Stabilization of carbon through co-addition of water treatment residuals with anaerobic digested sludge in a coarse textured soil.

Coarse textured soils have low potential to store carbon (C) due to lack of mineral oxides and have low clay content to protect C from biodegradation and leaching. This study evaluated the potential of stabilizing C by adding metal oxyhydroxide-rich water treatment residuals (WTRs) to an aeolian pure sand (<5% clay) topsoil amended with anaerobic digestate (AD) sludge. The AD sludge was applied at 5% (w/w) with aluminum based WTR (Al-WTR) and iron based WTR (Fe-WTR) co-applied at 1:1 and 2:1 WTR:AD (w/w) ratios and incubated at room temperature for 132 days. The cumulative mineralized C was normalized to the total organic C of the treatments. Co-addition with Al-WTR showed to be more effective in stabilizing C through decreased cumulative mineralized C by 48% and 57% in 1Al-WTR:1AD and 2Al-WTR:1AD, respectively, compared to AD sludge sole amendment. Co-application with Al-WTR also decreased permanganate oxidizable C by 37% and dissolved organic C by 51%. Co-application with Fe-WTR did not decrease the concentration of these labile C pools to the same extent, possibly due to the selective use of Fe-WTRs to treat organic-rich raw water. This makes it less effective in stabilizing C in a pure sand relative to Al-WTR due to chemical instability of the Fe-organic complexes. The Al-WTR provides a promising co-amendment to increase C sequestration in pure sands when co-applied with biosolids. The co-amendment approach will not only facilitate C sequestration but also contributes to waste management, aligning to the objectives of a circular economy.

Applying a User-Centered Design Framework to Develop a Remote Research Assessment Protocol for a Randomized Clinical Trial for Toddlers with Early Autism Characteristics.

COVID-19 required many research teams to shift from in-person to remote assessments, which posed both procedural and theoretical challenges. While research has explored the utility of remote assessments for autism diagnosis from the perspective of families and clinicians, less is known about their application in clinical trials. This paper describes the development of a remote research assessment protocol for a randomized clinical trial focusing on the implementation of reciprocal imitation teaching (RIT) with toddlers in Part C early intervention. This project spans two phases. For Phase 1, our team developed and documented a series of steps utilizing user-centered design (UCD) strategies (e.g., recruiting potential users, creating a prototype, engaging in iterative development) for the purpose of redesigning an assessment protocol for a remote environment. For Phase 2, we examined preliminary outcomes of the redesign process. Primary end users (assessors) rated post-redesign usability and acceptability, while acceptability was examined using attrition data from secondary end users (family participants). Preliminary fidelity of implementation was also examined. The iterative redesign process allowed the research team to refine aspects of the assessment that ultimately led to promising preliminary ratings of usability, acceptability, and feasibility, as well as high fidelity. Preliminary data suggest that the redesigned assessment appears to be an acceptable, feasible, and usable tool for autism clinical trial research and that assessors can use it with fidelity. Further research is needed to examine the reliability and validity of the assessment, as well as implementation characteristics on a larger scale.

Using virtual multiteam systems to conduct a multisite randomized clinical trial in the part C early intervention system: Benefits, challenges, and lessons learned.

BACKGROUND/AIMS: COVID-19 necessitated a shift to virtual data collection for many research projects, providing the opportunity for novel approaches to carrying out multi-site clinical trials. Virtual multiteam systems (VMTS) are a type of team structure in which multiple geographically dispersed teams collaborate using technology-mediated communication. The article presents a case study of our use of VMTS, in response to COVID-19, to carry out a multisite randomized hybrid effectiveness-implementation trial of a caregiver-implemented intervention. METHODS: We describe how we modified our team structure from predominantly site-specific, co-located teams to predominantly cross-site, virtual teams. We then present examples of how we have conducted the two primary data collection activities virtually. To demonstrate the feasibility of this approach, we present participant demographic information, the percent of cross-site data collection activities, and fidelity data. RESULTS: In the first 20 months of data collection, we have enrolled 108 EI providers and 132 families, with 17% and 9% attrition respectively. The family sample is highly diverse in terms of race/ethnicity, parent education, and household income. The majority of provider training activities and roughly 50% of family assessment activities have been conducted cross-site. Fidelity is high, with no differences across site. CONCLUSIONS: Our data illustrate the feasibility of using virtual teams, training, and assessment in a multisite clinical trial in the Part C system. We discuss the strengths and challenges of this approach, as well as lessons learned to facilitate the planning of future multisite randomized clinical trials which may benefit from this approach. CLINICAL TRIALS: NCT05114538.

Improving crop growing conditions with water treatment residual and compost co-amendments: Soil-water dynamics.

Land application of water treatment residual (WTR) in combination with phosphate-rich organic wastes, like compost or sewage sludge, in nutrient-poor soils was previously shown to promote crop growth. This WTR diversion from landfill to agriculture supports local and international mandates for waste circularity. Although soil-water dynamics-like saturated hydraulic conductivity, water retention, and hydrophobicity-are well-defined for compost and somewhat defined for WTR (except for hydrophobicity), the impacts of co-amending sandy soils with both are not well-defined. In laboratory analyses, co-amendment had an intermediate effect between individual amendments on the hydrophobic sandy soils, increasing water retention by 27% (WTR and compost both increased water retention), decreasing hydrophobicity by increasing hydraulic conductivity twofold (WTR and compost both decreased hydrophobicity), and having no effect on saturated hydraulic conductivity (decreased by WTR and increased by compost). With two positive effects and one "no effect" on soil-water dynamics in laboratory trials, the co-amendment was expected to buffer both crop water use efficiency (WUE) and nutrient availability under drought stress, for Swiss chard (Beta vulgaris L. var. cicla), co-investigated in a multifactorial pot trial. Soil nutrients, particularly phosphate, were shown more critical than soil-water dynamics to improve crop WUE. Thus, co-amended soils have significantly higher crop biomass and WUE than sandy soils. Phosphate-rich organic co-amendment is necessary for crop nutrient sufficiency and thus drought resilience in sandy soils amended with WTR. Thus, pairing wastes to soils for optimum fertility is a critical consideration in waste land application for both biomass and drought resilience.

An Australian housing conditions data infrastructure.

For the past two decades, researchers and policy makers have known very little about conditions within Australia's housing stock due to a lack of systematic and reliable data. In 2022, a collaboration of Australian universities and researchers commissioned a large survey of 22,550 private rental, social rental and homeowner households to build a data infrastructure on the household and demographic characteristics, housing quality and conditions in the Australian housing stock. This is the third and largest instalment in a national series of housing conditions data infrastructures.

Private renters in shared housing: investigating housing conditions and mental well-being in Australia during COVID-19.

Lockdowns were the major policy response to COVID-19 containment in many countries, and subsequently many people spent abnormal amounts of time at home. Research has found that housing conditions affected more peoples' mental health during the COVID-19 crisis than prior to it, and vulnerable groups were especially affected. One group that may be particularly vulnerable is private renters in shared housing. Using a socio-economic lens, our research examined to what extent mental well-being outcomes were associated with housing conditions in shared housing under COVID-19 restrictions in Australia. Data about private renters were obtained from the Australian Rental Housing Conditions Dataset (n = 1908), collected in mid-2020 during the easing of the first lockdown restrictions. Respondents living in shared arrangements reported higher levels of worry and anxiety (8.5-13.2%) and loneliness and isolation (3.7-18.3%) compared to other household types. Binary logistic regressions showed that COVID-19-related mental and financial well-being variables were the main contributors in COVID-19-related worry/anxiety and loneliness/isolation models. Accumulated housing problems were the only housing condition measure that was significant in the worry/anxiety model. Participants who had more than two people living in a household felt 1.4 times lonelier/isolated compared to those who lived with four or more people. Males and participants who reported good mental health were less likely to feel COVID-19-related worry/anxiety and loneliness/isolation. Our analysis demonstrates the importance of measures for mental health and income during a pandemic and concludes with recommendations of support for shared housing renters during and beyond crisis events.

The impact of endocrine disrupting compounds and carcinogens in wastewater: Implications for breast cancer.

The incidence of breast cancer is often associated with geographic variation which indicates that a person's surrounding environment can be an important etiological factor in cancer development. Environmental risk factors can include exposure to sewage- or wastewater, which consist of a complex mixture of pathogens, mutagens and carcinogens. Wastewater contains primarily carbonaceous, nitrogenous and phosphorus compounds, however it can also contain trace amounts of chemical pollutants including toxic metal cations, hydrocarbons and pesticides. More importantly, the contamination of drinking water by wastewater is a potential source of exposure to mammary carcinogens and endocrine disrupting compounds. Organic solvents and other pollutants often found in wastewater have been detected in various tissues, including breast and adipose tissues. Furthermore, these pollutants such as phenolic compounds in some detergents and plastics, as well as parabens and pesticides can mimic estrogen. High estrogen levels are a well-established risk factor for estrogen-receptor (ER) positive breast cancer. Therefore, exposure to wastewater is a risk factor for the initiation, progression and metastasis of breast cancer. Carcinogens present in wastewater can promote tumourigenesis through various mechanisms, including the formation of DNA adducts, gene mutations and oxidative stress. Lastly, the presence of endocrine disrupting compounds in wastewater can have negative implications for ER-positive breast cancers, where these molecules can activate ERα to promote cell proliferation, survival and metastasis. As such, strategies should be implemented to limit exposure, such as providing funding into treatment technologies and implementation of regulations that limit the production and use of these potentially harmful chemicals.

Community response to COVID-19: The case of rental housing cooperatives in Melbourne, Australia and Choluteca, Honduras.

COVID-19 and its restrictions have had widely documented negative impacts for private and social rental sectors, internationally. Limited evidence exists about how the pandemic effects were experienced in alternative forms of renting such as housing cooperatives. Rental cooperatives, recognised for their principles of democratic control, education and training and concern for community, may offer different outcomes for members than more individually-oriented rental forms. This paper seeks to explore whether and how COVID-19 was responded to within cooperative rental housing models, and if the pandemic posed a challenge to cooperative principles. Using a social practices approach, the analysis first identifies cooperative members' formal and informal responses to COVID-19, and second explores the meaning of such activities in the pandemic context in Australia and Honduras cooperatives. The continuity of usual housing cooperative practices and pandemic measures were analysed via in-depth interviews with 15 residents. Findings indicate that cooperative responses acted to reduce negative impacts of the pandemic or to find effective solutions. Rental housing cooperative residents' lived experiences during the COVID-19 pandemic, invite us to reflect on the role of housing cooperatives in the housing sector, the importance of collaborative housing models and the relevance of housing-based community resilience.

The implementation of the screening tool for autism in toddlers in Part C early intervention programs: An 18-month follow-up.

LAY ABSTRACT: The early detection of autism spectrum disorder can lead to access to autism spectrum disorder-specific services that have been shown to have a large impact on a child's overall development. Although a stable diagnosis of autism spectrum disorder can be made by age 2 years, most children are not diagnosed until much later. To address this issue, this study examined the effectiveness of training Part C Early Intervention providers to use an interactive autism spectrum disorder screening tool, the Screening Tool for Autism in Toddlers. Sixty-nine providers attended a 1-day training workshop on the use of the Screening Tool for Autism in Toddlers. After the workshop, providers reported increased knowledge about recognizing the early signs of autism spectrum disorder, and about 45% of the providers reported using the Screening Tool for Autism in Toddlers with families in their caseloads 18 months after the training. These results suggest that the Screening Tool for Autism in Toddlers is feasible for use within Early Intervention settings. In addition, they suggest that specific providers might serve as a screening "point-person," rather than expecting the Screening Tool for Autism in Toddlers to be used by all providers. Future research should aim to identify specific characteristics of agencies or providers that might be best suited for using the Screening Tool for Autism in Toddlers.

Telehealth Delivery in Part C Early Intervention: Provider and Caregiver Perspectives.

Telehealth is a promising modality for Part C early intervention (EI), services typically implemented face-to-face in home and community settings. Barriers to telehealth in EI reported prior to COVID-19 included lack of training and access to reliable internet. The abrupt telehealth shift at the onset of the pandemic did not permit a phased adoption approach. This mixed-methods study aimed to characterize perspectives of service changes resulting from the telehealth transition. Providers (n = 39) and caregivers (n = 11) completed surveys about perceptions towards the telehealth switch. All providers indicated at least one aspect of services had changed. Approximately half of caregivers reported satisfaction with services decreased and half that satisfaction remained the same. Implications for telehealth in EI beyond the pandemic are discussed.

Caregiver Attributions of Toddlers' Behaviors: A Comparison Between Groups of Children with Differing Developmental Concerns.

Little is known about the attributional patterns of caregivers of autistic children, particularly in relation to caregivers of children with other developmental or behavioral disorders. This study examined differences in caregiver attributions of child behavior between three groups: toddlers with (1) Autism spectrum disorder (ASD) or ASD concerns; (2) Other developmental concerns; and (3) No concerns. Qualitative descriptions of actual child behaviors were coded using a three-stage content analysis. Regression analyses were utilized to determine if group membership predicted types of positive and challenging behaviors caregivers endorsed, as well as their attributions of these behaviors. Caregivers of children with ASD or ASD concerns endorsed similar types of behaviors, but rated their child's positive behaviors as less characteristic of their child and more a function of the particular situation, less stable or permanent, and less controllable as compared to caregivers of toddlers with other developmental or no concerns. Additionally, they rated their child's challenging behaviors as more stable or permanent and less controllable as compared to caregivers of toddlers with other developmental concerns or no concerns. These findings suggest that caregivers of children with ASD and ASD related concerns may be vulnerable to a negative attributional pattern, which can have important implications for child and family functioning and overall quality of life.

Separate scoring algorithms for specific identification priorities optimize the screening properties of the Screening Tool for Autism in Toddlers (STAT).

The Screening Tool for Autism in Toddlers (STAT) is a validated stage-2 autism spectrum disorder (ASD) screening measure that takes 20 minutes to administer and comprises 12 play-based items that are scored according to specific criteria. This study examines an expanded version (STAT-E) that includes the examiner's subjective ratings of children's social engagement (SE) and atypical behaviors (AB) in the scoring algorithm. The sample comprised 238 children who were 24-35 months old. The STAT-E assessors had limited ASD experience to mimic its use by community-based non-specialists, and were trained using a scalable web-based platform. A diagnostic evaluation was completed by clinical experts who were blind to the STAT-E results. Logistic regression, ROC curves, and classification matrices and metrics were used to determine the screening properties of STAT-E when scored using the original STAT scoring algorithm versus a new algorithm that included the SE and AB ratings. Inclusion of the SE and AB ratings improved positive risk classification appreciably, while the specificity declined. These results suggest that the STAT-E using the original STAT scoring algorithm optimizes specificity, while the STAT-E scoring algorithm with the two new ratings optimizes the positive risk classification. Using multiple scoring algorithms on the STAT may provide improved screening accuracy for diverse contexts, and a scalable web-based tutorial may be a pathway for increasing the number of community providers who can administer the STAT and contribute toward increased rates of autism screening.

An Australian rental housing conditions research infrastructure.

Each year the proportion of Australians who rent their home increases and, for the first time in generations, there are now as many renters as outright homeowners. Researchers and policy makers, however, know very little about housing conditions within Australia's rental housing sector due to a lack of systematic, reliable data. In 2020, a collaboration of Australian universities commissioned a survey of tenant households to build a data infrastructure on the household and demographic characteristics, housing quality and conditions in the Australian rental sector. This data infrastructure was designed to be national (representative across all Australian States and Territories), and balanced across key population characteristics. The resultant Australian Rental Housing Conditions Dataset (ARHCD) is a publicly available data infrastructure for researchers and policy makers, providing a basis for national and international research.

A method for defining the CORE of a psychosocial intervention to guide adaptation in practice: Reciprocal imitation teaching as a case example.

LAY ABSTRACT: Interventions that support social communication include several "components," or parts (e.g. strategies for working with children and families, targeting specific skills). Some of these components may be essential for the intervention to work, while others may be recommended or viewed as helpful but not necessary for the intervention to work. "Recommended" components are often described as "adaptable" because they can be changed to improve fit in different settings where interventions are offered or with different individuals. We need to understand which parts of an intervention are essential (and which are adaptable) when translating interventions from research to community settings, but it is challenging to do this before studying an intervention in the community. This article presents the CORE (COmponents & Rationales for Effectiveness) Fidelity Method-a new method for defining the essential components of evidence-based interventions-and applies it to a case example of Reciprocal Imitation Teaching, an intervention that parents are taught to deliver with their young children with social communication delays. The CORE Fidelity Method involves three steps: (1) gathering information from multiple sources; (2) integrating information from previous research and theory; and (3) drafting a CORE model for ongoing use. The benefits of using the CORE Fidelity Method may include: (1) improving consistency in intervention and research materials to help all providers emphasize the most important skills or strategies; (2) clarifying which parts of the intervention can be adapted; and (3) supporting future research that evaluates which intervention components work and how they work.

Characterizing Available Tools for Synchronous Virtual Assessment of Toddlers with Suspected Autism Spectrum Disorder: A Brief Report.

The COVID-19 pandemic, and associated social distancing mandates, has placed significant limitations on in-person health services, requiring creative solutions for supporting clinicians engaged in the diagnosis of autism spectrum disorder (ASD). This report describes the five virtual instruments available at the time of manuscript development for use by experienced clinicians making diagnostic determinations of ASD for toddlers across the 12- to 36-months age range. We focus on synchronous virtual assessments in which clinicians guide the child's caregiver through a range of assessment activities and observe spontaneous and elicited behaviors. Assessments are compared on dimensions of targeted behavioral domains, specific activities and presses employed, scoring approaches, and other key logistical considerations to guide instrument selection for use in varied clinical and research contexts.

Reducing Barriers to Autism Screening in Community Primary Care: A Pragmatic Trial Using Web-Based Screening.

OBJECTIVE: To determine whether an intervention addressing both logistical and knowledge barriers to early screening for autism spectrum disorder (ASD) increases evidence-based screening during 18-month well-child visits and primary care providers' (PCPs') perceived self-efficacy in caring for children with ASD. METHODS: Forty-six PCPs from 10 diverse practices across four counties in Washington State participated. PCPs attended a 2-hour training workshop on early recognition and care for toddlers with ASD and use of a REDCap-based version of the Modified Checklist for Autism in Toddlers-Revised with Follow-up (webM-CHAT-R/F) that provided automated presentation and scoring of follow-up questions. Data were collected at baseline and 6 months following each county's training window. PCPs' screening methods and rates and perceived self-efficacy regarding ASD care were measured by self-report and webM-CHAT-R/F use was measured via REDCap records. RESULTS: At follow-up, 8 of the 10 practices were using the webM-CHAT-R/F routinely at 18-month visits. The proportion of PCPs reporting routine M-CHAT screening increased from 82% at baseline to 98% at follow-up (16% increase, 95% confidence interval [CI] 3%-28%; McNemar exact P = .02). The proportion using the M-CHAT-R/F follow-up interview questions increased from 33% to 82% (49% increase, 95% CI 30%-68%, exact McNemar test, P < .001). Significant increases in self-efficacy were found for all seven areas assessed (Ps ≤ .008). CONCLUSIONS: This brief intervention increased PCPs' self-reported valid use of the M-CHAT-R/F at 18 months and their self-efficacy regarding ASD care. Combining educational information with a web-based ASD screen incorporating the M-CHAT-R/F follow-up questions may increase universal ASD screening with improved fidelity.

Brief Report: Perceptions of Family-Centered Care Across Service Delivery Systems and Types of Caregiver Concerns About Their Toddlers' Development.

Family-centered care represents a collaborative partnership between caregivers and service providers, and is associated with positive caregiver and child outcomes. This approach may be especially important for caregivers with early concerns about autism, as service providers are often the gateway to appropriately-specialized intervention. Perceptions of family-centered care received from primary care providers (PCPs) and Part C Early Intervention (EI) providers were rated by two groups of caregivers: those concerned about autism (n = 37) and those concerned about another developmental problem (n = 22), using the Measure of Processes of Care (MPOC-20). Ratings did not differ across caregiver groups, but both groups rated EI providers significantly higher than PCPs, which may reflect systems-level differences between primary care and EI.

Rethinking autism spectrum disorder assessment for children during COVID-19 and beyond.

The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider approaches and assumptions that underlie the diagnostic assessment process, and to adopt new ways of individualizing standard assessments according to family and child needs. Mandates for physical distancing have uncovered deficiencies in diagnostic practices for suspected autism and have illuminated biases that have posed obstacles preventing children and families from receiving the services that they truly need. This Commentary outlines several considerations for improving diagnostic practices as we move forward from the current pandemic and continue to strive to build an adaptable, sustainable, equitable, and family-centered system of care. LAY SUMMARY: Physical distancing and the abrupt end to in-person services for many children on the autism spectrum has forced clinicians to examine the existing challenges with autism spectrum disorder (ASD) diagnostic assessment and consider things they want to keep and things that should be changed in the years ahead. New approaches such as telehealth both alleviated and exacerbated existing disparities, and brought into stark focus the importance of equitable and timely access to family-centered care. This commentary suggests ways of improving clinical practices related to ASD assessment to continue along this path.

The microbiology of rebuilding soils with water treatment residual co-amendments: Risks and benefits.

Water treatment residual (WTR) is composed of sludges from the potable water treatment process, currently largely destined for landfill. This waste can be diverted to rebuild degraded soils, aligning with the UN's Sustainable Development Goals 12 (Consumption and Production) and 15 (Terrestrial Ecosystems). Biosolids are tested against stringent pathogen guidelines, yet few studies have explored the microbial risk of WTR land application, despite anthropogenic impacts on water treatment. We explored the microbial risks and benefits of amending nutrient-poor sandy soil with WTRs. Our results showed that the culturable pathogen load of wet and dry WTRs did not warrant pre-processing before land application, according to South African national quality guidelines, with fecal coliforms not exceeding 104 colony forming units per gram dry weight in wet sludges sampled from four South African and Zimbabwean water treatment plants and decreasing upon drying and processing. There was no culturable pathogenic (fecal coliforms, enterococci, Salmonella, and Shigella) regrowth in soil incubations amended with dry WTR. However, the competition (microbial load and diversity) introduced by a WTR co-amendment did not limit pathogen survival in soils amended with biosolids. Application of WTR to nutrient-poor sandy soils for wheat (Triticum aestivum L.) growth improved the prokaryotic and eukaryotic culturable cell concentrations, similar to compost. However, the compost microbiome more significantly affected the bacterial beta diversity of the receiving soil than WTR when analyzed with automated ribosomal intergenic spacer analysis. Thus, although there was a low pathogen risk for WTR amendment in receiving soils and total soil microbial loads were increased, microbial diversity was more significantly enhanced by compost than WTR.

The Toddler Autism Symptom Inventory: Use in diagnostic evaluations of toddlers.

LAY ABSTRACT: Determining whether a young child has an autism spectrum disorder requires direct observation of the child and caregiver report of the child's everyday behaviors. There are few interviews for parents that are specifically designed for children under 3 years of age. The Toddler Autism Symptom Inventory is a new interview that asks caregivers of children age 12-36 months about symptoms of possible autism spectrum disorder. The Toddler Autism Symptom Inventory uses a cutoff score to indicate likelihood for autism spectrum disorder; this cutoff score appears to accurately identify most children who are diagnosed with autism spectrum disorder without identifying too many who do not have autism spectrum disorder. The Toddler Autism Symptom Inventory interview can help clinicians to determine whether a young child shows symptoms suggestive of an autism spectrum disorder.