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Young people who are lesbian, gay, bisexual, trans, queer or questioning, asexual and other diverse genders and sexualities (LGBTQA+) are at greater risk of adverse mental health outcomes and suicide, with additional barriers to accessing safe and affirming physical and mental health services in comparison to the general population. Parents of LGBTQA+ young people who are supportive and accepting can take on additional responsibilities and an active role in supporting young people, and more information is needed to understand how parents support LGBTQA+ young people in times of acute mental health difficulties (including suicide risk) and what parents experience while navigating support systems. It is imperative these experiences are better understood to inform other parents, clinicians and service providers alike. We aimed to develop a nuanced understanding of the experiences of Australian parents of LGBTQA+ young people in providing support during times of acute distress and suicidal crisis. We utilized an exploratory qualitative design using semi-structured one-on-one interviews with 11 parents. We provide clinically useful recommendations, with the aim of aiding enhanced parental support for LGBTQA+ young people, given this population’s unique needs.

From the 1850s, the expanding provincial centres of New Zealand were forced to address two overlapping social questions: first, how to support and meet the needs of increasing numbers of older people in the community, and, secondly, how to provide socially coordinated care for individuals with mental ill-health. These dual challenges were even more pressing because the settler communities lacked, at least initially, the budgetary resources and established support networks needed to care for people affected by advanced old age, mental ill-health, or a combination of both. This thesis focussed on personal and social dimensions of ageing and mental ‘ill-health’ in the population of colonial Otago and Southland. The analysis was based on admission documents and case records for 55 older people resident in the Dunedin Lunatic Asylum and Seacliff for the period 1863 to 1898 inclusive. This analysis examined five principal themes: (i) social contexts of older people with mental ill-health both within and outside the asylum system; (ii) the process of committal and pathway to admission; (iii) how characteristics and behaviours of older people within the asylum system were framed within alienist paradigms; (iv) the fate of older people in asylumdom; (iv) the social options and alternatives for care of older people with mental disorders in nineteenth century New Zealand, including international comparisons. In general, the asylum records from nineteenth century Otago indicated prolonged periods of admission for older patients with little evidence of ‘recovery’ and discharge. This challenged the earlier assumptions that episodes of asylum care might be limited and followed by a return to relatively independent life. Colonial perspectives on care for older people related to the prevailing attitudes and priorities of the wider community, but also reflected the financial or personal capacity of individuals or their families to manage the complexities of mental disorders.

We investigated the association of allergic diseases and epilepsy with risk of brain tumours, in Interphone, a 13-country case–control study. Data were obtained from 2693 glioma cases, 2396 meningioma cases, and 1102 acoustic neuroma cases and their 6321 controls. Conditional logistic regression models were used to estimate pooled odds ratios (ORs) and their respective 95% confidence intervals (CIs), adjusted for education and time at interview. Reduced ORs were observed for glioma in relation to physician-diagnosed asthma (OR = 0.73; CI 0.58–0.92), hay fever (OR 0.72; CI 0.61–0.86), and eczema (OR 0.78, CI 0.64–0.94), but not for meningioma or acoustic neuroma. Previous diagnosis of epilepsy was associated with an increased OR for glioma (2.94; CI 1.87–4.63) and for meningioma (2.12; CI 1.27–3.56), but not for acoustic neuroma. This large-scale case–control study adds to the growing evidence that people with allergies have a lower risk of developing glioma, but not meningioma or acoustic neuroma. It also supports clinical observations of epilepsy prior to the diagnosis of glioma and meningioma.

Since 2012, a long‐term in situ corrosion experiment (IC‐A) is being conducted in the Mont Terri Underground Research Laboratory in Switzerland to investigate the corrosion behaviour of candidate canister materials in conditions representative of the Swiss concept for the disposal of high‐level waste and spent nuclear fuel. To date, carbon steel and various types of copper coatings have been retrieved after different exposure periods of up to 3 years, and characterised to establish the composition of the corrosion product, the morphology of the corroded surface, the nature of the interaction between the metal and the surrounding bentonite, and the microbial populations in the bentonite and surrounding porewater. For carbon steel specimens, a complex corrosion product was identified, consisting predominantly of magnetite. Much less alteration on either the metal or the bentonite was observed in the case of copper samples. Low average anaerobic corrosion rates were measured for carbon steel and a very modest amount of alteration was identified on copper. The density and the initial form of the bentonite had a small influence on the rate of corrosion, across all materials. This paper summarises the results of the experimental programme obtained to date and discusses the relationship observed between exposure time and the evolution of the metal–bentonite interface for both carbon steel and copper.

The materials corrosion test (MaCoTe) is a long‐term, multinational in situ corrosion experiment setup at the Grimsel Test Site, Switzerland. The experiment has been operating since 2014 with a focus on the corrosion behaviour of container materials for the disposal of high‐level waste and spent nuclear fuel under conditions representing a granitic deep geological repository. The experiment consists of eight modules containing metal coupons and bentonite. Two of the modules, each with a different bentonite density, have been retrieved after 394 days of exposure and have been analysed using a range of techniques aimed at studying the corrosion behaviour of the metals and the mineralogical evolution of the bentonite. Weight loss measurements show that carbon steel had a relatively low average corrosion rate (~2 µm year−1). Much lower average corrosion rates were measured for the various types of copper (0.13–0.32 µm year−1). No detectable corrosion was measured on stainless steel coupons. To date, no significant differences were observed in the corrosion behaviour and rate of the test metals in bentonite with different dry densities.

Background: There is a growing emphasis on the importance of availability of specialist palliative care for people living with dementia. However, for people imminently dying with dementia, we still have little knowledge about their palliative care needs and utilization of different specialist services. Objectives: To (i) assess palliative care needs and other clinical and social characteristics of people imminently dying with dementia on their last admission in the context of community and inpatient palliative care services before death; (ii) compare care needs between patients requiring community-based and inpatient services; (iii) determine how and whether such care needs affect utilization of different palliative care services. Design: Observational study using data from the Australian Palliative Care Outcomes Collaboration. Settings: Specialist palliative care services across Australia registered in the Palliative Care Outcomes Collaboration. Participants: A total of 3361 people who required specialist palliative care principally for dementia (including Alzheimer's disease and other dementias), and whose death occurred between 1 January 2013 and 31 December 2018. Methods: Five validated clinical instruments were used to collect point-of-care outcomes on each individual's function (Resource Utilisation Groups - Activities of Daily Living & Australia-modified Karnofsky Performance Status), symptom distress (Symptoms Assessment Scale & Palliative Care Problem Severity Score) and other clinical characteristics (Palliative Care Phases). We fitted multivariate logistic regression models to examine the association between these clinical outcomes and utilization of different specialist palliative care services. Results: The majority of people imminently dying with dementia had absent or mild levels of symptom distress but experienced high levels of functional decline and needed substantial assistance with basic tasks of daily living in their last days of life. Large dis

2020 John Wiley & Sons Ltd Objectives: To (a) compare palliative care needs of lung cancer patients on their final admission to community-based and inpatient palliative care services; and (b) explore whether and how these care needs affect their utilisation of different palliative care services in the last days of life. Methods: Descriptive study involving 17,816 lung cancer patients who received the last episode of palliative care from specialist services and died between 1 January 2013 and 31 December 2018. Results: Both groups of patients admitted to community-based and inpatient palliative care services generally experienced relatively low levels of symptom distress, but high levels of functional impairment and dependency. "Unstable" versus "stable" palliative care phase (Odds ratio = 11.66; 95% Confidence Interval: 9.55-14.24), poorer functional outcomes and severe levels of distress from many symptoms predicted greater likelihood of use of inpatient versus community-based palliative care. Conclusions: Most inpatient palliative care admissions are not associated with high levels of symptom severity. To extend the period of home care and rate of home death for people with lung cancer, additional investment is required to improve their access to sufficiently skilled palliative care staff, multi-disciplinary teams and 24-hour home support in community settings.

Corrosion products generated in artificial pits of zirconium were characterized in-situ by synchrotron X-ray diffraction and X-ray absorption near edge structure (XANES) in physiological saline, with and without addition of 4% albumin and/or 0.1% H2O2. Zr metal fragments and tetragonal ZrO2 particles were detected in aggregated black corrosion products away from the corrosion front. At the corrosion front, a ZrOCl2·8H2O salt layer of a few hundreds of microns thickness was formed. Coarsened ZrOCl2·8H2O crystallites were found farther out into the solution. The Zr solution species were confirmed to be in a tetravalent state by XANES. TEM imaging of the corrosion products revealed heterogeneity of the morphology of the Zr metal fragments and confirmed their size to be less than a few microns. The formation and speciation of Zr corrosion products were found not affected by the presence of H2O2 and/or albumin in physiological saline. Furthermore, bulk Zr electrochemistry identified that the presence of H2O2 and/or albumin did not affect passive current densities and pitting potentials of the bulk Zr surface. Therefore, it is concluded that the pitting susceptibility and pit chemistry of Zr in physiological saline were unaffected by the presence of H2O2, albumin or their combinations.

Research data used in the paper 'Effect of Nitrate and Sulphate on Atmospheric Corrosion of 304L and 316L Stainless Steels', A. J. M. C. Cook, C. Padovani, A. J. Davenport, submitted to the Journal of the Electrochemical Society. This data is uploaded as part of the EPSRC Open-Data policy for grant EP/I036397/1. Data is stored on the Research Data Archive and may be requested.

Free to read Modern statistical models and computational methods can now incorporate uncertainty of the parameters used in Quantitative Microbial Risk Assessments (QMRA). Many QMRAs use Monte Carlo methods, but work from fixed estimates for means, variances and other parameters. We illustrate the ease of estimating all parameters contemporaneously with the risk assessment, incorporating all the parameter uncertainty arising from the experiments from which these parameters are estimated. A Bayesian approach is adopted, using Markov Chain Monte Carlo Gibbs sampling (MCMC) via the freely available software, WinBUGS. The method and its ease of implementation are illustrated by a case study that involves incorporating three disparate datasets into an MCMC framework. The probabilities of infection when the uncertainty associated with parameter estimation is incorporated into a QMRA are shown to be considerably more variable over various dose ranges than the analogous probabilities obtained when constants from the literature are simply ‘plugged’ in as is done in most QMRAs. Neglecting these sources of uncertainty may lead to erroneous decisions for public health and risk management.

Estimating potential health risks associated with recycled (reused) water is highly complex given the multiple factors affecting water quality. We take a conceptual model, which represents the factors and pathways by which recycled water may pose a risk of contracting gastroenteritis, convert the conceptual model to a Bayesian net, and quantify the model using one expert’s opinion. This allows us to make various predictions as to the risks posed under various scenarios. Bayesian nets provide an additional way of modeling the determinants of recycled water quality and elucidating their relative influence on a given disease outcome. The important contribution to Bayesian net methodology is that all model predictions, whether risk or relative risk estimates, are expressed as credible intervals.

Cresp, R., Clarke, K., McAuley, K. E., McAullay, D., Moylan, C. A., Peter, S., ... & Edmond, K. M. (2016). Effectiveness of the Koorliny Moort out-of-hospital health care program for Aboriginal and Torres Strait Islander children in Western Australia. Med J Aust, 204(5), 197. Available here.