Changing the paradigm for pesticide resistance management.

Collaborative action on the part of all stakeholders in pest management is essential to effectively address the challenges of pesticide resistance. The US Environmental Protection Agency (EPA), through its Pesticide Program Dialogue Committee, recently posted a report on pesticide resistance management and the role the Agency can play in these efforts. In this Perspective, we commend the Agency for acknowledging these needs, and encourage implementation of the recommendations. We urge all stakeholders to follow the example set by the EPA to engage openly, listen to other stakeholders, and determine their role as part of the broader community that is needed to address the challenges of resistance. Our contention is that pesticide resistance will continue to escalate until all stakeholders evaluate their roles in resistance management and work together as a community to influence effective management. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

COVID-19 case-fatality disparities among people with intellectual and developmental disabilities: Evidence from 12 US jurisdictions.

BACKGROUND: There is evidence from two US states that people with intellectual and developmental disabilities (IDD) are at more severe risk during the COVID-19 pandemic. Research has not explored whether this increased risk is consistent across the US. OBJECTIVE: This study compared COVID-19 case-fatality rates among people with IDD in 11 states and the District of Columbia that are publicly reporting data. METHODS: Cumulative data reported through March 31 - April 13, 2021 were analyzed. Case-fatality rates and risk ratio with 95% confidence intervals for IDD settings were compared the overall case-fatality rate for the jurisdictions from Johns Hopkins' Center for Systems Science and Engineering COVID-19 data. RESULTS: Settings were reported as receiving any services, community or institutional residential services, or living in own/family home. Comparison of case-fatality rates between people with IDD and their respective jurisdiction populations demonstrates that case-fatality rates were consistently higher for people with IDD living in congregate residential settings (fifteen instances) and receiving 24/7 nursing services (two instances). Results were mixed for people with IDD living in their own or a family home (eight instances). CONCLUSIONS: These findings highlight that people with IDD, especially those living in residential settings, are experiencing higher case-fatality rates from COVID-19 than the general population across multiple US jurisdictions. Short-term and long-term public health interventions addressing COVID-19 risks will not be able to properly address the needs of people with IDD until all states begin reporting COVID-19 outcomes for this population.

POWERSforID: Personalized online weight and exercise response system for individuals with intellectual disability: A randomized controlled trial.

BACKGROUND: Obesity is associated with early mortality and chronic disease among adults with intellectual disability (ID), yet there is a paucity of effective weight management interventions for this population. OBJECTIVE/HYPOTHESIS: This pilot study examined a tailored intervention on weight loss, waist circumference, A1c, and lipid profile among adults with ID. METHODS: Obese adults (BMI ≥ 30 kg/m2) with mild to moderate ID were randomized to an intervention (n = 17) or comparison group (n = 18) for a 24-week trial. All participants completed health-related questionnaires and clinic visits. Participants in the intervention group received access to an online weight management platform that assisted them in monitoring their diet and physical activity along with weekly coaching calls (weeks 1-12) that were tapered off to calls every other week (weeks 12-24). The comparison group completed questionnaires and clinic visits, but did not receive access to the online platform or calls. Differences in weight, waist circumference, percent body fat, A1c, lipid profile were assessed at baseline and at week 24. RESULTS: The intervention group reduced body weight by an average of 2.7% (-2.6 kg; p = 0.02) and waist circumference by 3.4% (-3.89 cm; p = 0.02) versus the comparison. There were no statistically significant group by time interactions observed among other variables. CONCLUSION: Adults with ID who received the intervention were able to maintain or slightly reduce their body weight and waist circumference after the 24-week intervention. Despite not achieving the targeted sample size, the pilot study findings serve as a basis for developing accessible weight management interventions for people with ID.

Community Supports and COVID-19: Self-Determination in a Pandemic.

The coronavirus disease 2019 (COVID-19) is impacting people with intellectual and developmental disabilities (IDD) significantly. Early data on the impact of COVID-19 suggests that people with IDD are experiencing more severe health outcomes compared to the general population. In addition to their elevated health risks, people with IDD, like the rest of the population, are struggling with boredom, isolation, and loneliness as they shelter in place. As people with IDD seek a return to their jobs, friends and families, and the activities of their community, community-based provider organizations must strike a difficult balance between actions that are intended to protect the health and safety of people they support and actions that honor people's choices and encourage self-determination. Practical issues that community-based provider organizations must consider when striking the correct balance are discussed, and recommendations on ways to support people with IDD to make informed, self-determined choices during the pandemic are offered.

Cross-Systems Care Integration Impact on Adults With Intellectual Disability Utilizing Risk Weight and Comorbidity Data: A Comparative Effectiveness Study, 2014-2017.

Health disparities are documented between adults with intellectual and developmental disabilities (IDD) and neurotypical peers. As progress has been slow in improving health outcomes in people with IDD, the aim of this retrospective study was to compare effectiveness of a new Cross-Systems Care Integration (CSCI) model of care coordination to standard care coordination for 927 adults with IDD receiving Medicaid services in central Colorado from 2014 through 2017. Health care cost risk weight decreased (not statistically significant) only in individuals receiving the CSCI intervention. Depression diagnoses remained statistically unchanged, while both hypertension and hyperlipidemia significantly improved in patients receiving CSCI. Further study is warranted to extend duration of study and to examine additional study variables such as health-related quality of life.

Clinical Utility of Multisensory Environments for People With Intellectual and Developmental Disabilities: A Scoping Review.

IMPORTANCE: Adults with intellectual and developmental disabilities (IDD) are twice as likely as their peers without disabilities to have had a physical exam in the past year; however, as a result of challenging behavior during office visits, they are significantly less likely to have received recommended health screenings. Challenging behaviors in clinical settings have been identified as a barrier to providing adequate care for this population. OBJECTIVE: This scoping review examined the within-session effects of multisensory environments (MSEs) on people with IDD to determine the clinical utility of MSEs for this population. DATA SOURCES: Studies published between January 1, 2000, and August 1, 2018, were identified using Summon and Google Scholar. STUDY SELECTION: Studies were included in the review if they systematically collected and reported data on within-session effects of an MSE intervention on people with IDD. FINDINGS: Thirteen studies met criteria for this review: 4 with Level I evidence, 2 with Level II evidence, 3 with Level III evidence, and 4 with Level IV evidence. Studies examined the effects of MSEs on maladaptive behaviors, positive behaviors, distress and discomfort, activity and alertness states, and cost of care for people with IDD. CONCLUSION AND RELEVANCE: Preliminary support was found for the use of MSEs in clinical settings to reduce anxiety and challenging behaviors in patients with IDD during clinical care. Further research is needed to determine the efficacy of MSEs for producing the effects described in this review. WHAT THIS ARTICLE ADDS: The findings support the potential of MSEs as a tool that occupational therapy practitioners can use to support their clients with IDD who have sensory sensitivities in clinical settings. This article also highlights a multidisciplinary approach whereby medical providers and occupational therapy practitioners could work together in nontraditional ways to support this population.

Do farmers manage weeds on owned and rented land differently? Evidence from US corn and soybean farms.

BACKGROUND: It has been frequently argued that growers have less incentive to manage the evolution and spread of herbicide-resistant weeds on leased than on owned land. This is because resistance management provides long-term rather than short-term benefits that operators may be less assured of capturing on land they do not own. Yet, empirical evidence supporting this argument has been lacking. RESULTS: This study reports on results from a large-scale national survey of weed management and other crop production practices on US agricultural fields. Up to 11 weed management practices were compared across owner-operated versus renter-operated fields. Analysis of survey data from corn and soybean fields did not support the hypothesis that adoption of resistance management practices is lower on rented acres. In most instances, there were no statistically significant differences in herbicide use or weed management practices on rented versus owned land. This was true at both national and regional levels of analysis. Where there were significant differences, practices associated with greater herbicide resistance management were, as often as not, more prevalent on rented than owned land. CONCLUSIONS: A useful area of future research would be to test for land tenure differences in resistance management using multivariate analysis to control for confounding effects. Unobserved farmer or land characteristics may be confounding results and masking land tenure effects. Results here, however, suggest that these other effects are dominating any obvious disincentive effects of land leasing on resistance management. Of greater concern, the adoption of key resistance management practices was low on both owned and rented land. © 2020 Society of Chemical Industry.

Feedback and Strategies From People With Intellectual Disability Completing a Personalized Online Weight Loss Intervention: A Qualitative Analysis.

Coaching log notes for 15 participants from a 24-week blended online and telehealth randomized controlled trial were analyzed using thematic analysis and analyst triangulation to determine the factors that facilitated participant adherence to weight loss strategies, use of technology, and motivational interviewing. Several participants reported that restricting processed carbohydrates, limiting portion size, and maintaining healthy substitutions were effective nutritional strategies. Participants were less successful with adherence to their exercise goals, often due to time constraints and a lack of support. Results suggested consistent caregiver support improved participants' adherence to weight loss strategies and use of technology. Future programs should address obesity among people with intellectual and developmental disabilities by offering a range of interventions that are customized to their specific weight loss needs.

POWERS forID: Personalized Online Weight and Exercise Response System for Individuals with Intellectual Disability: study protocol for a randomized controlled trial.

BACKGROUND: Intellectual disability (ID) is characterized by limitations in intellectual functioning and adaptive behavior. Adults with ID exhibit higher rates of obesity and poorer health status compared to the general population. Continuity of care and barriers to health-related activities may contribute to the poorer health status observed in this population. To address this problem, a tailored weight management online health information and communication technology platform, known as POWERSforID, was developed and is being tested to determine if this delivery mechanism can improve weight maintenance/weight loss in adults with ID. METHODS: Obese adults with mild-to-moderate ID (n = 70) are randomized to the POWERS forID intervention or control group for a 24-week trial. Each group undergoes an assessment that includes body weight, waist circumference, and percent body fat at baseline and at weeks 6, 12, and 24. Physical activity barriers, healthy eating barriers, food frequency, and psychosocial wellbeing are measured at baseline and at weeks 12 and 24. Blood lipids are assessed at baseline and 24 weeks. Participants randomized to POWERS forID receive access to the POWERS forID website and calls from a health coach (weekly during weeks 1-12, biweekly during weeks 13-24). The health coach employs motivational interviewing techniques adapted for individuals with ID to promote behavior change. Participants randomized to the control group receive standard clinical weight-loss care. Differences in weight, waist circumference, blood lipids, percent body fat, and psychosocial self-report will be assessed. Barriers and facilitators of implementation as well as perception of study outcomes will be conducted via qualitative analysis. DISCUSSION: POWERS forID is a novel information and communication technology platform designed to address health needs for adults with ID. This article describes the development and components of POWERS forID. The overall aim is to assess usability and feasibility of POWERS forID for promoting weight loss for obese adults with ID over the course of a 24-week randomized control trial. TRIAL REGISTRATION: Clinicaltrials.gov, NCT03139760 . Registered on XXX.

Healthcare for persons with intellectual and developmental disability in the community.

INTRODUCTION: While there has been impressive progress in creating and improving community healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done. METHODS: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical considerations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and delivery systems, and the areas of needed focus in their development are reviewed to set a starting point for more and greater work going forward. CONCLUSION: Today, we celebrate longer life spans of people with IDD, increased attention to the benefits of healthcare that is responsive to their needs, and the development of important healthcare delivery systems that are customized to their needs. We also know that the growing body of research on health status offers incentive to continue developing healthcare structures for people with IDD by training healthcare providers about the needs of people with IDD, by establishing systems of care that integrate acute healthcare with long-term services and support, by developing IDD medicine as a specialty, and by building health promotion and wellness resources to provide people with IDD a set of preventative health supports.

Primary care: mental and behavioral health and persons with intellectual and developmental disabilities.

INTRODUCTION: There are multiple ways to address the mental and behavioral health needs of people with intellectual and developmental disabilities (IDD). METHOD: In this paper, we do not argue for a particular approach or set of approaches, but instead review the benefits of integrating mental and behavioral health supports with primary healthcare based primarily on our experience in and understanding of healthcare systems in the United States. It is estimated that between 35 and 40% of people with IDD also live with psychiatric disorders. NADD, an association for persons with developmental disabilities and mental health needs in the US holds that coexisting IDD and a psychiatric disorder interferes with a person's education and job readiness, and disrupts family and peer relationships. Historically, the presence of such disorders among people with IDD was not well understood or was discounted altogether. CONCLUSION: Over the past 15 years, however, greater attention is being paid to these comorbidities and their treatment, including the need to integrate mental and behavioral health treatments into primary care. Healthcare must account for multiple domains of quality of life, going beyond yearly physicals, and acute care visits, for example, to assess individuals' healthcare goals and support them in achieving those goals. While integrated healthcare delivery systems can be difficult to find and access for people with IDD, such approaches are more responsive to the comprehensive needs and desires of people with IDD.

Valuing ecological systems and services.

Making trade-offs between ecological services and other contributors to human well-being is a difficult but critical process that requires valuation. This allows both better recognition of the ecological, social, and economic trade-offs and also allows us to bill those who use up or destroy ecological services and reward those that produce or enhance them. It also aids improved ecosystems policy. In this paper we clarify some of the controversies in defining the contributions to human well-being from functioning ecosystems, many of which people are not even aware of. We go on to describe the applicability of the various valuation methods that can be used in estimating the benefits of ecosystem services. Finally, we describe some recent case studies and lay out the research agenda for ecosystem services analysis, modeling, and valuation going forward.

Ontology mapping and data discovery for the translational investigator.

An integrated data repository (IDR) containing aggregations of clinical, biomedical, economic, administrative, and public health data is a key component of an overall translational research infrastructure. But most available data repositories are designed using standard data warehouse architecture that employs arbitrary data encoding standards, making queries across disparate repositories difficult. In response to these shortcomings we have designed a Health Ontology Mapper (HOM) that translates terminologies into formal data encoding standards without altering the underlying source data. We believe the HOM system promotes inter-institutional data sharing and research collaboration, and will ultimately lower the barrier to developing and using an IDR.

HPC AND GRID COMPUTING FOR INTEGRATIVE BIOMEDICAL RESEARCH.

Integrative biomedical research projects query, analyze, and integrate many different data types and make use of datasets obtained from measurements or simulations of structure and function at multiple biological scales. With the increasing availability of high-throughput and high-resolution instruments, the integrative biomedical research imposes many challenging requirements on software middleware systems. In this paper, we look at some of these requirements using example research pattern templates. We then discuss how middleware systems, which incorporate Grid and high-performance computing, could be employed to address the requirements.

A roadmap for caGrid, an enterprise Grid architecture for biomedical research.

caGrid is a middleware system which combines the Grid computing, the service oriented architecture, and the model driven architecture paradigms to support development of interoperable data and analytical resources and federation of such resources in a Grid environment. The functionality provided by caGrid is an essential and integral component of the cancer Biomedical Informatics Grid (caBIG) program. This program is established by the National Cancer Institute as a nationwide effort to develop enabling informatics technologies for collaborative, multi-institutional biomedical research with the overarching goal of accelerating translational cancer research. Although the main application domain for caGrid is cancer research, the infrastructure provides a generic framework that can be employed in other biomedical research and healthcare domains. The development of caGrid is an ongoing effort, adding new functionality and improvements based on feedback and use cases from the community. This paper provides an overview of potential future architecture and tooling directions and areas of improvement for caGrid and caGrid-like systems. This summary is based on discussions at a roadmap workshop held in February with participants from biomedical research, Grid computing, and high performance computing communities.

An assessment of air emissions from liquefied natural gas ships using different power systems and different fuels.

The shipping industry has been an unrecognized source of criteria pollutants: nitrogen oxides (NOx), volatile organic compounds, coarse particulate matter (PM10), fine particulate matter (PM2.5), sulfur dioxide (SO2), and carbon monoxide (CO). Liquefied natural gas (LNG) has traditionally been transported via steam turbine (ST) ships. Recently, LNG shippers have begun using dual-fuel diesel engines (DFDEs) to propel and offload their cargoes. Both the conventional ST boilers and DFDE are capable of burning a range of fuels, from heavy fuel oil to boil-off-gas (BOG) from the LNG load. In this paper a method for estimating the emissions from ST boilers and DFDEs during LNG offloading operations at berth is presented, along with typical emissions from LNG ships during offloading operations under different scenarios ranging from worst-case fuel oil combustion to the use of shore power. The impact on air quality in nonattainment areas where LNG ships call is discussed. Current and future air pollution control regulations for ocean-going vessels (OGVs) such as LNG ships are also discussed. The objective of this study was to estimate and compare emissions of criteria pollutants from conventional ST and DFDE ships using different fuels. The results of this study suggest that newer DFDE ships have lower SO2 and PM2.5/PM10 emissions, conventional ST ships have lower NOx, volatile organic compound, and CO emissions; and DFDE ships utilizing shore power at berth produce no localized emissions because they draw their required power from the local electric grid.

Sharing data and analytical resources securely in a biomedical research Grid environment.

OBJECTIVES: To develop a security infrastructure to support controlled and secure access to data and analytical resources in a biomedical research Grid environment, while facilitating resource sharing among collaborators. DESIGN: A Grid security infrastructure, called Grid Authentication and Authorization with Reliably Distributed Services (GAARDS), is developed as a key architecture component of the NCI-funded cancer Biomedical Informatics Grid (caBIG). The GAARDS is designed to support in a distributed environment 1) efficient provisioning and federation of user identities and credentials; 2) group-based access control support with which resource providers can enforce policies based on community accepted groups and local groups; and 3) management of a trust fabric so that policies can be enforced based on required levels of assurance. MEASUREMENTS: GAARDS is implemented as a suite of Grid services and administrative tools. It provides three core services: Dorian for management and federation of user identities, Grid Trust Service for maintaining and provisioning a federated trust fabric within the Grid environment, and Grid Grouper for enforcing authorization policies based on both local and Grid-level groups. RESULTS: The GAARDS infrastructure is available as a stand-alone system and as a component of the caGrid infrastructure. More information about GAARDS can be accessed at http://www.cagrid.org. CONCLUSIONS: GAARDS provides a comprehensive system to address the security challenges associated with environments in which resources may be located at different sites, requests to access the resources may cross institutional boundaries, and user credentials are created, managed, revoked dynamically in a de-centralized manner.

caGrid 1.0: an enterprise Grid infrastructure for biomedical research.

OBJECTIVE: To develop software infrastructure that will provide support for discovery, characterization, integrated access, and management of diverse and disparate collections of information sources, analysis methods, and applications in biomedical research. DESIGN: An enterprise Grid software infrastructure, called caGrid version 1.0 (caGrid 1.0), has been developed as the core Grid architecture of the NCI-sponsored cancer Biomedical Informatics Grid (caBIG) program. It is designed to support a wide range of use cases in basic, translational, and clinical research, including 1) discovery, 2) integrated and large-scale data analysis, and 3) coordinated study. MEASUREMENTS: The caGrid is built as a Grid software infrastructure and leverages Grid computing technologies and the Web Services Resource Framework standards. It provides a set of core services, toolkits for the development and deployment of new community provided services, and application programming interfaces for building client applications. RESULTS: The caGrid 1.0 was released to the caBIG community in December 2006. It is built on open source components and caGrid source code is publicly and freely available under a liberal open source license. The core software, associated tools, and documentation can be downloaded from the following URL: https://cabig.nci.nih.gov/workspaces/Architecture/caGrid. CONCLUSIONS: While caGrid 1.0 is designed to address use cases in cancer research, the requirements associated with discovery, analysis and integration of large scale data, and coordinated studies are common in other biomedical fields. In this respect, caGrid 1.0 is the realization of a framework that can benefit the entire biomedical community.