Global distribution and coincidence of pollution, climate impacts, and health risk in the Anthropocene.

Previous research demonstrates that low-income countries face higher risks than high-income countries from toxic pollution and climate change. However, the relationship between these two risks is little explored or tested, and efforts to address the risks are often independent and uncoordinated. We argue that the global risks from toxic pollution and climate change are highly correlated and should be jointly analyzed in order to inform and better target efforts to reduce or mitigate both risks. We provide such analysis for 176 countries and found a strong (rs = -0.798;95%CI -0.852, -0.727) and significant (p<0.0001) relationship between the distribution of climate risk and toxic pollution. We also found that inequities in pollution production, economic status, and institutional readiness are interconnected and exacerbate risk for countries already in the highest risk categories for both toxic and non-toxic (greenhouse gas) pollution. The findings have policy implications, including the use of the proposed Target assessment to decide where best to address toxic and non-toxic pollution simultaneously, based on the need to minimize human suffering and maximize return on effort.

Correction: Toxic trajectories under future climate conditions.

[This corrects the article DOI: 10.1371/journal.pone.0226958.].

Simulation-based evaluation of anaesthesia residents: optimising resource use in a competency-based assessment framework.

Introduction: Simulation training in anaesthesiology bridges the gap between theory and practice by allowing trainees to engage in high-stakes clinical training without jeopardising patient safety. However, implementing simulation-based assessments within an academic programme is highly resource intensive, and the optimal number of scenarios and faculty required for accurate competency-based assessment remains to be determined. Using a generalisability study methodology, we examine the structure of simulation-based assessment in regard to the minimal number of scenarios and faculty assessors required for optimal competency-based assessments. Methods: Seventeen anaesthesiology residents each performed four simulations which were assessed by two expert raters. Generalisability analysis (G-analysis) was used to estimate the extent of variance attributable to (1) the scenarios, (2) the assessors and (3) the participants. The D-coefficient and the G-coefficient were used to determine accuracy targets and to predict the impact of adjusting the number of scenarios or faculty assessors. Results: We showed that multivariate G-analysis can be used to estimate the number of simulations and raters required to optimise assessment. In this study, the optimal balance was obtained when four scenarios were assessed by two simulation experts. Conclusion: Simulation-based assessment is becoming an increasingly important tool for assessing the competency of medical residents in conjunction with other assessment methods. G-analysis can be used to assist in planning for optimal resource use and cost-efficacy.

Toxic trajectories under future climate conditions.

Extreme weather events, driven by changing climatic conditions, interact with our built environment by distributing-or redistributing-environmental risk and damaging physical infrastructure. We focus on the role of extreme weather events in the distribution of toxic substances within and between residential communities in the largest cities in the United States (US). We explore the impact of projected inland and coastal flooding on the redistribution of toxicity from known contaminated sites, and how patterns of toxic flow change the total population and social demographics of the population at risk from toxic materials. We use the Urban Adaptation Assessment and data on toxic site locations from the US government to evaluate risk of toxin dispersion from flooding in cities and down to the census tract level for the period 2021-2061. We demonstrate that future climate conditions significantly increase the risk of the dispersion of toxins from contaminated sites by 2041.

Toward an Understanding of the Essential Components of Behavior Analytic Service Plans.

Baer, Wolf, and Risley (1968) indicated "technological" was one of seven core dimensions of applied behavior analysis (ABA). They described this dimension as being met if interventions were described well enough to be implemented correctly. Often in the applied settings, a behavior plan is the method by which interventions are communicated to staff and parents for implementation. The necessary components of a behavior plan have been discussed in relation to compliance with regulations (e.g., Vollmer, Iwata, Zarcone, & Rodgers, Research in Developmental Disabilities 13:429-441, 1992), in school settings (e.g., Horner, Sugai, Todd, & Lewis-Palmer, Exceptionality: A Special Education Journal 8:205-215, 2000), and other applied settings (e.g., Tarbox et al., Research in Autism Spectrum Disorder 7:1509-1517, 2013) for the last 25 years. The purpose of this research is to review the literature regarding components of behavior plans and synthesize it with a recent survey of behavior analysts regarding essential components of behavior plans. The results are discussed in light of training, treatment fidelity implications (i.e., Registered Behavior Technician Task List), public policy development (e.g., state initiative for a single behavior plan template), and research opportunities (e.g., comparison of different visual structures).

Developing the Cultural Awareness Skills of Behavior Analysts.

All individuals are a part of at least one culture. These cultural contingencies shape behavior, behavior that may or may not be acceptable or familiar to behavior analysts from another culture. To better serve individuals, assessments and interventions should be selected with a consideration of cultural factors, including cultural preferences and norms. The purpose of this paper is to provide suggestions to serve as a starting point for developing behavior analysts' cultural awareness skills. We present strategies for understanding behavior analysts' personal cultural values and contingencies and those of their clients, integrating cultural awareness practices into service delivery, supervision, and professional development, and becoming culturally aware in everyday practice.