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Background Young people with Fetal Alcohol Spectrum Disorder (FASD) can face significant challenges in their lives, including overrepresentation in the justice system from a young age. Police questioning and court proceedings can be difficult for these young people to navigate. Practice and policy responses are necessary to identify these individuals, provide appropriate support/rehabilitation, and upskill the justice workforce. The aim of this research was to determine the unmet workforce development needs of a regional workforce providing care and support to youth involved with the justice system. Interviews were conducted with 29 participants from 14 organisations to understand the support provided to youth, existence and uptake of referral pathways, and unmet needs. Results Results revealed a workforce that wants to see improvements to outcomes for young people with FASD and other neurodevelopmental disabilities who enter the youth justice system. However more support is required through training, ongoing funding, and assistance to develop FASD informed work practices. Conclusions The workforce supporting youth to navigate the justice system requires practical interventions to achieve best practice so that young people with FASD and other neurodevelopmental disabilities receive the support that they need. Following the interviews a model of care tool was developed and piloted in the sector. The tool includes current pathways through the justice system and provides resources to assist staff in achieving best practice care for young people with FASD and other neurodevelopmental disabilities.

Anthropocentric climate change presents an existential threat through impacts such as rising sea levels, effects on agricultural crops and extreme weather events. However, governments, businesses and communities struggle to wean off fossil fuel dependency. In this article, we argue that this is due to the grip of fossil fuel hegemony. To explain this grip, we draw on the theoretical perspectives of new materialism to examine how fossil fuels and politics interact in upholding Australia's fossil fuel regime. Our analysis, based on 70 qualitative interviews conducted with politicians and political advisors, fossil fuel executives and experts and environmental activists, shows three processes – establishment, entrenchment and encroachment – through which political-material entanglements lock in a fossil fuel-based future. These processes are both discursive, with politicians and industry downplaying, if not outright denying, the climate emergency and material, with investment in new mines and infrastructure even while the negative ecological impacts of fossil fuel use gather pace.

Evidence based strategies are needed to enhance the ability of the Alcohol and Other Drugs (AOD) sector to prevent prenatal alcohol exposure (PAE) and harms including Fetal Alcohol Spectrum Disorde...

This study examines the relationship between religious and spiritual (R/S) struggle and religiosity with depression and anxiety in adolescents admitted to inpatient psychiatric units of a pediatric hospital in the Midwest of the United States. We administered four self-reported scales to 71 adolescents (ages 13-17) to assess religiosity, R/S struggle, depression, and anxiety. The prevalence of R/S struggle among this population was high (88.73%). Significant associations were found between R/S struggle and depression and anxiety, linking greater R/S struggles with more severe depression or anxiety. However, no significant associations between religiosity and depression and anxiety were noted. By examining the prevalence of R/S struggle among this population and its relationship to depression and anxiety, this study contributes to the expanding research on the impact of religion and spirituality on the psychological well-being of adolescents.

Identifying predictors of cognitive decline within older age helps to understand its mechanisms and to identify those at greater risk. Here we examine how cognitive change from 11 to 70 years is associated with cognitive change within older age (70 to 82 years) in the Lothian Birth Cohort 1936 longitudinal study (N=1091 at recruitment). Using latent growth curve models, we estimate rates of change from age 70 to 82 in general cognitive ability (g) and in three cognitive domains: visuospatial, memory and processing speed. g accounted for 71.3% of interindividual change variance. Greater 11-70 cognitive gain predicted slower decline in g over 12 subsequent years (β = .163, p = .001), independently of cognitive level in childhood and at age 70, and domain-specific change beyond g. These results contribute toward identifying people at higher risk of age-related cognitive decline.

The Aboriginal Family Planning Circle (AFPC) programme is an Aboriginal-led community programme, which works with Aboriginal families in Western Sydney to address their complex needs and reduce the risk of having their children put into out-of-home care (OOHC). This article explores two external evaluations undertaken by WESTIR Limited (WESTIR), a non-Aboriginal research service, on the AFPC programme. The purpose of the first evaluation was to provide an assessment of how effective the AFPC programme had been for participants and identify programme aspects that could be improved or developed. The second evaluation was undertaken to examine whether the AFPC programme had continued to meet its objectives and address some knowledge gaps, particularly the estimated savings and return on investment that the programme created for the OOHC system in New South Wales (NSW). The evaluations used qualitative and quantitative techniques, including interviews, focus groups and a return on investment analysis. This article outlines methods, results and recommendations from both evaluations, along with lessons learned to better inform evaluation practice. This case study shows that culturally responsive evaluations can provide an avenue for Aboriginal communities to advocate for the continued funding of their programmes. It also emphasises the need to adequately resource Aboriginal programme evaluations in the community services sector now and in the future.

Cercospora leaf spot (CLS) is a globally important disease of sugar beet (

The rapid and widespread evolution of fungicide resistance remains a challenge for crop disease management. The demethylation inhibitor (DMI) class of fungicides is a widely used chemistry for managing disease, but there has been a gradual decline in efficacy in many crop pathosystems. Reliance on DMI fungicides has increased resistance in populations of the plant pathogenic fungus Cercospora beticola worldwide. To better understand the genetic and evolutionary basis for DMI resistance in C. beticola, a genome-wide association study (GWAS) and selective sweep analysis were conducted for the first time in this species. We performed whole-genome resequencing of 190 C. beticola isolates infecting sugar beet (Beta vulgaris ssp. vulgaris). All isolates were phenotyped for sensitivity to the DMI tetraconazole. Intragenic markers on chromosomes 1, 4, and 9 were significantly associated with DMI fungicide resistance, including a polyketide synthase gene and the gene encoding the DMI target CbCYP51. Haplotype analysis of CbCYP51 identified a synonymous mutation (E170) and nonsynonymous mutations (L144F, I387M, and Y464S) associated with DMI resistance. Genome-wide scans of selection showed that several of the GWAS mutations for fungicide resistance resided in regions that have recently undergone a selective sweep. Using radial plate growth on selected media as a fitness proxy, we did not find a trade-off associated with DMI fungicide resistance. Taken together, we show that population genomic data from a crop pathogen can allow the identification of mutations conferring fungicide resistance and inform about their origins in the pathogen population.

Cercospora leaf spot is the most important disease of sugar beet worldwide. The disease is caused by the fungus Cercospora beticola and is managed principally by timely application of fungicides including those of the sterol demethylation inhibitor (DMI) class. However, reliance on DMIs has caused an increase in resistance to this class of fungicides in multiple C. beticola populations. To better understand the genetic and evolutionary basis for resistance in C. beticola, a genome-wide association study (GWAS) and selective sweep analysis were conducted for the first time in this fungal plant pathogen. We performed whole genome resequencing of 190 C. beticola isolates predominantly from North Dakota and Minnesota that were phenotyped for sensitivity to tetraconazole, the most widely used DMI fungicide in this region. GWAS identified mutations in genes associated with DMI fungicide resistance including a Regulator of G-protein Signaling (RGS) protein, an ATP-binding cassette (ABC) pleiotropic drug resistance transporter, a dual-specificity tyrosine phosphorylation-regulated kinase (DYRK), and a gene annotated as a hypothetical protein. A SNP upstream of CbCYP51, the gene encoding the target of DMI fungicides, was also identified via GWAS. Haplotype analysis of CbCYP51 identified a synonymous mutation (E170) in high linkage disequilibrium with the upstream SNP, and multiple non-synonymous mutations (L144F, I387M and Y464S) associated with DMI resistance. Additionally, a putative codon bias effect for the L144F substitution was identified that generated different resistance potentials. We also identified a CbCYP51 paralog in C. beticola, CbCYP51-like, with high protein homology to CYP51C found uniquely in Fusarium species but CbCYP51-like does not appear to influence DMI sensitivity. Genome-wide scans of selection showed that several of the GWAS mutations for fungicide resistance resided in regions that have recently undergone a selective sweep. Using radial plate growth on selected media as a fitness proxy, we did not find a trade-off associated with DMI fungicide resistance suggesting that resistance mutations can persist in C. beticola populations. Taken together, we show that population genomic data from a crop pathogen can allow the identification of mutations conferring fungicide resistance and inform about their origins in the pathogen population.

This paper is concerned with articulating the value of bringing commoning and spatial design pedagogy together. Developing a four-day intensive for the 130 first year interior design students to be...

Background: Quality of life (QoL) is an important outcome for people with dementia living in care homes but usually needs to be rated by a proxy. We do not know if relative or paid carer proxy reports differ. We conducted the first systematic review and meta-analysis of data investigating whether and how these proxy reports of QoL differ. Methods: We searched four databases: Medline, Embase, PsychInfo, and CINAHL in October 2015 with the terms: dementia, QoL, proxy, and care home. Included studies either compared proxy QoL ratings or investigated the factors associated with them. We meta-analyzed data comparing staff and family proxy rated QoL. Results: We included 17/105 papers identified. We found no difference between global proxy ratings of QoL (n = 1,290; pooled effect size 0.06 (95% CI = −0.08 to 0.19)). Studies investigating factors associated with ratings (n = 3,537) found family and staff ratings correlated with the resident's physical and mental health. Staff who were more distressed rated resident QoL lower. Relatives rated it lower when the resident had lived in the care home for longer, when they observed more restraint, or contributed more to fees. Conclusions: Relatives and staff proxy QoL ratings share a clear relationship to resident health and overall ratings were similar. Rater-specific factors were, however, also associated with scores. Understanding why different raters consider the QoL of the same person differently is an important consideration when evaluating the meaning of proxy rated QoL. Proxy raters’ backgrounds may affect their rating of QoL.

Health care providers are accustomed to identifying populations for whom cost-related concerns may be a significant barrier, such as the poor, but few empiric data have been collected to substantiate such assumptions, particularly among insured patients.Patients with cancer from academic and community hospitals completed a questionnaire that included closed-ended items concerning demographic variables, optimism, numeracy, and concerns about present and future medical costs. In addition, they answered open-ended questions regarding cost concerns and medical expenses.Nearly all (99%) participants were insured. In response to the closed-ended questions, 30.3% of patients reported concern about paying for their cancer treatment, 22.3% reported that their family had made sacrifices to pay for their care, and 8.3% stated that their insurance adequately covered their current health care costs, and 17.3% reported concerns about coverage for their costs in the future. On open-ended questions, 35.3% reported additional expenses, and 47.5% reported concerns about health care costs. None of the assessed patient characteristics proved to be a robust predictor across all cost-related concerns. There was a strong association between the identification of concerns or expenses on the open-ended questions and concerns on closed-ended questions.Cost concerns are common among patients with cancer who have health insurance. Health care providers may alleviate concerns by discussing cost-related concerns with all patients, not only those of lower socioeconomic status or those without insurance. A closed-ended screening question may help to initiate these conversations. This may identify potential resources, lower distress, and enable patients to make optimal treatment decisions.

Understanding people and school communities is complex. Facilitating helpful and meaningful change—at an individual or school‐wide level—is challenging. As a clinician‐educator and a socially and emotionally informed educator, we describe what we do and do not understand about School ABC. We suggest that at the school and individual levels, understanding needs to be based on a reliable, valid, and comprehensive assessment of school climate, biopsychosocial strengths, weaknesses, needs of the school, and the eighth‐grade girl, respectively. Second, we delineate how our understanding leads to a series of school‐wide climate, instructional, and very specific individual student goals. Third, we outline suggested systemic methods of intervening that have the potential to support the school’s transformation into a safer, more responsible caring environment that promotes positive youth development and learning. We suggest that school climate is a helpful organizing framework that supports healthy indivi...

6021 Background: When making treatment decisions, cancer patients (pts) must make trade-offs between efficacy, toxicity (tox) and cost. However, little is known about how individual characteristics influence these decisions, particularly as many face high out of pocket costs. Methods: We presented cancer pts with hypothetical scenarios that asked them to choose between 2 treatments of varying levels of efficacy, tox and cost. Each scenario included 9 choice pairs. Pts were given 2 of 3 scenarios described in the Table. Tox was also varied. Demographics, cost concerns and numeracy were assessed. Within each scenario, we used latent class methods to distinguish pt groups with discrete preferences. We then used regressions with group membership probabilities as covariates to identify associations. Results: We enrolled 400 pts. Median age was 61 years (range 27-90). 63% were female. 41% were college educated. 51% had an annual income ≥$60K. 25% were enrolled at a community hospital. 98% were insured. Within each of the 3 scenarios, we identified 3 pt classes with preferences for survival or aversion to high cost or toxicity. Across each of the scenarios, 92% of pts in the group that favored survival chose the highest efficacy treatment. >65% of pts in the group with aversion to tox chose the lower tox treatment. Within each of the scenarios, pts in the group with preference for survival were more likely to have an income of >$60K (p

e20543 Background: Cost-sharing is a method to control “over-use” of healthcare services but may have the unintended consequence of reducing utilization of necessary services among vulnerable patients (pts). It is not known if cost influences pts’ choices of cancer treatments. Methods: A survey was administered to a convenience sample of pts on surveillance for localized cancer. Domains included demographic questions as well as clinical scenarios to elicit the maximum co-payment pts would be willing to pay for hypothetical cancer treatments. Scenario A described adjuvant therapy; questions varied reductions in recurrence rates from 5–20%. Scenario B described palliative therapy; questions varied 2-year survival between 19–34%. Scenario C described palliative therapy; questions varied improvement in median life expectancy from 11–20 months. GEE fit multiple logistic regressions examined pts’ characteristics associated with willingness to pay (WTP). Pts chose from 9 co-payment levels (highest: >$7,000/6 months for Scenario A; >$1,000/3 weeks for Scenarios B-C), which were dichotomized (highest 5 vs lowest 4 levels). Results: 60 pts completed the survey. Demographics: Female (78%); < 65 (83%), Caucasian (97%), college degree (58%). 13% reported making financial sacrifices to pay for treatment. Overall, pts showed a greater WTP for more effective treatments (p [Table: see text]

Commoning describes the social and psychological process that individuals and collectives are involved in as they establish and manage space and life shared in common. The values that underpin commoning can be adapted by spatial and urban designers to privilege and encourage more inclusive and shared social, civic and environmental conditions and disrupt existing models and economic forces that currently organise private and public space. Commoning produces spaces and social relations through participation, developing in the protagonists a sense of agency over their lives. Design practitioners with interests in the processes of commoning can engage with those values to interrupt the homogenization of communities and the cauterization of spatial imagination by commercial imperatives. Drawing on design precedents, theorists and activists involved with various aspects of contemporary commoning, this paper proposes how designers can be informed and guided by the interrelated spatial and social modes of productions that are integral to commoning. Through a commitment to commoning, spatial designers can encourage and support commoning and proliferate values capable of transforming the future.