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There is a need for more attention to the importance of substantial parent involvement in programming for autistic children in community-based care. More encouragement is needed to ensure that practitioners prioritize parental training and involvement throughout interventions, including practitioner-led in-home applied behavioral analysis (ABA) interventions. There has been little to no research on the feasibility and efficacy of adding parental training to in-home practitioner-led ABA interventions. This study is intended to begin the consideration of efficacy by reporting on a series of focus groups involving parents of autistic children and the Board Certified Behavioral Analysts (BCBAs) and Registered Behavior Technicians (RBTs) who work with them. Method: Focus group meetings were conducted with a total of 18 participants: 7 family members, 5 RBTs, and 6 BCBAs drawn from two provider sites. Transcripts were generated, and data was analyzed using Braun & Clarke’s reflexive thematic analysis, a method for analyzing and interpreting qualitative data that involves systematically generating codes in order to develop themes. Findings: The findings are described using three main themes: (1) barriers to family involvement in applied behavioral analysis programming, (2) facilitators of family involvement in applied behavioral analysis programming, and (3) recommendations for improving family involvement in applied behavioral analysis programming. Conclusions: There are logistical challenges in involving parents in in-home interventions when they occur in evening hours when the family has multiple other responsibilities. However, being in-home also presents opportunities not available in school or clinic settings. The recommendations provided offer an initial road map to advancing parent training components.

Health equity is shaped by multiple factors intersecting with service delivery in community-based organizations (CBOs). Providers in under-resourced areas are often the first point of contact for families seeking child development, mental health, and behavioral support. However, system-level barriers hinder service delivery and access. This study explores provider perspectives to identify barriers and inform system-level changes that promote equity in child and family health. Using a narrative qualitative design, in-depth interviews were conducted with 21 health and mental health professionals from child- and family-serving CBOs. Guided by ecological and strengths-based frameworks, interviews examined provider insights on challenges, strengths, and supports affecting service delivery. Key themes emerged across macro (rights-based policies, racism/oppression), community (environmental impacts, social cohesion), organizational (secondary stress, system fragmentation, provider supports), and family levels (basic needs, parenting support, service access). Findings highlight the need for a multilevel approach that prioritizes rights-based policies, strengthens community cohesion, and improves system integration. Enhancing CBO capacity to address these determinants could advance equity-oriented service delivery and mitigate structural barriers that perpetuate health disparities.

There is an urgent need for more effective therapies for glioblastoma. Data from a previous unrandomised phase 2 trial suggested that lomustine-temozolomide plus radiotherapy might be superior to temozolomide chemoradiotherapy in newly diagnosed glioblastoma with methylation of the MGMT promoter. In the CeTeG/NOA-09 trial, we aimed to further investigate the effect of lomustine-temozolomide therapy in the setting of a randomised phase 3 trial. In this open-label, randomised, phase 3 trial, we enrolled patients from 17 German university hospitals who were aged 18–70 years, with newly diagnosed glioblastoma with methylated MGMT promoter, and a Karnofsky Performance Score of 70% and higher. Patients were randomly assigned (1:1) with a predefined SAS-generated randomisation list to standard temozolomide chemoradiotherapy (75 mg/m2 per day concomitant to radiotherapy [59–60 Gy] followed by six courses of temozolomide 150–200 mg/m2 per day on the first 5 days of the 4-week course) or to up to six courses of lomustine (100 mg/m2 on day 1) plus temozolomide (100–200 mg/m2 per day on days 2–6 of the 6-week course) in addition to radiotherapy (59–60 Gy). Because of the different schedules, patients and physicians were not masked to treatment groups. The primary endpoint was overall survival in the modified intention-to-treat population, comprising all randomly assigned patients who started their allocated chemotherapy. The prespecified test for overall survival differences was a log-rank test stratified for centre and recursive partitioning analysis class. The trial is registered with ClinicalTrials.gov, number NCT01149109. Between June 17, 2011, and April 8, 2014, 141 patients were randomly assigned to the treatment groups; 129 patients (63 in the temozolomide and 66 in the lomustine-temozolomide group) constituted the modified intention-to-treat population. Median overall survival was improved from 31·4 months (95% CI 27·7–47·1) with temozolomide to 48·1 months (32·6 months–not assessable) with lomustine-temozolomide (hazard ratio [HR] 0·60, 95% CI 0·35–1·03; p=0·0492 for log-rank analysis). A significant overall survival difference between groups was also found in a secondary analysis of the intention-to-treat population (n=141, HR 0·60, 95% CI 0·35–1·03; p=0·0432 for log-rank analysis). Adverse events of grade 3 or higher were observed in 32 (51%) of 63 patients in the temozolomide group and 39 (59%) of 66 patients in the lomustine-temozolomide group. There were no treatment-related deaths. Our results suggest that lomustine-temozolomide chemotherapy might improve survival compared with temozolomide standard therapy in patients with newly diagnosed glioblastoma with methylated MGMT promoter. The findings should be interpreted with caution, owing to the small size of the trial. German Federal Ministry of Education and Research.

Urban tree growth is often affected by reduced water availability, higher temperatures, small and compacted planting pits, as well as high nutrient and pollution inputs. Despite these hindering growth conditions, recent studies found a surprisingly better growth of urban trees compared to trees at rural sites, and an enhanced growth of trees in recent times. We compared urban versus rural growing Sakhalin fir (Abies sachalinensis (F. Schmidt) Mast.) trees in Sapporo, northern Japan and analyzed the growth differences between growing sites and the effects of environmental pollution (NO2, NOX, SO2 and OX) on tree growth. Tree growth was assessed by a dendrochronological study across a gradient from urban to rural sites and related to high detailed environmental pollution data with mixed model approaches and regression analyses. A higher growth of urban trees compared to rural trees was found, along with an overall accelerated growth rate of A. sachalinensis trees over time. Moreover, environmental pollution seems to positively affect tree growth, though with the exception of oxides OX which had strong negative correlations with growth. In conclusion, higher temperatures, changed soil nutrient status, higher risks of water-logging, increased oxide concentrations, as well as higher age negatively affected the growth of rural trees. The future growth of urban A. sachalinensis will provide more insights as to whether the results were induced by environmental pollution and climate or biased on a higher age of rural trees. Nevertheless, the results clearly indicate that environmental pollution, especially in terms of NO2 and NOX poses no threat to urban tree growth in Sapporo.

Background Recent projections expect that Vietnam will be affected most severely by climate change with higher temperatures, more precipitation and rising sea levels. Especially increased temperatures will worsen the situations in cities, amplifying the urban heat island effect. Green infrastructures, i.e. urban trees are a common tool to improve the urban micro-climate for humans. Vital and well growing trees provide greatest benefits such as evaporative cooling, shading, air filtering and carbon storage. However, urban tree growth is often negatively affected by urban growing conditions such as high soil sealing with compacted tree pits providing small growing spaces with limited water, nutrient and oxygen supply, further warm temperatures and high pollution emissions. This study analyzed the growth of urban and rural African mahogany ( Khaya senegalensis (Desr.) A. Juss.) trees in the city of Hanoi, Vietnam and the effects of the surrounding climate conditions on tree growth. Results The results showed that rural African mahogany trees grew better than trees situated in the city center, which is contrary to other results on tree growth of temperate and subtropical cities worldwide. Moreover tree growth was similar regardless of the time of growth. Other results regarding stem growth of African mahogany located in different areas of Hanoi (east, west, north, city center) revealed a better growth in the northern and western outskirts of the city compared to the growth of trees in the city center. Conclusion African mahogany trees in the urban centers of Hanoi showed a decreased growth compared to rural trees, which was likely induced by a low ground-water level and high pollution rates. In view of climate change and global warming, the decreased tree growth in the city center may also affect tree service provision such as shading and cooling. Those climate mitigation solutions are strongly needed in areas severely affected by climate change and global warming such as Vietnam.