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IntroductionAdults with intellectual and/or developmental disabilities (IDD) experience higher rates of age-related health concerns, including dementia, than adults without disabilities. Despite this, current efforts to support brain health in ageing have often excluded this population. To address this gap, we will codesign, codeliver and evaluate a national virtual brain health education programme, Brain Health-IDD, for ageing individuals with IDD, family caregivers and health and social care providers.Methods and analysisThis study will evaluate the Brain Health-IDD Program, an interactive virtual psychoeducation course codesigned and coled by an interdisciplinary team of clinicians and people with lived experience. Three participant groups will be recruited from across Canada: adults with IDD, aged 40 years and older; family caregivers who have a family member with IDD aged 40 years and older or who are themselves aged 60 years and older; and health or social service providers who support adults with IDD aged 40 years and older. Outcomes will be measured at baseline, postcourse and 3-month follow-up. Data will be collected through structured surveys, including both closed and open-ended questions, and focus group interviews.Primary outcomes are participation, satisfaction and changes in knowledge and self-efficacy related to brain health among the three participant groups. Secondary outcomes for both adults with IDD and family caregivers include changes in health-related behaviours (social connections, sleep hygiene and physical activity), physical health, mental wellbeing, resilience and whether cognitive screening is initiated for adults with IDD and for caregivers. For health and social service providers, secondary outcomes include changes in brain health promotion practices and whether cognitive screening for older adults with IDD is initiated.Analysis of open-text survey responses and qualitative data from focus group interviews will explore the experiences of participants with the Brain Health-IDD Program.Ethics and disseminationInstitutional ethics approval was obtained from the Centre for Addiction and Mental Health Research Ethics Board. Programme findings and resources will be shared with advocacy groups, disability agencies, family caregiver organisations, clinicians and policymakers in the fields of disability, health and ageing at the provincial, national and international levels.

Objective Adults with intellectual and developmental disabilities (IDD) experience high rates of poor mental health and challenges accessing timely and high-quality services. There is limited interprofessional training on mental health care for this population. Methods A virtual, synchronous program based on the Project Extension for Community Healthcare Outcomes (ECHO) Ontario IDD Mental Health program was developed for health and social service trainees. Participants represented 10 disciplines across 12 Canadian university or college programs. The program was taught by a team of health and social service providers together with individuals with lived experience and included didactics and case-based discussions. Program evaluation utilized a pre-, post-, and 12-week follow-up survey design with feedback surveys following each session. Results Fifty participants registered for the program; 34 (68%) completed baseline measures and attended at least two sessions. Overall, participants reported high session satisfaction (average rating of 4.47 of 5). Participants demonstrated significant improvement in self-efficacy regarding communication ( p  < 0.001), management of mental health needs ( p  < 0.001), and working across systems ( p  < 0.001). Participants self-reported feeling more knowledgeable about common comorbidities ( p  < 0.001), assessing behavioral challenges ( p  < 0.001), the role of interdisciplinary professionals ( p  < 0.001), and community resources ( p  < 0.001). Improvements were maintained at follow-up across outcomes. Conclusion The pilot Project ECHO for health and social service trainees in adult IDD mental health demonstrated high participant satisfaction and positive impact on trainees’ self-efficacy and knowledge. Interprofessional educational interventions can be effectively implemented using virtual technology to teach about other mental health populations requiring multisector care.

High‐resolution climate change projections are increasingly necessary to inform climate policy and adaptation planning. Downscaling of global climate models (GCMs) is required to simulate the climate at the spatial scale relevant for local impacts. Here, we dynamically downscaled 15 CMIP6 GCMs to a 10 km resolution over Australia using the Conformal Cubic Atmospheric model (CCAM), creating the largest ensemble of high‐resolution downscaled CMIP6 projections for Australia. We compared the host CMIP6 models and downscaled simulations to the Australian Gridded Climate Data (AGCD) observational data and evaluated performance using the Kling‐Gupta efficiency and Perkins skill score. Downscaling improved performance over host GCMs for seasonal temperature and precipitation (10% and 43% respectively), and for annual cycles of temperature and precipitation (6% and 13% respectively). Downscaling also improved the fraction of dry days, reducing the bias for too many low‐rain days. The largest improvements were found in climate extremes, with enhancements to extreme minimum temperatures in all seasons varying from 142% to 201%, and to extreme precipitation of 52% in Austral winter and 47% in summer. The ensemble average integrated skill score improved by 16%. Temperature and precipitation biases were reduced in mountainous and coastal areas. CCAM downscaling outperformed host CMIP6 GCMs at multiple spatial scales and regions—continental Australia, Australian IPCC regions and Queensland's regions—with integrated added value ranging from 9% to 150% and higher over densely populated regions more exposed to climate impacts. This data set will be a valuable resource for understanding future climate changes in Australia. Plain Language Summary High‐resolution climate models are used for producing climate change projections for assessing regional and local climate change impacts and for adaptation and policy formulation. We completed 15 high‐resolution climate simulations using the Conformal Cubic Atmospheric Model at a 10 km spatial resolution over the Australian continent and surrounds based on global climate models (GCMs) used in the Intergovernmental Panel on Climate Change Assessment Report 6. We evaluated the new high‐resolution data set by comparing it to observations and to their host global model across several regions within Australia. The high‐resolution simulations improved the representation of topography, seasonal temperature and annual cycles of temperature, precipitation, as well as the number of dry days, extreme precipitation and extreme minimum temperatures. The high‐resolution projections show improvement compared to GCMs consistently across spatial scales and regions, being particularly high (150%) over urban areas with high exposure to impacts. This new 10 km data set is the highest resolution, and largest ensemble of the latest climate projections for the Australian continent and surrounds and will be a valuable tool for evaluating future climate change impacts. Key Points We dynamically downscaled 15 CMIP6 global climate model simulations over Australia to a 10 km spatial resolution using the Conformal Cubic Atmospheric model Two new assessment metrics are proposed to assess model performance and added value of downscaling The integrated added value of downscaling can be as high as 150% over highly populated areas

Background Nutrition interventions commenced in ICU and continued through to hospital discharge have not been definitively tested in critical care to date. To commence a program of research, we aimed to determine if a tailored nutrition intervention delivered for the duration of hospitalisation delivers more energy than usual care to patients initially admitted to the Intensive Care Unit (ICU). Methods A multicentre, unblinded, parallel-group, phase II trial was conducted in twenty-two hospitals in Australia and New Zealand. Adult patients, requiring invasive mechanical ventilation (MV) for 72–120 h within ICU, and receiving < 80% estimated energy requirements from enteral nutrition (EN) were included. The intervention (tailored nutrition) commenced in ICU and included EN and supplemental parenteral nutrition (PN), and EN, PN, and/or oral nutrition after liberation from MV, and was continued until hospital discharge or study day 28. The primary outcome was daily energy delivery from nutrition (kcal). Secondary outcomes included duration of hospital stay, ventilator free days at day 28 and total blood stream infection rate. Main results The modified intention to treat analysis included 237 patients (n = 119 intervention and n = 118 usual care). Baseline characteristics were balanced; the median [interquartile range] intervention period was 19 [14–35] and 19 [13–32] days in the tailored nutrition and usual care groups respectively. Energy delivery was 1796 ± 31 kcal/day (tailored nutrition) versus 1482 ± 32 kcal/day (usual care)—adjusted mean difference 271 kcal/day, 95% CI 189–354 kcal. No differences were observed in any secondary outcomes. Conclusions A tailored nutrition intervention commenced in the ICU and continued until hospital discharge achieved a significant increase in energy delivery over the duration of hospitalisation for patients initially admitted to the ICU. Trial registration ClinicalTrials.gov Identifier NCT03292237 . First registered 25th September 2017. Last updated 10th Feb 2023.