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Background: Women seeking a vaginal birth after a caesarean section (VBAC) frequently want to keep their subsequent labour and birth free from intervention. Water immersion (WI) during labour is potentially an effective tool for women having a VBAC for its natural pain-relieving properties. However, negotiating access to WI can be difficult, especially in the context of VBAC., Aim: To explore women's experiences of negotiating WI for labour and birth in the context of VBAC., Methodology: This Grounded Theory study followed Strauss and Corbin's framework and analytic process. Twenty-five women planning or using WI for their VBAC labour or birth were recruited from two midwifery practices and a social media group across Australia. Participants were interviewed during pregnancy and/or postnatally., Findings: 'Taking the reins', the core category explaining the women's experiences of assuming authority over their birth, comprised five categories: 'Robbed of my previous birth experience'; 'My eyes were opened'; 'Water is my tool for a successful VBAC'; 'Actioning my choices and rights for WI', and 'Empowered to take back control'. 'Wanting natural and normal' was the driving force behind women's desire to birth vaginally. Two mediating factors: Having someone in your corner and Rules for birth facilitated or hindered their birth choices, respectively., Conclusion: The women became active participants in their healthcare by seeking information and options to keep their birth experience natural and normal. Support from other women and advocacy in the form of continuity of midwifery care was crucial in successfully negotiating WI for their VBAC when navigating the complex health system., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Background: The COVID-19 pandemic has caused isolation, fear, and impacted on maternal healthcare provision., Aim: To explore midwives' experiences about how COVID-19 impacted their ability to provide woman-centred care, and what lessons they have learnt as a result of the mandated government and hospital restrictions (such as social distancing) during the care of the woman and her family., Methods: A qualitative interpretive descriptive study was conducted. Twenty-six midwives working in all models of care in all states and territories of Australia were recruited through social media, and selected using a maximum variation sampling approach. Data were collected through in-depth interviews between May to August, 2020. The interviews were recorded, transcribed verbatim, and thematically analysed., Findings: Two overarching themes were identified: 'COVID-19 causing chaos' and 'keeping the woman at the centre of care'. The 'COVID-19 causing chaos' theme included three sub-themes: 'quickly evolving situation', 'challenging to provide care', and 'affecting women and families'. The 'Keeping the woman at the centre of care' theme included three sub-themes: 'trying to keep it normal', 'bending the rules and pushing the boundaries', and 'quality time for the woman, baby, and family unit'., Conclusion: Findings of this study offer important evidence regarding the impact of the pandemic on the provision of woman-centred care which is key to midwifery philosophy. Recommendations are made for ways to preserve and further enhance woman-centred care during periods of uncertainty such as during a pandemic or other health crises., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

Ecosystem services provided by lowland British floodplains respectively under semi-natural conditions and converted for intensive maize production were assessed. Floodplains across lowland Britain have been extensively disconnected from river channels, depleting habitat for wildlife and other beneficial ecosystem services. Conservation measures are often regarded as costly constraints on economic and development freedoms whilst, conversely, conversion for intensive agricultural production is rewarded by markets despite many often-overlooked externalities. Maize growing has increased in Britain since the 1970s, initially for feedlot production of livestock and now increasingly for grant-aided biofuel production for anaerobic digestion. Comparative literature-based ecosystem service assessments using the RAWES (Rapid Assessment of Wetland Ecosystem Services) approach reveal that lowland British floodplains in semi-natural condition provide a wider range of provisioning services than those converted for monocultural intensive production of maize, in addition to a diversity of regulating, cultural and supporting service benefits that are lost or transformed into disservices when floodplains are converted for intensive maize growth. Benefits and disbenefits of floodplains managed under the two scenarios (semi-natural versus monocultural maize) are presented graphically as an intuitive means to support decision-makers. Monetisation of benefits would be risky, not merely due to uncertainties but as this may skew conclusions and subsequent decision-making towards maximisation of marketed or near-market services, consequently misrepresenting the diversity of values of whole socioecological floodplain systems. Management solutions protective of the societal values provided by floodplain ecosystem may include buffer zoning as a mitigation measure, but a more strategic solution may be zonation of land use based on suitability not only for crop production but recognising the full spectrum of societally beneficial ecosystem services demonstrated by RAWES assessment. A variety of drivers for a changing approach to floodplain farming - statutory, fiscal and self-beneficial - are highlighted, and are generically applicable beyond Britain with context-specific modification., Competing Interests: Declaration of competing interest The author team has no interest to declare., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The environmental and financial costs of inputs to, and unintended consequences arising from narrow consideration of outputs from, water and environmental management technologies highlight the need for low-input solutions that optimise outcomes across multiple ecosystem services. Case studies examining the inputs and outputs associated with several ecosystem-based water and environmental management technologies reveal a range from those that differ little from conventional electro-mechanical engineering techniques through methods, such as integrated constructed wetlands (ICWs), designed explicitly as low-input systems optimising ecosystem service outcomes. All techniques present opportunities for further optimisation of outputs, and hence for greater cumulative public value. We define 'systemic solutions' as "…low-input technologies using natural processes to optimise benefits across the spectrum of ecosystem services and their beneficiaries". They contribute to sustainable development by averting unintended negative impacts and optimising benefits to all ecosystem service beneficiaries, increasing net economic value. Legacy legislation addressing issues in a fragmented way, associated 'ring-fenced' budgets and established management assumptions represent obstacles to implementing 'systemic solutions'. However, flexible implementation of legacy regulations recognising their primary purpose, rather than slavish adherence to detailed sub-clauses, may achieve greater overall public benefit through optimisation of outcomes across ecosystem services. Systemic solutions are not a panacea if applied merely as 'downstream' fixes, but are part of, and a means to accelerate, broader culture change towards more sustainable practice. This necessarily entails connecting a wider network of interests in the formulation and design of mutually-beneficial systemic solutions, including for example spatial planners, engineers, regulators, managers, farming and other businesses, and researchers working on ways to quantify and optimise delivery of ecosystem services., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Objective: To ascertain the extent to which general practitioners in Queensland recommend physical activity to their patients, the types of patients they target, types of activities they suggest and how patients respond to the recommendations., Methods: Questions designed to answer the research objectives were included in the Queensland Social Survey. Univariate, bivariate and logistic regression analyses were employed linking relevant variables with demographic data from the survey., Results: The survey was completed by 1,261 (35.2%) people. In the previous year, 225 (18%) of them were recommended by a general practitioner to do more physical activity. These people were more likely to have a higher body mass index and rate their general health as fair or poor. Walking was the most common activity recommended (75%). Only 18% of people were not pleased to be recommended to take more exercise and most (67%) reported following the advice. Blue-collar workers and older people were less likely to follow the recommendations., Conclusions: General practitioners in Queensland are recommending increased physical activity to patients with weight problems and with medical problems. Patients are usually pleased to receive the advice and act upon it., Implications: General practitioners should be aware that physical activity recommendations are received favourably by most patients and there is potential to improve public health by giving physical activity advice to sedentary and/or overweight patients when appropriate., (© 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.)

The central neuroendocrine system in the Drosophila brain includes two centers, the pars intercerebralis (PI) and pars lateralis (PL). The PI and PL contain neurosecretory cells (NSCs) which project their axons to the ring gland, a complex of peripheral endocrine glands flanking the aorta. We present here a developmental and genetic study of the PI and PL. The PI and PL are derived from adjacent neurectodermal placodes in the dorso-medial head. The placodes invaginate during late embryogenesis and become attached to the brain primordium. The PI placode and its derivatives express the homeobox gene Dchx1 and can be followed until the late pupal stage. NSCs labeled by the expression of Drosophila insulin-like peptide (Dilp), FMRF, and myomodulin form part of the Dchx1 expressing PI domain. NSCs of the PL can be followed throughout development by their expression of the adhesion molecule FasII. Decapentaplegic (Dpp), secreted along the dorsal midline of the early embryo, inhibits the formation of the PI and PL placodes; loss of the signal results in an unpaired, enlarged placodeal ectoderm. The other early activated signaling pathway, EGFR, is positively required for the maintenance of the PI placode. Of the dorso-medially expressed head gap genes, only tailless (tll) is required for the specification of the PI. Absence of the corpora cardiaca, the endocrine gland innervated by neurosecretory cells of the PI and PL, does not affect the formation of the PI/PL, indicating that inductive stimuli from their target tissue are not essential for early PI/PL development.

The paired-like homeodomain (HD) protein Chx10 is distinguished by the presence of the CVC domain, a conserved 56 amino acid sequence C-terminal to the HD. In mammals, Chx10 is essential both for the proliferation of retinal progenitor cells and for the formation or survival of retinal bipolar interneurons. We describe the cloning and characterization of a mouse Chx10 homologue, Vsx1; phylogenetic analysis suggests that Vsx1 and its putative vertebrate orthologues have evolved rapidly. Vsx1 expression in the adult is predominantly retinal. Whereas Chx10 is expressed both in retinal progenitors in the developing eye and apparently in all bipolar cells of the mature retina, Vsx1 expression is first detected in the eye at postnatal day 5, where it is restricted to cone bipolar cells.

Human argininosuccinic acid lyase (ASAL) has been expressed, purified and crystallized in several distinct crystal morphologies. At present only one form is suitable for X-ray diffraction analysis. These crystals grow as hexagonal prisms, with unit cell dimensions a = b = 104.6 A, c = 185.3 A and alpha = beta = 90 degrees, gamma = 120 degrees. The crystals exhibit the symmetry of space group P3(1)21 or its enantiomorph, P3(2)21 (indistinguishable crystallographically) and diffract to a minimum d-spacing of approximately 3.5 A.

The blend of biochemistry and molecular biology required to understand the pathogenesis of genetic disease is assuming an increasing role in research. We review three example of this inevitable post-cloning trend: first, the surprising relationship between mice with albino deletions and human hereditary tyrosinemia type I; second, the discovery that choroideremia is due to defect in prenylation; and third, fibrillin mutations in the Marfan syndrome.

Male dogs with X-linked hereditary nephritis (HN) serve as a model for studying male patients with this disease. In the present study, carrier female dogs were found to resemble female patients in showing a broad range of renal dysfunction. Of 37 carrier female dogs studied, all were healthy up to 5 years of age; however, all had proteinuria develop at 2 to 3 months, and focal segmental glomerulosclerosis (FSGS) was detected after 7 months. After 5 years, 4 of 13 dogs remained healthy and showed mild FSGS on renal biopsy; 4 had mild renal dysfunction develop and their kidneys showed extensive FSGS; 5 died prematurely of renal failure with end-stage kidneys. By immunofluorescence, using antibody to the NC1 domain of collagen type IV, segmental staining of glomerular basement membranes (GBM) was seen in all dogs before 3 to 4 years, and lesions of FSGS were negative. Thereafter, a transition to global staining of GBM was noted and lesions of FSGS became positive. Lens capsule and basement membranes in lung and choroid plexus showed discontinuous staining in two young carrier female dogs and continuous staining in one older carrier female dog. By electron microscopy, multilaminar splitting of some GBM was seen up to 4 years, and thereafter, splitting took on a compressed appearance, with the layers becoming apposed though still detectable. The authors conclude that: 1) carrier female dogs with X-linked HN are mosaics for an abnormality in the NC1 domain of GBM and other basement membranes; 2) FSGS develops in all carrier female dogs in glomerular capillary loops that possess an abnormal NC1 domain, and progresses to a variable extent in different dogs; and 3) the abnormality of NC1 in GBM of carrier female dogs appears to diminish with age, but this does not prevent progression of renal disease. Similar conclusions may apply to females with X-linked HN.

In an attempt to evaluate the efficacy of salpingoovariolysis we studied 147 women who were found to have periadnexal adhesions on laparoscopic examination. Among these women, 69 were treated by laparotomy and salpingoovariolysis and 78 were not treated. There was no significant difference between the degree of adhesions in the treated group and in the nontreated group. With the use of life table analysis, the cumulative pregnancy rate at 12 and 24 months follow-up was 32% and 45% in the treated group and 11% and 16% in the nontreated group, respectively (p less than 10(-6)). We suggest that although pregnancy might occur in infertile women who have periadnexal adhesions, treatment with salpingoovariolysis is associated with a higher pregnancy rate.

Samoyed hereditary glomerulopathy (SHG) in dogs serves as a model for human X-linked hereditary nephritis (HN). We previously showed that glomerular capillaries of affected males did not stain by immunofluorescence (IF) using serum from a patient with Goodpasture's syndrome. Our goal in the present study was to determine whether the NC1 domain of the collagen type IV molecule, which contains Goodpasture antigen (GPA), could be demonstrated in these dogs, and to assess its immunological reactivity. By SDS-PAGE, NC1 in collagenase digests of glomerular basement membranes (GBM) of unaffected and carrier female dogs in the family with SHG showed 24 kilodalton (kD), 26 kD and 28 kD monomer, and 46 kD and 47 kD dimer components, but the 24 kD monomer was diminished in the affected males. By IF, a rabbit antibody to NCl stained glomerular capillaries of unaffected, affected male, and carrier female dogs. In contrast, a human anti-GBM plasmapheresis fluid (PPF) stained glomerular capillaries of only the unaffected and carrier female dogs. By RIA, both antibodies reacted strongly with NCl in collagenase digests of GBM of the unaffected and carrier female dogs, but showed reduced reactivity with NCl of affected males. By Western blotting, both antibodies bound to dimers and 24 kD and 26 kD monomers of the NCl domain in collagenase digests of GBM of unaffected and carrier female dogs. However, in affected males, the rabbit anti-NCl antibody did not bind to the 24 kD monomer, while the human anti-GBM PPF showed weak binding to the 24 kD and 26 kD monomers.(ABSTRACT TRUNCATED AT 250 WORDS)

A 15-year-old patient with hyperornithinaemia (0.6--1.2 mmol/l) and gyrate atrophy of the retina was given a low-arginine diet to reduce plasma ornithine to a concentration (0.15--0.25 mmol/l) near the normal range. After five weeks of treatment, there was improvement in the visual function of one eye which had been severely impaired without improvement for 3 years. This improved visual function was maintained until compliance with the diet deteriorated at eight months, after which visual function regressed towards pretreatment status. Overrestriction of dietary arginine produced hyperammonaemia, indicating that arginine is an essential aminoacid in ornithine transaminase deficiency. These results suggest that reduction of plasma ornithine may reverse a metabolic neuroretinopathy in this disease, and offer hope that progression of the retinal atrophy can be arrested as well.