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A replication of experiment 1 from Neuhoff et al. (2015). We added an additional comparison between rising and falling formant (in addition to rising / falling pitch).

Although the relief of suffering and emotional support are fundamental to children's palliative care, their empirical study has been limited. The research questions for this study address three areas: the lived experience of parents of dying children; how other people's responses shape the parents' lived experience; and the place of emotion and suffering in the parents' lived experience. Implementing a qualitative strategy, a collective case study was undertaken in a children's hospice in England, with fieldwork completed between March 2008 and September 2009. Data was collected with nine parents using a range of tools including a focus group, participant observation, documentary observation and individual interviews. Within-case and cross-case modified grounded theory analysis facilitated clarification of emerging themes whilst preserving individual parent voices. The findings show that parents of dying children had existential issues put at stake through the emotional experience of parenting a dying child; these included their identity, place in society, time, and relationships. Such losses could constitute suffering, but in addition they limited the parents' interaction with society so that over time both the 'quantity' and 'quality' of intersubjectivity reduced. The parents perceived that other people tended not to legitimate their lived experience. Emotion was an important influence in this process. The parents of dying children managed their emotions, particularly those of a negative nature, in everyday life and when using hospice services. As a result they expressed somewhat inauthentic accounts of their felt experience, reframed according to perceived feeling rules. This also reduced intersubjectivity and supported the delegitimation of the parental experience. In conclusion, delegitimation of the parental experience stems from feeling rules which are derived from day to day interactions and contemporary social policy. Suffering may be prevented if individual experience is legitimated through improved intersubjectivity. A key factor for this is effective communication through which observers engage with the felt emotion of the suffering individual.

CYP2C19 genotyping is used to guide antiplatelet therapy after percutaneous coronary intervention (PCI). This study evaluated the potential impact of CYP2C19 and multigene pharmacogenomic (PGx) testing on medications beyond antiplatelet therapy in a real-world cohort of PCI patients that underwent CYP2C19 testing. Multiple medications with actionable PGx recommendations, notably proton pump inhibitors, antidepressants and opioids, were commonly prescribed. Approximately 50% received a CYP2C19 metabolized medication beyond clopidogrel, and 7% met criteria for a CYP2C19 genotype-guided intervention. A simulation analysis projected that 17.5 PGx-guided medication interventions per 100 PCI patients could have been made if multigene PGx results were available. This suggests that CYP2C19 and multigene PGx results could be used to optimize medication prescribing beyond antiplatelet therapy in PCI patients.

ARAD list of current ethics approvals across Australia. (DOCX 19 kb)

Objective Glucocorticoids (GCs) are often used to treat Rheumatoid Arthritis (RA) despite their many side effects and the availability of other effective therapies. Cataract and glaucoma are known side effects of GCs but the risk of them developing in the setting of GC use for RA is unknown. The aim was to perform a systematic review and meta-analysis to determine the association between GCs and the risk of developing cataract and/or glaucoma in RA. Methods A systematic search was carried out using MEDLINE, EMBASE, and Web of Science. All RCTs comparing GC use to non-use in RA populations were sought. Observational studies reporting cataract and/or glaucoma amongst GC users and non-users were also included. Data extracted included incidence/prevalence of cataract and/or glaucoma in each arm, dose and duration of therapy. Two independent reviewers performed quality assessment. Results 28 RCTs met eligibility criteria, however only 3 reported cataracts and glaucoma, suggesting significant under-reporting. An association between GC use and the development of cataracts in RA patients was seen in observational studies but not RCTs. There was no statistically significant association between GC use and the development of glaucoma, although data were sparse. There were insufficient data to determine the impact of dose and duration of therapy. Conclusion The current literature suggests a possible association between GC use and the development of cataract. However, this risk cannot be accurately quantified in RA from the available evidence. RCTs have not adequately captured these outcomes and well-designed observational research is required.

Kent New Opportunities to Work (Kent NOW) has been developed by Kent County Council (KCC) to deliver the Second Local Public Service Agreement (LPSA2) target 8.2, to return 250 long-term Incapacity Benefit (IB) claimants to sustained (13+ weeks) employment. This report presents a qualitative evaluation of the programme, comprising interviews with service providers at three intervention sites, service users and others working with the same client group. The evaluation aims:\ud ? To provide a rich description of the interventions deployed in Folkestone, Maidstone and North Kent;\ud ? To reveal the experiences of the service users and staff who use or provide these interventions;\ud ? To uncover possible explanations for the limited success of the interventions in achieving the LPSA2 target;\ud ? In light of the above, to discover alternative perceptions of ‘success’;\ud ? To identify which aspects of each programme are performing most effectively and why; and\ud ? To provide recommendations regarding the future direction of future interventions with this client group.\ud An overwhelming message from this evaluation is that Kent NOW is working within a\ud very difficult environment, considering: the client group; the lack of prior knowledge of\ud the client group, not just within Kent NOW, but throughout government, in light of the\ud novelty of policy and action in this area; strategic and managerial difficulties; and the\ud political environment. These factors have been shown to have impacted upon the ability\ud of the interventions to achieve their goals to an extent that should not be\ud underestimated. Lessons learnt from the Kent NOW programme can be taken forward\ud and applied in future interventions with this client group. In this sense, the authors\ud consider the Kent NOW programme to be successful, exposing the many barriers to\ud returning long-term IB claimants to work. This evaluation has, in turn, highlighted the\ud ways in which future interventions may overcome these barriers, increasing the\ud likelihood of their future success.

In August of 2001, Wildlife Resources Division staff notified the Office of the State Archaeologist that human remains had eroded from a bluff along Newell Creek on Ossabaw Island and following a storm. DNR Archaeologists visited the site and found four pit features exposed in the bluff profile. Two of the pits had been heavily damaged by slumping, and were completely excavated by the archaeologists. Another pit appeared to be less damaged, but also contained some exposed bones, facial and maxillary, which were in danger of filling into the creek and were removed. The pit appeared to be stable and was not further excavated. The fourth pit appeared to be stable, and had no exposed bones, so it was not disturbed. Archaeologists determined that the remains were American Indian. The Council on American Indian Concerns was notified. The Council recommended to the Commissioner of DNR that the remains should be reburied on the island, on a site known to contain burials, and at a site that was not in any danger of erosion in the near future. Council recommended setting aside an area that could serve to bury additional remains that might erode from sites on the island. Council further recommended excavation of the pit from which exposed bones had been removed in order to rebury all the bones from the pit together at the new location.

At the end of the nineteenth century, middle-class social life in Paris underwent drastic changes. Restaurant life, gastronomic literature and literary dinners during this period offer an interesting social and cultural discourse on middle-class social life. Restaurants were unique environments, where private and public lives mingled. By studying eating habits and the spaces in which people preferred to both eat and socialize, it is possible to learn more about middle-class identity. Brillat-Savarin's aphorism, "tell me what you eat and I will tell you who you are," rings true in the case of the Parisian bourgeoisie during the nineteenth century. Consequently, dining out can provide a window onto social changes that are difficult to discern using textual sources or conventional historiographical approaches. This paper focuses on the period of 1848 to 1888. The close of the century compounded both the excitement and the uncertainty of modern life. These sentiments were expressed in a multitude of ways: from daily life in the quartiers of Paris to high art in the salons. The restaurant Chez Brebant, located in Montmartre, serves as a specific case study. In conjunction, the gastronomic writings of Charles Monselet (1825-1888) help to further illuminate the middle-class perspective of changing sociability and eating habits during this period. Beginning with a brief history of the restaurant in Paris, this paper follows the rise and fall of the middle-class restaurant as an important place for bourgeois social life. The second chapter deals with the affects of Haussmannization and mass culture on bourgeois group identity. In conclusion, the third chapter looks at the resistance to change that was expressed by gastronomic literature and bourgeois hommes de lettres at the end Second Empire. Dining out offers insight into how the democratization of taste affected the bourgeoisie as a group. The modernization of city-life was a central cause of anxiety. This study attempts to offer new insights into the complexity of the daily lives of the Parisian bourgeoisie during a period of rapid change.

Refereed/Peer-reviewed Objective: To determine vaccination rates, perceptions, and information sources in people with inflammatory arthritis. Methods: Participants enrolled in the Australian Rheumatology Association Database were invited to participate in an online questionnaire, conducted in January 2020, prior to the COVID-19 pandemic. Included questions were about vaccination history, modified World Health Organization Vaccination Hesitancy Scale, views of the information sources consulted, the Beliefs About Medicines Questionnaire, education, and the Single-Item Health Literacy Screener. Results: Response rate was 994 of 1498 (66%). The median age of participants was 62 years, with 67% female. Self-reported adherence was 83% for the influenza vaccine. Participants generally expressed positive vaccination views, particularly regarding safety, efficacy, and access. However, only 43% knew which vaccines were recommended for them. Vaccine hesitancy was primarily attributable to uncertainty and a perceived lack of information about which vaccines were recommended. Participants consulted multiple vaccination information sources (median 3, interquartile range 2-7). General practitioners (89%) and rheumatologists (76%) were the most frequently used information sources and were most likely to yield positive views. Negative views of vaccination were most often from internet chatrooms, social media, and mainstream media. Factors of younger age, male gender, and having more concerns about the harms and overuse of medicines in general were associated with lower adherence and greater uncertainty about vaccinations, whereas education and self-reported literacy were not. Conclusion: Participants with inflammatory arthritis generally held positive views about vaccination, although there was considerable uncertainty as to which vaccinations were recommended for them. This study highlights the need for improved consumer information about vaccination recommendations for people with inflammatory arthritis.

Refereed/Peer-reviewed Objectives: To investigate the knowledge and beliefs of Australian patients with inflammatory arthritis regarding biologic/targeted synthetic DMARDs (b/tsDMARDs) and biosimilars and their sources of information. Methods: Participants enrolled in the Australian Rheumatology Association Database (ARAD) with RA, PsA and axial SpA were sent an online survey. They were asked about information sources for b/tsDMARDs and how positive or negative this information was. The Beliefs about Medicine Questionnaire (BMQ) was used to measure beliefs about b/tsDMARDs with scores ranging from 1 (strongly disagree) to 5 (strongly agree). Participants were asked about their knowledge of biosimilars and willingness to switch to biosimilar. Results: There was a response rate of 66% (994/1498; 67% female, median age 62 years). Participants currently taking b/tsDMARDs (n =794) had a high bitsDMARD-specific BMQ 'necessity' score {median 4.2 [interquartile range (IQR) 3.6-4.8]}, with a lower specific 'concerns' score [median 2.4 (IQR 2.0-3.0)]. Participants consulted multiple information sources [median 3 (IQR 2-5)]. Positive sources were rheumatologists and educational websites and negative were chat rooms and social media. Only 18% were familiar with biosimilars, with half knowing of availability in Australia. Following a short paragraph describing biosimilars, 75% (744) of participants indicated they would consider switching if recommended by their rheumatologist, with nearly half identifying safety and efficacy of biosimilars as an important concern. Conclusion: Australian patients have positive attitudes towards b/tsDMARDs overall, although little knowledge of biosimilars specifically. They have a high degree of trust in their rheumatologist regarding treatment decisions, even if they are unfamiliar with the medication recommended.

Giant cell arteritis (GCA) is one of the commonest forms of vasculitis in the elderly, and may result in blindness and stroke. The pathogenesis of GCA is not understood, although environmental, infectious and genetic risk factors are implicated. One gene of interest is PTPN22, encoding lymphoid protein tyrosine phosphatase (Lyp), expressed exclusively in immune cells, which is proposed to be an 'archetypal non-HLA autoimmunity gene'. The minor allele of a functional PTPN22 single nucleotide polymorphism (rs2476601, R620W), which disrupts an interaction motif in the protein, was originally reported to be associated with biopsy-proven GCA in Spanish patients, with supporting data from three replicate Northern European studies. Recently, this observation was extended with additional patients and controls, and studies encompassing European, Scandinavian, UK and American patients. The aim of our study was to determine the association between PTPN22 rs2476601 (R620W) and biopsy-proven GCA in an Australian case cohort. Refereed/Peer-reviewed