Regional Area Research Articles

Structural Magnetic Resonance Imaging-Based Surface Morphometry Analysis of Pediatric Down Syndrome.

Down syndrome (DS) is a genetic disorder characterized by intellectual disability whose etiology includes an additional partial or full copy of chromosome 21. Brain surface morphometry analyses can potentially assist in providing a better understanding of structural brain differences, and may help characterize DS-specific neurodevelopment. We performed a retrospective surface morphometry study of 73 magnetic resonance imaging (MRI) examinations of DS patients (aged 1 day to 22 years) and compared them to a large cohort of 993 brain MRI examinations of neurotypical participants, aged 1 day to 32 years. Surface curvature measurements, absolute surface area measurements, and surface areas as a percentage of total brain surface area (%TBSA) were extracted from each brain region in each examination. Results demonstrate broad reductions in surface area and abnormalities of surface curvature measurements across the brain in DS. After adjusting our regional surface area measurements as %TBSA, abnormally increased presentation in DS relative to neurotypical controls was observed in the left precentral, bilateral entorhinal, left parahippocampal, and bilateral perirhinal cortices, as well as Brodmann's area 44 (left), and the right temporal pole. Findings suggest the presence of developmental abnormalities of regional %TBSA in DS that can be characterized from clinical MRI examinations.

Regional gray matter changes in steatotic liver disease provide a neurobiological link to depression: A cross-sectional UK Biobank cohort study

BackgroundSteatotic liver disease (SLD) is characterized by excessive accumulation of lipids in the liver. It is associated with elevated risk of hepatic and cardiometabolic diseases, as well as mental disorders such as depression. Previous studies revealed global gray matter reduction in SLD. To investigate a possible shared neurobiology with depression, we examined liver fat-related regional gray matter alterations in SLD and its most significant clinical subgroup metabolic dysfunction-associated steatotic liver disease (MASLD). MethodsWe analyzed regional cortical thickness and area obtained from brain MRI in 29,051 participants in UK Biobank. Liver fat amount was computed as proton density fat fraction (PDFF) from liver MRI scans. We examined the relationship between brain structure and PDFF, adjusting for sociodemographic, physical, lifestyle, and environmental factors, as well as alcohol intake and a spectrum of cardiometabolic covariates. Finally, we compared patterns of brain alterations in SLD/MASLD and major depressive disorder (MDD) using previously published results. ResultsPDFF-related gray matter alterations were region-specific, involving both increases and decreases in cortical thickness, and increased cortical area. In several regions, PDFF effects on gray matter could also be attributed to cardiometabolic covariates. However, PDFF was consistently associated with lower cortical thickness in middle and superior temporal regions and higher cortical thickness in pericalcarine and right frontal pole regions. PDFF-related alterations for the SLD and the MASLD group correlated with those observed in MDD (Pearson r = 0.45–0.54, p < 0.01). ConclusionThese findings suggest the presence of shared biological mechanisms linking MDD to SLD and MASLD. They might explain the well-known elevated risk of depression in these groups and support early lifestyle interventions and treatment of metabolic risk factors for the successful management of the interconnected diseases depression and SLD/MASLD.

The Genetic Architecture of the Human Corpus Callosum and its Subregions.

The corpus callosum (CC) is the largest set of white matter fibers connecting the two hemispheres of the brain. In humans, it is essential for coordinating sensorimotor responses, performing associative/executive functions, and representing information in multiple dimensions. Understanding which genetic variants underpin corpus callosum morphometry, and their shared influence on cortical structure and susceptibility to neuropsychiatric disorders, can provide molecular insights into the CC's role in mediating cortical development and its contribution to neuropsychiatric disease. To characterize the morphometry of the midsagittal corpus callosum, we developed a publicly available artificial intelligence based tool to extract, parcellate, and calculate its total and regional area and thickness. Using the UK Biobank (UKB) and the Adolescent Brain Cognitive Development study (ABCD), we extracted measures of midsagittal corpus callosum morphometry and performed a genome-wide association study (GWAS) meta-analysis of European participants (combined N = 46,685). We then examined evidence for generalization to the non-European participants of the UKB and ABCD cohorts (combined N = 7,040). Post-GWAS analyses implicate prenatal intracellular organization and cell growth patterns, and high heritability in regions of open chromatin, suggesting transcriptional activity regulation in early development. Results suggest programmed cell death mediated by the immune system drives the thinning of the posterior body and isthmus. Global and local genetic overlap, along with causal genetic liability, between the corpus callosum, cerebral cortex, and neuropsychiatric disorders such as attention-deficit/hyperactivity and bipolar disorders were identified. These results provide insight into variability of corpus callosum development, its genetic influence on the cerebral cortex, and biological mechanisms related to neuropsychiatric dysfunction.

Survival Probability of Tourist Accommodation Establishments in Romania in Relation to the Action of Some Relevant Factors

The units with tourist functions in Romania have a variable duration of activity resulting from the actions of different factors, but which can be analysed mathematically through survival analysis models. The number of establishments offering accommodation for tourism purposes in Romania exceeds 22,000, and the data indicated by the Ministry of Economy, Entrepreneurship and Tourism on the companies that manage them are the inputs of the study. These allowed for the creation of a statistical database showing the total operating time from establishment to the present or to the cessation of activity. Grouping was carried out according to the type of establishment, the location of the companies in rural or urban areas, their belonging to a geographical region of Romania and classification according to the comfort category. The drawing up of evolution curves describing the probability of survival of the establishments, distinctly for the groups mentioned, and the statistical analysis to establish the significance of the differences between the groups provide information that allows for determining and understanding how certain factors influence the chances of survival of the tourist establishment. The type of accommodation unit, the region of development in which the unit is located and the category of comfort are the factors that have a statistically significant influence on the probability of survival of these units. The location of tourism units in rural or urban areas is not a relevant factor. Knowledge of the actions of these factors allows for optimising the measures taken at the start of an activity in the tourism industry. These can result in improving the survivability of tourism. Sustainable tourism involves developing and supporting different forms of tourism by implementing activity management at both the accommodation unit level and at the locality, regional or whole tourist area level. The survival and continuity of the tourism business on the market and, at the same time, respect for the natural, social and economic integrity of the environment can ensure the rational exploitation of natural and cultural resources for future generations.

Large-scale analysis of structural brain asymmetries during neurodevelopment: Associations with age and sex in 4265 children and adolescents.

Only a small number of studies have assessed structural differences between the two hemispheres during childhood and adolescence. However, the existing findings lack consistency or are restricted to a particular brain region, a specific brain feature, or a relatively narrow age range. Here, we investigated associations between brain asymmetry and age as well as sex in one of the largest pediatric samples to date (n = 4265), aged 1-18 years, scanned at 69 sites participating in the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) consortium. Our study revealed that significant brain asymmetries already exist in childhood, but their magnitude and direction depend on the brain region examined and the morphometric measurement used (cortical volume or thickness, regional surface area, or subcortical volume). With respect to effects of age, some asymmetries became weaker over time while others became stronger; sometimes they even reversed direction. With respect to sex differences, the total number of regions exhibiting significant asymmetries was larger in females than in males, while the total number of measurements indicating significant asymmetries was larger in males (as we obtained more than one measurement per cortical region). The magnitude of the significant asymmetries was also greater in males. However, effect sizes for both age effects and sex differences were small. Taken together, these findings suggest that cerebral asymmetries are an inherent organizational pattern of the brain that manifests early in life. Overall, brain asymmetry appears to be relatively stable throughout childhood and adolescence, with some differential effects in males and females.

Forty-Year Fire History Reconstruction from Landsat Data in Mediterranean Ecosystems of Algeria following International Standards

Algeria, the main fire hotspot on the southern rim of the Mediterranean Basin, lacks a complete fire dataset with official fire perimeters, and the existing one contains inconsistencies. Preprocessed global and regional burned area (BA) products provide valuable insights into fire patterns, characteristics, and dynamics over time and space, and into their impact on climate change. Nevertheless, they exhibit certain limitations linked with their inherent spatio-temporal resolutions as well as temporal and geographical coverage. To address the need for reliable BA information in Algeria, we systematically reconstructed, validated, and analyzed a 40-year (1984–2023) BA product (NEALGEBA; North Eastern ALGeria Burned Area) at 30 m spatial resolution in the typical Mediterranean ecosystems of this region, following international standards. We used Landsat data and the BA Mapping Tools (BAMTs) in the Google Earth Engine (GEE) to map BAs. The spatial validation of NEALGEBA, performed for 2017 and 2021 using independent 10 m spatial resolution Sentinel-2 reference data, showed overall accuracies &gt; 98.10%; commission and omission errors &lt; 8.20%; Dice coefficients &gt; 91.90%; and relative biases &lt; 3.44%. The temporal validation, however, using MODIS and VIIRS active fire hotspots, emphasized the limitation of Landsat-based BA products in temporal fire reporting accuracy terms. The intercomparison with five readily available BA products for 2017, by using the same validation process, demonstrated the overall outperformance of NEALGEBA. Furthermore, our BA product exhibited the highest correspondence with the ground-based BA estimates. NEALGEBA currently represents the most continuous and reliable time series of BA history at fine spatial resolution for NE Algeria, offering a significant contribution to further national and international fire hazard and impact assessments and acts as a reference dataset for contextualizing future weather extremes, such as the 2023 exceptional heat wave, which we show not to have led to the most extreme fire year over the last four decades.

The supply elasticity and housing price bubbles in New South Wales, Australia

AbstractIn this study, we use a supply and demand model to estimate housing supply elasticity in New South Wales Australia based on yearly data for the 126 local government areas from 1991 to 2019, and investigate effects of supply elasticity on responses of housing prices and new constructions to housing price bubbles from 2002 to 2004. In particular, when conducting supply elasticity estimation, we use multi‐factor error structures to address cross‐sectional dependence issues, which is ignored by previous studies. We find that the supply elasticity estimates are statistically significant at the state level (0.36), in the regional coastal area (0.97) and in the regional inland area (0.41 but can be inconsistent and inefficient due to cross‐sectional dependence), while perfectly inelastic in the metropolitan area. Effects of supply elasticity on the market responses to bubbles are largely affected by market heterogeneity such as overall supply elasticity levels and demand degrees. The findings may compensate for the limitations of the theory in Glaeser et al. (2008, J Urban Econ, 64:198–217) and offer potential avenues for future development of the theory. Our results implies that bubbles promote development in elastic areas of the metropolitan market and inelastic areas of the regional coastal market, and that balancing urban and regional development is important for dealing with bubble‐related affordability issues.

Short-Term Accommodations and Long-Term Housing Challenges in the Margaret River Tourist Destination: A Perspective of Population Movement and Pricing

This study aimed to investigate the impact of short-stay accommodation (SSA) on housing dynamics, community welfare, and economic development in the Margaret River regional area. Grounded in an exploratory research paradigm, qualitative methods were used to gather insights from key stakeholders such as property owners, realtors, and council officials. Purposive sampling was utilized to select participants with diverse experiences and perspectives on SSA. Semi-structured interviews were conducted, totaling 21 interview sessions spanning almost 600 min, to capture in-depth and nuanced perspectives on SSA’s impact and regulatory landscape. Thematic analysis of the interview data, which was divided into two segments, revealed significant concerns regarding housing affordability, community well-being, and regulatory effectiveness. Additionally, the study uncovered a complex relationship between SSA and population dynamics, highlighting implications for the local housing infrastructure and market stability. The findings underscore the urgency of collaborative policy interventions to address the housing crisis and mitigate the adverse effects of SSA on local communities. Policymakers and stakeholders can utilize these insights to develop holistic strategies that prioritize equity, inclusivity, and shared prosperity in shaping the future of housing in regional areas such as Margaret River. This study contributes original insights by providing a nuanced understanding of the multifaceted implications of SSA on housing dynamics and community welfare in a regional context. By using qualitative methods and engaging key stakeholders, the research offers unique perspectives on the challenges and opportunities associated with the proliferation of SSA, thereby advancing scholarly discourse, and informing evidence-based policymaking in the field of housing studies.

Calibration of the online dose monitoring system at the free-electron laser SwissFEL

The latest large-scale research facility of the Paul Scherrer Institute, the x-ray free-electron laser SwissFEL, is installed in a 740 m long building. The facility accelerates electrons to a maximal energy of 5.8 GeV with repetition rates up to 100 Hz. The building is integrated in a regional recreation area with shielding of the accelerator vault dimensioned to tolerate temporary beam losses. An online dose monitoring system capable of shutting down SwissFEL ensures compliance with legal requirements. The studies present an overview of the evaluation of calibration factors for this system and results of dedicated benchmark measurements, carried out to verify underlying assumptions and simplifications.

A dataset of social-economic and environmental parameters at township and county levels in Guangxi Zhuang Autonomous Region

Guangxi Zhuang Autonomous Region is located in the southwest of China, boasting rich natural ecological resources and diverse social and cultural backgrounds. To carry out sustainable development research in the provincial (regional) area, it is essential to have accurate socio-economic and environmental data at township and county levels across spatial and temporal scales. In this study, we gathered environmental, infrastructure, and industrial and agricultural production data from various sources, and produced the environmental parameter data, infrastructure and industrial and agricultural production data for 1,241 township units through extracting parameters and superposing township boundary vectors with environmental parameters, infrastructure data as well as industrial and agricultural production raster data. Additionally, based on the statistical yearbook of Guangxi issued by Guangxi Zhuang Autonomous Region Statistical Bureau, we compiled the socio-economic data for 111 counties in Guangx, resulting in the formation of a dataset of social-economic and environmental parameters at township and county levels in Guangxi Zhuang Autonomous Region. The dataset maintains the accuracy of the original data and meets the requirements for data completeness, positional accuracy, and attribute accuracy, as verified by multiple reviewers in accordance with relevant technical regulations and standards. This dataset is publicly available, featuring a long time series and multiple types. The parameter dimensions as well as the spatial and temporal dimensions of the dataset can be expanded, providing data support for sustainable development in the region at multiple scales.

دور تيارات النقل في إبراز المركزية الحضرية وتنظيم المجال الجهوي للمدن حالة مدينة القنيطرة، المغرب

This article aims to highlight the role of transportation streams in enhancing the urban centralization of Kenitra. The study will analyze how the city’s regional area is organized, starting with the first-class taxi transport streams and other forms of transportation such as dual and unrevealed transportation. We will be able to get precise data regarding the number of daily trips made between the city of Kenitra and other locations due to this study. Additionally, it will provide us with a clear understanding of the relationships that exist between the city and the territorial areas and surrounding regions, which enables us to calculate the difference in movement density between the city of Kenitra and the various regions that fall under its area of impact. This study is contemporary because it is one of the few that examined how transportation organized Kenitra's regional area and increased its urban centrality. It is also contemporary because field research was used, which lends scientific validity to the conclusions drawn.

Identification and integration of ventilation corridors in Shijiazhuang City, China

The construction of a ventilation corridor network is of great significance for alleviating the urban heat island effect, controlling air pollution, and improving environmental problems. Based on the "source–sink" theory and climatology, this study has developed the identification model for ventilation corridors and the evaluation model for the significance of ventilation corridors. Focusing on Shijiazhuang City as the study area, we integrated meteorological data, remote sensing, and fundamental geographic information to study the distribution characteristics of resistance surfaces, the delineation of source areas, the assessment of ventilation corridor potential, and the amalgamation of the ventilation corridor distribution pattern across various scales. The results showed the following: (1) In Shijiazhuang City, a comprehensive assessment identified a total of 55 supply–type sources and 20 demand–type sources. 19 ventilation corridors were identified in winter, with a commensurate count of 20 in summer. In the urban district of Shijiazhuang City, 42 supply–type sources and 24 demand–type sources underwent screening, leading to the identification of 27 ventilation corridors in both summer and winter. (2) Through a process of amalgamating and streamlining ventilation corridors with superior connectivity in both winter and summer, we identified and designated seven first–level ventilation corridors and six second–level corridors within the regional area. Similarly, within the urban district, ten first–level ventilation corridors and six second–level ventilation corridors were singled out. This selection serves as a preliminary establishment of the spatial configuration, delineating "five horizontal and eight vertical" ventilation corridors in Shijiazhuang City (regional area) and "seven horizontal and seven vertical" ventilation corridors in the urban district. Finally, leveraging geospatial analysis tools facilitated the seamless connection of ventilation corridors across different scales. These research results furnish a theoretical framework for urban planning, offering a valuable reference in the determination of ventilation corridors.

Patisiran for the treatment of patients with p.Ile88Leu hereditary transthyretin amyloidosis: an Italian real-life experience.

Evidence on the activity of patisiran therapy in specific subgroups of patients with hereditary transthyretin amyloidosis variant (ATTRv) is still scarce. This prospective real-world study was designed to provide the first in-depth clinical data on the effectiveness of patisiran in patients with ATTRv reporting the p.Ile88Leu variant, the most widespread variant in the Emilia-Romagna regional area, which has been less represented in previous clinical trials. This prospective study evaluated all the patients with genetically proven ATTRv (p.Ile88Leu) and polyneuropathy treated with patisiran in the Emilia-Romagna referral centers for ATTRv (Institute of Neurological Sciences in Bologna and Division of Neurology in Rimini) from March 2021 to April 2023. All subjects underwent clinical and neurological evaluations at baseline and after 9-12 months of treatment. A total of 22 patients were included in the study; the median age was 73 years (IQR: 9), the age at diagnosis was 72 years (IQR: 10), and the disease duration was 1.6 years (IQR: 2.3). We observed stability of all considered neurological and cardiological parameters at 9-12 months after the beginning of patisiran treatment. Our findings support the clinical data regarding the effectiveness of patisiran in stabilizing the disease course and extend this activity to the subset of patients with the p.Ile88Leu variant.

Effect of nivolumab combined with definitive chemoradiotherapy on response rate for esophageal cancer: An immune active intrinsic subtype could be its biomarker—The NOBEL trial.

4068 Background: The usefulness of combined therapy with immune checkpoint inhibitors (ICI) and chemoradiotherapy (CRT) and its potential biomarker of treatment efficacy for esophageal cancer remains unclear. We investigated the safety, efficacy, and associated biomarkers of combined therapy with ICI and definitive CRT in operable and inoperable esophageal squamous cell carcinoma (ESCC). Methods: This prospective single-arm phase 2 trial was performed at five hospitals in Japan. Patients aged 20–75 years with histologically confirmed ESCC, an ECOG PS score of 0 or 1, and adequate organ and bone marrow functions were eligible. Inoperable patients did not have distant organ metastasis. Patients did not receive any chemotherapy or surgical resection as an initial therapy. Concurrent radiotherapy (50.4 Gy/28 fractions to the primary lesion and 41.4 Gy/23 fractions to the regional LN area) consisted of 4 courses of CF (cisplatin, 75 mg/m2/day, day 1; 5-fluorouracil, 1000 mg/m2/day, days 1–4) plus nivolumab (240 mg/m2/day, every 2 weeks for up to 1 year). The primary endpoint was safety. The incidence rates of nonhematological toxicity grade ≥ 4 and pneumonitis grade ≥ 3 were ≤10% and ≤15%, respectively. The secondary endpoints included overall survival (OS), progression-free survival (PFS), complete response (CR) rate, and time to esophagectomy-free survival (EFS). Sixty patients were to be accrued, but the trial enrollment was terminated because of slow accrual. This trial was registered as jRCT1091220408. Results: Between January 2019 and September 2021, 42 patients were enrolled. Twenty-five patients had operable disease and 16 had inoperable disease. Two patients (4.8%) experienced grade 3 pneumonitis, suggesting that the primary endpoint was met. The median relative dose intensity of nivolumab was 92.4%. One-year OS, PFS, and EFS rates in all cases were 92.7%, 65.4%, and 78.0%, respectively. One-year OS, PFS, and EFS rates in operable and inoperable cases were 100%, 79.6%, and 84.0% and 81.3%, 43.8%, and 68.8%, respectively. The CR and objective response rates were 73.2% (95% confidence interval [CI]: 58.1%–84.3%) and 87.8% (95% CI: 74.5%–94.7%), respectively. The CR rates in operable and inoperable cases were 84% (95% CI: 65.3%–93.6%) and 56.3% (95% CI: 33.2%–76.9%), respectively. Immune high-active intrinsic subtype before treatment (n=4) with an expression score &gt; 80 of 51 immune-related genes showed a high CR rate (100%, n=4), whereas the immune low-active intrinsic subtype (n=37) with an expression score &lt; 80 showed a relatively high CR rate (70%). Conclusions: Nivolumab combined with definitive CRT provided encouraging efficacy and acceptable toxicity in patients with ESCC. Immune high-active intrinsic subtype before treatment has the potential to predict a high CR rate for this combination treatment. Clinical trial information: jRCT1091220408 .

Few large or many small fires: Using spatial scaling of severe fire to quantify effects of fire‐size distribution shifts

AbstractAs wildfire activity increases and fire‐size distributions potentially shift in many forested regions worldwide, anticipating the spatial patterns of burn severity expected with future fire activity is critical for ecological understanding and informing management and policy. Because spatial patterns of burn severity are influenced by a complex mixture of drivers, they remain difficult to predict for any given burned landscape. At broader extents, however, spatial scaling relationships relating high‐severity patch size and shape to overall fire size, when combined with scenarios regarding regional area burned and fire‐size distributions, offer a means to anticipate the spatial configuration of burn severity in future fires. Here, leveraging a satellite burn‐severity dataset for 1615 fire events occurring across the northwest United States between 1985 and 2020, we present an approach for simulating expected patch‐level burn‐severity patterns at the scale of a region or fire regime of interest. We demonstrate this approach in a historically climate‐limited fire regime within the Pacific Northwest, USA, where relatively infrequent but large and severe fires shape biomass‐rich forests, and where fire potential is projected to increase as summer fire seasons become warmer and drier. We quantify how, for a given total burned area, the range of cumulative burn‐severity patterns is expected to vary with the size distributions of fire events. Our results illustrate how shifts in fire‐size distributions toward larger fire events will lead to increasingly large high‐severity burn patches with interior areas that are increasingly far from unburned seed sources following fire. In contrast, the same total area burned in more numerous but smaller fire events will result in qualitatively different cumulative patterns of burn severity, characterized by smaller high‐severity patches and closer proximity to postfire seed sources across burned landscapes. These results have important implications in forested regions, informing management actions ranging from prefire planning (e.g., fire response preparedness) to real‐time decision‐making (e.g., fire suppression vs. managed wildfire use) and postfire responses (e.g., replanting to restore tree cover and/or promoting early‐seral habitat). The approach we present is generalizable and can be applied across regions and fire regimes to anticipate potential future fire effects.

Analysis of spatial patterns and influencing factors of farmland transfer in China based on ESDA-GeoDetector

Farmland transfer is a critical component in facilitating agricultural scale management and improving agricultural production efficiency. This study examines the spatial distribution of farmland transfer in China and identifies the factors influencing it, offering valuable guidance for advancing China’s farmland transfer practices. Through the application of mathematical statistics and GIS spatial analysis, the study investigates changes in spatial patterns related to the scale, rate, mode, and recipients of farmland transfer across China's 30 provinces from 2015 to 2020. Geographical detectors are also employed to identify the key factors influencing the extent and pace of farmland transfer. The study reveals that between 2015 and 2020, China's farmland transfer area increased from 29,789 to 37,638 million hectares. Provinces with abundant farmland resources generally experienced larger farmland transfers, while economically developed regions and major grain-producing areas saw higher rates of farmland transfers. The predominant mode of farmland transfer in China was leasing (subcontracting), accounting for over 80% of the total transferred area. Large-scale grain growers and family farms were significant participants in farmland transfers, acquiring approximately 60.1% of the transferred lands, followed by professional cooperatives (21.5%), enterprises (10.4%), and other entities (7.9%). Key factors influencing the farmland transfer area include the "regional farmland area", the "proportion of family farms supported by loans", and the "proportion of non-agricultural population", with explanatory powers of 0.663, 0.319, and 0.225, respectively. Notably, there is a substantial interaction between the "regional farmland area" and factors such as the "proportion of family farms supported by loans" and the "grain yield per unit area", with explanatory powers reaching 0.957 and 0.901, respectively. These findings offer valuable insights for promoting farmland transfer in agriculturally rich regions. Factors affecting the farmland transfer rate include "grain yield per unit area", "GDP per capita", and the "proportion of non-agricultural population", each with an explanatory power above 0.500. Moreover, their interactive explanatory powers with other indicators exceed 0.600, indicating that provinces with high agricultural productivity or economic development levels are more likely to undergo farmland transfer. The paper concludes by proposing strategies and recommendations to promote farmland transfer in both "large agricultural areas" and "metropolitan suburbs."

The process of co-designing a model of social prescribing: An Australian case study.

Social needs such as housing, employment, food, incomeand social isolation are having a significant impact on individuals, familiesand communities. Individuals are increasingly presenting to health settings with social needs, which are ill-equipped to address nonmedical needs. Social prescribing is a systematic approach connecting the health, social and community sectors to better address social needs and improve health and wellbeing. Social prescribing interventions are being implemented world-wide. With variability in health and social care systems internationally, it is important that social prescribing interventions are co-designed with key stakeholders to ensure they can be implemented and sustained within local systems. This Australian case study provides a detailed description of the process undertaken to co-design a social prescribing service model in a regional area. Four co-design workshops were undertaken, two with health and social care professionals and two with community members. The project followed an iterative process of resourcing, planning, recruiting, sensitising, facilitation, reflectionand building for change across the workshops. Through this process, key stakeholders were able to successfully co-design a social prescribing model of care for the region. By demonstrating the process and materials used in our project, we aim to open the 'black box' of co-design for social prescribing and provide ideas and resources for others to adapt and utilise. The project was designed and undertaken by a steering committee comprising university-based researchers (authors C. O. andS. B.), local government (author D. A.)and health, socialand community services (authors B. G., M. W., J. O.andS. R.). Members of the steering committee participated in project design, participant recruitment, workshopfacilitation, data analysisand interpretation.

Kids+ Parent Infant Program (PIP): a community model for supporting partnerships in early developmental follow-up and support.

High-risk infants are discharged home from hospital with increased care needs and the potential for the emergence of developmental disabilities, contributing to high levels of parental stress and anxiety. To enable optimal outcomes for high-risk infants and their families, developmental follow-up programs need to continue following hospital discharge. However, current follow-up care for high-risk infants is variable in terms of type, access and equity, and there seems to be a gap in existing services such as supporting the transition home, parental support, and inclusion of all at-risk infants regardless of causality. Routine follow-up that identifies developmental delays or neuromotor concerns can facilitate timely referral and access to targeted intervention during critical periods of development. The Kids+ Parent Infant Program (PIP) is a unique model of developmental follow-up that shares some characteristics with established programs, but also includes additional key elements for a seamless, wrap-around service for all high-risk infants and their families living in a regional area of Australia. This community-based program provides integrated assessment and intervention of infants, alongside parent support and education, embracing a holistic model that accounts for the complexity and interrelatedness of infant, parent, medical and developmental factors. By prioritising the well-being of high-risk infants and their families, the Kids+ PIP paves the way for improved developmental outcomes and provides an innovative model for developmental follow-up, with the potential for reproduction in other healthcare settings.

SCOPING THE AVAILABILITY AND APPROPRIATENESS OF EXERCISE SERVICES FOR PEOPLE WITH CANCER IN REGIONAL WESTERN AUSTRALIA

BACKGROUND National guidance directs oncology healthcare professionals to refer patients to exercise in standard care, yet referrals happen rarely in practice resulting in a critical research-to-practice gap. One major barrier preventing referrals—especially in rural and regional areas—is the lack of appropriate exercise programming available to people with cancer. Therefore, the aims of this study are to 1) determine the availability of exercise oncology programs in a regional area of Western Australia; and 2) explore the appropriateness of these resources to meet the needs of people living with cancer in this region so that a comprehensive referral resource can be created for the region. METHODS A comprehensive online search identified all exercise services available in the region for people with cancer. Services were categorised using the Cancer Rehabilitation to Recreation (CaReR) framework to describe the level of care each provided. The geographical makeup and demographics of the cancer population in the region were matched to the services to identify service-gaps. RESULTS Approximately 194 000 people live in the Soutwest, with ∼1300 residents diagnosed with cancer each year. Sixty-six exercise oncology services were identified as appropriate for serving this entire population. 62% of all programs were located in the two largest shires across the region. 66% of services were categorised as CaReR Phase 1, providing targeted, supervised care for high-needs patients; 79% as Phase 2, providing targeted, supervised care for medium needs patients; and 28 percent as Phase 3, independent, community-based care for low needs patients. CONCLUSION The Southwest region is significantly under-resourced to meet the national directive to embed exercise referrals into care for people with cancer. Lack of available exercise services for this population, and few programs catering for a diverse range of patient needs underpin this. Implementation-focused research is required to address this critical research-to-practice gap.

The Latrobe Smoking Support Service: A quantitative study of participants in a regional area.

More than 70% of current smokers in Australia have a definite plan to stop smoking and around half of them try to quit every year. Latrobe Community Health Service (LCHS) was commissioned by Gippsland Primary Health Network to establish Latrobe Smoking Support Service (LSSS) to break down barriers to accessing services and increase support for smoking cessation. This research aims to assess the feasibility of an ongoing smoking cessation support service and determine the effect the LSSS has on client smoking behavior. Quantitative data were collected for the LSSS situated at LCHS during the period from September 2021 to March 2022. A new client survey, a returning client survey, and a 6-week follow-up survey were conducted by Clinic staff. The consent forms were obtained from the clients. A total of 117 clients attended the LSSS at least once, and a further 315 returning client sessions were conducted. The data analysis was undertaken by means of various descriptive and inferential statistical techniques, such as multiple linear regression analysis. The research findings demonstrate the strong positive effect of the LSSS in helping clients to change their smoking behavior. Results of multiple regression analysis highlight the significant role of behavioral intervention strategies in the LSSS's success. A combination of both nicotine replacement therapy (NRT) and counseling was a key contributor to the project's success. This research proposed and tested the model of a smoking cessation support service that combines a comprehensive mix of services for smokers including free NRT, free counseling, and ongoing support of counselors or/and nurse practitioners.