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Feasibility, acceptability and effectiveness data of a virtual adaptation of the WHO Caregiver Skills Training (CST; n = 25) were compared with those of a pilot RCT of CST delivered in person (n = 43) against treatment as usual (TAU; n = 43). Virtual CST was delivered with high levels of integrity, but received lower ratings in some caregiver- and facilitator-rated acceptability and feasibility dimensions. Qualitative analysis identified both benefits (flexibility, convenience, clinical usefulness) and challenges, (technological issues, distraction from family members, emotional distance). Virtual and in-person CST improved significantly more on caregiver competence than TAU; there were no other significant effects. Potential for use of virtual CST as a clinical response in contexts where in-person delivery is not possible is discussed.

Resumo No Brasil, a soja representa 29,4% do valor bruto da produção agropecuária. Todavia, essa cultura enfrenta diversas intempéries climáticas. Nesse sentido, o seguro agrícola emerge com o propósito de mitigar esses desafios, porém sua expansão é dificultada por problemas como a seleção adversa e os riscos sistêmicos que afetam os resultados das seguradoras. Nesse sentido, o objetivo deste artigo é analisar os fatores que afetam a lucratividade das seguradoras agrícolas no estado do Paraná, no período de 2007 a 2021, por meio da regressão de dados em painel, a qual possibilita a análise de dados de várias unidades, como municípios e empresas, ao longo do tempo. Observou-se que a área segurada, a produtividade efetiva e a variável dummy indenização constituem os principais fatores determinantes da lucratividade das seguradoras tanto na modalidade de custeio como na de produtividade. Entre as empresas analisadas, apenas a Brasilseg e a Mapfre apresentaram resultados negativos, enquanto a Newe, uma empresa iniciante, teve resultados positivos. As contribuições do estudo incluem a compreensão detalhada dos fatores que afetam a lucratividade das seguradoras agrícolas e o fornecimento de informações úteis para o aprimoramento da gestão de riscos e para a formulação de políticas, contribuindo para a sustentabilidade e a competitividade do setor.

Parents of children with ASD (N = 86; mean age 44.8 months; 67 boys) were randomized to either WHO Caregiver Skills Training (CST) delivered in public health settings in Italy or enhanced treatment-as-usual. Primary blinded outcomes were 3-months post-intervention change scores of autism severity and engagement during caregiver-child interaction. CST was highly acceptable to caregivers and feasibly delivered by trained local clinicians. Intention-to-treat analysis showed a large and significant effect on parent skills supporting joint engagement and a smaller significant effect on flow of interaction. Expected changes in child autism severity and joint engagement did not meet statistical significance. Analysis of secondary outcomes showed a significant effect on parenting stress, self-efficacy, and child gestures. Strategies to improve the effectiveness of CST are discussed.

The Caregiver Skills Training programme is an evidence-informed group intervention developed by the World Health Organization to counter the treatment gap for neurodevelopmental disorders in children. We examined feasibility and acceptability of Caregiver Skills Training in public child neuropsychiatry services in Italy. Following a formative adaptation process and a pre-pilot implementation, the programme was piloted in six centres. Caregivers of children (2-5 years) with autism spectrum disorder were randomised to either Caregiver Skills Training (n = 43) or treatment as usual (n = 43). Professionals' and caregivers' experiences in the treatment arm were examined with focus groups and questionnaires. The programme was largely considered acceptable, relevant and feasible. Specific implementation challenges and suggestions for optimising the package are discussed.

Chronic pain in youth has an unsung etiology and limited treatment options. Affected adolescents show difficulties in different functioning domains, and their parents can develop associated distress, which negatively influences the adolescent’s capacity to adjust to pain. The aims of this study are the following: (1) to develop an internet-delivered (online) pain intervention (SMART4Pain) program for adolescents and their parents, and to test its feasibility and acceptability; (2) to evaluate, in adolescents, the impact of the face-to-face, randomized, two-armed (i.e., CBT or biofeedback), open-label pilot study, developed together with the online program. The overall program consisted of six sessions scheduled over six weeks. Twenty adolescents (N = 20) and their parents (N = 20) completed the entire program and are included in this study. The results showed that all interventions were feasible and acceptable, as well as potentially effective in improving quality of life. Only the group receiving the biofeedback intervention showed some improvements in psychological indicators of stress. In conclusion, more research is needed to better understand and develop new, multimodal rehabilitation programs in outpatient settings.

We investigated the mechanism of impact of poor communication skills and emotional and behavioural problems in children with ASD (22-61 months) on parental psychological distress. Participants were dyads enrolled in two pilot intervention studies; the dataset includes cross-sectional data at baseline (N = 82). We postulated an indirect effect of child expressive and receptive communication on parent psychological distress, through child emotional and behavioural problems. The effect of receptive skills on parent psychological distress was fully mediated by child emotional problems: lower receptive skills were associated with higher levels of emotional symptoms, which in turn predicted higher parent psychological distress. Expressive skills did not show either direct or indirect effects. Findings are discussed in light of children's marked 'receptive disadvantage' communication profile.

Contamination of the environment by glyphosate (GLP) and its metabolite aminomethylphosphonic acid (AMPA) is still of major concern worldwide due to specific interactions among these molecules and soil and water. Two monitoring sites were established in the Prosecco wine production area (Conegliano and Valdobbiadene) in northeastern Italy, which has been included in UNESCO’s World Heritage List since 2019. The study aims to increase the knowledge about GLP dynamics in this area where it has been intensively used by farmers and the potential risk for groundwater pollution is still debated. Each site was equipped with two soil-water monitoring stations consisting of multisensor soil probes and suction cups at three soil depths (10, 30, and 70 cm). Soil and water were sampled for 10 and 6 months, respectively, and analyzed for GLP and AMPA concentrations, for a total of 242 samples to describe their vertical movement and dissipation dynamics. Soil properties, in particular, the different forms of Fe and Al oxide contents, and Freundlich adsorption coefficients were quantified along the soil profile. First attempts showed that glyphosate dissipation time was 36 ± 8 days in Conegliano and Valdobbiadene soils and fully completed in both after 6 months. In contrast, AMPA dissipation dynamic —first described by an original equation—was longer than that of GLP and fully dissipated after almost 300 days. GLP showed a strong binding affinity with clay and Fe and Al chelated to soil organic matter, which likely acted as cation bridges and in turn led to low GLP mobility. GLP and AMPA were mostly detected after heavy rainfall events at 70 cm depth, likely bypassing the porous matrix of the intermediate layers.

Abstract Background New-generation, cell-based assays have demonstrated a robust association of serum autoantibodies to full-length human myelin oligodendrocyte glycoprotein (MOG-IgG) with (mostly recurrent) optic neuritis, myelitis, and brainstem encephalitis, as well as with neuromyelitis optica (NMO)-like or acute-disseminated encephalomyelitis (ADEM)-like presentations. However, only limited data are yet available on cerebrospinal fluid (CSF) findings in MOG-IgG-associated encephalomyelitis (MOG-EM; also termed MOG antibody-associated disease, MOGAD). Objective To describe systematically the CSF profile in children with MOG-EM. Material and methods Cytological and biochemical findings (including white cell counts [WCC] and differentiation; frequency and patterns of oligoclonal bands; IgG/IgM/IgA and albumin concentrations and CSF/serum ratios; intrathecal IgG/IgM/IgA fractions; locally produced IgG/IgM/IgA concentrations; immunoglobulin class patterns; IgG/IgA/IgM reibergrams; Link index; measles/rubella/zoster [MRZ] reaction; other anti-viral and anti-bacterial antibody indices; CSF total protein; CSF l-lactate) from 108 lumbar punctures in 80 pediatric patients of mainly Caucasian descent with MOG-EM were analyzed retrospectively. Results Most strikingly, CSF-restricted oligoclonal IgG bands, a hallmark of multiple sclerosis (MS), were absent in 89% of samples (N = 96), and the MRZ reaction, the most specific laboratory marker of MS known so far, in 100% (N = 29). If present at all, intrathecal IgG synthesis was low, often transient and mostly restricted to acute attacks. Intrathecal IgM synthesis was present in 21% and exclusively detectable during acute attacks. CSF WCC were elevated in 54% of samples (median 40 cells/μl; range 6–256; mostly lymphocytes and monocytes; > 100/μl in 11%). Neutrophils were present in 71% of samples; eosinophils, activated lymphocytes, and plasma cells were seen only rarely (all

Recent studies have experimentally analyzed the leaching at local scale of some of the most diffused pesticides used in agriculture. To evaluate the vulnerability of wells supplying drinking water to PPPs used within wellhead protection areas (WHPAs), a map of vulnerability has been developed starting from the PPPs sales data in the Treviso province. The PPPs spatial distribution, obtained from the sellers’ locations and the extension of the cultivation areas was superimposed with the extension of the WHPAs, led to a vulnerability map, giving a clear picture of the wells that require PPPs-specific actions.

Introduction Hypoestrogenism is a gonadal and reproductive dysfunction in women that is often associated with conditions such as obesity, insulin resistance, and diabetes (Chalvon-Demersay et al. 2017). The control of [...], We investigated the structural and functional adaptations of the pancreas during weight cycling in animals submitted to hypoestrogenism. Female Wistar rats were distributed among the following test groups: ShamAL (AL, ad libitum); OVXAL (ovariectomized); and OVXcycle (dietary restriction with weight cycling). The ShamAL and OVXAL groups received commercial feed ad libitum, whereas the OVXcycle group received 21 days of commercial feed ad libitum, and 21 days of caloric restriction, with caloric intake amounting to 40% of the amount of feed consumed by the rats in the OVXAL group. The tolerance tests for glucose and insulin were applied. After euthanasia, the pancreas and adipose tissue were collected. The disappearance of glucose during the insulin assay occurred at a higher rate in tissues from the OVXcycle group, compared with the OVXAL group. Fasting glycemia and perirenal adipose tissue were lower in the OVXcycle group. By comparison with the ShamAL and OVXAL groups, the OVXcycle group showed higher protein expression of the M1 and M3 receptors and SOD1--2, as well as higher carbachol-induced insulin secretion. Under highly stimulatory conditions with 16.7 mmol/L glucose, the OVXAL and OVXcycle groups presented lower insulin secretion compared with the ShamAL group. Morphological analysis revealed higher iron deposition in the OVXAL islets bycomparison with the OVXcycle group. These results show that ovariectomy accelerated the lossofpancreatic islet function, and that weight cycling could restore the function of the islets. Key words: pancreatic islets, insulin secretion, cholinergic pathway, oxidative stress. Les auteurs ont examiné les adaptations structurales et fonctionnelles du pancréas durant la perte du poids chez des animaux soumis à une hypoestrogénie. Des femelles Wistar ont été réparties en groupes faux traitement (FT) AL (AL, ad libitum), OVXAL (ovariectomie) et OVXcycle (restriction calorique et perte de poids). Les groupes FTAL et OVXAL ont été nourris avec une moulée commerciale à volonté alors que le groupe OVXcycle a été alimenté pendant 21 jours avec une moulée commerciale à volonté et soumis à une restriction calorique pendant 21 jours comportant 40 % de la nourriture consommée par le groupe OVXAL. Les tests de tolérance au glucose et à l'insuline ont été réalisés. Après l'euthanasie, le pancréas et le tissu adipeux ont été récoltés. Un taux plus élevé d'élimination du glucose lors du test à l'insuline était observé dans le groupe OVXcycle compara-tivement au groupe OVXAL. La glycémie à jeun et le tissu adipeux périrénal étaient plus faibles chez le groupe OVXcycle. L'expression des récepteurs M1 et M3 ainsi que de SOD1-2 était plus élevée chez les animaux du groupe OVXcycle, comparativement aux groupes FTAL et OVXAL. La sécrétion d'insuline induite par le carbachol était aussi plus élevée. La sécrétion d'insuline fortement stimulée par 16,7 mmol/Ldeglucose était plus faible chez les groupes OVXALetOVXcycle comparativement augroupe FTAL. L'analyse morphologique révélait un dépôt de fer dans les ilots plus élevé chez le groupe OVXAL comparativement au groupe OVXcycle. Les résultats montraient que l'ovariectomie accélérait la perte de fonction des ilots pancréatiques, alors que la perte de poids pouvait rétablir les caractéristiques des ilots. [Traduit par la Rédaction] Mots-clés: ilots pancréatiques, sécrétion d'insuline, voie cholinergique, stress oxydant.

Laboratory experiments and numerical modeling were conducted to assess the effects of glycerol concentration gradients on water flow through an unsaturated loamy sand (Yellow bush sand, Australia) at 46% glycerol mass fraction and 12.5% volumetric water content. When the contaminated and uncontaminated experimental soil sections were placed into contact, two opposite mechanisms were found to drive the flow: (i) the matric potential gradient affected by concentration-dependent surface tension, viscosity, and density repelled contaminated water; and (ii) the osmotic potential gradient had an opposite effect. Experiments demonstrated that the tested sand did not exhibit the complete semipermeable characteristic necessary to induce pure osmotic flow. Rather, physicochemical effects caused by dissolved glycerol were more relevant for water flow than those induced by the osmotic potential. We confirmed our experimental finding by numerical modeling that explicitly accounted for these effects compared with our experiments and earlier experiments conducted with 7% butanol–water mixtures as benchmarks. Our results were finally confirmed by a thermodynamic interpretation of matric and osmotic potentials. Experiments suggest that a rapid transient condition occurred on the first day and that equilibrium was recovered only after >60 d. The results support the hypothesis that chemically induced water flow in the vadose zone is contributed mainly by matric and only secondarily by osmotic effects, which have displaced 3 to 10% water during the initial transient condition. Predictive tools of contaminant hydrology in unsaturated soil may have to account for the osmotic effects in particular applications that involve soil with high osmotic efficiency.

Feasibility, acceptability and effectiveness data of a virtual adaptation of the WHO Caregiver Skills Training (CST; n = 25) were compared with those of a pilot RCT of CST delivered in person (n = 43) against treatment as usual (TAU; n = 43). Virtual CST was delivered with high levels of integrity, but received lower ratings in some caregiver- and facilitator-rated acceptability and feasibility dimensions. Qualitative analysis identified both benefits (flexibility, convenience, clinical usefulness) and challenges, (technological issues, distraction from family members, emotional distance). Virtual and in-person CST improved significantly more on caregiver competence than TAU; there were no other significant effects. Potential for use of virtual CST as a clinical response in contexts where in-person delivery is not possible is discussed. [ABSTRACT FROM AUTHOR]