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As part of the US Army Corps of Engineers’ mission to evaluate and move dredged material (DM) to maintain navigation channels, environmental evaluation of the prospective material is required by the Code of Federal Regulations. While existing guidance manuals provide useful guidance to DM regulators, they are over 30 years old and not reflective of the latest science. However, efforts to update procedures and publish the documents individually or as a combined dredging manual have been thus far unsuccessful. These issues, coupled with a lack of consistent reporting and decision documentation, lead to delays arising from challenges addressing project-specific issues not clearly covered within the existing guidance, revisiting previously resolved issues or negotiating disputes between permitting authorities. This technical report provides a path toward modernization of the environmental compliance aspects of DM evaluation guidance in part through software executables guiding the management and decision process and through a structured, evidence-based approach. The value added is an updated approach to DM testing and evaluation decisions.

Since early March 2020, government agencies have utilized a wide variety of non-pharmaceutical interventions to mitigate the spread of COVID-19 and have struggled to determine when it is appropriate to return to in-person activities after an outbreak is detected. At many universities, fundamental issues related to understanding the spread of the disease (e.g. the transmission rate), the ability of administrators to respond quickly enough by closing when there is a sudden rise in cases, and how to make a decision on when to reopen remains a concern. Surveillance testing strategies have been implemented in some places, and those test outcomes have dictated whether to reopen, to simultaneously monitor community spread, and/or to isolate discovered cases. However, the question remains as to when it is safe to reopen and how much testing is required to remain safely open while keeping infection numbers low. Here, we propose an extension of the classic SIR model to investigate reopening strategies for a fixed testing strategy, based on feedback from testing results. Specifically, we close when a predefined proportion of the population becomes infected, and later reopen when that infected proportion decreases below a predefined threshold. A valuable outcome of our approach is that our reopening strategies are robust to variation in almost all model parameters, including transmission rates, which can be extremely difficult to determine as they typically differ between variants, location, vaccination status, etc. Thus, these strategies can be, in theory, translated over to new variants in different regions of the world. Examples of robust feedback strategies for high disease transmission and a fixed testing capacity include (1) a single long lock down followed by a single long in-person period, and (2) multiple shorter lock downs followed by multiple shorter in-person periods. The utility of this approach of having multiple strategies is that administrators of universities, schools, business, etc. can use a strategy that is best adapted for their own functionality.

The climate crisis has detrimental impacts on the mental health and wellbeing of children and young people. Psychological effects include feelings of fear, overwhelm, worry, distress, hopelessness and anger; PTSD; depression; anxiety; phobias; panic disorder; sleep disturbances; attachment disorders; learning difficulties; substance abuse; shock and trauma symptoms; adjustment problems; behavioural problems; and, suicidal thinking. First Nations' children and young people are particularly at risk due to loss of place, identity, culture, land and customs informed by kinship relationships with the Earth; while sustainable land use practices and connection to Country and community can enhance climate resilience. In Western Australia (WA), some young people engage in climate activism - including striking from school - to demand government action to address the causes of climate change, including colonisation and capitalism. Climate activism can promote resilience, particularly when children and young people can emotionally engage in the climate crisis; when mental health is systemically supported; when climate communication is transparent and comprehensive; and, when activism is informed by the knowledges and wisdoms of First Nations peoples and grounded on Country. This article is co-authored by WA young people, Aboriginal and non-Aboriginal academics, activists and practitioners engaged in youth, mental health and climate justice spaces. We argue for structural change to address the causes of the climate crisis, alongside enhanced evidence and approaches to appropriately support the mental health of children and young people. Furthermore, we support the call of Aboriginal peoples to ensure culturally appropriate, place-based responses based in caring for Country.

Over the last decade, studies have highlighted that young people with disproportionately high and multiple needs have clustered in the juvenile justice system. These young people experience higher levels of diagnosable mental health problems and neurodisability than the general population. This chapter provides a developmental approach to understanding the needs of young people in contact with the criminal justice system. It reviews the prevalence of a range of mental health and neurodevelopmental disorders in young offenders and describes the key principles of assessment and intervention approaches. The policy and legal framework have been illustrated by reference to the system in England but will have relevance to readers from further afield.

Service learning is an educational methodology that facilitates transformation of students' knowledge, attitudes and attitudes around holistic care through work with community organizations. To implement academically, defensible service learning requires faculty endorsement, consideration of course credit, an enthusiastic champion able to negotiate agreements with organizations, organizations' identification of their own projects so they are willing to both fund and supervise them, curricular underpinning that imparts the project skills necessary for success, embedding at a time when students' clinical identity is being formed, small packets of curriculum elements delivered "just in time" as students engage with their project, flexible online platform/s, assessment that is organically related to the project, providing cross cultural up-skilling, and focused on the students' responsibility for their own product. The result is a learning experience that is engaging for medical students, links the university to the community, and encourages altruism which is otherwise reported to decline through medical school.

In this paper, the authors theorise on eco-social work, an emerging descriptor for practices located at the intersection of social work and eco-justice. It presents a collaborative auto-ethnographi...

This paper introduces the story of the 1940s debate between the Australian state of Victoria and the north-bordering state of New South Wales, over Australia’s Snowy Mountains Hydro Electric Scheme. It describes the campaign imagery generated by the state of Victoria and the Murray Valley Development League (MVDL) to promote their vision for a Murray Valley TVA. The focus is on Australian documentary film-maker John Heyer and The Valley is Ours (1948). The Valley was created to support the MVDL’s claims that a scheme to benefit their valley would be the best post-war scheme for both New South Wales and Victoria, and for the nation. This paper takes a transnational and cultural approach to investigating this story. This is because Heyer used nationalist US concepts to strengthen Australian national myths ‐ the film’s transnational content was set to a nationalist purpose. This paper describes the environmental imagery ‐ not just images, but sound and text, used by Heyer and the MVDL campaign, to convey a transnational set of ideas. It retrieves a material record from the archives, of what these transnational environmental ideas actually looked and sounded like. And it sheds light on the cultural influences and political forces behind the Murray TVA campaign and the film’s creation.

Objective The National Health Service (NHS) in England makes data on demographics, prescribing, location, and specific conditions in general practice (GP) practices publicly available. The GP Patient Survey captures patients' views of their GP practice. The objective of this study was to determine how patient experience of a GP may relate to the volume of antidepressant prescribing at that practice. Methods We examined how antidepressant prescribing rates relate to specific NHS GP Patient Survey metrics. Postal questionnaires were sent out to 2.2 million adults registered with GP practices in England from January to March 2018. The national survey response rate was 34.1%. Results The average annual antidepressant practice prescribing rate (AAAPPR) was 0.11, with 90% of practices falling between 40% and 160% of this value. Practices with a higher overall experience rating prescribed more antidepressants. Practices more effective in empowering their patients, as assessed by "How confident are you that you can manage any issues arising from your condition (or conditions)," prescribed less antidepressants. The difference between the lowest and highest decile of prescribing for this response was over 10% and potentially modified by changing practice approach. Conclusions There are opportunities to optimize antidepressant prescribing in GP practices. Antidepressants are a key facet of depression treatment. Our findings show that patient empowerment is a key modulator of antidepressant prescribing.

BackgroundInflammatory bowel disease (IBD) is a chronic relapsing-remitting condition affecting 600 000 people in the UK. Traditionally, patients attend outpatient clinics for monitoring regardless of their symptoms or risk of developing complications. This can lead to a mismatch between need and access: patients in remission given elective appointments displace those in need of urgent specialist attention. Novel initiatives implemented in the UK to improve outpatient monitoring have often required a well-maintained patient registry, empowered patients and significant information technology support.Design and strategyIn this large-scale quality improvement project at St Mark’s Hospital, a tertiary centre for IBD, we stratified over 1000 patients attending three non-complex IBD clinics over 12 months according to disease activity and risk profile. The aim was to offer a choice and subsequently transfer 50% of eligible patients to specialist nurse-led telephone clinics and demonstrate non-inferior satisfaction levels to existing outpatient follow-up. We also sought to ensure there was timely access to a newly established rapid access clinic for patients requiring urgent specialist attention.A core project team consisting of healthcare professionals, patients and quality improvement scientists met regularly. The team tested and scaled up interventions using ‘Plan-Do-Study-Act’ cycles within the ‘Model for Improvement’ framework and analysed data continuously using statistical process charts.ResultsOver 12 months, the average number of eligible patients transferred to telephone clinics rose from 17.6% (42/239) using a questionnaire method to 59.3% (73/123) using active discussion in clinic. Patient satisfaction scores remained high and non-inferior to baseline scores in face-to-face clinics. The median waiting time to be seen in the rapid access clinic was 6.5 days.ConclusionThis is the first published study to report on the successful stratification of patients with IBD based on disease activity and risk of complications to create a more responsive, sustainable and patient-centred model for IBD monitoring.

In September 2013, the Department of Education and Skills introduced revised anti-bullying guidelines which made it compulsory for all schools to ensure that their individual anti-bullying policies include a clause on identity-based bullying, specifically referencing transphobic and homophobic bullying. The introduction of these guidelines would appear to represent an anomaly within the context of the Irish primary education system, which is 96% denominational. This paper considers the possibilities of the co-existence of guidelines which aim to counter homophobic and transphobic bullying and a school ethos which views homosexuality and transsexuality as sinful. Employing Scheurich’s policy archaeology methodology, this paper presents some of the discursive practices which were at play in permitting the bullying of lesbian, gay, bisexual, and transgender children to emerge as an educational problem for which the revised anti-bullying guidelines were constructed as the policy solution.

Objective: Extensive research exists on breaking bad news by clinicians. This study examines perspectives of patients and those accompanying them at diagnosis-giving of subsequently sharing news of lung cancer with adult family/friends, and views of healthcare professionals, to inform development of a supportive intervention.Methods: Qualitative interviews with 20 patients, 17 accompanying persons; focus groups and interviews with 27 healthcare professionals from four Thoracic Oncology Units. Intervention development workshops with 24 healthcare professionals and six service users with experience of sharing a cancer diagnosis. Framework thematic analysis.Results: Patients and accompanying persons shared news of lung cancer whilst coming to terms with the diagnosis. They recalled general support from healthcare professionals but not support with sharing bad news. Six elements were identified providing a framework for a potential intervention: 1-people to be told, 2-information to be shared, 3-timing of sharing, 4-responsibility for sharing, 5-methods of telling others and 6-reactions of those told.Conclusion: This study identifies the challenge of sharing bad news and a potential framework to guide delivery of a supportive intervention tailored to individual needs of patients.Practice Implications: The identified framework could extend the portfolio of guidance on communication in cancer and potentially in other life-limiting conditions. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Background Inflammatory Bowel Disease (IBD) requires lifelong monitoring that is mostly offered in hospitals. The demand for outpatient clinic appointments continues to increase in parallel to the increasing prevalence of IBD, resulting in delays in accessing medical care. We developed a patient centred pathway that stratifies care according to clinical needs as part of a quality improvement project. The first step was to engage patients aiming to develop a patients’ information leaflet (PIL) to inform about our initiative and determine their preferred type of follow up depending on their clinical state. Methods We used the National Institute for Health Research Collaboration for Leadership and Applied Healthcare Research for quality improvement methodology namely Plan-Do-Study-Act cycles (PDSA). The first version PIL and questionnaire was tested on patients attending clinic on week 1 (plan). PIL was distributed to patients (do) and feedback collated (study) including PIL readability using FK reading ease score. The PIL was adjusted (act) and the cycle repeated until no more changes were necessary. A structured questionnaire was developed to assess patients‘ preferred type of follow up and was distributed to sequential patients attending non-complex IBD clinics. Patients opting for out of hospital follow up, would have their care transferred to the telephone clinic if they were in remission according to the physician’s global assessment. Results The FK Reading ease score of the first PIL was 53.5. After 1 PDSA cycle, it increased to 64.5. Sequential reviews of the document up to 15th version resulted in a final score of 65.8. (Figure) 12 patients reviewed the document. All agreed that the information provided was readable, adequate and useful. At 5 months, 107 patients completed the questionnaire. The mean (SD) age was 52.1 (16.1) years. 62 (58%) preferred hospital monitoring for remission compared with 45 (42%) who preferred outside hospital care (telephone clinic, community services, eHealth). For active disease 45% of patients would still prefer to be given advice over the phone. Overall, 21 patients in remission were identified as appropriate to have their care transferred in our telephone clinic in the first phase of our improvement plan. Conclusions In the first steps of our quality improvement plan, we show the value of patient involvement on designing PIL. We show that out of hospital follow up is a viable option for a select group of patients. The next step is to assess the impact of out of hospital monitoring on quality of care.

This study explored bereaved mothers’ responses to the death of a child from cancer, with a focus on identifying adaptive and complicated grief reactions. To understand the unique meaning of their loss, in-depth interviews were conducted with 13 mothers at two time points. Interpretative phenomenological analysis—guided by meaning-making theories of loss—revealed five master categories: the perceptions of the child’s life with cancer and death from the disease, changed self-identity, coping style, developing an ongoing relationship to the deceased child, and the postdeath social environment. Each of these master categories and associated subthemes provided insights into the characteristics of the bereaved mothers’ adaptive and complicated grief responses to their loss. Given all the mothers evidenced multiple forms or types of these responses over time, they could not be categorized as adaptive or complicated grievers. However, the varying proportions of each of these responses highlighted differences in overall bereavement adaptation.

This study investigated the meaning-making phenomena underlying the responses of 13 bereaved mothers to the death of a child from cancer. Using a mixed-methods research design incorporating constructivist data collection methods, we found specific characteristics, coping processes, and factors to distinguish adaptive as opposed to complicated grief responses to this type of loss. However, the findings did not distinguish the bereaved mothers themselves as “adaptive” or “complicated grievers,” as they all evidenced both types of responses to their loss within or across different datasets. Despite this finding, the mothers’ results varied in terms of the proportions of adaptive as compared to complicated grief responses to their loss, which in turn were related to features of their self-construing, change or reinforcement of their world assumptions, ongoing relationship to their child and others in their social world, and management of loss- and restoration-oriented coping. Results suggest the utility of co...

This chapter describes how the concept of “Australia’s Tennessee Valley Authority” became central to a fourth transnational narrative emerging in 1940s Australia during fierce debate between New South Wales and Victoria over a post-war, nation-building water conservation scheme for the waters of the iconic Snowy River. Campaigners, writers, film-makers—G.V. Lawrence, Mervyn Weston, Murrumbidgee Valley Water Users’ Association, Ken Hall, Murray Valley Development League, John Heyer—drew “dust bowl” imagery into contrast with imagery evoking US Bureau of Reclamation and TVA dams and planning achievements. However, neither Australian dust bowl nor Australian TVA narratives endured as national myths. They contributed to national debate that reinterpreted Australia’s existing Snowy River mythology and changed the Australian landscape forever when the Snowy Mountains Hydro-electric Scheme construction began in 1949.

This introduction describes the idea of a soil menace to civilization, and the concept of a “dust bowl.” It describes the major print, film, and broadcast media event generated by the ecological catastrophe of the Dust Bowl as circulating around the world and the Dust Bowl as a defining US national mythology. This section explains why a cultural and transnational research approach was needed to understand how, when, and why the idea of a dust bowl found currency in World War Two Australia. It introduces those who created a hitherto unknown and vast collection of Australian dust bowl imagery, where Australian narratives of the Snowy River, the Australian and New Zealand Army Corps (Anzacs), sheep, the Mallee, and deserts converged with US national narratives describing dams, the Tennessee Valley Authority (TVA), and the Dust Bowl.

This chapter introduces Australians such as William McKell, Sam Clayton, John (Jack) Bailey, Arthur G. Lowndes, Jock Pick, Mary Gilmore, Ken Hall, and broadcast journalist Bruce Miller to describe how ideas about enemies and traitors converged with the ideas of Bennett, the USDA, and the US SCS in Australia’s World War Two “dust bowl” narratives. The focus is on the fall of Singapore, war-time sentiment, drought, and soil erosion in New South Wales. The US imagery targeting the farmer centered on over-plowing wheat farmers, not overstocking sheep farmers (graziers). However, Australians employed this New Deal rhetoric in films, political speeches, broadcast radio, and literature to strengthen re-interpretations of Australian national mythologies about sheep, and the Anzacs in warnings of a US-style “dust bowl” at home.

This conclusion describes how each of the chapters of this book have tracked the circulation of the “dust bowl” idea in World War Two and early post-war Australian print, film, broadcast, and rhetorical narratives. It describes how together, these chapters examine the political influences behind the proliferation of a vast collection of highly dramatic transnational “dust bowl” imagery. To help, as he writes from the dust-laden battlefields of the Middle East not long after the fall of Singapore, in 1942, Australian pastoralist and soil conservationist Jock Pick is reintroduced. The conclusion summarizes the impact and the meaning of the US national narratives of the Dust Bowl, the TVA, and the dams of the US Bureau of Reclamation, to World War Two and early post-war Australia.

This chapter describes how New Deal era storytellers constructed Dust Bowl narratives to raise an urgent national alarm and promote the need for soil conservation and “conservation mindedness” to address serious wind erosion (sand drift and dust storms) on the US Great Plains. It describes how, bolstered by a New Deal social reform agenda, a broad set of ideas can be seen to have converged in Dust Bowl narratives. The myth of American national exceptionalism and ideas of the frontier and the yeoman, a Great American Desert, “soil infinity,” and soil-fallen civilizations, ideas surrounding the developing documentary mode, social realism, ingrained ideas about women, theories of ecology, soil, deserts, and technological salvation converged to varying degrees and can be traced in US Dust Bowl narratives.

This chapter describes the role of American storytellers in bringing a broad set of ideas to life in three US Dust Bowl narratives that endure as part of the US national narrative. Those storytellers include the US Soil Conservation Service (SCS), Hugh Bennett, Russell Lord, Alexandre Hogue, the Farm Security Administration, Roy Stryker, Arthur Rothstein, Dorothea Lange, Jack Glenn, Archibald Macleish, Stuart Chase, Paul Sears, the Resettlement Administration, and Pare Lorentz. Strengthened by developments such as the photo-essay and documentary film, these Americans constructed three compelling narratives, centered on ideas about farmers’ attitudes, soil, and human extinction, and thirdly, women, natural disaster, and civilization. In addition, central to this entire set of Dust Bowl imagery, was the myth of once-mighty civilizations fallen to soil neglect.

Chapter 6 explains how journalists responded to Australian “dust bowl” narratives of human culpability and impending doom. It shows how writers constructed both negative and positive imagery of wind erosion’s impacts upon women, and how in turn, these struggled for dominance in popular narratives. The chapter introduces Hazel Hogan who lived in the Mallee wheatlands of Victoria. Her widely published writing reflects tensions that existed within narratives at the time regarding soil erosion as either natural disaster or a human-made disaster, and the place of women as enduring figures, as victims of soil erosion, or as both. The chapter investigates how storytellers combined ingrained ideas about women, with actual observations of environmental conditions, and the impact of this imagery on attempts to promote soil conservation.

Beginning with The Grapes of Wrath, this chapter revisits iconic US Dust Bowl imagery describing human erosion/soil erosion leading to declining civilizations, “man-made deserts” then human extinction. It describes Dust Bowl imagery as constructed by war-time Australians. Among them, Geoffrey Thompson, Arthur Calwell, Noel Adams, Fred Alexander, Ken Hall, Elyne Mitchell, and Gerard Blackburn drew on US experiences, knowledge and arguments, to try and construct a national “dust bowl” narrative for Australia, and a national soil service inspired by US warnings and conservation achievements. Repeated references to the US Dust Bowl and Dust Bowl refugees converged in this imagery, with Australian ideas about “creeping deserts,” “the dead heart,” federalism, and state and rural politics. But state politics (Victoria’s Premier Albert Dunstan) frustrated this national vision.

A child's death is regarded as among the most traumatic, incomprehensible and devastating of losses, with the potential to precipitate a crisis of meaning for bereaved parents. While complications in grieving are a significant possibility, bereaved parents can also respond in very constructive and adaptive ways to the death of a child. Creative and ethically sensitive assessment methods are needed to capture the diversity and complexity of parental grief responses. This article uses a case example approach to explain the biographical grid method (BGM), a constructivist-narrative model for assessment, and its use in the exploration of parental grief responses to the death of a child.