Providing Family Centered Care Within Pediatric Integrated Care Settings

Parent engagement remains critical to pediatric care. Both pediatric medical and mental health care remains dependent upon parent/guardian engagement to support successful outcomes for children and adolescents. Efforts to enhance Family Centered Care (FCC) has been spotlighted within pediatric care since the 1950s and the inclusion of counselors within integrated behavior health (IBH) teams ushers a need for an evolved understanding of the implementation of FCC, including parent/guardian engagement across professional roles. Using an explanatory mixed-method design, I examined team implementation of Family Centered Care (FCC) among different provider types (e.g., physicians, nurses, licensed mental health providers, social workers, technicians) in a pediatric care setting. Results identified shared valuation of FCC and noted differences in delivery by professionals’ role type and care setting. Implications offer guidance for healthcare leadership, pediatric professionals, and counselor education programs to recognize strengths of FCC practices within multidisciplinary teams and invest in both program and counselor development within IBH settings

Economic and physical determinants of the global distributions of crop pests and pathogens.

© 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.Crop pests and pathogens pose a significant and growing threat to food security, but their geographical distributions are poorly understood. We present a global analysis of pest and pathogen distributions, to determine the roles of socioeconomic and biophysical factors in determining pest diversity, controlling for variation in observational capacity among countries. Known distributions of 1901 pests and pathogens were obtained from CABI. Linear models were used to partition the variation in pest species per country amongst predictors. Reported pest numbers increased with per capita gross domestic product (GDP), research expenditure and research capacity, and the influence of economics was greater in micro-organisms than in arthropods. Total crop production and crop diversity were the strongest physical predictors of pest numbers per country, but trade and tourism were insignificant once other factors were controlled. Islands reported more pests than mainland countries, but no latitudinal gradient in species richness was evident. Country wealth is likely to be a strong indicator of observational capacity, not just trade flow, as has been interpreted in invasive species studies. If every country had US levels of per capita GDP, then 205 ± 9 additional pests per country would be reported, suggesting that enhanced investment in pest observations will reveal the hidden threat of crop pests and pathogens.BBSR

Economic and physical determinants of the global distributions of crop pests and pathogens

Crop pests and pathogens pose a significant and growing threat to food security, but their geographical distributions are poorly understood. We present a global analysis of pest and pathogen distributions, to determine the roles of socioeconomic and biophysical factors in determining pest diversity, controlling for variation in observational capacity among countries. Known distributions of 1901 pests and pathogens were obtained from CABI. Linear models were used to partition the variation in pest species per country amongst predictors. Reported pest numbers increased with per capita gross domestic product (GDP), research expenditure and research capacity, and the influence of economics was greater in micro-organisms than in arthropods. Total crop production and crop diversity were the strongest physical predictors of pest numbers per country, but trade and tourism were insignificant once other factors were controlled. Islands reported more pests than mainland countries, but no latitudinal gradient in species richness was evident. Country wealth is likely to be a strong indicator of observational capacity, not just trade flow, as has been interpreted in invasive species studies. If every country had US levels of per capita GDP, then 205 +/- 9 additional pests per country would be reported, suggesting that enhanced investment in pest observations will reveal the hidden threat of crop pests and pathogens

Genetic steps to organ laterality in zebrafish.

All internal organs are asymmetric along the left-right axis. Here we report a genetic screen to discover mutations which perturb organ laterality. Our particular focus is upon whether, and how, organs are linked to each other as they achieve their laterally asymmetric positions. We generated mutations by ENU mutagenesis and examined F3 progeny using a cocktail of probes that reveal early primordia of heart, gut, liver and pancreas. From the 750 genomes examined, we isolated seven recessive mutations which affect the earliest left-right positioning of one or all of the organs. None of these mutations caused discernable defects elsewhere in the embryo at the stages examined. This is in contrast to those mutations we reported previously (Chen et al., 1997) which, along with left-right abnormalities, cause marked perturbation in gastrulation, body form or midline structures. We find that the mutations can be classified on the basis of whether they perturb relationships among organ laterality. In Class 1 mutations, none of the organs manifest any left-right asymmetry. The heart does not jog to the left and normally leftpredominant BMP4 in the early heart tube remains symmetric. The gut tends to remain midline. There frequently is a remarkable bilateral duplication of liver and pancreas. Embryos with Class 2 mutations have organotypic asymmetry but, in any given embryo, organ positions can be normal, reversed or randomized. Class 3 reveals a hitherto unsuspected gene that selectively affects laterality of heart. We find that visceral organ positions are predicted by the direction of the preceding cardiac jog. We interpret this as suggesting that normally there is linkage between cardiac and visceral organ laterality. Class 1 mutations, we suggest, effectively remove the global laterality signals, with the consequence that organ positions are effectively symmetrical. Embryos with Class 2 mutations do manifest linkage among organs, but it may be reversed, suggesting that the global signals may be present but incorrectly orientated in some of the embryos. That laterality decisions of organs may be independently perturbed, as in the Class 3 mutation, indicates that there are distinctive pathways for reception and organotypic interpretation of the global signals

Taxonomic revision of the banana Fusarium wilt TR4 pathogen is premature

This is the final version. Available on open access from the American Phytopathological Society via the DOI in this recordTaxonomic revisions for pathogens of crops should be based on robust underpinning evidence. Recently, a substantial revision was proposed for the taxonomy of the causative agent of Fusarium wilt on banana. We re-analysed the data on which this revision was based and discovered that the data do not robustly support the proposals. Several apparent discrepancies and errors in the published phylogenies cast further doubt on the conclusions drawn from them. Though we do not assert that the authors' conclusions are incorrect, we posit that the taxonomic changes are premature, given the data currently in the public domain.Waitrose Agronomy Group/PrimafruitAyudar FoundationUniversity of Exete

Using climate information to support crop breeding decisions and adaptation in agriculture

Population growth in the next few decades will increase the need for food production, while the yields of major food crops could be impacted by the changing climate and changing threats from pests and pathogens. Crop breeding, both through conventional techniques, and GM assisted breeding could help meet these challenges, if adequately supported by appropriate information on the future climate. We highlight some of the major challenges for crop breeders and growers in the coming decades, and describe the main characteristics of crop breeding techniques and other adaptation options for agriculture. We review recent uses of climate information to support crop breeding decisions and make recommendations for how this might be improved. We conclude that there is significant potential for breeders to work more closely with climate scientists and crop modellers in order to address the challenges of climate change. It is not yet clear how climate information can best be used. Fruitful areas of investigation include: provision of climate information to identify key target breeding traits and develop improved success criteria (e.g. for heat/drought stress); identification of those conditions under which multiple stress factors (for example, heat stress, mid-season drought stress, flowering drought stress, terminal drought stress) are important in breeding programmes; use of climate information to inform selection of trial sites; identification of the range of environments and locations under which crop trials should be performed (likely to be a wider range of environments than done at present); identification of appropriate duration of trials (likely to be longer than current trials, due to the importance of capturing extreme events); and definition of appropriate methods for incorporating climate information into crop breeding programmes, depending on the specific needs of the breeding programme and the strengths and weaknesses of available approaches. Better knowledge is needed on climate-related thresholds important to crop breeders, for example on the frequency and severity of extreme climate events relevant to the product profile, or to help provide tailored climate analyses (particularly for extreme events). The uncertainties inherent in climate and impact projections provide a particular challenge for translating climate science into actionable outcomes for agriculture. Further work is needed to explore relevant social and economic assumptions such as the level and distribution of real incomes, changing consumption patterns, health impacts, impacts on markets and trade, and the impact of legislation relating to conservation, the environment and climate change

Relationships between tree growth and weather extremes: spatial and interspecific comparisons in a temperate broadleaf forest

Three years of monthly growth increment data identified large interannual differences in growth rate across six contrasting species in a broadleaved, temperate forest with minimum management intervention (Wytham Woods, UK). Growth rates varied by species and canopy position, and were higher in canopy species. Growth rate in 2010 was up to 40% lower than in 2011 and 2012. This can best be explained as an effect of low temperature, which delayed the start of spring and the growing season. This had a greater impact on the growth of sub-canopy trees than that of canopy species. In temperate systems, late spring and summer is an important component of the whole growing season carbon balance because of long day length. In 2010 there were also periods of lower-than-average rainfall, which may additionally have constrained growth during the growing season. Fluctuations and seasonal changes in both temperature and rainfall are projected to continue, so we may expect to see increasing differences in growth and growth rates. A small effect of location relative to the nearest edge was also detected, with higher growth rates only found >50. m from the forest edge. The findings have implications for forest structure and productivity under climate change, and may thus inform current and future forest management

Miniaturization optimized weapon killing power during the social stress of late pre-contact North America (AD 600-1600)

Before Europeans arrived to Eastern North America, prehistoric, indigenous peoples experienced a number of changes that culminated in the development of sedentary, maize agricultural lifeways of varying complexity. Inherent to these lifeways were several triggers of social stress including population nucleation and increase, intergroup conflict (warfare), and increased territoriality. Here, we examine whether this period of social stress co-varied with deadlier weaponry, specifically, the design of the most commonly found prehistoric archery component in late pre-contact North America: triangular stone arrow tips (TSAT). The examination of modern metal or carbon projectiles, arrows, and arrowheads has demonstrated that smaller arrow tips penetrate deeper into a target than do larger ones. We first experimentally confirm that this relationship applies to arrow tips made from stone hafted onto shafts made from wood. We then statistically assess a large sample (n = 742) of late pre-contact TSAT and show that these specimens are extraordinarily small. Thus, by miniaturizing their arrow tips, prehistoric people in Eastern North America optimized their projectile weaponry for maximum penetration and killing power in warfare and hunting. Finally, we verify that these functional advantages were selected across environmental and cultural boundaries. Thus, while we cannot and should not rule out stochastic, production economizing, or non-adaptive cultural processes as an explanation for TSAT, overall our results are consistent with the hypothesis that broad, socially stressful demographic changes in late pre-contact Eastern North America resulted in the miniaturization–and augmented lethality–of stone tools across the region

Systematic evaluation of patient-reported outcome (PRO) protocol content and reporting in UK cancer clinical trials: the EPiC study protocol.

Emerging evidence suggests that patient-reported outcome (PRO)-specific information may be omitted in trial protocols and that PRO results are poorly reported, limiting the use of PRO data to inform cancer care. This study aims to evaluate the standards of PRO-specific content in UK cancer trial protocols and their arising publications and to highlight examples of best-practice PRO protocol content and reporting where they occur. The objective of this study is to determine if these early findings are generalisable to UK cancer trials, and if so, how best we can bring about future improvements in clinical trials methodology to enhance the way PROs are assessed, managed and reported.Trials in which the primary end point is based on a PRO will have more complete PRO protocol and publication components than trials in which PROs are secondary end points.Completed National Institute for Health Research (NIHR) Portfolio Cancer clinical trials (all cancer specialities/age-groups) will be included if they contain a primary/secondary PRO end point. The NIHR portfolio includes cancer trials, supported by a range of funders, adjudged as high-quality clinical research studies. The sample will be drawn from studies completed between 31 December 2000 and 1 March 2014 (n=1141) to allow sufficient time for completion of the final trial report and publication. Two reviewers will then review the protocols and arising publications of included trials to: (1) determine the completeness of their PRO-specific protocol content; (2) determine the proportion and completeness of PRO reporting in UK Cancer trials and (3) model factors associated with PRO protocol and reporting completeness and with PRO reporting proportion.The study was approved by the ethics committee at University of Birmingham (ERN_15-0311). Trial findings will be disseminated via presentations at local, national and international conferences, peer-reviewed journals and social media including the CPROR twitter account and UOB departmental website (http://www.birmingham.ac.uk/cpro0r)