contamination.

This study assessed the psychological predictors of preferences for return of comprehensive tumor genomic profiling (CTGP) results in patients with advanced cancers, enrolled in the Molecular Screening and Therapeutics Program. Patients completed a questionnaire prior to undergoing CTGP. Of the 1434 who completed a questionnaire, 96% would like to receive results that can guide treatment for their cancer, and preference for receiving this type of result was associated with lower tolerance of uncertainty. Sixty-four percent would like to receive results that cannot guide treatment, and lower tolerance of uncertainty, self-efficacy, and perceived importance were associated with this preference. Fifty-nine percent would like to receive variants of unknown significance, which was associated with lower tolerance of uncertainty, higher self-efficacy, and perceived importance. Eighty-six percent wanted to receive germline results that could inform family risk. This was associated with higher self-efficacy, perceived importance, and perceived susceptibility. Although most patients wanted to receive all types of results, given the differing patient preferences regarding the return of results depending on the utility of the different types of results, it appears critical to safeguard patient understanding of result utility to achieve informed patient choices. This should be accompanied by appropriate consent processes.

An overview of the current state of knowledge on the pollution of agricultural soils with microplastic and nanoplastic (MnP) particles is provided and the main MnP sources are discussed. MnP transport mechanisms from soil to groundwater, as well as the potential impact of MnPs on soil structure are considered, and the relevance of co-contaminants such as agrochemicals is further highlighted. We elaborate on why MnPs in soil and groundwater are understudied and how analytical capabilities are critical for furthering this crucial research area. We point out that plastic fragmentation in soils can generate secondary MnPs, and that these smaller particles potentially migrate into aquifers. The transport of MnP in soils and groundwater and their migration and fate are still poorly understood. Higher MnP concentrations in agricultural soils can influence the sorption behavior of agrochemicals onto soil grains while attachment/detachment of MnPs onto soil grains and MnP-agrochemical interactions can potentially lead to enhanced transport of both MnP particles and agrochemicals towards underlying groundwater systems.

Most social movements will encounter setbacks in their pursuit of sociopolitical change. However, little is known about how movements are affected after protestors fail to achieve their aims. What are the effects of failure on subsequent engagement in various conventional and radical actions? Does failure promote divergent reactions among protestors and/or dissatisfaction with democracy? A meta-analysis of nine experiments ( N = 1,663) assessed the effects of one-off failure on protestors’ reactions, subsequent tactical choices, and support for democracy; and iterative stochastic simulations modeled the effects of failure over multiple protests over time. Results indicated that initial failure gives rise to divergent, somewhat contradictory responses among protestors and that these responses are further influenced by the repeated failure (vs. success) over time. Further, the simulations identified “tipping points” in these responses that promote radicalization and undermine support for democracy.

Aim Children living in families impacted by parental mental illness are at increased risk of adverse mental and physical health outcomes compared with children living in families unaffected by mental illness. Considered to be a hard-to reach group, it is likely that there are unique barriers for these young people in seeking help for their difficulties. This systematized review synthesizes what is currently known about help-seeking barriers, facilitators and interventions for young people affected by parental mental illness. Methods Three databases were searched, yielding 2556 results and three studies were identified through other sources. Studies were screened on title and abstract review and were excluded if they were published before 2005 or if they did not include the perspectives of young people. At a second stage, full-text articles were screened based on the inclusion criteria. Eleven studies were included for data extraction and quality appraisal. Results Qualitative and quantitative data synthesis revealed three significant barriers (i) stigma, (ii) family communication and (iii) lack of belonging and shared experience, three key facilitators (i) individual characteristics, (ii) group identification and (iii) anonymity and three primary components of therapeutic interventions (i) psychoeducation, (ii) connection with peers and (iii) accessibility. Conclusions It was found that stigma towards mental illness is highly salient amongst young people impacted by parental mental illness and has unique effects on their patterns of help-seeking. Help-seeking research amongst this group is still emerging, with a need for greater clarity in operationalisation of help-seeking constructs and more robust methodological designs.

Fear of cancer recurrence/occurrence (FCR/O) is prevalent and associated with poorer psychological outcomes but can also motivate individuals to pursue genomic information about cancer risk. Guided by Protection Motivation Theory, this study investigated FCR/O prevalence and associated factors among probands previously diagnosed with a cancer of likely heritable origin, and their relatives, who had agreed to have germline genome sequencing. Three hundred and forty-eight probands and 167 relatives completed the Concerns about Recurrence Questionnaire (adapted for occurrence for some relatives) within 1 month of agreeing to undertake genome sequencing. Linear regressions investigated demographic, disease, attitude and behavioral associations with FCR/O. Probands demonstrated greater FCR compared to relatives. In probands, greater FCR was associated with being female, non-English speaking at home, less time since diagnosis, greater intention to change behavior if gene variant found, lower perceived ability to cope with results, higher perceived susceptibility to having a recurrence, and more negative attitudes towards uncertainty. For relatives with cancer, greater FCR was associated with being male, greater intention to change behavior if a gene variant found, and higher perceived susceptibility to recurrence. In relatives without cancer, greater FCO was associated with not having had genetic testing prior to this study, lower perceived ability to cope with results, and higher perceived susceptibility to developing cancer. Current findings on FCR/O prevalence and associated demographic and attitudinal variables in those who pursue genomic risk information might be used to target interventions that can prevent adverse psychological outcomes in vulnerable patients.

Global plastic production reached 368 million tonnes in 2019 (Plastics Europe, 2020), with the greatest demand being for packaging. Plastic waste management in many countries is mismanaged, with ~25% of post-consumer waste globally sent to landfill in 2018, this increases the likelihood of plastic ending up in the environment, raising concerns about the impact of plastic pollution on the environment. Microplastics (particles Microplastics are present in all environmental compartments, but research to date has focused on marine systems, leaving a substantial knowledge gap in understanding how microplastics behave in and impact other environments, especially terrestrial ones. Terrestrial soils provide key ecosystem services (e.g. food provision and climate regulation), however these services are threatened by soil pollution including from microplastics. Soils act as a sink for microplastics, which typically enter the soil through their widespread use in agriculture. Common entry pathways include the application of microplastic containing sewage sludge as fertiliser, and the direct application of microplastics via the polymer encapsulation of pesticides and seeds. Whilst the impacts of microplastics are not fully known, it is possible that they will compromise soil health and functions.We urgently need to understand how microplastics of different compositions and sources affect soil ecosystems, but research progress is hindered due to the lack of standardised protocols for the identification, extraction, and analysis of microplastics in the complex soil environment. Soil is high in organic matter, meaning protocols devised for aquatic samples are not feasible because more aggressive digestion steps are required to remove soil organics.This poster looks at the extraction and analysis of microplastics from soil samples, following a generalised framework of sieving, density separation, organic digestion, and analysis. It outlines the effectiveness of each step in the soil matrix and its applicability for both biodegradable and non-biodegradable microplastics. It compares the effect of commonly used digestion solutions (e.g. Fenton’s reagent, hydrogen peroxide) on the polymers, by using Raman spectroscopy to characterise the plastics before and after treatment, and thus to assess chemical changes arising from the sample processing. Based on these results an optimal workflow is defined as the basis for evaluating the biodegradation of microplastics in soil.

OBJECTIVE This study aimed to discern preferences for receiving somatic molecular profiling (MP) results in cancer patients who have given consent to undergo testing. METHODS We conducted a mixed-methods study to explore patients' views on which MP results they would like to receive and why. Advanced cancer patients (n = 1299) completed questionnaires after giving consent to participate in a parent genomics study and undergoing MP. A subset of patients (n = 20) participated in qualitative interviews. RESULTS Almost all (96%) participants were interested in receiving results which would direct cancer treatment (ie, were actionable). A smaller majority wanted to access results which were not actionable (64%) or were variants of unknown significance (60%). Most (86%) were interested in finding out about germline findings, though not as a priority. Themes identified in interview data were: (a) Cancer is the focus; (b) Trust in clinicians; and (c) Respect for a right not to know. CONCLUSIONS The majority of advanced cancer patients undergoing MP prioritised results which would lead to treatment options. They trusted their oncologists to help them navigate the results return process. While there was interest in knowing about other results, this was a lesser priority. Nevertheless, given high levels of interest in receiving all results, ethical aspects of not providing uninformative results requires further research, including a consideration of patient rationales for desiring this information and what health professionals can and should do to support patients in the absence of meaningful information being available.

Genomic Sequencing (GS) to identify high cancer risk will soon enter clinical practice at significant cost to the health system. This study aimed to quantify perceived value of GS to Australian cancer patients and their first-degree relatives participating in a genomic sequencing study, and factors associated with value. Participants were recruited upon consent to the genomics study. Eligible participants (with cancer of likely genetic etiology, or a first-degree relative) completed a questionnaire prior to GS. Willingness to pay was assessed via hypothetical trade-off scenarios of actionable result return rates of 1%, 10%, 20%, 30%, 40% or 50%. Of 348 probands and 213 relatives (92% and 93% response rate), 81% would consistently have GS for as little as a 1% actionable return rate. Participants would pay a median of $1,000 for return rates of at least 20% (probands) or 30% (relatives), and $300 for lower return rates. Probands with common cancers and negative attitudes to uncertainty were more likely to have GS; those with higher education were more willing to pay $1,000 and $3,000 for lower return rates. This study found high interest in, but lower willingness to pay for GS in cancer patients and their first-degree relatives, possibly due to inability to pay. Further research is needed to improve our understanding of how individuals in different risk circumstances, trade-off the risks, harms, and benefits of GS.

This study assessed the psychological predictors of attitudes toward the return of germline genomic sequencing results in cancer patients and their biological relatives with a likely genetic basis for their cancer diagnosis, who completed a questionnaire prior to undergoing genomic sequencing. Of 602 probands and relatives, 94% of probands and 89% of relatives thought people would like to be informed about single-gene conditions for which there is prevention or treatment. Amongst relatives, this view was associated with higher perceived susceptibility and self-efficacy. Probands (66%) and relatives (59%) thought people would be interested in learning about single-gene conditions for which there is no prevention or treatment. Amongst probands, this view was associated with lower tolerance of uncertainty and amongst relatives with higher self-efficacy. Probands (92%) and relatives (90%) thought people would like to be informed about polygenic conditions that can have a major impact on health. Amongst probands this view was associated with lower perceived susceptibility of cancer recurrence, and amongst relatives, with higher perceived susceptibility and self-efficacy. Probands (86%) and relatives (86%) thought that people would like to be informed about polygenic conditions that can have a lower impact on health, and this view was associated with a lower perceived susceptibility of recurrence amongst probands. In conclusion, these findings show that individuals' attitudes about the return of results depend on the perceived utility of different types of tests. Therefore, individuals need to gain a clear understanding of test utility, and appropriate consent processes are required to achieve informed choices.

Fear of cancer recurrence/occurrence (FCR/O) is prevalent and associated with poorer psychological outcomes but can also motivate individuals to pursue genomic information about cancer risk. Guided by Protection Motivation Theory, this study investigated FCR/O prevalence and associated factors among probands previously diagnosed with a cancer of likely heritable origin, and their relatives, who had agreed to have germline genome sequencing.Three hundred and forty-eight probands and 167 relatives completed the Concerns about Recurrence Questionnaire (adapted for occurrence for some relatives) within 1 month of agreeing to undertake genome sequencing. Linear regressions investigated demographic, disease, attitude and behavioral associations with FCR/O.Probands demonstrated greater FCR compared to relatives. In probands, greater FCR was associated with being female, non-English speaking at home, less time since diagnosis, greater intention to change behavior if gene variant found, lower perceived ability to cope with results, higher perceived susceptibility to having a recurrence, and more negative attitudes towards uncertainty. For relatives with cancer, greater FCR was associated with being male, greater intention to change behavior if a gene variant found, and higher perceived susceptibility to recurrence. In relatives without cancer, greater FCO was associated with not having had genetic testing prior to this study, lower perceived ability to cope with results, and higher perceived susceptibility to developing cancer.Current findings on FCR/O prevalence and associated demographic and attitudinal variables in those who pursue genomic risk information might be used to target interventions that can prevent adverse psychological outcomes in vulnerable patients.

Germline genome sequencing (GS) holds great promise for cancer prevention by identifying cancer risk and guiding prevention strategies, however research evidence is mixed regarding patient preferences for receiving GS results. The aim of this study was to discern preferences for return of results by cancer patients who have actually undergone GS. We conducted a mixed methods study with a cohort of cancer probands (n = 335) and their genetic relatives (n = 199) undergoing GS in a research setting. Both groups completed surveys when giving consent. A subset of participants (n = 40) completed semi-structured interviews. A significantly higher percentage of probands thought people would like to be informed about genetic conditions for which there is prevention or treatment that can change cancer risk compared to conditions for which there is no prevention or treatment (93% [311] versus 65% [216]; p p

OBJECTIVES: Germline genome sequencing (GS) is becoming mainstream in cancer diagnosis and risk management. Identifying knowledge gaps and determinants of health behavior change intentions will enable effective targeting of educational and management strategies to translate genomic findings into improved cancer outcomes. METHODS: Probands diagnosed with cancer of likely genetic origin that consented to but not yet undergone GS, and their biological relatives, completed a cross-sectional questionnaire assessing GS knowledge and hypothetical intention to change behaviors. RESULTS: Probands (n = 348; 57% university educated) and relatives (n = 213; 38% university educated) had moderate GS knowledge levels, with greater knowledge associated with higher education. Both populations reported high behavioral change intentions, significantly associated with being female (p = 0.01) and greater perceived importance of GS (p

Objectives Single-gene testing is associated with psycho-social challenges for cancer patients. Genomic testing may amplify these. The aim of this study was to understand patients’ motivations and barriers to pursue cancer genomic testing, to enable healthcare providers to support their patients throughout the testing process and interpretation of test results. Methods Five databases were searched for original peer reviewed research articles published between January 2001 and September 2018 addressing motivation for genomic cancer testing. QualSyst was used to assess quality. Results 182 studies were identified and 17 were included for review. Studies were heterogenous. Both somatic and germline testing were included, and 14 studies used hypothetical scenarios. 3249 participants were analyzed, aged 18 to 94. Most were female and white. The most common diagnoses were breast, ovarian, lung and colorectal cancer. Interest in testing was high. Motivations included ability to predict cancer risk, inform disease management, benefit families, and understand cancer. Barriers included concerns about cost, privacy/confidentiality, clinical utility, and psychological harm. Conclusions Despite concerns, consumers are interested in cancer genomic testing if it can provide actionable results for themselves and their families. Practice Implications Providers must manage understanding and expectations of testing and translate genetic information into health-promoting behaviours.

1541 Background: Somatic tumor mutation profiling (STMP) is entering clinical practice. We aimed to investigate psychological impacts of receiving results. Methods: Eligible participants had: advanced solid cancers of any histological type; accessible tissue for STMP; and enrolled in the Molecular Screening and Therapeutics (MoST) Program. 1074 participants (91%) completed a baseline assessment prior to STMP (T0), of whom 570 (47%) received results and completed a post-result assessment (T1) of impact of genetic results (MICRA), anxiety and depression (HADS), cancer-specific anxiety (IES), and satisfaction with decision to have STMP. Linear regression models controlling for age, gender, parental status, cultural diversity, education and ECOG status explored associations between result received and psychological outcomes. Results: 360 participants received an actionable result and were recommended personalised treatment: 152 via a MoST sub-study (G1) and 208 via their treating oncologist (G2). 210 received a non-actionable result (G3). At T1, G3 were significantly more distressed and less positive about their result (MICRA subscales) and less satisfied with their decision to have STMP than both G1 and G2; G2 was less positive than G1. IES and HADs were not impacted by type of result. Interactions between gender and age, and result were non-significant for all psychological outcomes. Perceived self-efficacy in coping with results (p=0.015) and knowledge (p=0.04) at T0 was significantly correlated with satisfaction with decision at T1; self efficacy (T0) was also correlated with MICRA total (T1) (p=0.006). Conclusions: Pathway to treatment receipt is less important to advanced cancer patients than actionability. Patients’ self-efficacy to cope with results prior to testing can identify patients vulnerable to distress post-receipt of STMP results who should be offered psychological counseling. Ensuring good knowledge of STMP at consent may avoid decisional regret. [Table: see text]

Key Points Question What value do patients with advanced cancer place on tumor variation profiling? Findings In this survey study of 777 patients with advanced cancer, 689 individuals (89%) indicated that they would have tumor molecular profiling for as little as a 1% actionable return rate, but fewer were willing to pay for it. Country of birth, medical- or science-related occupation, attitude toward uncertainty, and perceived importance of tumor molecular profiling were associated with willingness to pay. Meaning Ability to pay may limit access to tumor molecular profiling; ongoing societal debate is required to establish the value of tumor molecular profiling and whether subsidization is necessary to ensure equity of access., Importance Use of tumor molecular profiling (MP) is entering routine clinical practice; however, little is known about how much and why patients value MP. Objective To examine the perceived value of MP to patients with advanced cancer and factors associated with perceived value. Design, Setting, and Participants A cross-sectional survey that included willingness-to-pay trade-off scenarios was administered to participants after consent and before MP. A total of 777 participants (94% response rate) were recruited from the Molecular Screening and Therapeutics Program. Eligible patients had advanced solid cancers of any histologic type, were receiving or had completed their last line of effective therapy, had an Eastern Cooperative Oncology Group Performance Status 0 to 3, and had sufficient accessible tissue for MP. The participants were recruited between October 24, 2017, and March 12, 2019, and data analysis was conducted from March 13 to April 14, 2019. Main Outcomes and Measures Willingness to pay for MP was assessed via hypothetical trade-off scenarios varying in the actionable return rate (1%, 20%, or 40%) and cost (A$0, A$300 [US$210], A$1000 [US $700], A$3000 [US $2100], or A$10 000 [US $7000]). Ordinal regressions were used to explore factors associated with willingness to have and pay for MP. Results Of 777 participants (405 women [52%]; mean [SD] age, 55.47 [14.26] years), 689 patients (89%) would have MP for as little as a 1% actionable return rate. Fifty-six patients (7%) would require at least a 20% return rate and 11 patients (1%) would require at least a 40% return rate. Fifteen patients (2%) consistently chose not to have the test; 6 participants (0.8%) had missing values on this item. Participants were willing to pay a median of A$1000 if the actionable return rate was 1% and A$3000 for an actionable return rate of 20% to 40%. Of 762 individuals who agreed to testing, 482 patients (64%) were consistently unwilling to pay A$10 000, regardless of the actionable return rate. Patients born in Australia or New Zealand were more likely to want MP (eg, participants born in South Asia had an ordered odds for the tipping point of 7.74 [95% CI, 1.67-36.05; P = .009] times higher than Australian- and/or New Zealand–born participants). Patients born in Australia or New Zealand were also more willing to pay A$1000 or A$3000 (eg, participants born in Western Europe had an ordered odds for the tipping point for paying A$1000 of 1.74 [95% CI, 1.01-3.00; P = .048] times higher than Australian- and/or New Zealand–born participants). People with a medical- or science-related occupation and with more negative attitudes toward uncertainty were more likely to pay A$10 000 (eg, A$10 000 tipping point–ordered odds of participants with a medical- or science-related occupation was 0.49 [95% CI, 0.7-0.87; P = .02] times that of participants without a medical- or science-related occupation). Conclusions and Relevance This study found apparent high interest in but lower willingness to pay for MP among patients with advanced cancer. Ability to pay may limit access to MP. Ongoing societal debate is required to establish the value of MP and whether subsidization is needed to ensure equity of access., This survey study examines the acceptance of and willingness to pay for molecular profiling of tumors by patients with advanced cancer.

“This is Chester, the best-dressed man at FOCUS.” I was introduced to Chester on my first day volunteering at FOCUS Pittsburgh by Miss Cheryl, who is second-in-command at FOCUS. FOCUS is located in a two-story duplex in the Hill District of Pittsburgh. The Hill is mainly populated by low-income black families, and the crime rate is high. The median income is less than $15,000 (Damewood 2011). In 1950, the city of Pittsburgh displaced 1,239 black families and 312 white families to build the Mellon Arena in the heart of the Hill (Bauder 2014). The neighborhood still has not recovered from this economic loss and is only now beginning to see the rewards promised in exchange, like the Shop ’N Save that just opened on Centre Avenue. Before the Shop ’N Save, the Hill District was a food desert, a poor, urban area lacking quality fresh, whole food.