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Patients with OSA are at increased risk of postoperative cardiorespiratory complications and death. Attempts to stratify this risk have been inadequate, and predictors from large, well-characterized cohort studies are needed. What is the relationship between OSA severity, defined by various polysomnography-derived metrics, and risk of postoperative cardiorespiratory complications or death, and which metrics best identify such risk? In this cohort study, 6,770 consecutive patients who underwent diagnostic polysomnography for possible OSA and a procedure involving general anesthesia within a period of 2 years before and at least 5 years after polysomnography. Participants were identified by linking polysomnography and health databases. Relationships between OSA severity measures and the composite primary outcome of cardiorespiratory complications or death within 30 days of hospital discharge were investigated using univariable and multivariable analyses. The primary outcome was observed in 5.3% (n = 361) of the cohort. Although univariable analysis showed strong dose-response relationships between this outcome and multiple OSA severity measures, multivariable analysis showed its independent predictors were: age older than 65 years (OR, 2.67 [95% CI, 2.03-3.52]; P <.0001), age 55.1 to 65 years (OR, 1.47 [95% CI, 1.09-1.98]; P =.0111), time between polysomnography and procedure of ≥ 5 years (OR, 1.32 [95% CI, 1.02-1.70]; P =.0331), BMI of ≥ 35 kg/m2 (OR, 1.43 [95% CI, 1.13-1.82]; P =.0032), presence of known cardiorespiratory risk factor (OR, 1.63 [95% CI, 1.29-2.06]; P <.0001), > 4.7% of sleep time at an oxygen saturation measured by pulse oximetry of < 90% (T90; OR, 1.91 [95% CI, 1.51-2.42]; P <.0001), and cardiothoracic procedures (OR, 7.95 [95% CI, 5.71-11.08]; P <.0001). For noncardiothoracic procedures, age, BMI, presence of known cardiorespiratory risk factor, and percentage of sleep time at an oxygen saturation of < 90% remained the significant predictors, and a risk score based on their ORs was predictive of outcome (area under receiver operating characteristic curve, 0.7 [95% CI, 0.64-0.75]). These findings provide a basis for better identifying high-risk patients with OSA and determining appropriate postoperative care. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: Malnutrition is common among patients with head and neck cancer (HNC) and associated with poorer outcomes. Oral nutritional supplements (ONS) are often prescribed, with concerns raised about their cariogenicity. This study examined ONS use and caries experience in patients with HNC 12 months post‐diagnosis. Methods: Fifty‐four patients with HNC referred for pre‐radiotherapy dental assessment were recruited. Data collected included: age, gender, residential postcode, smoking, alcohol use, HNC characteristics, dental history, oral hygiene habits, dietary advice and ONS use. Data was collected at diagnosis, during radiotherapy and 6 weeks, three, six‐ and 12‐months post‐treatment completion. Results: Fifty‐one subjects completed the study. 76.5% of the participants used ONS for an average of 13.8 weeks. Caries developed in 22.9% of ONS users and 11.1% of non‐users (p = 0.6585). The mean overall duration of ONS use was 18.7 weeks for the caries group and 8.5 weeks for the caries‐free group (p = 0.1507). Lack of collaboration and disconnection was noted between dietary advice given by dieticians and dentists. Conclusions: ONS use is common among patients with HNC. Larger studies are needed to establish the reasons for caries development and impacts of ONS use on oral health. Importance of multidisciplinary management of malnutrition is highlighted. [ABSTRACT FROM AUTHOR]

Social impact assessment as a concept and practice is generally framed as a process for delivering socially equitable outcomes, and in particular, a vehicle for improving the lives of society's most vulnerable and marginalised people. For example, the International Association for Impact Assessment 2015 guidance document makes the normative statement that projects should benefit local communities and be a 'force for positive social change and beneficial social development'. Yet most guidance provides little prescription for what this looks like in practice. More recently, the New South Wales 2021 guideline includes distributive equity as a principle for social impact assessment, but its application is yet to be tested. This article discusses key dimensions of equity concepts, drawing on international social impact assessment guidance documents, academic literature on equity, fairness and justice, and case studies in Australia. We elaborate process/procedural/participative and outcome/distributive dimensions of equity. We further argue that, to reflect the International Association for Impact Assessment position, social impact assessment needs to defend its normative purpose of advancing equity, rather than simply 'considering' equity impacts. [ABSTRACT FROM AUTHOR]

Background Early in the coronavirus disease 2019 (COVID-19) pandemic, peak viral loads coincided with symptom onset. We hypothesized that in a highly immune population, symptom onset might occur earlier in infection, coinciding with lower viral loads. Methods We assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza A viral loads relative to symptom duration in symptomatic adults (≥16 years) presenting for testing in Georgia (4/2022–4/2023; Omicron variant predominant). Participants provided symptom duration and recent testing history. Nasal swabs were tested by Xpert Xpress SARS-CoV-2/Flu/RSV assay and cycle threshold (Ct) values recorded. Nucleoprotein concentrations in SARS-CoV-2 polymerase chain reaction (PCR)-positive samples were measured by single molecule array. To estimate hypothetical antigen rapid diagnostic test (Ag RDT) sensitivity on each day after symptom onset, percentages of individuals with Ct value ≤30 or ≤25 were calculated. Results Of 348 newly-diagnosed SARS-CoV-2 PCR-positive individuals (65.5% women, median 39.2 years), 317/348 (91.1%) had a history of vaccination, natural infection, or both. By both Ct value and antigen concentration measurements, median viral loads rose from the day of symptom onset and peaked on the fourth/fifth day. Ag RDT sensitivity estimates were 30.0%–60.0% on the first day, 59.2%–74.8% on the third day, and 80.0%–93.3% on the fourth day of symptoms. In 74 influenza A PCR-positive individuals (55.4% women; median 35.0 years), median influenza viral loads peaked on the second day of symptoms. Conclusions In a highly immune adult population, median SARS-CoV-2 viral loads peaked around the fourth day of symptoms. Influenza A viral loads peaked soon after symptom onset. These findings have implications for ongoing use of Ag RDTs for COVID-19 and influenza. [ABSTRACT FROM AUTHOR]

Social impact assessment (SIA) is experiencing both evolutionary and revolutionary forces for change. Using the example of New South Wales, Australia, forces for change include community pressure and shifting expectations, industry desire for clarity and certainty, departmental leadership, a collaborative approach to policy development, and perceived legitimacy of the guideline itself. Inhibiting these forces are general resistance to change, a concern around costs of good SIA, unfamiliarity with social sciences, and insufficient practitioner capacity. The recent Rocky Hill judgement, which highlights concepts such as community cohesion, sense of place, and distributive equity, may accelerate change. However, there is also a need to build capacity among SIA practitioners, and afford sufficient time and budget to meet the standard of leading-practice guidelines. At the same time, unfolding trends such as the climate change and extinction crises, the gendered nature of development, ever-widening inequalities, and 'post-truth' discourses may catalyse more revolutionary change in SIA practice – changes that paradoxically may enable SIA to reclaim its social-science principles and the overarching goal of sustainable social development. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF.Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals.Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were adults and 1.12 million were regular patients. Of these patients 15,468 were classified as having 'definite HF', 4751 as having 'probable HF' and 33,556 as having 'possible HF'. A further 39,247 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify 'definite' HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify 'probable HF' patients. The majority of 'possible' HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign.Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting. [ABSTRACT FROM AUTHOR]

Motivation A fundamental interest in chronobiology is to compare patterns between groups of rhythmic data. However, many existing methods are ill-equipped to derive statements concerning the statistical significance of differences between rhythms that may be visually apparent. This is attributed to both the form of data used (longitudinal versus cross-sectional) and the limitations of the statistical tests used to draw conclusions. Results To address this problem, we propose that a cosinusoidal curve with a particular parametrization be used to model and compare data of two sets of observations collected over a 24-h period. The novelty of our test is in the parametrization, which allows the explicit estimation of rhythmic parameters [mesor (the rhythm-adjusted mean level of a response variable around which a wave function oscillates), amplitude and phase], and simultaneously testing for statistical significance in all three parameters between two or more groups of datasets. A statistically significant difference between two groups, regarding each of these rhythmic parameters, is indicated by a P -value. The method is evaluated by applying the model to publicly available datasets, and is further exemplified by comparison to the currently recommended method, DODR. The results suggest that the method proposed may be highly sensitive to detect rhythmic differences between groups in phase, amplitude and mesor. Availability and implementation https://github.com/RWParsons/circacompare/ [ABSTRACT FROM AUTHOR]

There is a significant variability in the prevalence of psychotropic medication use among young autistic persons worldwide and this is under-studied in Australia. Apart from risperidone, approved by the Therapeutic Goods Administration to manage challenging behaviour, the appropriateness of other psychotropic medications prescribed to young autistic persons warrants scrutiny. This retrospective study aims to gain initial insight into the magnitude, types and indications of psychotropic medication use in autistic children and adolescents in Western Australia. We analysed de-identified data from 239 autistic children and adolescents (⩽21 years) who participated in the Western Australian Autism Biological Registry between 2011 and 2015 and who completed a questionnaire regarding medication use. One-quarter (n = 66, 28%) of young autistic people reported using a total of 137 medications. Most (n = 46, 70%) of those medicated were under 12 years of age; half (n = 33) were 6–12 years and a fifth (n = 13) were under 6 years. The most used medications were stimulants (n = 35, 53.0%), followed by antidepressants (n = 24, 36.4%), antiepileptics (n = 21, 31.8%), sedatives (n = 15, 22.7%) and antipsychotics (n = 14, 21.2%). These medications were mainly to manage attention deficit hyperactivity disorder, challenging behaviours, seizures, insomnia, undefined anxiety, depression and mood instability. While most autistic young people in the Western Australian Autism Biological Registry did not report using psychotropic medication, over a quarter were prescribed medications, primarily stimulants, to manage symptoms of attention deficit hyperactivity disorder. Various medications, including risperidone, were used to help manage challenging behaviours. Medication use should be studied more comprehensively in a larger cohort of autistic persons to confirm our current preliminary observations. Further, future studies should monitor the effectiveness and safety outcomes of such medications due to a limited understanding of their effectiveness in managing the atypical presentation of co-occurring disorders in young autistic persons. Prescriptions and use of medications to treat mental health conditions in young autistic populations are inconsistent worldwide. This makes it hard to compare findings from international studies to the Australian autistic population, where there are limited relevant studies. Apart from risperidone, there are no other medications specified for direct use in autistic persons. This study aims to gain initial broad understanding of the use of medications, commonly prescribed for mental health conditions, specifically by autistics under the age of 21 years. We analysed data that were previously collected as part of the Western Australian Autism Biological Registry between 2011 and 2015 which amounted to 239 surveys completed on young persons with diagnosed autism. The questionnaires included information on co-occurring conditions, current or previous use of medications and reasons for use of the medications. Only one-quarter of the participants in this study reported using at least one mental health–related medication in their lifetime. The most reported medications were stimulants, antidepressants and antiepileptics. The reasons for using medication included managing attention deficit hyperactivity disorder, challenging behaviours, seizures, sleep difficulties and symptoms of anxiety and depression. The number of individuals reporting medication use in this study was lower compared to other developed countries. Nevertheless, these medications should be monitored due to limited understanding of their use to manage co-occurring symptoms in young autistic persons. The findings highlight the importance of ongoing research to better understand mental health–related medications and inform best practice. [ABSTRACT FROM AUTHOR]

• Effects of B, C, Si and P additions on Fe 86 B 14 prepared by ultra-rapid annealing (URA) were investigated. • The effectiveness of URA was affected by metalloid additives and the soft magnetic properties after URA were degraded. • Addition of 1 at% Cu was found to be effective in enhancing the effectiveness of URA. • Multiple compositions were identified to exhibit low coercivity (H c < 3 A/m) where high glass-formability is expected. The effects of metalloid additives (ML = B, C, Si and P) on the structural and magnetic properties were investigated for nanocrystalline Fe 86- x B 14 ML x alloys prepared by ultra-rapid annealing (URA) of melt-spun ribbons. It was found that the effectiveness of URA was affected by these elements and the soft magnetic properties after URA were degraded. Contrarily, addition of 1 at% Cu was found to be effective in enhancing the effectiveness of URA and coercivity (H c) after URA was reduced significantly by Cu addition. These effects of additives on the soft magnetic properties after URA were well understood by considering the activation energy of crystallization. [ABSTRACT FROM AUTHOR]

Few jurisdictions have translated internationally agreed social impact assessment (SIA) principles into statutory provisions. Governments and regulatory bodies tend to provide developers with high-level frameworks, or require that social impacts be 'considered', without specifying how this is to be done. In Australia, this lack of clarity leaves all parties uncertain about requirements for SIA. The New South Wales (NSW) Government's 2017 release of the SIA guideline for State-significant mining, petroleum and extractive industry development represents an attempt to clarify requirements and provide guidance. In this paper, we describe the process of bringing this guideline to fruition from the perspective of being directly involved in its development, and highlight the challenges involved in integrating leading-practice principles into the state's pre-existing policy framework. While the guideline represents a significant advance in policy-based SIA guidance, some aspects leave room for improvement. The real test of the guideline's impact will lie in its influence on SIA practice in NSW, and ultimately in social outcomes for communities affected by resources projects. [ABSTRACT FROM AUTHOR]

Background Hospital discharge of older people receiving care at home offers a salient opportunity to identify and address their family caregivers’ self-identified support needs. Objectives This study tested the hypothesis that the extent to which family caregivers of older people discharged home from hospital felt prepared to provide care at home would be positively influenced by their inclusion in the new Further Enabling Care at Home program. Design This single-blind randomised controlled trial compared outcomes from usual care alone with those from usual care plus the new program. The program, delivered by a specially trained nurse over the telephone, included: support to facilitate understanding of the patient’s discharge letter; caregiver support needs assessment; caregiver prioritisation of urgent needs; and collaborative guidance, from the nurse, regarding accessing supports. Setting and participants Dyads were recruited from the medical assessment unit of a Western Australian metropolitan public hospital. Each dyad comprised a patient aged 70 years or older plus an English speaking family caregiver. Methods The primary outcome was the caregiver’s self-reported preparedness to provide care for the patient. Data collection time points were designated as: Time 1, within four days of discharge; Time 2, 15–21 days after discharge; Time 3, six weeks after discharge. Other measures included caregivers’ ratings of: their health, patients’ symptoms and independence, caregiver strain, family well-being, caregiver stress, and positive appraisals of caregiving. Data were collected by telephone. Results Complete data sets were obtained from 62 intervention group caregivers and 79 controls. Groups were equivalent at baseline. Needs prioritised most often by caregivers were: to know whom to contact and what to expect in the future and to access practical help at home. Support guidance included how to: access help, information, and resources; develop crisis plans; obtain referrals and services; and organise legal requirements. Compared to controls, preparedness to care improved in the intervention group from Time 1 to Time 2 (effect size = 0.52; p = 0.006) and from Time 1 to Time 3 (effect size = 0.43; p = 0.019). These improvements corresponded to a change of approximately 2 points on the Preparedness for Caregiving instrument. Small but significant positive impacts were also observed in other outcomes, including caregiver strain. Conclusions These unequivocal findings provide a basis for considering the Furthering Enabling Care at Home program’s implementation in this and other similar settings. Further testing is required to determine the generalisability of results. [ABSTRACT FROM AUTHOR]

Large companies must increasingly satisfy not only the conditions of their formal licences, but also the concerns and expectations of host communities and broader society. This has led to the emergence, particularly in the minerals industry, of the notion of “social licence”, an interdiscursive term whose meaning is rarely interrogated. We use textual analysis to critically investigate the construction of social licence discourse in minerals companies’ sustainable development reports and at a recent industry conference. We find that the texts mystify the nature of agency, and privilege processes that maintain existing power relations. Through their partial accommodation of heterogeneous discourses, the texts downplay tensions and conflicts. We conclude that there is a need to reconceptualise the nature of company–stakeholder relationships through a more collaborative, dialogic and reflexive process, avoiding the binary state implied by the term licence. [ABSTRACT FROM AUTHOR]

Impact assessment and social licence both derive from the discourse of business and society, following related concepts such as corporate social responsibility. However, they have different emphases, implying an organisational focus on impacts and relationships respectively. Using a case study of a large coal-seam gas project in Australia, this paper considers prospects for better integration of these concepts in practice. We interviewed 37 stakeholders – affected landholders plus representatives of government, councils, business and community-based organisations – to ascertain perceptions of impacts and relationships. Participants' perceptions are described in terms of ‘impact narratives’ and ‘relationship narratives’. Impact narratives concern long-term security of artesian water and complex trade-offs between economic and social/environmental domains. All participants perceive both positive and negative impacts; many had difficulty deciding whether to support or oppose the project as a whole. Relationship narratives concern trust in local company staff and capacity to influence company decisions. Perceptions of both impacts and relationships appear to shape the level of social licence. In turn, impact assessment may best reflect stakeholder concerns when it explicitly incorporates relational constructs. [ABSTRACT FROM AUTHOR]

Purpose: The aims of this study were to evaluate the extent of adherence to hypoglycemic medications, assess the relationship between adherence and glycemic control, and evaluate factors affecting adherence. Research design and methods: This was a cross-sectional study of patients with established type 2 diabetes attending the Port Moresby General Hospital Diabetes Clinic. Face-to-face interviews were conducted using a questionnaire designed for the study and data were collected concerning the 3 months prior to interview. The questionnaire covered demographic details, lifestyle, biochemical and physical measurements, and medication management. Glycemic control was investigated among patients adhering to their medications (not missing doses) to different degrees (100%, 95%, 90%, and 80%). Results: Of a total of 356 participants who were prescribed hypoglycemic medications, 59.6% omitted some of their doses. Age appeared to have a significant impact on adherence at some levels of adherence, with those aged ?60 years being more likely to be adherent (logistic regression). Those who were 95%-99% and those who were ?80% adherent had a statistically significant risk of a high glycated hemoglobin of ?10% (85.5 mmol/mol). Multiple factors were identified as contributors to nonadherence, with patient-based issues (86.0%) and the health care system (21.7%) being the most common. Conclusion: This study showed a significant level of nonadherence among patients with type 2 diabetes in Papua New Guinea. Nonadherence to medication appeared to be associated with poor glycemic control and was due to a variety of reasons. Future interventions aimed at improving adherence will need to take these into account. [ABSTRACT FROM AUTHOR]

Students negotiate the transition to secondary school in different ways. While some thrive on the opportunity, others are challenged. A prospective longitudinal design was used to determine the contribution of personal background and school contextual factors on academic competence (AC) and mental health functioning (MHF) of 266 students, 6-months before and after the transition to secondary school. Data from 197 typically developing students and 69 students with a disability were analysed using hierarchical linear regression modelling. Both in primary and secondary school, students with a disability and from socially disadvantaged backgrounds gained poorer scores for AC and MHF than their typically developing and more affluent counterparts. Students who attended independent and mid-range sized primary schools had the highest concurrent AC. Those from independent primary schools had the lowest MHF. The primary school organisational model significantly influenced post-transition AC scores; with students from Kindergarten - Year 7 schools reporting the lowest scores, while those from the Kindergarten - Year 12 structure without middle school having the highest scores. Attending a school which used the Kindergarten - Year 12 with middle school structure was associated with a reduction in AC scores across the transition. Personal background factors accounted for the majority of the variability in post-transition AC and MHF. The contribution of school contextual factors was relatively minor. There is a potential opportunity for schools to provide support to disadvantaged students before the transition to secondary school, as they continue to be at a disadvantage after the transition. [ABSTRACT FROM AUTHOR]

Background/aim Previous research has shown that children with spina bifida use clean intermittent catheterisation for urination, a rather complex procedure that increases the time taken to completion. However, no studies have analysed the factors impacting on the time taken to complete the urination that could inform occupational therapy practice. Therefore, the aim was to identify the variables that predict extended time children with spina bifida take to complete urination. Methods Fifty children, aged 5-18 years old with spina bifida using clean intermittent catheterisation, were observed while toileting and responding to a set of assessments tools, among them the Canadian Occupational Performance Measure. A logistic regression was used to identify which variables were independently associated with an extended toileting time. Results Children with spina bifida do take long time to urinate. More than half of this study's participants required more than five minutes completing urination, but not all required extended times. Ambulant, independent girls were more likely to perform toileting in less than six minutes compared with other children with spina bifida. However, age, IQ, maintained focus on the task, Canadian Occupational Performance Measure, time processing abilities and self-reported ratings of independence appeared to be of no relevance, to predict extended toileting times. Conclusion To minimise occupational disruption caused by extended toileting times, occupational therapists should utilise the relevant predictors: gender, independence and ambulation when they prioritise children for relevant interventions. [ABSTRACT FROM AUTHOR]

Gaze cues and direct gaze attract visual attention. However, few studies have explored visual cues in children within realistic contexts. The effect of information and repetitive stimulus presentation has not been thoroughly studied with dynamic stimuli. The aim of the present study was to investigate how information affects the visual strategies of children measured by the number of fixations on certain areas of interest and their durations. Furthermore, this study examined the effect of gaze cues and direct gaze. In two consecutive experiments, children's visual strategies when viewing magic tricks were measured by an eye tracker. Gaze cues were only present in Experiment 1.The results showed that repetitive stimulus presentation and information caused children to change their visual strategies when viewing magic tricks with and without gaze cues. However, the effect was larger when the gaze cues were not present. These findings in children were similar to those in adults. [ABSTRACT FROM AUTHOR]

Background: Oral leukoplakia (OL) is one of the most prevalent oral potentially malignant disorders (OPMD). Although there is emerging evidence that quality of life (QoL) is impaired in subjects with OL; studies to date are based on single and heterogenous point‐in‐time assessments. The aim of this study was to ascertain if QoL scores change over time in individuals diagnosed with OL. Methods: Forty‐one individuals with OL were administered the Short Generic Health Questionnaire (SF‐12) and the discipline‐specific Oral Potentially Malignant Disorder Questionnaire (OPMDQ) at four points in time: at the time of clinical diagnosis, at the post‐biopsy review (confirmed diagnosis), and at 3‐ and 6‐month follow‐up appointments. Responses were compared between the four time points. Results: No significant differences were observed in the SF‐12 questionnaire scores over time. However, a general improvement in the participants' life quality was evident over the 6‐month period under investigation in the domains of psychological and social well‐being (p = 0.0027) and effect of treatment on daily life (p = 0.0317) as well as in the total score (p = 0.0005) of the OPMDQ. Age, gender, medical status, tobacco/alcohol use, lesion site, size, the presence of dysplasia and treatment did not impact QoL scores over time. Conclusions: QoL scores of OL subjects may improve with time. Our results suggest that studies examining QoL in individuals with OL should be controlled for time at which the participants are surveyed. [ABSTRACT FROM AUTHOR]

To create an inclusive classroom and act accordingly, teachers' understanding of the experiences of participation of students with autism spectrum conditions (ASCs) is crucial. This understanding may depend on the teachers' professional experiences, support and personal interests. The aim of the present questionnaire study was to investigate how well the teachers' ratings of their students with ASCs' perception of participation matched with the students' own ratings. Furthermore, possible correlations between the accuracy of teachers' ratings and the teachers' self-reported professional experience, support (including supportstaff), and personal interest were investigated. Teachers' ratings were also used to examine how their understandings correlated with classroom actions. The agreements between teachers' and students' ratings were moderate to high, and the ability to attune to the students' perception of participation was not affected by the presence of a support-staff. The teachers' personal interest in teaching students with ASC correlated with their accuracy, suggesting that this is a factor to consider when planning for successful placements in mainstream schools. Teachers' understandings of the students with ASCs' perception of being bullied or unpopular correlated with implementation of activities to improve the attitudes of classmates, but not with actions to enhance social relations for the students with ASC. [ABSTRACT FROM AUTHOR]

Abstract: Host recognition of conserved pathogen-associated molecular patterns (PAMPs) and their interactions with pattern-recognition receptors, including the Toll-like receptors (TLR) is essential for innate immune response induction. The TLR1 family (TLR1, 2, 6 and 10) is involved in the recognition of gram-positive and gram-negative bacteria and heterodimers of TLR1 or TLR6 with TLR2 are crucial for the identification of several PAMPs. Studies on cell surface expression of TLR in ruminants are hampered by the lack of specific antibodies and no convincingly cross-reactive anti-human antibodies have been described so far. We describe herein four antibodies which recognise bovine TLR2. Differences in TLR2 expression were evident on bovine antigen presenting cells with high level expression on peripheral blood monocytes and monocyte-derived macrophages. Lower levels of expression were evident on dendritic cell populations derived in vitro and ex vivo, and on alveolar macrophages. One of the antibodies recognised TLR2 expression on ovine peripheral blood monocytes. The identification of antibodies specific for bovine and ovine TLR2 will facilitate studies of the role of this important PRR in the initiation of immune responses to important pathogens. [ABSTRACT FROM AUTHOR]

We have previously shown that statins reduce the production of amyloid-β (Aβ) by both isoprenoid- and cholesterol-dependent mechanisms. These pathways contribute to the regulation of the dimerisation of BACE into its physiologically active form. Statins reduce cellular cholesterol levels by 20–40%; therefore, it is possible that the remaining cholesterol within the cell may play a significant role in the production of Aβ. Incubation of cells with the specific cholesterol biosynthesis inhibitor BM15.766 together with 50 μmol/L simvastatin and 400 μmol/L mevalonate reduced cellular cholesterol levels in a dose-dependent manner with increasing BM15.766 concentration ( r = −0.9736, p = 0.0264). Furthermore, decreases in cellular cholesterol levels correlated with reductions in total Aβ production ( r = 0.9683, p = 0.0317). A total of 2.5 μmol/L BM15.766 inhibited the dimerisation of BACE, whilst the expression of BACE monomer was reduced by 5 μmol/L BM15.766. BM15.766 treatment localised BACE predominantly within the Golgi, and reduced total BACE expression per cell. Similar changes were observed in the expression of the Golgi marker golgin-97, suggesting that reduced BACE expression may arise from a decrease in protein trafficking and an increase in degradation. By targeting cholesterol synthesis using specific cholesterol biosynthesis inhibitors, it is possible to reduce Aβ production without reducing protein isoprenylation. [ABSTRACT FROM AUTHOR]

Abstract: Epidemiologists have found a decreased risk of developing Alzheimer''s disease (AD) in people taking statins (cholesterol biosynthesis inhibitors). We have reported previously that, in cell culture, lovastatin decreases the output of β-amyloid, a peptide that is toxic to neurones, and is reputably the prime cause of neurodegeneration seen in AD. This report probes the mechanism of statin protection further by finding out how the protease β-secretase, that releases β-amyloid from its precursor protein, behaves under changed cholesterol levels induced by statins. We found that, with high cellular cholesterol levels, there is a decrease in glycosylation of mature oligosaccharides in β-secretase, whereas in the presence of lovastatin, glycosylation progresses further. Moreover, lovastatin does not inhibit β-secretase in vitro. Thus, the cholesterol and statin effects are due to changes in cellular targeting induced by changed cholesterol gradients. Some of these changes are mimicked by the action of U18666A, a cholesterol-transport inhibitor that produces a defect in cells seen in patients with Neimann Pick''s disorder. [Copyright &y& Elsevier]

A preference to novelty paradigm used to study human infants ( ) examined attention to novel animal pictures at subordinate, basic and superordinate levels in tamarins. First, pairs of pictures were presented in phases, starting with a monkey species (subordinate level) and ending with mammal and dinosaur sets (superordinate levels). After each phase, tests paired novel pictures from the familiarized set with a novel broader category. Look rates toward each picture were coded. Tamarins looked significantly longer at a novel species after being familiarized with a monkey species, a species-specific effect. Subjects attended equivalently to novel primate species after habituation to four monkey species, but looked significantly longer at pictures of mammals, marking a more global-level inclusion and exclusion. Superordinate testing revealed that more novel and diverse sets were differentiated attentionally. The evidence implies that natural categorical representation occurs at an attentional level in primates in ways similar to human infants, and is affected by recent exposure and category variability. [ABSTRACT FROM AUTHOR]

We have previously speculated that elevated levels of nicotinamide N-methyltransferase (NNMT), the primary catabolic enzyme of nicotinamide, may result in reduced Complex I activity in idiopathic Parkinson''s disease (IPD) in two ways: (1) reduction in the levels of nicotinamide available for nicotinamide adenine dinucleotide synthesis; and (2) increased methylation of compounds such as tetrahydroisoquinolines and β-carbolines, which are potent Complex I inhibitors. Expression of NNMT was assessed in 91 cerebella (53 IPD, 38 control) using immunohistochemistry coupled with quantitative digital image analysis. Control cerebella showed a distribution of expression ascribed to low, intermediate and high expressors with ratios of 1:2:1 categories. Expression in the parkinsonian cerebella was significantly higher than in the control group (control group median expression 17%, mean expression 16.6%, range 0–51%, standard deviation 11.4%, standard error 1.9%; IPD group median expression 46%, mean expression 53.7%, range 21–100%, standard deviation 23.4%, standard error 3.2%; P<0.0001; unpaired t-test with Welch correction (parametric) and Mann–Whitney U-test (non-parametric)). These results confirm that NNMT expression is elevated in IPD, which may ultimately lead to neurodegeneration via a reduction in Complex I activity. [Copyright &y& Elsevier]

Assesses products of nitrogen fixation by bacteroids from soybean root nodules. Production of alanine; Assimilation of [sup 15]N by bacteroids; Contamination of bacteroid preparations.

To obtain and concentrate reduced N from the environment, plants have evolved a diverse array of adaptations to utilize soil, biotic and atmospheric N. In symbiotic N2‐fixing systems the potential for oversupply exists and regulation of activity to match demand is crucial. N status in plants is likely to be most strongly sensed in the shoot and signals translocated to the roots may involve phloem transported amino compounds or very low concentrations of specific signal molecules. The mechanism for sensing N status in plant cells is not understood at the molecular level although it may be expected to be similar in all plants. Mechanisms for the regulation of symbiotic N2 fixation may be very different in the different symbiotic types. Rhizobia, Frankia and cyanobacteria are all symbiotic with different species of plants and the provision of O2, carbohydrate or other nutrients may control symbiotic activity to varying extents in the different symbioses. [ABSTRACT FROM PUBLISHER]

Conclusions. These data illustrate the evolution of the smoking epidemic in populations and provide the basis for targeted public health interventions to support the WHO priority for tobacco control. (Am J Public Health. 2001;91:206-212) [ABSTRACT FROM AUTHOR]

Nicotinamide N-methyltransferase (NNMT) has progressed from being considered merely a Phase II metabolic enzyme to one with a central role in cell function and energy metabolism. Over the last three decades, a significant body of evidence has accumulated which clearly demonstrates a central role for NNMT in cancer survival, metastasis, and drug resistance. In this review, we discuss the evidence supporting a role for NNMT in the progression of the cancer phenotype and how it achieves this by driving the activity of pro-oncogenic NAD+-consuming enzymes. We also describe how increased NNMT activity supports the Warburg effect and how it promotes oncogenic changes in gene expression. We discuss the regulation of NNMT activity in cancer cells by both post-translational modification of the enzyme and transcription factor binding to the NNMT gene, and describe for the first time three long non-coding RNAs which may play a role in the regulation of NNMT transcription. We complete the review by discussing the development of novel anti-cancer therapeutics which target NNMT and provide insight into how NNMT-based therapies may be best employed clinically. [ABSTRACT FROM AUTHOR]

Emphasizes the need for an early intervention with childhood aggression. Factors associated with childhood aggression; Explanation on the ineffectiveness of some intervention programs; Types of student aggression; Implications for counselors.

In Gunnera, Nostoc cells invade secretory tissue forming well defined symbiotic areas within the stems and are termed internal nodules (Silvester, 1976). Excised, but intact, internal stem Nostoc nodules taken from Gunnera magellanica show light-stimulated nitrogenase activity and release a small, but measurable, proportion of their current N2, fixation as NH3 into the external solution. When nodules arc disrupted arid Nostoc extracted anaerobically, 90% or more of the estimated N2 fixation is released from the Nostoc cells as NH3 into the surrounding medium. Use of 15N2 confirmed that only 12% of N2 fixed is retained within the cells of Nostoc. The remaining 88% was identified as NH3 released outside the cells. Within the intact nodule system, 15N2 uptake showed that 2-5% of recently fixed N2 remains within the Nostoc cells and up to 30% of extracellular N is in asparagine after 1 h. Evidence is presented that stimulation of nitrogenase by light in the intact Gunnera/Nostoc system produces more NH3 than can be assimilated by the host cells, resulting in significant NH3 accumulation. [ABSTRACT FROM AUTHOR]

The growth and nitrogenase activity of stern nodules of Sesbania rostrata Brem were strongly influenced by the humidity surrounding the nodule. Nodules developed under high humidity showed the fastest rates of growth and the highest specific nitrogenase activity (determined by acetylene reduction). Development of stem nodules in both the light and dark was similar and showed a similar lowering of growth and activity with decreasing humidity. Stem nodules developed in the dark were pale and unlike the dark green nodules that developed in the light, they did not have chloroplasts in the nodule cortex. Adventitious root development required darkness and relative humidities approaching 100%. In stem nodules that were grown at high humidity and subsequently exposed to lower humidities, there was only a small loss of nitrogenase activity, and high rates of acetylene reduction were maintained for 6 d after treatments were begun. The area of nodule attachment to the stem or root was measured in nodules of many sizes and found to be consistently greater in stem nodules. This may have implications for the comparative water balance of nodules on these two organs. [ABSTRACT FROM AUTHOR]

In Myrica gale L. plants the assimilation of ammonia released by symbiotic Frankia was observed by 15N2 labelling and subsequent analysis of the isotopic enrichment of nodule amino acids over time by single ion monitoring gas chromatography-mass spectrometry. In detached nodules of Myrica, glutamine was the first amino acid labelled at 30 s and subsequently the amino acids glutamate, aspartate, alanine and γ-amino butyric acid (GABA) became labelled. This pattern of labelling is consistent with the incorporation of ammonium via glutamine synthetase [GS; EC 6.3.1.2]. No evidence for the ammonium assimilation via glutamate dehydrogenase [GDH; EC 1.4.1.2] was observed as glutamate became labelled only after glutamine. Using attached nodules and pulse-chase labelling, we observed synthesis of glutamine, glutamate, aspartate, alanine, GABA and asparagine, and followed the transport of fixed nitrogen in the xylem largely as glutamine and asparagine. Estimation of the cost of nitrogen fixation and asparagine synthesis in Myrica nodules suggests a minimum of one sucrose required per asparagine produced. Rapid translocation of recently fixed nitrogen was observed in Myrica gale nodules as 80% of the nitrogen fixed during a 1-h period was translocated out of the nodules within 9 h. The large pool of asparagine that is present in nodules may buffer the transport of nitrogen and thus act to regulate nitrogen fixation via a feedback mechanism. [ABSTRACT FROM AUTHOR]

Poor comprehenders are a significant subgroup of poor readers who, due to their ability to read aloud accurately, are often difficult to identify. This study aimed to determine whether assessment using two oral language tasks, mapped onto the two components of the Simple View of Reading, would provide an efficient approach to identification. Children (N = 218) from School Years 3 to 6 (ages 7; 8–12; 1) attending two schools in Australia were assessed, and 45 identified as potential poor comprehenders, based on a profile of average phonological awareness but poor listening comprehension. Subsequent assessment of decoding and text reading comprehension confirmed 24 of these children to be poor comprehenders, consistent with reported prevalence rates. Five of these children were judged to be weak readers by their classroom teacher. The oral tasks alone overidentified this group; however, the findings suggest that using the tasks as an initial phase, followed up with a reading assessment, could be effective in identifying poor comprehenders, and reduce time spent in testing as this would only involve at-risk children. [ABSTRACT FROM AUTHOR]

Background: Oral antineoplastic agents have caused a paradigm shift in cancer treatment, however, they produce many unique challenges. Although oral antineoplastics can have complex administration regimes, low adherence rates and high possibilities of drug-drug interactions, they are administered unsupervised at home. Cancer services pharmacists have the required skillsets to improve patient outcomes associated with oral antineoplastic treatment by increasing patient health literacy, improving concordance and optimising administration protocols. Aim: To evaluate patients' perceptions, experiences and overall satisfaction with dedicated clinical pharmacist consultations in patients treated with oral antineoplastic agents at a major public hospital. Method: In this retrospective cross-sectional study at a quaternary hospital in Western Australia, data were collected by a paper questionnaire (mailed in March 2022) to a random sample of 191 patients initiated on oral antineoplastic drugs between January 2021 and February 2022. Demographics, prescribed antineoplastic drug/s, cancer type data were collected including using 5-point Likert scale questions assess patients' overall satisfaction with the clinical pharmacist consultations. Results: The questionnaire response rate was 27.7% (52/188) (mean age 63.2 years; 57.5% female). Most patients (42/52; 80.8%) were satisfied with pharmacist consultations, trusted the pharmacist's advice (45/52; 86.5%), considered that the pharmacist improved their understanding of how to manage side effects (43/52; 82.7%) and they provided an important service in outpatient care (45/52; 86.5%). Conclusion: Overall, patients reported positive perceptions, experiences, and satisfaction with the cancer services pharmacist counselling services during their oral antineoplastic treatment. [ABSTRACT FROM AUTHOR]

People with disabilities in Australia face significant employment barriers. Research and policy initiatives over the past fifteen years have consistently emphasised the benefits of vocational education and training generally, and apprenticeship and traineeships specifically, as leading to positive vocational pathways and employment outcomes for people with disabilities. However, there is a dearth of evidence of graduate outcomes for apprentices and trainees with disabilities. This paper presents the employment outcomes including hours of work and salaries for a cohort of apprenticeship and traineeship graduates with and without disabilities across a three-year longitudinal Australian study. Overall, there are positive employment outcomes for the research participants although graduates without a disability achieved better outcomes than graduates with disabilities and participants in receipt of the disability support pension had significantly lower wages than other participants with disabilities. There are indications that the gap in outcomes between graduates with and without disabilities has reduced over time, although generalisability of the findings may be limited by the observational study design. Nevertheless, the study has confirmed positive employment and related outcomes for apprenticeship and traineeship graduates with disabilities, which were sustained, or arguably improved, over the three-year period covered by the study. [ABSTRACT FROM AUTHOR]

This paper reports a preliminary evaluation of the [Talkable] 10-week language learning programme. This training programme aims to help caregivers provide a rich language learning environment in a child's first 3 years of life through the provision of evidence-based information and practical strategies to promote language development delivered primarily via mobile application. Participants in the study completed pre- and post-programme surveys on a range of questions relating to their knowledge and confidence in assisting their child's language learning. Results indicated significant improvements in participant's self-reported levels of knowledge about early language development and ways to assist their child's language learning, while level of concern about their child's language development remained fairly constant. These findings provide preliminary support for the use of [Talkable] in primary prevention, and direction for future development of the programme. Findings also add to the currently limited evidence-base for providing early language primary prevention programmes via mobile application. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Cytotoxicity of Oxycodone and Morphine in Human Neuroblastoma and Mouse Motoneuronal Cells: A Comparative Approach" by M. Kokki and colleagues published in a previous issue of the periodical.

Single-nucleotide polymorphisms (SNPs) in and around the nicotinamide N -methyltransferase (NNMT) gene are associated with a range of cancers and other diseases and conditions. The data on these associations have been assembled, and their strength discussed. There is no evidence that the presence of either the major or minor base in any SNP affects the expression of nicotinamide N -methyltransferase. Nevertheless, suggestions have been put forward that some of these SNPs do affect NNMT expression and thus homocysteine metabolism. An alternative idea involving non-coding messenger RNAs (mRNAs) is suggested as a possible mechanism whereby health is influenced. It is postulated that these long, non-coding NNMT mRNAs may exert deleterious effects by interfering with the expression of other genes. Neither hypothesis, however, has experimental proof, and further work is necessary to elucidate NNMT genetic interactions. [ABSTRACT FROM AUTHOR]

Background: Data on off-label and unlicensed prescribing in children in Indonesia is limited. The aims of this study were to determine the prevalence of off-label and unlicensed prescribing for paediatric patients in a public hospital, Indonesia. Method: A retrospective cross-sectional study of 200 randomly selected paediatric patients admitted to hospital between August and October 2014, collected patient details and all drugs prescribed. Licensed drugs were classified as off-label if there was a non-compliance with the Product Information for age, weight, indication, dose, frequency and route of administration, if there was a contraindication, special precautions or not recommended for children. Unlicensed drugs were those not approved for use in Indonesia. The main outcome was the prevalence of off-label or unlicensed prescribing to infants, children and adolescents and the impact of age group on off-label prescribing. Results: A total of 200 patients received 1961 medicines of which 1807/1961 (92.1%) were licensed and 154/1961 (7.9%) were unlicensed. There were 1403/1961 (71.5%) drugs prescribed off-label. More than half of the total drugs (n = 1066; 54.4%) were administered parenterally. Every patient was prescribed at least one off-label drug. Indication (n = 810; 34.6%) was the most common reason for off-label prescribing. Ranitidine was the most frequent drug prescribed off label. Darplex® (dihydroartemisinin and piperaquine), although manufactured in Indonesia, was unlicensed. There was a significant difference between age group and off-label prescribing in that children were prescribed significantly less off-label drugs (p<0.0003). Conclusion: This study revealed a high prevalence of off-label and unlicensed drug use in paediatric patients in this hospital, exposing them to drug treatments or regimens that had not been approved by regulatory authorities. The high incidence of invasive parenteral prescribing is of concern for paediatric patients. Incentives are needed to encourage specific drug evaluation in paediatric populations. [ABSTRACT FROM AUTHOR]

Single-nucleotide polymorphisms (SNPs) in and around the nicotinamide N -methyltransferase (NNMT) gene are associated with a range of cancers and other diseases and conditions. The data on these associations have been assembled, and their strength discussed. There is no evidence that the presence of either the major or minor base in any SNP affects the expression of nicotinamide N -methyltransferase. Nevertheless, suggestions have been put forward that some of these SNPs do affect NNMT expression and thus homocysteine metabolism. An alternative idea involving non-coding messenger RNAs (mRNAs) is suggested as a possible mechanism whereby health is influenced. It is postulated that these long, non-coding NNMT mRNAs may exert deleterious effects by interfering with the expression of other genes. Neither hypothesis, however, has experimental proof, and further work is necessary to elucidate NNMT genetic interactions. [ABSTRACT FROM AUTHOR]

Objectives: To quantify the impact of cognitive impairment on pain assessment and management practices in the ED. Methods: A retrospective, cross‐sectional study of patient records was conducted for all elderly patients (65 years or older) who presented to the ED of a large Western Australian tertiary hospital with a fracture because of a fall between 6 February and 14 December 2015. Of 327 records identified, 318 were suitable for data extraction. Of these, 120 patients had a cognitive impairment. Primary outcome measures were the method and frequency of pain assessment, and the delay to the administration of a pain intervention after pain was first assessed for patients with and without a cognitive impairment. Results: Patients with a cognitive impairment were less likely to have their pain assessed with a standardised pain assessment tool (55% vs 91.4%, P < 0.001), and 9.4 times more likely to have their pain assessed using ad hoc assessments only (95% confidence interval 4.6–19.1). The median time between ED presentation and a patient's first pain assessment was longer for patients with cognitive impairment (28 vs 17 min; P < 0.001), as was the time between repeat assessments (81 vs 62 min; P < 0.004). The median times to receive a pain intervention following pain assessment were 51 and 50 min for cognitively intact and impaired patients, respectively (P = 0.209, after adjustment for the first pain score). Conclusion: Pain is inadequately and inappropriately assessed for elderly patients with a cognitive impairment in the ED, resulting in delays in initiation of pain management. [ABSTRACT FROM AUTHOR]

Issue Addressed: The activities and well-being outcomes from participating at Men's Sheds are the focus of a growing body of research. Although many Men's Sheds have a clear health or social philosophy, this does not always translate into health and social activities.Method: This cross-sectional survey explored the health promotion and social inclusion activities of Men's Sheds and features of Sheds that predict greater levels of these activities. All Australian Men's Sheds were invited to participate. Based on survey responses, Sheds were classified as "active" or "not active" in health promotion and social inclusion, which formed the main survey outcomes. Profiles of the responding Sheds were summarised and compared against the main survey outcomes. Multivariate logistic regression analyses explored the profile variables associated with "active" Sheds.Results: Responses from 300 Sheds indicated 37% and 70% of Sheds were "active" in health promotion and social inclusivity respectively. Number of members, members with mental illness or of Indigenous descent, providing meals and targeting war veterans were associated with health promotion. Having five or more members with a disability, members with English as a second language, targeting of war veterans were associated with social inclusiveness.Conclusions: Men's Sheds may serve as a unique community resource to reduce barriers of access to preventative health care, education and social connectedness, especially for marginalised members and those living in rural communities. SO WHAT?: A proportion of Men's Sheds reflects the health and well-being exemplars mentioned in the National Male Health Policy that can help to counter the social determinants of poor health, particularly for marginalised males. [ABSTRACT FROM AUTHOR]

Prior literature has established a positive association between sickle cell disease and risk of contracting SARS-CoV-2. Data from a cross-sectional study evaluating COVID-19 testing devices (n = 10,567) was used to examine the association between underlying health conditions and SARS-CoV-2 infection in an urban metropolis in the southern United States. Firth's logistic regression was used to fit the model predicting SARS-CoV-2 positivity using vaccine status and different medical conditions commonly associated with COVID-19. Another model using the same method was built using SARS-CoV-2 positivity as the outcome and hemoglobinopathy presence, age (<16 Years vs. ≥16 Years), race/ethnicity and comorbidities, including hemoglobinopathy, as the factors. Our first model showed a significant association between hemoglobinopathy and SARS-CoV-2 infection (OR: 2.28, 95 % CI: (1.17,4.35), P = 0.016). However, in the second model, this association was not maintained (OR: 1.35, 95 % CI: (0.72,2.50), P = 0.344). We conclude that the association between SARS-CoV-2 positivity and presence of hemoglobinopathies like sickle cell disease is confounded by race, age, and comorbidity status. Our results illuminate previous findings by identifying underlying clinical/demographic factors that confound the reported association between hemoglobinopathies and SARS-CoV-2. These findings demonstrate how social determinants of health may influence disease manifestations more than genetics alone. • Hemoglobinopathies have been reported as a risk factor for SARS-CoV-2 infection. • Age and race explain association between hemoglobinopathy and SARS-CoV-2. • CKD and diabetes higher odds of SARS-CoV-2 infection than heart and liver disease. [ABSTRACT FROM AUTHOR]