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Herbicide resistance has been studied extensively in agronomic crops across North America but is rarely examined in vegetables. It is widely assumed that the limited number of registered herbicides combined with the adoption of diverse weed management strategies in most vegetable crops effectively inhibits the development of resistance. It is difficult to determine whether resistance is truly less common in vegetable crops or whether the lack of reported cases is due to the lack of resources focused on detection. This review highlights incidences of resistance that are thought to have arisen within vegetable crops. It also includes situations in which herbicide-resistant weeds were likely selected for within agronomic crops but became a problem when vegetables were grown in sequence or in adjacent fields. Occurrence of herbicide resistance can have severe consequences for vegetable growers, and resistance management plans should be adopted to limit selection pressure. This review also highlights resistance management techniques that should slow the development and spread of herbicide resistance in vegetable crops.
Minority and older adult patients remain underrepresented in cancer clinical trials (CCTs). The current study sought to examine sociodemographic inequities in CCT interest, eligibility, enrollment, decline motivation, and attrition across two psychosocial CCTs for gynecologic, gastrointestinal, and thoracic cancers.
Patients were approached for recruitment to one of two interventions: (1) a randomized control trial (RCT) examining effects of a cognitive-behavioral intervention targeting sleep, pain, mood, cytokines, and cortisol following surgery, or (2) a yoga intervention to determine its feasibility, acceptability, and effects on mitigating distress. Prospective RCT participants were queried about interest and screened for eligibility. All eligible patients across trials were offered enrollment. Patients who declined yoga intervention enrollment provided reasons for decline. Sociodemographic predictors of enrollment decisions and attrition were explored.
No sociodemographic differences in RCT interest were observed, and older patients were more likely to be ineligible. Eligible Hispanic patients across trials were significantly more likely to enroll than non-Hispanic patients. Sociodemographic factors predicted differences in decline motivation. In one trial, individuals originating from more urban areas were more likely to prematurely discontinue participation.
These results corroborate evidence of no significant differences in CCT interest across minority groups, with older adults less likely to fulfill eligibility criteria. While absolute Hispanic enrollment was modest, Hispanic patients were more likely to enroll relative to non-Hispanic patients. Additional sociodemographic trends were noted in decline motivation and geographical prediction of attrition. Further investigation is necessary to better understand inequities, barriers, and best recruitment practices for representative CCTs.
Climate change and weather shocks have multi-faceted impacts on food systems with important implications for economic policy. Combining a longitudinal household survey with high-resolution climate data, we demonstrate that both climate and weather shocks increase food insecurity; cash assistance and participation in Ethiopia’s Productive Safety Net Programme have reduced food insecurity; but food assistance has been ineffective. Importantly, households with savings, and those that stored their harvest to sell at higher prices rather than for home use, suffered less from food insecurity, yet both strategies are harder for the poorest and most food insecure households to adopt. Our paper provides micro-founded evidence needed to design policies that both improve agricultural yields in the context of a changing climate and target households’ abilities to cope with shocks that put upwards pressure on food prices.
Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage ‘on their own’ following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role of Aboriginal Brain Injury Coordinator (ABIC) to assist in navigating information and services, particularly after discharge from hospital. Eight positions for this role have been instigated across metropolitan and rural regions in the state. Healing Right Way’s aim is to enhance rehabilitation services and improve quality of life for Aboriginal Australians after brain injury. The ABIC’s role is to provide education, support, liaison and advocacy services to participants and their families over a six-month period, commencing soon after the participant’s stroke or injury has occurred. This paper outlines the development of this role, the partnerships involved, experiences to date and identifies some facilitators and barriers encountered that may impact the role’s ongoing sustainability. Details of components of the planned full Process Evaluation of Healing Right Way related to the ABIC role and the partnerships surrounding it are also provided. In combination with the trial’s ultimate results, this detail will assist in future service planning and provide a model of culturally secure care for stroke and brain injury services that can also inform other sub-acute and primary care models.
Outbreaks of cyclosporiasis, a food-borne illness caused by the coccidian parasite Cyclospora cayetanensis have increased in the USA in recent years, with approximately 2300 laboratory-confirmed cases reported in 2018. Genotyping tools are needed to inform epidemiological investigations, yet genotyping Cyclospora has proven challenging due to its sexual reproductive cycle which produces complex infections characterized by high genetic heterogeneity. We used targeted amplicon deep sequencing and a recently described ensemble-based distance statistic that accommodates heterogeneous (mixed) genotypes and specimens with partial genotyping data, to genotype and cluster 648 C. cayetanensis samples submitted to CDC in 2018. The performance of the ensemble was assessed by comparing ensemble-identified genetic clusters to analogous clusters identified independently based on common food exposures. Using these epidemiologic clusters as a gold standard, the ensemble facilitated genetic clustering with 93.8% sensitivity and 99.7% specificity. Hence, we anticipate that this procedure will greatly complement epidemiologic investigations of cyclosporiasis.
Implementation of genome-scale sequencing in clinical care has significant challenges: the technology is highly dimensional with many kinds of potential results, results interpretation and delivery require expertise and coordination across multiple medical specialties, clinical utility may be uncertain, and there may be broader familial or societal implications beyond the individual participant. Transdisciplinary consortia and collaborative team science are well poised to address these challenges. However, understanding the complex web of organizational, institutional, physical, environmental, technologic, and other political and societal factors that influence the effectiveness of consortia is understudied. We describe our experience working in the Clinical Sequencing Evidence-Generating Research (CSER) consortium, a multi-institutional translational genomics consortium.
A key aspect of the CSER consortium was the juxtaposition of site-specific measures with the need to identify consensus measures related to clinical utility and to create a core set of harmonized measures. During this harmonization process, we sought to minimize participant burden, accommodate project-specific choices, and use validated measures that allow data sharing.
Identifying platforms to ensure swift communication between teams and management of materials and data were essential to our harmonization efforts. Funding agencies can help consortia by clarifying key study design elements across projects during the proposal preparation phase and by providing a framework for data sharing data across participating projects.
In summary, time and resources must be devoted to developing and implementing collaborative practices as preparatory work at the beginning of project timelines to improve the effectiveness of research consortia.
Fremont societies of the Uinta Basin incorporated domesticates into a foraging lifeway over a 1,000-year period from AD 300 to 1300. Fremont research provides a unique opportunity to critically examine the social and ecological processes behind the adoption and abandonment of domesticates by hunter-gatherers. We develop and integrate a 2,115-year precipitation reconstruction with a Bayesian chronological model for the growth of Fremont societies in the Cub Creek reach of Dinosaur National Monument. Comparison of the archaeological chronology with the precipitation record suggests that the florescence of Fremont societies was an adaptation to multidecadal precipitation variability with an approximately 30-plus-year periodicity over most, but not all, of the last 2,115 years. Fremont societies adopted domesticates to enhance their resilience to periodic droughts. We propose that reduced precipitation variability from AD 750 to AD 1050, superimposed over consistent mean precipitation availability, was the tipping point that increased maize production, initiated agricultural intensification, and resulted in increased population and development of pithouse communities. Our study develops a multidecadal/multigenerational model within which to evaluate the strategies underwriting the adoption of domesticates by foragers, the formation of Fremont communities, and the inherent vulnerabilities to resource intensification that implicate the eventual dissolution of those communities.
We analyze individual white dwarfs in open clusters observed by Gaia. In particular, we determine ages when different model ingredients are used. We also explore fundamental properties of the white dwarfs, including temperature and mass, when using different filter combinations. Such tests are important to understanding any systematic effects when applying similar techniques to field stars.
We employ Pan-STARRS photometry, Gaia trigonometric parallaxes, modern stellar evolution and atmosphere models, and our Bayesian fitting approach to determine cooling and total ages for 159,238 white dwarfs. In many cases we are able to derive precise ages (better than 5%) for individual white dwarfs. These results are meant for broad use within the white dwarf and stellar astrophysics communities and we plan to make available on-line the posterior distributions for cooling age, total age, initial stellar mass, and other parameters.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.
Livia was a pivotal figure in ancient Rome and the Roman Empire in general. Her unique role as the first Roman empress is reflected in the series of honours she received and tasks she accomplished, many of which had never been possible for a Roman woman and some of which would only ever be achieved by her. Her life ushered in several historical changes and many firsts, particularly after her second husband Octavian ended the Roman Republic and founded the Roman Empire. Octavian then became Rome's first emperor and officially took on the title Augustus while Livia, as his wife, became empress and Augusta. Despite her long life, it is difficult to formulate a well-rounded picture of Livia. This is partially a result of the nearly two thousand years that have elapsed since her death. Another contributing factor is that ancient authors often pay little attention to women, and when they discuss them they often provide stereotypes and few personal details. In Livia's case, she is repeatedly overshadowed by the accomplishments of her second husband, the emperor Augustus, and her son, the emperor Tiberius. Even when we do find references to her, some are inherently biased, making it difficult to separate the real story from the spin. Nevertheless, Livia's biography yields important insights into the early period of the Roman Empire. Although many of the places associated with her can no longer be seen, visits to areas such as the Palatino that were significantly associated with Livia provide a deeper connection to her and to the world that she inhabited.
Early Life and First Marriage
We know very little about Livia Drusilla's early life. She was born on January 30 of 59 or 58 in Italy, perhaps in Rome. Her father's family was very distinguished: he came from the Claudius family and was adopted into the Livius family. The Claudii boasted such ancestors as Appius Claudius Caecus, the commissioner of Rome's first aqueduct and its first consular road. The Livius family, on the other hand, included Marcus Livius Drusus, famous for his defence of the plebeians’ rights in Rome at the time of the Gracchi. In contrast, Livia's mother Alfidia likely came from a wealthy family that had not participated in Roman government. Livia was probably their only natural child.
Managed Entry Agreements (MEAs) enable payers to subsidize access to new medicines while addressing uncertainties. Uncertainties may relate to the criteria for decision-making articulated in decision-making frameworks. The study's aim was to determine if there was any association between the type of MEA and criteria considered during decision-making.
All medicines with MEAs listed on the Australian national subsidy scheme between 2012-2016 were identified. Data were extracted on the types of MEA and information related to the criteria considered in decision-making for each medicine and its associated indication (i.e. a medicine-indication pair [MIP]). The criteria considered in decision-making included the comparator (therapy to which it was compared), type of economic analysis, accepted value, budget impact, financial cost of supply, cost of therapy per patient, access control (such as restrictions or prior authorization), and clinical need. Associations between types of MEA and the criteria were assessed using Chi Squared test.
There were 87 MIPs, of which 56 had only financial MEAs and 31 had performance-based MEAs. Coverage with evidence development MEAs had very high incremental cost-effectiveness ratio (ICER)/quality adjusted life year (QALY) (74 percent > AUD 50,000 [USD 37,822]). Financial MEAs where performance measures were linked to reimbursement had lower ICER/QALY (13 percent > AUD 50,000 [USD 37,822]) but greater budget impact (33% > AUD 80million [USD 60.5million]) compared to simple financial MEAs. A statistically significant association (Cramer's V = 0.5, p < 0.001) was only found between performance-based MEAs and the cost of unsubsidized therapy per patient.
The main influence on the choice of performance based MEA was the provision of access to clinically important medicines with a high treatment cost for patients.
Objectives: Australia relies on managed entry agreements (MEAs) for many medicines added to the national Pharmaceutical Benefits Scheme (PBS). Previous studies of Australian MEAs examined public domain documents and were not able to provide a comprehensive assessment of the types and operation of MEAs. This study used government documents approved for release to examine the implementation and administration of MEAs implemented January 2012 to May 2016.
Methods: We accessed documents for medicines with MEAs on the PBS between January 2012 and May 2016. Data were extracted on Anatomical Therapeutic Classification (ATC), type of MEA (financial, financial with outcomes, outcomes, and subcategories within each group), implementation and administration methods, source of MEA recommendation, and type of economic analysis.
Results: Of all medication indication pairs (MIPs) recommended for listing, one-third had MEAs implemented. Our study of eighty-seven MIPs had 170 MEAs in place. The Government's expert health technology assessment (HTA) committee recommended MEAs for 90 percent of the eighty-seven MIPs. A total of 81 percent of MEAs were simple financial agreements: the majority either discounts (32 percent) or reimbursement caps (43 percent). Outcome-based MEAs were least common (5 percent). Ninety-two percent of MEAs were implemented and operated through legal agreements. Approximately half of the MIPs were listed on the basis of accepted claims of cost-minimization. Forty-nine percent of medicines were in ATC L group.
Conclusion: Advice from HTA evaluations strongly influences the implementation of ways to manage uncertainties while providing access to medicines. The government relied primarily on simple financial agreements for the managed entry of medicines for which there were perceived risks.
A controversy at the 2016 IUCN World Conservation Congress on the topic of closing domestic ivory markets (the 007, or so-called James Bond, motion) has given rise to a debate on IUCN's value proposition. A cross-section of authors who are engaged in IUCN but not employed by the organization, and with diverse perspectives and opinions, here argue for the importance of safeguarding and strengthening the unique technical and convening roles of IUCN, providing examples of what has and has not worked. Recommendations for protecting and enhancing IUCN's contribution to global conservation debates and policy formulation are given.
Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL.
The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations.
This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.
Despite an increasing prevalence of adults living with a CHD, little is known about the psychosocial impact of CHD. We sought to investigate the relative impact of disease severity and patients’ perceptions about their condition on depression, anxiety, and quality of life over a period of a year.
A total of 110 patients aged over 16 years completed an initial questionnaire containing measures for anxiety, depression, quality of life, and illness perceptions when they attended the Adult Congenital Heart Disease Clinic. Cardiologists rated the patients’ disease severity and illness course. A year later, patients were invited to complete the same measures. Regression analyses were performed to determine the relative impact of illness perceptions and disease severity on psychological outcomes a year later.
At baseline, 23% of the study population had depressive symptoms and 30% had elevated trait anxiety. After controlling for associations with disease-related variables, illness perceptions explained 28% of the variance in depression, 40% anxiety, and 27% overall quality of life at baseline. Baseline illness perceptions bivariately predicted quality of life, cardiac anxiety, and depression 1 year later, and regression analyses controlling for other factors showed that they were significant predictors of outcomes 1 year later.
Symptoms of depression and anxiety are common among adults with CHD. Patients’ illness perceptions are related to psychological outcomes, especially cross-sectionally. Future research could investigate whether an intervention to discuss patients’ perceptions about their CHD can improve mental health and quality of life.
The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:
1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.
2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
Until the early 1990s, it seemed unlikely that any progeny of the Nuremberg and Tokyo IMTs would appear soon. However, in response to two conflicts in the 1990s (the Yugoslav wars of dissolution and the Rwandan genocide of 1994), the United Nations revived the idea of international criminal tribunals. This chapter will introduce those Tribunals, and explain their practice. Although both Tribunals are now winding down, it is too early to come to any final conclusions about them, but this chapter will draw out some of the plaudits and criticisms that have attended the operation of the Tribunals to date. This chapter does not, however, attempt to provide a comprehensive analysis of the jurisprudence of the Tribunals, as their output is analysed elsewhere in this book.
The International Criminal Tribunal for Yugoslavia
The creation of the ICTY
Although some of the roots of the dissolution of Yugoslavia go back to the Second World War if not further, political developments in what was then the Socialist Federal Republic of Yugoslavia in the 1980s led that country to break up through a number of linked armed conflicts starting in 1991. The conflicts were characterized by large-scale violations of international criminal law committed especially against civilians, most notably sexual offences and the practice of ‘ethnic cleansing’. Pictures of concentration camps in Bosnia, which evoked memories of the Holocaust, caused public outcry and led to demands that something be done about the situation.