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Introduction: Antenatal corticosteroids are widely used to prevent morbidity and mortality after preterm birth, but there are ongoing concerns about the possible risk of long‐term adverse effects, including perturbation of endocrine systems, with potential implications for reproduction. A small number of animal studies have suggested possible adverse effects on reproduction after antenatal exposure to corticosteroids, but there is a paucity of human data. Material and Methods: This is a secondary cohort analysis of the 50‐year follow‐up of the Auckland Steroid Trial (1969–1974) comparing antenatal exposure to corticosteroids or placebo. Participants whose mothers took part in the placebo‐controlled randomized trial of antenatal corticosteroids completed a questionnaire reporting reproductive outcomes at 50 years of age. The main outcome was at least one pregnancy ≥20 weeks or fathered at least one pregnancy ≥20 weeks. Additional outcomes included a number of pregnancies or fathered pregnancies ≥20 weeks, outcomes relating to female reproductive lifespan (including age at menarche and menopause), and outcomes relating to their offspring (including birthweight and gestation). Results: Of 917 eligible participants, 415 (45% of eligible) completed the questionnaire at a mean (SD) age of 49.3 (1.0) years. The proportion of participants who had experienced at least one pregnancy ≥20 weeks or fathered at least one pregnancy ≥20 weeks was similar in betamethasone and placebo‐exposed groups (163/217 [75%] vs. 136/190 [72%]; RR 1.08, (95% CI 0.95 to 1.22); p = 0.23). Participants exposed to betamethasone had a slightly higher number of pregnancies or fathered pregnancies ≥20 weeks compared to those exposed to placebo (mean 1.89 vs. 1.60; marginal mean difference 0.20, (95% CI 0.03–0.37); p = 0.03). Other outcomes, including female reproductive lifespan and offspring‐related outcomes, were similar in both randomized groups. There were also no differences in any outcomes between those born preterm and those born at term. Conclusions: Antenatal exposure to corticosteroids appears to have no clinically important effect on reproductive outcomes to 50 years. [ABSTRACT FROM AUTHOR]

This work presents a study of piezoelectric zinc oxide (ZnO) thin films deposited by a novel post‐reactive sputtering method. The process utilizes a rotating drum with DC magnetron sputtering deposition onto substrates with subsequent DC plasma‐assisted oxidation of the deposited metal to metal oxide. The paper analyzes the influence of plasmaassisted magnetron sputtering (PA‐MS) deposition parameters (O2 plasma source power, O2 flow, and Ar flow) on the morphological, structural, optical, and piezoelectric properties of ZnO thin films. Design of experiments has been utilized to evaluate the role of these parameters on the growth rate (rg) and the properties of resulting films. Results indicate a predominant influence of the plasma power on the rg over other parameters. Among the eight tested samples, three of them show high crystal quality with high intensity (0001) diffraction peak, characteristic of the wurtzite crystalline structure of ZnO, and one of them exhibits piezoelectric coefficient values of ≈11pC N−1. That sample corresponding to a ZnO film deposited at the lowest rg of 0.075 nm s−1, confirmed the key role of the deposition parameters on the piezoelectric response of films, and demonstrated PA‐MS as a promising technique to produce high‐quality piezoelectric thin films. [ABSTRACT FROM AUTHOR]

Objective: To investigate associations of the Fetal Pillow® with maternal and neonatal morbidity. Design: Retrospective cohort. Setting: Two tertiary maternity units, New Zealand. Population or Sample: Full dilatation singleton, term, cephalic caesarean section, with three comparisons: at Unit A (1) before versus after introduction of the Fetal Pillow® (1 Jaunary 2016–31 October 2021); (2) with versus without the Fetal Pillow® after introduction (27 July 2017–31 October 2021); and (3) between Unit A and Unit B during the same time period (1 January 2019–31 October 2021). The Fetal Pillow® is unavailable at Unit B. Methods: Cases were ascertained and clinical data were extracted from electronic clinical databases and records. Outcome data were adjusted and presented as adjusted odds ratios (aOR) with 95% CI. Main Outcome Measures: Primary outcome "any" uterine incision extension; secondary outcomes included major extension (into adjacent structures), and a composite neonatal outcome. Results: In all, 1703 caesareans were included; 375 with the device and 1328 without. Uterine incision extension rates were: at Unit A before versus after introduction: 26.8% versus 24.8% (aOR 0.88, 95% CI 0.65–1.19); at Unit A with the Fetal Pillow® versus without: 26.1% versus 23.8% (aOR 1.14, 95% CI 0.83–1.57); and at Unit A versus Unit B: 24.2% versus 29.2% (aOR 0.73, 95% CI 0.54–0.99). No differences were found in major extensions, or neonatal composite outcome. Conclusions: Despite the relatively large size of this study, it could not rule out either a positive or a negative association between use of the Fetal Pillow® and uterine extensions, major uterine incision extensions, and neonatal morbidity. Randomised controlled trial evidence is required to assess efficacy. [ABSTRACT FROM AUTHOR]

Purpose: The Queensland Children's Hospital Paediatric Optometry Alignment Program commenced with a pilot phase to assess its feasibility, effectiveness and acceptability. This study identified the barriers that hinder effective interprofessional collaboration and the facilitators that contribute to its success, and assessed changes in optometrists' satisfaction since the pilot phase of the collaborative care programme. Methods: Qualitative deductive and inductive content analysis was applied to open‐ended free‐text survey responses collected in 2018 from the optometrists involved in the Program's pilot phase. The responses were coded using the Theoretical Domains Framework (TDF) to categorise barriers and facilitators into key themes. Key behavioural determinants were mapped to the COM‐B (Capability, Opportunity, Motivation‐Behaviour) elements of the Behaviour Change Wheel model to identify intervention strategies. Intervention recommendations were derived from behaviour change mapping and compared with programme quality improvement initiatives. A cross‐sectional explanatory survey informed by the TDF was conducted within the current 2023 cohort, and a longitudinal comparative analysis was carried out using data from the 2018 survey. Results: Among the 97 surveys distributed in 2018, 44 respondents participated; from this group, 38 individuals contributed a total of 200 free‐text responses. Facilitators (240 comments) outnumbered barriers (65 comments). Key facilitators were accessible and timely care, professional development, confidence and positive outcome beliefs. Barriers included communication, information handover, credibility, relationships and skill gaps. Optometrists actively engaged in the programme in 2023 reported heightened satisfaction with their involvement, increased confidence and greater engagement in paediatric eyecare delivery. However, challenges in clinical information transfer persist. Conclusion: The interprofessional collaborative model of paediatric eyecare has contributed efficiencies within the health system by building paediatric care capacity in the community, fostering professional credibility and promoting interdisciplinary trust. Insights gained should prove valuable for other paediatric eyecare services exploring hospital‐to‐community care models. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis (OA) negatively impacts the health outcomes and equity, social and employment participation, and socio‐economic wellbeing of those affected. Little community‐based support is offered to people with knee OA in Aotearoa New Zealand. Identifying Māori and non‐Māori with knee OA in community pharmacy and providing co‐ordinated, evidence‐ and community‐based care may be a scalable, sustainable, equitable, effective and cost‐effective approach to improve health and wellbeing. Aim: Assess whether the Knee Care for Arthritis through Pharmacy Service (KneeCAPS) intervention improves knee‐related physical function and pain (co‐primary outcomes). Secondary aims assess impacts on health‐related quality of life, employment participation, medication use, secondary health care utilisation, and relative effectiveness for Māori. Methods and analysis: A pragmatic randomised controlled trial will compare the KneeCAPS intervention to the Pharmaceutical Society of New Zealand Arthritis Fact Sheet and usual care (active control) at 12 months for Māori and non‐Māori who have knee OA. Participants will be recruited in community pharmacies. Knee‐related physical function will be measured using the function subscale of the Short Form of the Western Ontario and McMaster Universities Osteoarthritis Index. Knee‐related pain will be measured using an 11‐point numeric pain rating scale. Primary outcome analyses will be conducted on an intention‐to‐treat basis using linear mixed models. Parallel within‐trial health economic analysis and process evaluation will also be conducted. Ethics and trial dissemination: Ethical approval was obtained from the Central Health and Ethics Committee (2022‐EXP‐11725). The trial is registered with ANZCTR (ACTRN12622000469718). Findings will be submitted for publication and shared with participants. [ABSTRACT FROM AUTHOR]

Future climatic scenarios forecast increases in average temperatures as well as in the frequency, duration, and intensity of extreme events, such as heatwaves. Whereas behavioral adjustments can buffer direct physiological and fitness costs of exposure to excessive temperature in wild animals, these may prove more difficult during specific life stages when vagility is reduced (e.g., early developmental stages). By means of a nest cooling experiment, we tested the effects of extreme temperatures on different stages of reproduction in a cavity‐nesting Mediterranean bird of prey, the lesser kestrel (Falco naumanni), facing a recent increase in the frequency of heatwaves during its breeding season. Nest temperature in a group of nest boxes placed on roof terraces was reduced by shading them from direct sunlight in 2 consecutive years (2021 and 2022). We then compared hatching failure, mortality, and nestling morphology between shaded and non‐shaded (control) nest boxes. Nest temperature in control nest boxes was on average 3.9°C higher than in shaded ones during heatwaves, that is, spells of extreme air temperature (>37°C for ≥2 consecutive days) which hit the study area during the nestling‐rearing phase in both years. Hatching failure markedly increased with increasing nest temperature, rising above 50% when maximum nest temperatures exceeded 44°C. Nestlings from control nest boxes showed higher mortality during heatwaves (55% vs. 10% in shaded nest boxes) and those that survived further showed impaired morphological growth (body mass and skeletal size). Hence, heatwaves occurring during the breeding period can have both strong lethal and sublethal impacts on different components of avian reproduction, from egg hatching to nestling growth. More broadly, these findings suggest that the projected future increases of summer temperatures and heatwave frequency in the Mediterranean basin and elsewhere in temperate areas may threaten the local persistence of even relatively warm‐adapted species. [ABSTRACT FROM AUTHOR]

SUMMARY: Nucleolus organizer regions (NORs) are eukaryotic chromosomal loci where ribosomal RNA (rRNA) genes are clustered, typically in hundreds to thousands of copies. Transcription of these rRNA genes by RNA polymerase I and processing of their transcripts results in the formation of the nucleolus, the sub‐nuclear domain in which ribosomes are assembled. Approximately 90 years ago, cytogenetic observations revealed that NORs inherited from the different parents of an interspecific hybrid sometimes differ in morphology at metaphase. Fifty years ago, those chromosomal differences were found to correlate with differences in rRNA gene transcription and the phenomenon became known as nucleolar dominance. Studies of the past 30 years have revealed that nucleolar dominance results from selective rRNA gene silencing, involving repressive chromatin modifications, and occurs in pure species as well as hybrids. Recent evidence also indicates that silencing depends on the NOR in which an rRNA gene is located, and not on the gene's sequence. In this perspective, we discuss how our thinking about nucleolar dominance has shifted over time from the kilobase scale of individual genes to the megabase scale of NORs and chromosomes and questions that remain unanswered in the search for a genetic and biochemical understanding of the off switch. Significance Statement: Nucleolar dominance is one the earliest recognized epigenetic phenomena, describing the expression of some, but not all, of the rRNA genes clustered in the nucleolus organizer regions of eukaryotic genomes. In the past five decades our conception of nucleolar dominance has evolved from models of selective gene activation to models of selective gene silencing and from mechanisms thought to act on individual rRNA genes to mechanisms that may act on a multi‐megabase scale. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationship between neonatal hypoglycaemia and specific areas of executive function and behaviour in mid‐childhood. Method: Participants in a prospective cohort study of infants born late preterm or at term at risk of neonatal hypoglycaemia were assessed at 9 to 10 years. We assessed executive function using performance‐based (Cambridge Neuropsychological Tests Automated Battery) and questionnaire‐based (Behavior Rating Inventory of Executive Function) measures and behaviour problems with the Strengths and Difficulties Questionnaire. Data are reported as adjusted odds ratio (aOR) with 95% confidence intervals, and standardized regression coefficients. Results: We assessed 480 (230 females, 250 males; mean age 9 years 5 months [SD 4 months, range 8 years 8 months–11 years 0 months]) of 587 eligible children (82%). There were no differences in performance‐based executive function between children who did and did not experience neonatal hypoglycaemia (blood glucose <2.6 mmoL/L). However, children who experienced hypoglycaemia, especially if severe or recurrent, were at greater risk of parent‐reported metacognition difficulties (aOR 2.37–3.71), parent‐reported peer (aOR 1.62–1.89) and teacher‐reported conduct (aOR 2.14 for severe hypoglycaemia) problems. Both performance‐ and questionnaire‐based executive functions were associated with behaviour problems. Interpretation: Neonatal hypoglycaemia may be associated with difficulties in specific aspects of parent‐reported executive functions and behaviour problems in mid‐childhood. [ABSTRACT FROM AUTHOR]

This work details the triboelectric characteristics of diamond‐like carbon (DLC) film where a proportioned sp3:sp2 bond ratio is engineered through a patented pulsed DC magnetron sputtering process to achieve a durable commercial energy harvesting material. A triboelectric nanogenerator (TENG) is fabricated by creating the triboelectric interface between DLC and PTFE. The presence and synchronization of σ – σ and σ – π bonds between DLC‐PFTE contact surface amplify the electronic cloud overlap between their atoms leading to an enhancement of the triboelectric surface charge density. The inherent hardness and reduced friction achieved through DLC and PTFE respectively prevent the mass transfer, and consequent power loss upon consecutive mechanical contact and achieves a stable electric power output of 141 mW m−2. The DLC durability achieved with PTFE in TENG demonstrates its significant potential as low frequency (1 – 10 Hz) energy harvesting devices and self‐/low‐power electronic devices and sensors. The paper uniquely contributes to a better understanding of the triboelectrification mechanism by insightfully detailing the band‐to‐band transition of electrons between the PTFE and DLC tribo‐interface, as well as discussing gap and frequency limitation of the tribo‐pair on the triboelectric charge yield, storage, transfer, and on the friction layer electric field. [ABSTRACT FROM AUTHOR]

Objective: Upper airway stimulation (UAS) therapy has become increasingly utilized to treat obstructive sleep apnea, which is an independent risk factor for the development of hypertension. This study examines the impact of this therapy on blood pressure (BP). Study Design: Retrospective cross‐sectional cohort study. Setting: Tertiary center, Military Health System. Methods: Patients who underwent UAS implantation at Brooke Army Medical Center between July 2015 and July 2020 were included if they used their device for at least 25 h/wk. Pre‐ and postoperative systolic BP, diastolic blood pressure (DBP), calculated mean arterial pressure (MAP), and the apnea‐hypopnea index (AHI) were compared using paired t test or Wilcoxon's signed‐rank test. Results: Thirty patients met the inclusion criteria. The median age was 60, and the median body mass index was 29.9 kg/m2. The mean time between pre‐ and postoperative BP measurements was 11.6 months. AHI decreased from 35.1 to 16.5 events/h (p <.001). DBP decreased from 78.5 (73.8, 85.0) to 74.5 mm Hg (68.8, 81.3), with a mean difference of −3.7 mm Hg (p =.002). MAP decreased from 94.8 (89.6, 100.6) to 90.2 mm Hg (84.3, 100.0), with a mean difference of −3.7 mm Hg (p =.004). Conclusion: UAS therapy was associated with a significant reduction in DBP, MAP, and AHI. These reductions in BP could potentially lead to favorable decreases in cardiovascular morbidity. [ABSTRACT FROM AUTHOR]

This prospective, open-label trial (NCT04720469) screened 16 consecutive mrET patients who had undergone MRgFUS thalamotomy at least 1 year prior (MRgFUS SB 1 sb ). Herein, staged, bilateral MRgFUS thalamotomy was safe in a small sample of patients with mrET. Keywords: essential tremor; bilateral; thalamotomy; focused ultrasound; safety EN essential tremor bilateral thalamotomy focused ultrasound safety 1559 1561 3 10/24/23 20231001 NES 231001 Staged, open-surgical lesioning of the thalamic ventral intermediate nucleus to abate medication-refractory essential tremor (mrET) has been historically associated with a high frequency of adverse events (AEs), including speech and balance impairments.[1] More recently, the real-time imaging and thermometry guidance offered by magnetic resonance-guided focused ultrasound (MRgFUS) have allowed for minimally-invasive thalamotomies with increased focal accuracy to address upper limb tremor in ET patients.[2] Qualitative and semi-quantitative trials evaluating the safety of staged, bilateral MRgFUS thalamotomy have reported AEs that were mostly transient with mild to moderate severity based on patients' and physicians' perceived deficits.[[3], [5]] However, a comprehensive quantitative analysis of the potential post-thalamotomy changes in stance and gait balance (ie, equilibrium), and oro-motor function is lacking. We comprehensively evaluated the incidence and severity of AEs, including changes in equilibrium, speech, and cognition, following staged, bilateral MRgFUS thalamotomy for patients with mrET. [Extracted from the article]

Background: Osteoarthritis (OA) clinical guidelines recommend self‐management education, but education is often not included in primary care consultations. Objective: To explore pharmacists' and patients' perceptions of a pharmacist‐led model of service delivery for knee OA that was integrated within pharmacies' day‐to‐day workflow. Methods: Cross‐sectional qualitative design using Thematic Analysis. Community pharmacies were recruited in New Zealand and Australia. Pharmacy patients were screened for knee OA and offered tailored explanations, self‐management information and referral for further support. Pharmacist focus groups and patient 1:1 interviews explored perceptions of the service delivery model. Results: Nineteen pharmacists and 12 patients with knee OA participated. Pharmacist and patient data were analysed separately, with themes compared and contrasted to derive three meta‐themes. Meta‐theme 1: 'Welcome Engagement' included two pharmacist themes ('putting my broad skill set to use' and 'we're here and happy to help') and two patient themes ('information delivered well' and 'a welcome offer of help'). Meta‐theme 2: 'The Knowledgeable and Trustworthy Pharmacist' included two pharmacist themes ('professional knowledge to help all sorts of patients' and 'managing time to help my patients') and one patient theme ('the accessible professional who I know and trust'). Meta‐theme 3: 'The Opportunity for More Support' included one pharmacist theme ('this is not the end of the story') and one patient theme ('more help is available'). Conclusion: Community pharmacists are well‐positioned to provide information and support to people with knee OA. Pharmacists appreciate the opportunity to better use their skills and accessibility for OA care, and patients welcome this engagement. [ABSTRACT FROM AUTHOR]

Aim: To determine whether a multi-domain school readiness screening, the Before School Check (B4SC), identifies children at risk of low educational achievement and to compare the educational outcomes between those referred for intervention and those with B4SC concerns who were not referred.Methods: In this longitudinal cohort study of children born at risk of neonatal hypoglycaemia (N 331), the B4SC was performed at 4.5 years of age and a standardised curriculum-based measure of educational achievement was completed at 9-10 years of age. Outcomes of school readiness screening were categorised into 'school readiness concern' or 'no school readiness concern' while 'below standard' and 'well below standard' ratings of educational achievement were combined into a single category of 'low educational achievement'.Results: Overall, 52% of children had ≥1 school readiness concerns at the B4SC, predominantly about behaviour (46%). Having ≥1 school readiness concern was associated with a nearly twofold increase in the likelihood of low academic achievement (OR 1.85, 95% CI 1.14, 3.02), which was apparent only for behaviour concerns. Of the 128 children with behaviour concerns, only 10 (8%) were referred for further interventions. There was a statistically non-significant increase in the rates of low academic achievement among those referred than those non-referred (60% vs. 47%).Conclusion: Identification of behaviour concerns during B4SC is associated with a moderate increase in the likelihood of low academic achievement at 9-10 years. Further, research is needed to determine how academic achievement can be improved in children with behaviour concerns at school entry. [ABSTRACT FROM AUTHOR]

Objectives: To assess (i) paediatric fever management practices among New Zealand ED doctors and nurses, including adherence to best practice guidelines; and (ii) the acceptability of a randomised controlled trial (RCT) of antipyretics for relief of discomfort in young children. Methods: A cross‐sectional survey of doctors and nurses across 11 New Zealand EDs. The primary outcome of adherence to paediatric fever management best practice guidelines was assessed with clinical vignettes and defined as single antipyretic use for the relief of fever‐related discomfort. Results: Out of 602 participants (243 doctors, 353 nurses and six unknown; response rate 47.5%), only 64 (10.6%, 95% confidence interval [CI] 8.3–13.4%) demonstrated adherence to best practice guidelines. In a febrile settled child with normal fluid intake, the percentage of participants that would use antipyretics doubled with abnormal vital signs (33.7% vs 72.9%, difference −39.2%, 95% CI –44.4% to −34.0%). Most participants would use antipyretics for reduced fluid intake (n = 494, 82.1%, 95% CI 78.8–85.0%) in a febrile settled child. Over half (n = 339, 57.1%, 95% CI 53.0–61.1%) would advise giving antipyretics to prevent febrile convulsions. Most (n = 467, 80.0%, 95% CI 76.5–83.1%) participants agreed that a RCT of antipyretics in febrile children <2 years of age with relief of discomfort as a primary outcome is needed. Conclusions: Just over 10% of New Zealand ED doctors and nurses demonstrated adherence to paediatric fever management best practice guidelines. A RCT of antipyretics in febrile children <2 years of age specifically addressing relief of discomfort as a primary outcome is strongly supported. [ABSTRACT FROM AUTHOR]

Young people are known to face challenges when accessing healthcare and generally have low rates of health service utilisation. Use of telehealth might be one way to improve access, but evidence is needed from young people as to how acceptable it is. This online survey of 15‐ to 25‐year olds in the greater Wellington region of New Zealand sought young people's views on telehealth (phone and videocalls) as a means of accessing primary care. The survey included both forced‐choice questions and free‐text options. We report here on the free‐text data from open‐ended questions that were qualitatively analysed using template analysis. A total of 346 participants took part between August 6 and September 21, 2021, of whom 60% were female, 12% Māori (indigenous) ethnicity, and 38% had used telehealth methods of consulting previously. Analysis was undertaken of the free‐text comments that were provided by 132 participants (38%). Although those contributing comments described both benefits and drawbacks to using telehealth, more drawbacks were cited, with specific examples given to illustrate a range of concerns and potential limitations of telehealth including privacy, communication difficulties and compromised quality of care. Participants thought telehealth could be used successfully in specific situations, for example by people concerned about leaving the house due to anxiety, illness or being immunocompromised and for simple consultations or when the person knows exactly what they need. Respondents expressed a strong desire to be offered the choice between in‐person and telehealth consultations. Providing young people with a choice of consultation mode together with clear information about all aspects of a telehealth consultation is important if clinicians want young people to engage with this method of primary care service delivery. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine patterns of injury, the impact of these injuries on patients and identification of potentially modifiable contributing factors through industry regulation reforms and education. Methods: Food delivery rider (FDR)‐related presentations to the Royal Brisbane and Women's Hospital Emergency and Trauma Centre for a year from September 2020 were identified. Data collected included patient and incident demographics: time, type and location of injuries, investigations and care required, length of stay, admission requirements and follow up. Results: The cohort included 81.8% male with a mean age of 25.2 years. Most injuries occurred on the road from a collision with a vehicle. The most common injury was fractures. Incidence increased on weekends and during the evening. More than half the cohort were admitted to hospital. Only 22.7% of patients were eligible for workers compensation and less than half were covered by Medicare. The majority (72.7%) of cases involved non‐resident riders from other countries. Conclusion: The majority of FDRs presenting with injuries are not Australian citizens and less than half were Medicare eligible potentially contributing to inadequate access to care especially fracture follow up. There were spikes in injuries occurring at night, weekends and during periods of pandemic associated lockdowns demonstrating an increased usage of delivery services during these times. Results highlight injury patterns experienced by delivery riders and potentially modifiable risk factors for this rapidly growing area of employment within the gig economy. [ABSTRACT FROM AUTHOR]

Aim: To explore factors influencing fever management practices and antipyretic use among New Zealand Emergency Department (ED) doctors and nurses using the Theoretical Domains Framework (TDF).Methods: Cross-sectional survey of doctors and nurses across 11 New Zealand EDs. The questionnaire examined eight of 12 TDF domains, based on a generic questionnaire validated to assess TDF-based determinants of health-care professional behaviour. Relevant domains were identified by the frequency of beliefs; the presence of conflicting beliefs within a domain; and the likely strength of impact of a belief on paediatric fever management in the ED.Results: About 602 participants (243 doctors, 353 nurses and 6 unknown) completed the survey (response rate 47.5%). Over half (351/591, 59.6%, 95% confidence interval (CI) 55.5-63.5%) knew the content of clinical practice guidelines regarding antipyretic use in febrile children (TDF Domain Knowledge), or had been trained to ensure antipyretics are given to febrile children only if they appear distressed (347/592, 58.6%, 95% CI 54.5-62.6%) (Skills). Over 40% (246/590, 95% CI 37.7-45.8%) aim to reduce the fever before discharge (Goals). Most (444/591, 75.1%, 95% CI 71.4-78.6%) participants felt capable of explaining appropriate antipyretic use to parents/care givers (Beliefs about Capabilities). Only a minority (155/584, 26.5%, 95% CI 23.0-30.3%) thought that they can ensure antipyretics are given to febrile children only if they appear distressed when the ED is busy (Environmental Context and Resources).Conclusions: Using the TDF, we identified factors influencing fever management practices and antipyretic use in the ED. These factors can guide the design of targeted, theory-informed knowledge translation strategies. [ABSTRACT FROM AUTHOR]

Objective: Dominant spinocerebellar ataxias (SCA) are characterized by genetic heterogeneity. Some mapped and named loci remain without a causal gene identified. Here we applied next generation sequencing (NGS) to uncover the genetic etiology of the SCA25 locus. Methods: Whole‐exome and whole‐genome sequencing were performed in families linked to SCA25, including the French family in which the SCA25 locus was originally mapped. Whole exome sequence data were interrogated in a cohort of 796 ataxia patients of unknown etiology. Results: The SCA25 phenotype spans a slowly evolving sensory and cerebellar ataxia, in most cases attributed to ganglionopathy. A pathogenic variant causing exon skipping was identified in the gene encoding Polyribonucleotide Nucleotidyltransferase PNPase 1 (PNPT1) located in the SCA25 linkage interval. A second splice variant in PNPT1 was detected in a large Australian family with a dominant ataxia also mapping to SCA25. An additional nonsense variant was detected in an unrelated individual with ataxia. Both nonsense and splice heterozygous variants result in premature stop codons, all located in the S1‐domain of PNPase. In addition, an elevated type I interferon response was observed in blood from all affected heterozygous carriers tested. PNPase notably prevents the abnormal accumulation of double‐stranded mtRNAs in the mitochondria and leakage into the cytoplasm, associated with triggering a type I interferon response. Interpretation: This study identifies PNPT1 as a new SCA gene, responsible for SCA25, and highlights biological links between alterations of mtRNA trafficking, interferonopathies and ataxia. ANN NEUROL 2022;92:122–137 [ABSTRACT FROM AUTHOR]

This scoping review describes the current state of research about two‐wheeled delivery riders who have been injured while performing commercial food delivery. The key areas of interest are the patterns of injury, associated risk factors and current gaps in knowledge. Five databases were searched to identify key papers that describe injuries to two‐wheeled food delivery riders. Papers were assessed for quality and eligibility and key information was extracted relating to patterns of injury and risk factors. From an initial 264 records from PubMed, Embase, CINAHL, Scopus and SafetyLit, studies were screened by title, abstract and full text to yield 12 key papers for analysis. No papers reporting on Australian data were identified. Men comprise over 85% of workers in the food delivery industry. The average age of injured riders varies by country, but is commonly under 30 years old. Most injuries are lower limb musculoskeletal injuries, although there are no consistent data about frequency, severity or cost to the healthcare system. Twenty‐three key risk factors were categorised according to rider characteristics, working conditions and environmental factors. The most common risk factors were younger age, lack of driving experience, time‐pressured work and inadequate protective gear. There are very few publications describing food delivery rider injuries and risk factors. This is an emerging industry in which the worker population may be younger and more vulnerable. Given the different legal and cultural contexts across different countries, Australian‐specific research is needed. [ABSTRACT FROM AUTHOR]

Objective: Gastric bypass surgery results in long‐term weight loss. Small studies have examined protein changes during rapid weight loss (up to 1 or 2 years post surgery). This study tested whether short‐term changes were maintained after 12 years. Methods: A 12‐year follow‐up, protein‐wide association study of 1,297 SomaLogic aptamer‐based plasma proteins compared short‐ (2‐year) and long‐term (12‐year) protein changes in 234 individuals who had gastric bypass surgery with 144 nonintervened individuals with severe obesity. Results: There were 51 replicated 12‐year protein changes that differed between the surgery and nonsurgery groups. Adjusting for change in BMI, only 12 proteins remained significant, suggesting that BMI change was the primary reason for most protein changes and not non‐BMI‐related surgical effects. Protein changes were related to BMI changes during both weight‐loss and weight‐regain periods. The significant proteins were associated primarily with lipid, uric acid, or resting energy expenditure clinical variables and metabolic pathways. Eight protein changes were associated with 12‐year diabetes remission, including apolipoprotein M, sex hormone binding globulin, and adiponectin (p < 3.5 × 10−5). Conclusions: This study showed that most short‐term postsurgical changes in proteins were maintained at 12 years. Systemic protection pathways, including inflammation, complement, lipid, and adipocyte pathways, were related to the long‐term benefits of gastric bypass surgery. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of fever phobia among caregivers of children presenting to New Zealand EDs. Methods: A cross‐sectional survey was administered to caregivers of children <5 years of age presenting to three New Zealand EDs. We defined fever phobia as caregivers having a high level of concern regarding fever or having incorrect beliefs regarding the consequences of fever. Results: A total of 502 caregivers completed the survey. Fever phobia was present in 365 (74.3% [95% confidence interval, CI 70.3–78.0%]) respondents, with 242 (49.3% [95% CI 44.9–53.7%]) caregivers reporting a high level of concern regarding fever, and 288 (61.8% [95% CI 57.3–66.1%]) caregivers reporting at least one incorrect belief regarding the consequences of fever. Majority of caregivers (n = 383, 87.6% [95% CI 84.2–90.4%]) knew the correct dosing interval for paracetamol, compared to less than half of caregivers (n = 179, 42.5% [95% CI 37.9–47.3%]) for ibuprofen. Caregivers reported non‐evidence‐based fever management practices such as sponging, always giving paracetamol and/or ibuprofen for fever, and waking children from sleep to give antipyretics. Over one‐third of caregivers identified ED doctors (n = 195, 40.2% [95% CI 34.7–43.2%]) and ED nurses (n = 173, 35.7% [95% CI 31.5–40.0%]) as sources of information regarding fever management. A higher level of education was associated with fever phobia (odds ratio 1.68 [95% CI 1.04–2.72], P = 0.04). Conclusions: Fever phobia is prevalent among caregivers of children presenting to New Zealand EDs. Opportunistic caregiver education in the ED in conjunction with public health strategies are needed to dispel undue fears and misconceptions about fever. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions To determine how gestational age at birth and postnatal growth relate to body composition in childhood.We calculated conditional growth (birth‐2 years, 2 years‐6 years) and measured body composition at 2 and 6 years using bioelectrical impedance in cohorts of New Zealand children born very preterm (VPT; 23–31 weeks), late preterm (LPT; 35– <37 weeks) and term (≥37 weeks). We explored the relationships between growth and fat mass (FM) index and fat‐free mass (FFM) index at 6 years using multivariable linear regression.Of 1125 children (51% male), 202 were VPT, 114 LPT and 809 Term. Compared to Term, VPT but not LPT were lighter and shorter at 2 and 6 years and had lower FM index and FFM index. The association between weight growth from 2 to 6 years and both FM index and FFM index at 6 years was stronger than for weight growth from birth to 2 years or height growth at any period in all gestational age groups.Size and body composition at 2 and 6 years are different between infants born VPT, but not LPT, and at term. Later weight growth is more strongly associated with childhood body composition than earlier growth. [ABSTRACT FROM AUTHOR]

Background: Antenatal corticosteroids (ACSs) administered to women before preterm birth improve neonatal health. Proportionately more women are obese or overweight in current obstetric populations than those who were included in the original trials of ACSs, and it remains uncertain if higher doses are required for such women. Aim: Our aim was to assess the association between maternal body mass index (BMI) and infant morbidity after the administration of ACSs. Methods: In the secondary analysis of the ASTEROID trial cohort, women at risk of preterm birth at <34 weeks' gestation were randomised to betamethasone or dexamethasone. Infant outcomes were compared according to whether women were of normal weight (BMI < 25 kg/m2), overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). Results: Of 982 women with a singleton pregnancy and BMI data, 519 (52.9%) were of normal size, 241 (24.5%) were overweight and 222 (22.6%) were obese. Compared with infants born to women of normal weight, there was little or no difference in respiratory distress syndrome in infants born to women who were overweight (odds ratio (OR) = 0.92, 95% confidence interval (CI) 0.57, 1.49) or obese (OR = 1.44, 95% CI 0.90, 2.31). Similarly, there were no significant differences between infants born to women in the three BMI groups for other morbidities, including bronchopulmonary dysplasia, mechanical ventilation, intraventricular haemorrhage, retinopathy of prematurity, patent ductus arteriosus, necrotising enterocolitis, perinatal death or combined serious morbidity. Conclusions: Maternal body size is not associated with infant morbidity after ACS exposure. Dose adjustment for women with higher BMI is not required. [ABSTRACT FROM AUTHOR]

Background: Timely detection of small for gestational age (SGA) fetuses is important for reducing severe perinatal morbidity and mortality, and better tools are needed to detect SGA in maternity care. Aim: We evaluated the effect of the introduction of the Perinatal Institute's Growth Assessment Protocol (GAP) in the Counties Manukau Health region, South Auckland, New Zealand, on antenatal detection of SGA and maternal and perinatal outcomes. Materials and Methods: Uncontrolled before and after study in women booked under hospital community midwife care with a singleton, non‐anomalous pregnancy. Antenatal detection of SGA (birthweight <10th customised centile) was compared pre‐GAP (2012, N = 1105) and post‐GAP (2017, N = 1082). Composite adverse neonatal outcome was defined as neonatal unit admission >48 h, five‐minute Apgar score <7, and/or any ventilation. Analyses were adjusted for maternal age, body mass index, deprivation, smoking and ethnicity. Results: SGA rates were similar across epochs (13.8% vs 12.9%) but antenatal detection of SGA increased from 22.9% (35/153) to 57.9% (81/140) post‐GAP (adjusted odds ratio (aOR) = 4.8, 95% CI 2.82–8.18). Rates of induction of labour and caesarean section increased between epochs but were similar in SGA, non‐SGA, and detected and non‐detected SGA subgroups. Among SGA babies, there was some evidence that antenatal detection of SGA may be associated with lower composite adverse neonatal outcome (detected SGA: aOR 0.44 95% CI 0.17–1.15; non‐detected SGA: aOR = 1.81 95% CI 0.73–4.48; interaction P = 0.03). Pre‐term birth did not appear to be influenced by GAP. Conclusion: Implementation of GAP was associated with a nearly five‐fold increase in SGA detection without increasing obstetric intervention for SGA. [ABSTRACT FROM AUTHOR]

Objective: To ascertain former students' perceptions of and influences from a final‐year pre‐registration, rurally located, clinically based, 5 week interprofessional program on their subsequent work and career in the health professions. Design: Online survey delivered 5 years post‐program (4 years post‐graduation). Setting: The Tairāwhiti interprofessional education program was first undertaken in 2012/2013 by students from six health professional degree programs (dentistry, dietetics, medicine, nursing, pharmacy and physiotherapy) in the Tairāwhiti region, New Zealand. Participants: Health professionals who attended the Tairāwhiti interprofessional education program in 2012/2013 as students were invited to participate; 70 of 86 (81%) responded in 2017/2018. Results: Five years on, most respondents (91%;64/70) were working as health professionals, with a fifth (23%;15/64) working overseas. Of those currently practising in New Zealand, 51% (24/47) were working in hospital practice and 49% (23/47) in the community, with 56% (27/48) working in metropolitan areas and 44% (21/48) in regional/rural locations. Of the 51 respondents who provided free‐text comments about perceived influences of program participation, the majority described positive influences on their clinical practice as health professionals or their subsequent career choices. Five themes emerged from the free‐text data: 'made me a better clinician'; 'made me consider rural/regional work'; 'collaborating for care'; 'choosing an area of practice to work in,' and 'little or no impact.' Conclusion: This work reports positive influences on subsequent careers among respondents who had previously participated as final‐year students in a rurally located IPE program, particularly with respect to interprofessional working, rural health, and contextual and cultural influences. [ABSTRACT FROM AUTHOR]

The genome is the blueprint for life. We can build genomes Ten years ago, only 15 years after the first bacterial genome sequence was reported (Fleischmann I et al i ., 1995), the J. Craig Venter Institute reported the creation of the first organism, a I Mycoplasma i bacterium, derived from a chemically synthesized genome (Gibson I et al i ., 2010). The original motivation behind genome synthesis was to define a minimal genome, allowing for a detailed understanding of the contribution of every gene to an organism's physiology (Gibson I et al i ., 2010). [Extracted from the article]

Objective: Personalised music reportedly has a positive effect on behaviour and mood in people living with dementia. This intervention has not been conducted in low‐resourced or rural aged‐care settings. We evaluated the effect of a non–therapist‐led personalised music listening intervention on residents with dementia and workplace culture in a rural aged‐care facility in South Australia. Design: Qualitative pilot study. Setting: Rural aged‐care home in South Australia. Participants: Ten residents with dementia and 15 aged‐care staff participated in this study. Interventions: Ten residents participated in an 8‐week music program. Four focus groups were conducted with aged‐care staff post‐intervention. A thematic analysis was used to identify emerging themes. Main outcome measure: Personalised music positively influenced resident's behaviour and well‐being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care. Results: Three themes emerged: quality of life, personalised care and better aged‐care environment. Personalised music positively influenced resident's behaviour and well‐being, social interaction and the workplace environment and culture, and served as a useful tool for personalised care. Conclusion: Personalised music program is an effective, low‐cost intervention to improve quality of life and personalised care of residents living with dementia, staff well‐being, and a workplace and culture in low‐resourced or rural aged‐care settings. [ABSTRACT FROM AUTHOR]

Areas that contain ecologically distinct biological content, called bioregions, are a central component to spatial and ecosystem‐based management. We review and describe a variety of commonly used and newly developed statistical approaches for quantitatively determining bioregions.Statistical approaches to bioregionalization can broadly be classified as two‐stage approaches that either 'Group First, then Predict' or 'Predict First, then Group', or a newer class of one‐stage approaches that simultaneously analyse biological data with reference to environmental data to generate bioregions. We demonstrate these approaches using a selection of methods applied to simulated data and real data on demersal fish. The methods are assessed against their ability to answer several common scientific or management questions.The true number of simulated bioregions was only identified by both of the one‐stage methods and one two‐stage method. When the number of bioregions was known, many of the methods, but not all, could adequately infer the species, environmental and spatial characteristics of bioregions. One‐stage approaches, however, do so directly via a single model without the need for separate post‐hoc analyses and additionally provide an appropriate characterization of uncertainty.One‐stage approaches provide a comprehensive and consistent method for objectively identifying and characterizing bioregions using both biological and environmental data. Potential avenues of future development in one‐stage methods include incorporating presence‐only and multiple data types as well as considering functional aspects of bioregions. [ABSTRACT FROM AUTHOR]

The X‐ray fluorescence microscopy (XFM) beamline is an in‐vacuum undulator‐based X‐ray fluorescence (XRF) microprobe beamline at the 3 GeV Australian Synchrotron. The beamline delivers hard X‐rays in the 4–27 keV energy range, permitting K emission to Cd and L and M emission for all other heavier elements. With a practical low‐energy detection cut‐off of approximately 1.5 keV, low‐Z detection is constrained to Si, with Al detectable under favourable circumstances. The beamline has two scanning stations: a Kirkpatrick–Baez mirror microprobe, which produces a focal spot of 2 µm × 2 µm FWHM, and a large‐area scanning 'milliprobe', which has the beam size defined by slits. Energy‐dispersive detector systems include the Maia 384, Vortex‐EM and Vortex‐ME3 for XRF measurement, and the EIGER2 X 1 Mpixel array detector for scanning X‐ray diffraction microscopy measurements. The beamline uses event‐mode data acquisition that eliminates detector system time overheads, and motion control overheads are significantly reduced through the application of an efficient raster scanning algorithm. The minimal overheads, in conjunction with short dwell times per pixel, have allowed XFM to establish techniques such as full spectroscopic XANES fluorescence imaging, XRF tomography, fly scanning ptychography and high‐definition XRF imaging over large areas. XFM provides diverse analysis capabilities in the fields of medicine, biology, geology, materials science and cultural heritage. This paper discusses the beamline status, scientific showcases and future upgrades. [ABSTRACT FROM AUTHOR]

Aim: Information sharing is a key component of family-centred care, which has traditionally occurred through patient information leaflets. Although patients' access to health information is rapidly changing with internet and mobile technologies, there are few data on parents' perception and preferences for information sharing. Our aim was to evaluate parents' perception of information sharing in neonatal care, to determine parents' preferred medium for health information and to identify priority content for inclusion in a smartphone application.Methods: Parents at Kidz First Neonatal Care (KFNC) were eligible to take part in our survey, which comprised five sections: (i) demographics, (ii) information in neonatal care, (iii) printed information in neonatal care, (iv) parental views about development of a neonatal smartphone application and (v) general feedback. Parental satisfaction with information sharing in KFNC was assessed with a modified version of the Empowerment of Parents in the Intensive Care-neonatology questionnaire. Descriptive and summary statistics were calculated, and free text data were analysed by content analysis.Results: Forty-one surveys were received, with 62% completed by mothers. Parents were supportive of electronic information, with 88% highly scoring the question 'I would download and use a free neonatal care app'. However, parental views on the need to continue printed material if a neonatal care smartphone application was provided were mixed. Of those parents who provided free-text recommendations, priority content included information about neonatal conditions, preparing for discharge and available supports.Conclusion: Parents had positive perceptions of information sharing in neonatal care and were strongly supportive of the introduction of a neonatal phone application. [ABSTRACT FROM AUTHOR]

Aim: To determine whether teachers' reports of student academic performance can suffice for research purposes by comparing it with a curriculum-based standardised test.Methods: In this longitudinal cohort study of children born at risk of neonatal hypoglycaemia, teachers' global assessment of student performance was compared with assessment tools for teaching and learning (asTTle) at 9-10 years. Performance on asTTLe was rated as being below, at or above that expected on the national curriculum for year and term of schooling. Teachers similarly rated the child's performance against the national curriculum.Results: Of 125 children assessed, 104 had paired data for analysis. On asTTLe, 28% were rated below, 55% at and 17% above the expected curriculum level in reading and 24, 54 and 22%, respectively, in mathematics. Equivalent teacher ratings were 23, 58 and 19% in reading and 36, 55 and 9% in mathematics, respectively. However, there was limited agreement between asTTle and teacher rating of achievement in reading (κ = 0.23 (95% confidence interval 0.07-0.40)) and no significant agreement in mathematics (κ = 0.07 (95% confidence interval -0.09-0.22)). Only 45% of children performing below the curriculum level in reading and 52% in mathematics were correctly identified by teachers.Conclusion: In cohort studies, teacher ratings cannot substitute standardised educational testing. [ABSTRACT FROM AUTHOR]

In producing arguments against minority groups that are designed to avoid accusations of prejudice, speakers routinely deploy two discursive strategies. One strategy of "inoculation" seeks to ward off such accusations, while the other strategy of "attention deflection" directs attention away from the potential target group. Where despite use of one or both strategies accusations arise, the result is a puzzle that needs to be resolved through explanation. Here, in a discourse analysis of online discussions as to whether "blacking up" is to count as racism, we see contributors contest (a) whether absence of intention to offend inoculates individuals from accountability for potentially racist actions, (b) whether "blacking up" depicts toys/characters rather than people, and (c) whether attempted explanations of accusations of racism work to resolve the apparent puzzle that has arisen. Contributors do not reach any consensus. These findings point to the difficulties in attempting to challenge potential racism. [ABSTRACT FROM AUTHOR]

Strategic change in public sector organizations has been well documented. This article suggests that public management research would benefit from a greater appreciation of how calculative practices are deeply imbricated with, and constitutive of, organizational life. In turn, the article argues that the field of interdisciplinary accounting has much to learn from public administration, especially in terms of leadership. The overarching argument is that understanding strategic change in public organizations can be enhanced by bringing together insights from the academic fields of public administration and interdisciplinary accounting. In this respect, organizational reform can be understood as a triptych, involving strategic change, leadership and accounting practices. We illustrate this thesis through a case study of strategic change in the world's largest public service broadcaster—the British Broadcasting Corporation (BBC). It is shown how, during the tenure of one organizational leader—John Birt—accounting became pivotal to his leadership. [ABSTRACT FROM AUTHOR]

Summary: Background: Cancer care is typically delivered by a range of health professionals, and is frequently a uniprofessional pre‐registration clinical placement. A workplace‐based, 6‐hour interprofessional education (IPE) pilot on cancer care, led by clinical tutors, was undertaken in a New Zealand hospital, accompanied by an external evaluation. The pilot involved a cohort of 21 dietetic, medicine, pharmacy, physiotherapy and radiation therapy students. The aim of the evaluation was to determine student and tutor reactions to IPE, and any changes in perceptions and attitudes. Methods: The evaluation used focus groups to collect data: two student groups and one tutor group. Focus groups were audio‐recorded, transcribed; the content was coded and then analysed. Results: Both students and tutors reported benefits from having IPE in the workplace environment, with cancer care seen as a suitable topic. Students reported a better understanding of professional roles, skills and the provision of collaborative care, and suggested other professions should be included in future IPE. Patient selection needed to be better tailored for physiotherapy students to ensure uniform relevance. As a result of competing demands, tutors found that they needed an 18‐month lead time to establish the IPE programme. Tutors felt that the programme had gone relatively smoothly and that they had benefitted from forming closer interpersonal relationships, but noted considerable unanticipated and unremunerated preparation time. Discussion: This short workplace‐based IPE programme elicited a positive student and tutor response, but highlighted the need for improvements: broadening the topic area, targeted patient selection, including more professions and providing administrative support for tutors. Cancer care was generally seen as a suitable topic [ABSTRACT FROM AUTHOR]

We present herein the first comprehensive study of the one‐ and two‐photon absorption of Fe(CO)5 utilising a hierarchy of linear‐ and quadratic‐response coupled cluster (LR‐ and QR‐CC) methodologies to provide an in‐depth characterisation, as well as potential energy curves for axial and equatorial bond dissociations, highlighting the state crossings leading from the bright 1A2′′ state through to the dissociative 1E′ state. We have characterised a range of metal‐to‐ligand charge transfer (MLCT) and ligand field (LF) states that are in agreement with both previous studies and experiment, including the identification of a series of E′ states that present Rydberg character in the 5.9–7.2 eV region. Due to the rapid excited state dissociation of Fe(CO)5 through the low lying 1E′ and 2E′′ ligand‐field states, we have also included an LR‐CCSD analysis of the major dissociative product, Fe(CO)4. Analysis of the C2v geometry of Fe(CO)4 reveals four accessible ligand field states at 1.085, 1.684, 1.958, and 2.504 eV respectively, reinforcing the highly unstable nature of Fe(CO)4 along with a strong MLCT band between 4.300 and 5.573 eV. This band overlaps with one in the spectra of Fe(CO)5 suggesting that full fragmentation could proceed by two paths: two‐photon excitation leading to dissociation, or through sequential one‐photon absorption events, the first causing dissociation to and the second initiating further fragmentation of the complex. [ABSTRACT FROM AUTHOR]

Summary: Takotsubo cardiomyopathy is a rare disorder associated with catecholamine discharge in response to episodes of stress. We present the case of a 39‐year‐old patient with no other significant medical history who suffered acute ECG changes, left ventricular dysfunction with regional wall motion abnormalities and raised cardiac enzymes following a period of severe and sustained hypertension and tachycardia associated with resection of tumour from the floor of the fourth ventricle. We believe this to be only the second case of a takotsubo cardiomyopathy related to intracranial surgery. It demonstrates the need for consideration, recognition and diagnosis of takotsubo cardiomyopathy following periods of severe peri‐operative stress. [ABSTRACT FROM AUTHOR]

Aim: The aim was to survey the Australian and New Zealand Neonatal Network (ANZNN) member units regarding current services and management guidelines for the ex-premature infant with severe chronic lung disease (CLD) still requiring significant respiratory support at term.Methods: A 16-question survey was sent to clinical directors of all Level 3 units in Australia and New Zealand via the network. Reminder emails were sent, as required, to prompt a satisfactory response rate.Results: Survey responses were received from 26 of the 29 (90%) ANZNN Level 3 units. At 37 weeks' corrected gestation, over 90% of the units provide ongoing respiratory support in the neonatal intensive care unit (NICU). However, by 50 weeks, ongoing care is provided in several settings, including NICU, high dependency unit (HDU)/paediatric intensive care unit or respiratory wards. The majority (76%) of units arrange transfer on an ad hoc basis, but six units (24%) have set criteria for transfer based on gestation, workload and respiratory requirement. Three units declared a maximum age in NICU (44, 46 or 48 weeks). A variety of approaches were used to identify infants who were likely to require transfer, and 78% of units had a staff member assigned to assist transition. Three units stated that they had a home ventilation programme suitable for these infants. No unit supplied a guideline on tracheostomy or specific respiratory management post-term.Conclusion: Despite a significant number of babies requiring ongoing support for severe CLD, the location of the service appears very variable, and there is a lack of specific written guidelines. [ABSTRACT FROM AUTHOR]

Objective: To investigate the use of 5α‐reductase inhibitors (5ARIs) and α‐blockers among men with benign prostatic hyperplasia (BPH) in relation to prostate cancer (PCa) incidence, severity and mortality. Patients and Methods: A retrospective 20‐year cohort study in men residing in Saskatchewan, aged 40–89 years, with a BPH‐coded medical claim between 1995 and 2014, was conducted. Cox proportional hazards regression was used to compare incidence of PCa diagnosis, metastatic PCa, Gleason score 8–10 PCa, and PCa mortality among 5ARI users (n = 4 571), α‐blocker users (n = 7 764) and non‐users (n = 11 677). Results: In comparison with both non‐users and α‐blocker users, 5ARI users had a ~40% lower risk of a PCa diagnosis (11.0% and 11.4% vs 5.8%, respectively), and α‐blocker users had an 11% lower risk of a PCa diagnosis compared with non‐users. Overall, the incidence of metastatic PCa and PCa mortality was not significantly different among 5ARI or α‐blocker users compared with non‐users (adjusted hazard ratios [HR] of metastatic PCa: 1.12 and 1.13, respectively, and PCa mortality: 1.11 and 1.18, respectively, P > 0.05 for both drugs), but both 5ARI and a‐blocker users had ~30% higher risk of Gleason score 8–10 cancer, adjusted HR 1.37, 95% confidence interval [CI] 1.03–1.82, P = 0.03, and adjusted HR 1.28, 95% CI 1.03–1.59, P = 0.02, respectively compared with non‐users. Conclusion: The use of 5ARIs was associated with lower risk of PCa diagnosis, regardless of comparison group. Risk of high grade PCa was higher among both 5ARI users and α‐blocker users compared with non‐users; however, this did not translate into higher risk of PCa mortality. [ABSTRACT FROM AUTHOR]

One recurring criticism of immigrant groups is their alleged failure to be employed and contribute to the host society. Here we examine how speakers mobilise a criticism that has attracted less research attention: that through their economic activity immigrant groups usurp others' employment entitlements. Discourse analysis of data from seven focus group discussions about pre‐Brexit Polish immigration into the UK, involving 31 UK nationals, shows that participants accomplish exclusionary outcomes in two divergent ways. The first attributes qualities to Polish workers but also makes explicit the consequences of these attributions for UK nationals, rendering speakers' investment in such claims visible. The second relies on the production of category pairs, within which claims can be made for the category that excludes Polish workers. This use of categories comprises 'safe prejudice', a form of prejudice not previously identified but which is less open to challenge than other forms of prejudiced talk. [ABSTRACT FROM AUTHOR]

Background: In New Zealand, it is recommended that all pregnant women have a haemoglobin A1c (HbA1c) test performed with their booking antenatal bloods to identify previously unrecognised diabetes. However, screening rates in some groups are low. Use of a point‐of‐care device may improve compliance with screening. Aim: To assess the accuracy of the COBAS b101 point‐of‐care system referenced against a laboratory method, for measurement of HbA1c levels in pregnant women. Materials and methods: Convenience sample of 40 obese pregnant women enrolled in a clinical trial. HbA1c was assayed in paired capillary and venous whole blood samples using the COBAS b101 point‐of‐care system and Primus Ultra2 high performance liquid chromatography laboratory analyser, respectively. The accuracy of the point‐of‐care system was assessed by Bland–Altman analysis. Results: The mean (SD) laboratory HbA1c was 35.9 (2.0) mmol/mol. The COBAS b101 point‐of‐care system, compared with the laboratory reference method, had a small negative bias for HbA1c (−1.0 mmol/mol, 95% CI −2.0 to −0.03, P = 0.03) and relatively wide 95% limits of agreement (−7.2 to 5.1 mmol/mol). Conclusion: In conclusion, we found that in pregnancy, the COBAS b101 point‐of‐care system has a small negative bias and modest point accuracy for HbA1c. When used to screen for previously unrecognised diabetes in pregnancy, appropriate COBAS b101 HbA1c point‐of‐care HbA1c thresholds for a negative and positive result are 7 mmol/mol below and 5 mmol/mol above the clinical threshold, respectively. Values between these limits should be confirmed by laboratory testing. [ABSTRACT FROM AUTHOR]

Aim: Very preterm (VPT) children (≤32 weeks) have school readiness difficulties across multiple domains, but routine follow-up is often limited. We assessed the performance of VPT children on the Before School Check (B4SC), a community-based screening programme of school readiness at 4 years of age.Methods: VPT children discharged from Wellington and Auckland Neonatal Intensive Care Units (2005-2009) were compared to a national control cohort born during the same period. Outcome measures included Parental Evaluation of Developmental Status (PEDS), parent and teacher versions of the Strengths and Difficulties Questionnaire (SDQ-P and SDQ-T) and vision and hearing screening, and were related to perinatal and demographic characteristics obtained from the Australia and New Zealand Neonatal Network database.Results: Of 1105 VPT children, 920 were matched to the B4SC database, of whom 814 (88%) had one or more B4SC screening outcomes recorded. Compared with controls, VPT children were more likely to have abnormal PEDS (odds ratio (OR) = 1.79, 1.53-2.10), SDQ-P (OR = 1.82, 1.49-2.23), SDQ-T (OR = 1.51, 1.10-2.06), vision (OR = 2.00, 1.54-2.60) and hearing (OR = 1.95, 1.65-2.31) screen outcomes. While VPT children with an abnormal screen were more likely to be referred for further assessment, only 34%, 22%, 94% and 51% with abnormal PEDS, SDQ or vision and hearing screen, respectively, had evidence of appropriate referral. School readiness difficulties were significantly associated with birthweight z-score ≤ -1, vaginal delivery, significant cranial ultrasound abnormalities, younger maternal age, higher deprivation neighbourhood and ventilation ≥72 h.Conclusion: Community-based screening may be useful for identifying VPT children with school readiness difficulties, but low referral rates may limit the effectiveness of such programmes. [ABSTRACT FROM AUTHOR]

Abstract: Recent events demonstrate the need for greater understanding of intercultural relations between Muslim minorities and majority of cultures in host societies. We examine British Muslims' descriptions of their experiences of acculturation. Data from interviews with first‐generation Muslims were analysed by using discourse analysis. Participants' descriptions reflect the acculturation possibilities made available in local interactional contexts. Where invited to choose between assimilation and separation, participants provide ‘trouble‐telling’ accounts that detail the difficulties involved. In contexts involving integration, participants account for their own efforts. By contrast, contexts that allow participants to introduce acculturation in their own terms lead to descriptions of acculturation success. Thus, participants' accounts of relations with British culture reflect not simply orientations towards acculturation but rather how acculturation is framed and negotiated in local contexts: The success or failure of intercultural relations reflects as much how the issues are presented as they do immigrants' acceptance or non‐acceptance of British culture. [ABSTRACT FROM AUTHOR]

Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury. As yet, there are no specific treatment options for the injured kidney, although there are several modifiable risk factors of which the anaesthetist should be aware. As well as the avoidance of potential nephrotoxins and appropriate volume balance, optimal anaesthetic management should aim to reduce the risk of postoperative renal complications. This may include careful ventilatory management and blood pressure control, as well as appropriate analgesic strategies. The choice of anaesthetic agent may also influence renal outcomes. Rather than concentrate on the classical management of acute kidney injury, this review focuses on the potential development of acute kidney injury peri-operatively, and the means by which this may be ameliorated. [ABSTRACT FROM AUTHOR]

Introduction: Presentation with decreased fetal movement (DFM) is associated with fetal growth restriction and stillbirth. Some studies report that DFM is frequent among overweight or obese mothers. We aimed to determine the significance and associations of fetal movements in women of increased body size.Material and Methods: This systematic review was conducted in accordance with the PRISMA statement and the protocol was registered with PROSPERO (CRD42016046352). Major databases were explored from inception to September 2017, using a predefined search strategy. We restricted inclusion to studies published in English and considered studies of any design that compared fetal movements in women of increased and normal body size. Two authors independently extracted data and assessed quality.Results: We included 23 publications from 19 observational studies; data were extracted from 10 studies. Increased maternal body size was not associated with altered perception of fetal movement (four studies, 95 women, very low-quality evidence), but was associated with increased presentation for DFM (two cohort studies, 20 588 women, OR 1.56, 95% CI 1.27-1.92: three case-control studies, 3445 women, OR 1.32, 95% CI 1.12-1.54; low-quality evidence). Among women with DFM, increased maternal body size was associated with increased risk of stillbirth and fetal growth restriction (one study, 2168 women, very low-quality evidence).Conclusions: This systematic review identified limited evidence that women with increased body size are more likely to present with DFM but do not have impaired perception of fetal movements. In women with DFM, increased body size is associated with worse pregnancy outcome, including stillbirth. [ABSTRACT FROM AUTHOR]