Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia

Acknowledging that the NDIS alone will not be able to solve the issues faced by young people in nursing homes, this review makes 12 recommendations including establishing a joint taskforce to ensure the recommendations are put in place. LIST OF RECOMMENDATIONS Recommendations to the Australian Government Recommendation 1 6.7 The committee recommends that the Australian Government compile a database of all young people under the age of 65 years living in residential aged care facilities using the data held by the Aged Care Assessment Team (ACAT) program. This list should be provided in a regularly updated form to the National Disability Insurance Agency (NDIA) and to state and territory governments. This data should include the following information: name; age and age of entry to aged care; diagnosis; length of time spent in the aged care system; and the factors that need to be addressed for the person to move out of the aged care facility. Recommendation 2 6.8 The committee recommends that the Australian Bureau of Statistics (ABS) conduct a Longitudinal Survey of Disability, Ageing and Carers in addition to its triennial survey of Disability, Ageing and Carers. Recommendation 3 6.10 The committee recommends that the Australian Government develop and implement a comprehensive assessment and placement tool or residential assessment instrument to assess the care and accommodation needs for all young people living in or at risk of entering residential care. Recommendation 4 6.12 The committee recommends that supplementary assessment guidelines and tools are developed for the ACAT program to ensure that all young people being considered for an aged care placement are properly assessed. As part of this process, the committee recommends that: all young people placed in aged care are intensively case managed; and all ACAT placements for those aged under 65 are reviewed on an annual basis. Recommendation 5 6.13 The committee recommends that the accreditation standards for residential aged care are amended to include standards relating to the clinical outcomes and lifestyle needs of young people. In order to assist with meeting these new accreditation standards, the committee recommends that the Australian Government: • provide a supplementary payment to residential aged care facilities to ensure that these accreditation standards can be met; and • invest in disability specific training for all staff involved in the care of young people living in aged care. This training should focus on building improved awareness of the needs of young people and those living with disability in order to provide better support. It should also lead to improved connectivity between the aged care sector and other service sectors including allied health and disability services. Recommendation 6 6.17 The committee recommends that the Department of Social Services\u27 current discussion paper on disability housing consider capital funding options for construction of specialised disability accommodation. 6.18 The committee recommends that the discussion paper is released as a matter of urgency. 6.19 The committee recommends that the Australian Government establish a supported disability accommodation fund similar to the Supported Accommodation Innovation Fund. Recommendations to the Joint Standing Committee on the National Disability Insurance Scheme Recommendation 7 6.21 The committee recommends that the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) conduct an inquiry into the issue of disability housing after the release of the discussion paper on disability housing. Recommendations to the Council of Australian Governments (COAG) Recommendation 8 6.23 The committee recommends that the COAG develop and implement a national rehabilitation strategy including a framework for the delivery of slow stream rehabilitation in all jurisdictions. Recommendation 9 6.28 The committee recommends that the NDIS, in all NDIS trial sites, and the relevant state or territory government in all other areas: • assign an advocate to all young people living in residential care to provide information to a young person and their families about their options. If appropriate, the advocate can act on behalf of the young person; • assign an advocate to all young people at risk of entering residential care to provide information to a young person and their families about their options. If appropriate, the advocate can act on behalf of the young person. The advocate should be made available as early as possible after diagnosis of an illness or disability and be assigned before any placement commences; • extend the National Younger Onset Dementia Key Worker Program (YODKWP) to all young people identified as being at risk of placement in residential care to provide collaborative case management. The key worker should be assigned before any placement commences; and • these programs should be proactively extended to young people living in residential care facilities under the age of 65 years by June 2017. Consideration of the mental health status of young people should be prioritised with appropriate support provided where necessary. Recommendation 10 6.30 The committee recommends that the NDIS, in all NDIS trial sites, should consider how it supports those with Foetal Alcohol Spectrum Disorder (FASD). 6.31 The committee also recommends that the NDIS, in all NDIS trial sites, and the relevant state or territory government in all other areas work closely with community health services to provide the following for those with FASD agreement on a standardised diagnostic tool; and provision of early intervention services and other health services such as speech pathology, physiotherapy and occupational therapy. Recommendation 11 6.32 The committee recommends that the COAG establish a joint taskforce for young people living in residential care. This taskforce will: • facilitate the development and implementation of integrated service pathways involving a range of portfolios at a state and federal level including housing, health, aged care, disability, and transport; and • facilitate the collation and development of information packs outlining support, transition and placement options for young people. These packs should be made available to young people, their families, health practitioners and other relevant professionals in hospitals and aged care facilities. This process should collate all information and tools developed by the states during the Younger People with Disability in Residential Aged Care (YPIRAC) program and lead to the development of a standardised national information pack and make available to all state and territory governments for deployment. 6.33 The joint taskforce will also be responsible for oversight of the following for young people living in a Residential Aged Care Facility (RACF):  access to appropriate prescribed specialist services including speech pathology, physiotherapy, occupational therapy and other allied health services; the national rehabilitation strategy; the provision of advocates; the expanded key worker program; access to fully funded equipment as part of all state and territory Aids and Equipment schemes; • a cross sector approach is adopted to explore options for the provision of short term respite services; and • that all young people who indicate that they do not wish to live in residential care are transitioned into appropriate alternate accommodation by June 2018. Recommendation 12 6.34 The committee recommends that the joint taskforce issues a half yearly report on the progress of Recommendation 11 to the COAG

Executive functions and the ω-6-to-ω-3 fatty acid ratio: a cross-sectional study

BACKGROUND: The ω-6 (n-6) to ω-3 (n-3) fatty acid (FA) ratio (n-6:n-3 ratio) was previously shown to be a predictor of executive function performance in children aged 7-9 y. OBJECTIVE: We aimed to replicate and extend previous findings by exploring the role of the n-6:n-3 ratio in executive function performance. We hypothesized that there would be an interaction between n-3 and the n-6:n-3 ratio, with children with low n-3 performing best with a low ratio, and those with high n-3 performing best with a high ratio. DESIGN: Children were recruited on the basis of their consumption of n-6 and n-3 FAs. The executive function performance of 78 children aged 7-12 y was tested with the use of the Cambridge Neuropsychological Test Automated Battery and a planning task. Participants provided blood for plasma FA quantification, and the caregiver completed demographic and activity questionnaires. We investigated the role of the n-6:n-3 ratio in the entire sample and separately in children aged 7-9 y (n = 41) and 10-12 y (n = 37). RESULTS: Dietary and plasma n-6:n-3 ratio and n-3 predicted performance on working memory and planning tasks in children 7-12 y old. The interaction between dietary n-6:n-3 ratio and n-3 predicted the number of moves required to solve the most difficult planning problems in children aged 7-9 y and those aged 10-12 y, similar to results from the previous study. There was also an interaction between the plasma n-6:n-3 ratio and n-3 predicting time spent thinking through the difficult 5-move planning problems. The n-6:n-3 ratio and n-3 predicted executive function performance differently in children aged 7-9 y and in those aged 10-12 y, indicating different optimal FA balances across development. CONCLUSIONS: The n-6:n-3 ratio is an important consideration in the role of FAs in cognitive function, and the optimal balance of n-6 and n-3 FAs depends on the cognitive function and developmental period studied. This trial was registered at clinicaltrials.gov as NCT02199808

Characterisation of bacteriophage-encoded inhibitors of the bacterial RNA polymerase

RNA polymerase (RNAP) is an essential enzyme which catalyses transcription; a highly regulated process. Bacteriophage are viruses which infect bacteria and as a result have evolved a diverse range of mechanisms to regulate the bacterial RNAP to serve the needs of the virus. T7 Gp2 and Xp10 P7 are two bacteriophage-encoded transcription factors that inhibit the activity of the bacterial RNAP. The aim of this study is to investigate the molecular mechanisms of action of Gp2 and P7. Fluorescence anisotropy experiments proved Gp2 to bind to RNAP, independently of the σ- factor, with a 1:1 stoichiometry and a low nanomolar affinity. In vitro transcription assays demonstrated that a negatively charged strip in Gp2 is the major determinant for its inhibitory activity. Furthermore, it was shown that efficient Gp2-mediated inhibition of RNAP also depends upon the highly negatively charged and flexible σ70 specific domain, R1.1. Gp2 and R1.1 both bind in the downstream-DNA binding channel and exert long-range antagonistic effects on RNAP-promoter DNA interactions around the transcription start site. A systematic mutagenesis screen was used to identify residues in P7 necessary for binding to the RNAP; results were interpreted in the context of a newly resolved NMR structure of P7. Electrophoretic mobility shift assays revealed that P7 ‘traps’ a RNAP-promoter DNA complex en route to the transcriptionally-competent complex. Preliminary results from a fluorescence based RNAP-DNA interaction assay suggest that P7 may target RNAP interactions with the -35 promoter element and the ‘discriminator region’. This study has contributed to our understanding of how non-bacterial transcriptional factors can influence bacterial gene expression by modulating RNAP activity. This study has also uncovered vulnerabilities in RNAP, which have the potential to be exploited therapeutically. To this end, these structure-function studies of Gp2 and P7 have provided the basis for the rational design of novel anti-bacterial compounds

Omega-6/omega-3 fatty acid intake of children and older adults in the U.S.: dietary intake in comparison to current dietary recommendations and the Healthy Eating Index

Abstract Background Omega-6 and omega-3 fatty acids (FAs) and their ratio have been shown to affect cognitive function in children and older adults. With these analyses, we aimed to describe omega-6 and omega-3 FA intake among children and older adults in light of FA intake recommendations and with consideration of overall diet. Methods Data were merged from two cross-sectional studies with 219 children 7 to 12 years old and one longitudinal study with 133 adults 65 to 79 years old. Demographic data, anthropometric data, and Healthy Eating Index scores were used to study relations among the omega-6 to omega-3 FA ratio and age, education, body mass index, and diet quality. FA intake, demographic, and anthropometric data were examined using partial correlations, t-tests, and analysis of variance. Results Most children and adults consumed at least the recommended amount of alpha-linolenic acid (LNA; omega-3) for their age and gender without consuming high amounts of linoleic acid (LA; omega-6), but did not consume sufficient eicosapentaenoic acid (EPA; omega-) and docosahexaenoic acid (DHA; omega-3). The average omega-6 to omega-3 ratios in both groups were lower than previously reported. Eating lower ratios was associated with healthier diets and consuming adequate amounts of several other nutrients. No demographic or anthropometric variables were related to FA intake in children. Adults with a college degree had significantly lower ratios than those without a college degree. Conclusions American children and older adults are able to consume more balanced omega-6 to omega-3 ratios than has been indicated by commodity data. However, very few American children met even the lowest recommendations for EPA and DHA intake. Research is needed to clarify recommendations for the optimal ratio across development, which may aid in increasing EPA and DHA intake and improving health outcomes in the United States. Trial registration ClinicalTrials.gov NCT02199808 13 July 2014, NCT01823419 (retrospectively registered) 20 March 2013, and NCT01515098 18 January 2012

Reverse genetics in Candida albicans predicts ARF cycling is essential for drug resistance and virulence

Peer reviewedPublisher PD

Driving students towards their best- an integrated approach to science reports

Background The ability to accurately and logically write up experimental findings in scientific report form is a skill that all tertiary science students need to master. However, many students strongly dislike report writing and resist engaging with supplementary help resources. Consequently, many students often aim for ‘satisfactory’ rather than ‘excellent’ in such written assignments – a position that is usually in directly opposition to that of their instructors. Aims Here we report on an integrated approach that aimed to: (i) better engage Diploma level tertiary science students in the scientific report writing process, and (ii) encourage students to write reports of a high (rather than a satisfactory) standard. Design and methods Short written activities were embedded before, during and after a practical laboratory exercise that later formed the basis of a longer, more formal scientific report. Students were required to conduct preliminary research prior to attending a practical laboratory class at James Cook University, Queensland. Students collected experimental data in a laboratory, and reported their methods, discussions and conclusions in short answer form. Students received formative feedback on their laboratory work from peers and lecturers and the revised work was then directly incorporated into a formal report framework. The students then expanded on this work and submitted it as a formal, 1500 word scientific report, worth 25% of their overall grade. To encourage students to aim for a high level of work, a minimum grade of Distinction (75%) was necessary in order for them to receive a grade for the assignment. Students who received less than 75% were not given a grade but were permitted to resubmit their reports on the proviso that they: (i) attended a 15-minute consultation to discuss their report submission, and (ii) submitted a written paragraph outlining how they had responded to feedback on their original report. Results The quality of work submitted was greatly improved on previous semesters where students were required to submit a draft for grading and feedback prior to submitting their final scientific report. Student engagement with online help resources was also much higher. Whilst marking time was substantially increased for the first report submission in comparison with drafts marked in previous semesters, marking time for the final report was greatly reduced. Conclusions Setting a high initial grading standard for students, withholding less than excellent ‘draft’ grades and integrating a stepwise writing approach to science report writing resulted in significantly higher student grades and resource interaction than previous, more traditional approaches

Structures of H5N1 influenza polymerase with ANP32B reveal mechanisms of genome replication and host adaptation

Avian influenza A viruses (IAVs) pose a public health threat, as they are capable of triggering pandemics by crossing species barriers. Replication of avian IAVs in mammalian cells is hindered by species-specific variation in acidic nuclear phosphoprotein 32 (ANP32) proteins, which are essential for viral RNA genome replication. Adaptive mutations enable the IAV RNA polymerase (FluPolA) to surmount this barrier. Here, we present cryo-electron microscopy structures of monomeric and dimeric avian H5N1 FluPolA with human ANP32B. ANP32B interacts with the PA subunit of FluPolA in the monomeric form, at the site used for its docking onto the C-terminal domain of host RNA polymerase II during viral transcription. ANP32B acts as a chaperone, guiding FluPolA towards a ribonucleoprotein-associated FluPolA to form an asymmetric dimer—the replication platform for the viral genome. These findings offer insights into the molecular mechanisms governing IAV genome replication, while enhancing our understanding of the molecular processes underpinning mammalian adaptations in avian-origin FluPolA