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Critical pedagogy has the potential to create transformation experiences within early childhood settings, as educators open up children's worlds to explore fairness, equity, and democratic participation across issues of interest and relevance to young children. Using a critical inquiry framework, informed by the work of Paulo Freire, teachers from an Auckland kindergarten provided examples of what the critical pedagogy elements can look like in practice with young children. These illustrative glimpses demonstrate the workability and impact that critical pedagogy can have in an early childhood education setting.

This article is based on a 2-year TLRI-funded research project that examined how three early childhood centres explored the ways in which walking, reading, and storying the land with teachers, community members, iwi, and whanau enabled children to experience and learn about their local area, its stories, geology, biodiversity, and cultural meanings, and envision democratic socioecological futures. This article focuses on Pakuranga Baptist Kindergarten, one of the research settings that participated in this study. It analyses how the kindergarten's inquiry-based approach, relational pedagogy, and use of walking, storytelling, and arts deepened children's knowledge, understanding, and relationships with people and place.

In light of policies and programs designed to address the domination of academic positions by male, frequently white individuals, we review the participation of women, one of multiple minority identities within the academy, in Aotearoa New Zealand's academic workforce using employment data from eight universities from 2002-2017. While the number of women employed continues to improve, the rate has slowed in recent years and senior roles remain heavily dominated by men. Women were more likely to be employed at lower levels of seniority, to advance to seniority more slowly than male colleagues, and were more likely to be employed part-time. We call for active strategies to address the cultural and structural bias in universities that favour the hiring and promotion of men to improve workforce diversity at all levels of seniority.

Human nutrition is a growing field with an increasing job market and high demand for university study, yet graduates report feeling underprepared for and unaware of potential job opportunities. This scoping review aimed to identify employment initiatives used in undergraduate programs to support an evidence-based approach to the development of future initiatives for human nutrition courses. The scoping review following PRISMA-ScR criteria was initially conducted in October 2018 and updated in April 2020. Search terms were selected to identify studies that reported on employability or work-readiness embedded within the course curriculum for undergraduate students. Fourteen papers met the eligibility criteria. Papers included were from Australia (9), United Kingdom (2), United States (1), New Zealand (1) and Germany (1). Papers described initiatives fitting broad categories of placements, project-based industry collaboration, practice-based eLearning, mentoring and building graduate attributes. Placements were the most common type of initiative and project-based industry collaboration demonstrated the highest levels of student and employer satisfaction. The success of initiatives was often attributed to incorporating diverse approaches to real-world, problem-solving skills. Mentoring and eLearning were used to promote employability soft skills, while industry-based placements provided students with practical experience. Placement in specific workplace settings should be representative of the diverse job options for nutrition graduates. Human nutrition degrees should consider incorporating strategies that develop soft skills and project-based skills while exposing students to diverse workplace settings within industry.

This is the first study to investigate the effects of test methods (while-listening performance and post-listening performance) and gender on measured listening ability and brain activation under test conditions. Functional near-infrared spectroscopy (fNIRS) was used to examine three brain regions associated with listening comprehension: the inferior frontal gyrus and posterior middle temporal gyrus, which subserve bottom-up processing in comprehension, and the dorsomedial prefrontal cortex, which mediates top-down processing. A Rasch model reliability analysis showed that listeners were homogeneous in their listening ability. Additionally, there were no significant differences in test scores across test methods and genders. The fNIRS data, however, revealed significantly different activation of the investigated brain regions across test methods, genders, and listening abilities. Together, these findings indicated that the listening test was not sensitive to differences in the neurocognitive processes underlying listening comprehension under test conditions. The implications of these findings for assessing listening and suggestions for future research are discussed.

As the COVID-19 virus has spread worldwide, much attention has been paid to its impact on the health and wellbeing of adults, with less attention to how the virus has impacted on young children. This article draws on documentation and video data from a kindergarten in Aotearoa New Zealand. It discusses the working theories of 4 year-old children whose teachers encouraged them to draw, construct images, explain and tell stories about their experiences, ideas and feelings about the virus. A main argument is that children's working theories about the virus, knowledge of the virus and sense of personal control over keeping themselves safe developed over time. Arts-based and storytelling pedagogy were central in enabling children to communicate with others, to be understood themselves and to extend their own understanding.

This article draws from a 2-year TLRI-funded research project looking at how four early childhood centres constructed positive outcomes for children from migrant families. The research questions focused on how the people, places, and practices in early childhood settings support a sense of bicultural belonging to Aotearoa New Zealand, sustain children's connections to homelands and people, and enable them to contribute important cultural aspects from their home country. This article focuses on one of the research settings that participated in this study, Pakuranga Baptist Kindergarten. Observations and staff reflections revealed the ways teachers used the visual arts, storytelling, and play to value children's and their families' cultural funds of knowledge and foster children's sense of belonging in New Zealand.

High stakes examinations can have profound implications for how science is taught and learned. Limitations of school science such as the 'cookbook problem' can potentially be addressed if high stakes assessments target learning outcomes that are innovative. For example, less mindless procedural engagement and more thoughtful consideration of practical science can potentially improve science learning. In this paper, we investigate how practical work is represented in the assessment frameworks of several countries that demonstrate above average performance in the latest PISA science assessments. The main motivation is the need to understand if there are aspects of high stakes summative assessments in these countries that can provide insight into how best to structure national examinations. Assessment documents from a set of selected countries have been analysed qualitatively guided by questions such as 'what is the construct of practical science' and 'what is the format of assessment?' The examined jurisdictions used different approaches from traditional external pen-and-paper tests to internal teacher assessments that included different formats (e.g. laboratory report). Innovative approaches to the assessment of practical skills (e.g. PISA computer-based tasks) do not seem to be represented in these high-stakes assessments. Implications for innovative assessments for high-stakes purposes are discussed.

This article reflects upon an international collaboration between supervision experts from South Africa, Hong Kong and New Zealand with the Singapore Association of Social Workers. This collaboration was focused on developing the supervision of supervisory practice. An overview of social work supervision in Singapore is discussed, followed by the process of developing the programme content, delivering training and providing consultation on creating a curriculum. The outcomes include supervision guidelines, curriculum development and further cross-national collaborations. The article concludes by discussing the learning from this international collaboration. [ABSTRACT FROM AUTHOR]

Background: Vaccine hesitancy (the reluctance or refusal to vaccinate) poses a significant threat to public health worldwide, with declining vaccination coverage resulting in the resurgence of vaccine-preventable diseases (e.g., measles) in recent years. Despite efforts to combat vaccine hesitancy through information-based campaigns and other interventions, vaccine-hesitant attitudes persist. Given that such interventions likely expose individuals to information that conflicts with their own viewpoints about vaccination, cognitive flexibility – the ability to adapt one's thoughts, attitudes, beliefs, or behavior in response to changing information or environmental demands – may play a role in vaccine hesitancy. Methods: The current study investigated the relationship between cognitive flexibility and attitudes towards vaccination in a sample of New Zealand residents (N = 601). Cognitive flexibility was measured using perseverative responses in the Wisconsin Card-Sorting Task, and vaccination attitudes were measured using an adapted version of the Multidimensional Vaccine Hesitancy Scale (MVHS). Linear regression was used with MVHS scores as the dependent variable and cognitive flexibility and sociodemographic variables (age, gender, ethnicity, education level, religion) as predictors. Results: Cognitive flexibility predicted personal barriers to vaccination (e.g.," vaccines go against my personal beliefs"), with participants with lower levels of cognitive flexibility reporting greater personal barriers. In contrast, there was no significant relationship between cognitive flexibility and external barriers to vaccination (e.g., "vaccines cost too much"). Additionally, religious participants reported overall higher levels of vaccine hesitancy than non-religious participants. Conclusions: These findings join others demonstrating that individual differences in cognitive style are associated with attitudes towards vaccination, and tentatively suggest that interventions aiming to reduce vaccine hesitancy may be more effective if combined with techniques to increase cognitive flexibility. To be sure, future work is needed to test the causal relationship between cognitive flexibility and attitudes towards vaccination. [ABSTRACT FROM AUTHOR]

Many of the implications of climate change for Aotearoa (New Zealand) remain unclear. To identify so-far unseen or understudied threats and opportunities related to climate change we applied a horizon-scanning process. First, we collated 171 threats and opportunities across our diverse fields of research. We then scored each item for novelty and potential impact and finally reduced the list to ten threats and ten opportunities through a prioritisation process. Within the 20 items presented in this paper, we uncover a range of climate-related costs and benefits. Unexpected opportunities evolve from economic reorganisation and changes to perspectives. The threats we highlight include the overall failure to interconnect siloed policy responses, as well as those relating to extreme events and feedbacks, as well as pressures that undermine the coherence of society. A major theme of our work is that climate change effects in Aotearoa are likely to transgress the boundaries of research disciplines, industry sectors and policy systems, emphasising the importance of developing transdisciplinary methods and approaches. We use this insight to connect potential responses to climate change with Aotearoa's culture and geography. [ABSTRACT FROM AUTHOR]

Twice-exceptional (gifted with associated learning difficulties) students face complex learning challenges because of their varying combinations of high ability alongside domains of learning difficulty. There is currently little original empirical research in the New Zealand education setting specifically concerning twice-exceptional students. The problem of twice-exceptional student underachievement is, however, well documented in the international literature. Failure to identify and provide for such students has been shown to negatively affect academic, social, and emotional self-efficacy, which has serious implications for the development of individual capability and wellbeing. This article presents the findings from a survey of 54 teachers currently teaching in New Zealand schools. The findings reveal considerable variability in teacher understandings about twice-exceptionality that affect confidence in dealings with, and provision for, individuals with dual exceptionalities. Some suggestions for assisting teachers in developing informed understandings are proposed.

Marginal zone lymphomas (MZLs) are a rare, indolent group of non‐Hodgkin lymphomas with different diagnostic, genetic and clinical features and therapeutic implications. The most common is extranodal MZL of mucosa‐associated lymphoid tissue, followed by splenic MZL and nodal MZL. Patients with MZL generally have good outcomes with long survival rates but frequently have a relapsing/remitting course requiring several lines of therapy. The heterogeneous presentation and relapsing course present the clinician with several diagnostic and therapeutic challenges. This position statement presents evidence‐based recommendations in the setting of Australia and New Zealand. [ABSTRACT FROM AUTHOR]

Twice-exceptional students are characterized by the almost paradoxical combination of giftedness accompanied by learning difficulties that hinder their ability to reach their potential in a traditional academic setting. This qualitative study examined the experiences of three twice-exceptional students during transfer to a New Zealand high school. Successful transfer has been shown to be dependent on factors such as the timely handover of accurate and complete student records. Barriers to successful transfer result in disruption in curriculum continuity, which can be especially detrimental for learners with special needs. Using student voice data from interviews and journal entries, the participants' lived experiences of the transfer process were revealed. Findings suggest that the way in which the twice-exceptional students experienced transfer influenced the development of their personal capabilities as learners in the education setting.

With an ageing population, ophthalmologists are becoming burdened with glaucoma management, and patient care can be delayed. Therefore, the use of optometrists in glaucoma management can help alleviate the burden. The ageing population and subsequent rise of glaucoma prevalence are putting a strain on the public health system in New Zealand. Glaucoma collaborative care between optometrists and ophthalmologists has been gaining support with the aim to reduce this burden on ophthalmologists. There has been little investigation of the agreement in care and management of mild-to-moderate severity glaucoma patients by optometrists and ophthalmologists. One hundred and three glaucomatous eyes were used in a survey where clinical history and examination, intraocular pressures (IOPs), visual field testing and optical coherence tomography (OCT) imaging were evaluated for glaucoma progression and decision-making regarding subsequent management by four participants. Two participants were glaucoma-credentialled optometrists (Group 1), and the other two were glaucoma specialists (Group 2). With respect to glaucoma progression, Spearman coefficients identified strong agreement between the two groups for IOP, visual fields and overall status and moderate agreement for OCT imaging. A confusion matrix was used to analyse management and found 80% ± 10% agreement between the two groups. Review periods gave an agreement of 55% ± 20% between the two groups. There was strong agreement in the assessment of glaucoma progression between the two groups. The 80% level of agreement for subsequent management between the two groups is comparable to other published reports. These results provide some reassurance that a collaborative care system can perform safely and as intended. [ABSTRACT FROM AUTHOR]

Background: Transcutaneous auricular vagus nerve stimulation (taVNS) is considered a safe and promising tool for limb rehabilitation after stroke, but its effect on cough has never been studied. It is known that the ear and larynx share vagal afferent pathways, suggesting that stimulating the ear with taVNS might have effects on cough sensitivity. The specific stimulation parameters used can influence outcomes. Objective: To investigate the effect of various stimulation parameters on change in cough sensitivity, compared to the reference parameter of 25 Hz stimulation at the left concha (most commonly-used parameter for stroke rehabilitation). Design, setting, and participants: Randomized, single-blind, active-controlled, eight-period cross-over design conducted March to August 2022 at a New Zealand research laboratory with 16 healthy participants. Interventions: All participants underwent eight stimulation conditions which varied by stimulation side (right ear, left ear), zone (ear canal, concha), and frequency (25 Hz, 80 Hz). Main outcome measures: Change in natural and suppressed cough threshold (from baseline to after 10 min of stimulation) assessed using a citric acid cough reflex test. Results: When compared to the reference parameter of 25 Hz stimulation at the left concha, there was a reduction in natural cough threshold of -0.16 mol/L for 80 Hz stimulation at the left canal (p = 0.004), indicating increased sensitivity. For the outcome measure of suppressed cough threshold, there was no significant effect of any of the stimulation conditions compared to the active reference. Conclusion: Since stroke patients often have cough hyposensitivity with resulting high risk of silent aspiration, using 80 Hz taVNS at the left canal may be a better choice for future stroke rehabilitation studies than the commonly used 25 Hz taVNS at the left concha. Treatment parameters should be manipulated in future sham-controlled trials to maximize any potential treatment effect of taVNS in modulating cough sensitivity. [ABSTRACT FROM AUTHOR]

Introduction: Primary aldosteronism (PA) causes 10–15% of cases of hypertension, and it is increasingly recognised as being under‐diagnosed. An interventional radiology procedure, adrenal vein sampling (AVS), is a necessary and important diagnostic procedure for complete workup of PA. There is an anticipated increase in demand for AVS as detection of PA improves. This study aims to describe the current landscape of AVS in Australia and New Zealand (NZ). Methods: Two surveys exploring AVS methodology and performance were conducted of (i) Endocrinology Unit Heads and (ii) interventional radiologists who perform AVS, at public hospitals with Endocrinology Units across Australia and NZ. Results: Responses were received from 48/53 Endocrinology Unit Heads (91%) and 35 radiologists from 26 sites (87% of AVS sites). AVS was provided at 28/48 Endocrinology sites (58%) across Australia and NZ. In Australia, sites were concentrated in Victoria, New South Wales and Queensland with none in the Northern Territory; in NZ, sites were more evenly distributed across the North and South Islands. AVS was performed by 1–2 dedicated radiologists at 24 sites, 2–3 radiologists at two sites and a rotating roster of radiologists at two sites. Responses to both surveys revealed significant variation in AVS methodology and interpretation of AVS results. Conclusion: There is significant heterogeneity in the availability of AVS, the procedural details and the interpretation of results across Australia and NZ, which potentially impacts the quality of patient care and ability to scale up AVS capacity to meet increasing demand. [ABSTRACT FROM AUTHOR]

Background: While there is increasing evidence on the benefits of PROMs in cancer care, the extent of routine collection and use of PROMs in clinical cancer practice across Australia and New Zealand (ANZ) is unknown. This study examined the prevalence and characteristics of PROMs use in routine clinical cancer care in ANZ. Methods: An online survey was designed and disseminated via professional societies and organisations using a snowball sampling approach to clinical and health administration professionals managing cancer care in ANZ. A poster advertising the study was also circulated on professional social media networks via LinkedIn and Twitter inviting health professionals from ANZ to participate if they were using or intending to use PROMs in clinical cancer practice. Responders opted into the survey via the survey link. Results: From 132 survey views, 91(response rate, 69%) respondents from 56 clinical practices across ANZ agreed to participate in the survey, and of these 55 (n = 55/91, 60%) respondents reported collecting PROMs within their clinical practice. The majority of the respondents were from the State of New South Wales in Australia (n = 21/55, 38%), hospital (n = 35/55, 64%), and a public setting (n = 46/55, 83%). PROMs were collected in all cancer types (n = 21/36, 58%), in all stages of the disease (n = 31/36, 86%), in an adult population (n = 33/36, 92%), applied in English (n = 33/36, 92%), and used to facilitate communication with other reasons (27/36, 75%). A geospatial map analysis provided insights into the variation in PROMs uptake between the two countries and in certain jurisdictions within Australia. This study also highlights the limited resources for PROMs implementation, and a lack of systematic priority driven approach. Conclusion: PROM use across Australia and New Zealand seems variable and occurring predominantly in larger metropolitan centres with limited standardisation of approach and implementation. A greater focus on equitable adoption of PROMs in diverse cancer care settings is urgently needed. [ABSTRACT FROM AUTHOR]

The aim of this study is to identify the methods and content of hospital-based serious incident reviews involving mental health related homicide where a service user was the perpetrator between 2007 and 2017. Eleven reports were obtained from mental health services in New Zealand's largest city and thematically analysed. Nine used the London protocol to identify clinical and system factors that may have contributed to the serious incident, but there was considerable variation in the way in which it was applied. Feedback to services was inconsistent. The voices of family members of the victims were largely absent and consideration of cultural context was missing. A structured protocol to specifically address the mental health context in New Zealand and internationally could resolve some of these issues and lead to a process that is more likely to provide comprehensive coverage of relevant matters and produce clear recommendations to effect improvements to services. [ABSTRACT FROM AUTHOR]

Objective: To assess topographic concordance between the histopathological features of patients' radical prostatectomy (RP) specimens and the location of the prostate‐specific membrane antigen positron emission tomography (PSMA PET) local recurrences, qualitatively and quantitatively. Patients and Methods: Our cohort was selected from the 100 men who received a 18F‐DCFPyL PET scan in the IMPPORT trial (Australian New Zealand Clinical Trials Registry Number: ACTRN12618001530213), a prospective non‐randomised study completed by GenesisCare Victoria. Eligibility included patients with a rising prostate‐specific antigen (PSA) level (>0.2 ng/mL) after RP and PSMA PET detected local recurrence. Histopathological parameters collated included the location of tumour, extraprostatic extension (EPE), and positive margins. Criteria for the location and 'concordance' between histopathological features and local recurrences were pre‐defined. Results: A total of 24 patients were eligible; the median age was 71 years, the median PSA level was 0.37 ng/mL, and the time between RP and PSMA PET was 2.6 years. In all, 15 patients had recurrences within the vesicourethral anastomotic region and nine within the lateral surgical margins. There was 100% concordance in the left–right plane between tumour location and local recurrence, with 79% of these lesions concordant three‐dimensionally; across craniocaudal, left–right, and anterior–posterior planes. In all, 10 of the 16 (63%) patients with EPE and five of the nine patients with positive margins had three‐dimensional concordance between their pathology and their local recurrence. In quantitative assessment, 17 of the 24 patients, had local recurrences that correlated with the location of their original tumour in the craniocaudal plane. Conclusion: Local recurrence is highly concordant with the position of the tumour within the prostate. Predicting the location of local recurrence using the location of the EPE and positive margins is less helpful. Further investigation into this field, could impact surgical technique and salvage radiotherapy clinical target volume. [ABSTRACT FROM AUTHOR]

This study investigates the information-seeking behavior of fourteen ethnomusicologists in New Zealand via interviews. The findings shed light on what information ethnomusicologists seek, the sources and services they use, and the barriers they face in information seeking and use. A number of ways in which libraries can create collections and design services that will meet the information needs of ethnomusicologists are proposed.

Examines how the wording of statistical problems affects 11-12 year old children's answers. Ninety-six children were given statistical problems on two statistical concepts (base-rate and the law of large numbers). Indicates that the children had a high level of statistical intuition and knew when to reason statistically. (CMK)

Backgrounds: Surgery remains mainstay management for colon cancer. Post‐operative anastomotic leak (AL) carries significant morbidity and mortality. Rates of, and risk factors associated with AL following right hemicolectomy remain poorly documented across Australia and New Zealand. This study examines the Bowel Cancer Outcomes Registry (BCOR) to address this. Methods: A retrospective cohort study was undertaken of consecutive BCOR‐registered right hemicolectomy patients undergoing resection for colon cancer (2007–2021). The primary outcome measure was AL incidence. Clinicopathological data were extracted from the BCOR. Factors associated with AL and primary anastomosis were identified using logistic regression. AL‐rate trends were assessed by linear regression. Results: Of 13 512 patients who had a right hemicolectomy (45.2% male, mean age 72.5 years, SD 12.1), 258 (2.0%) had an AL. On multivariate analysis, male sex (OR 1.33; 95% CI 1.03–1.71) and emergency surgery (OR 1.41; 95% CI 1.04–1.92) were associated with AL. Private health insurance status (OR 0.66; 95% CI 0.50–0.88) and minimally‐invasive surgery (OR 0.61; 95% CI 0.47–0.79) were protective for AL. Anastomotic technique (handsewn versus stapled) was not associated with AL (P = 0.84). Patients with higher ASA status (OR 0.47; 95% CI 0.39–0.58), advanced tumour stage (OR 0.56; 95% CI 0.50–0.63), and emergency surgery (OR 0.16; 95% CI 0.13–0.20) were less likely to have a primary anastomosis. AL‐rate and year of surgery showed no association (P = 0.521). Conclusion: The AL rate in Australia and New Zealand following right hemicolectomy is consistent with the published literature and was stable throughout the study period. Sex, emergency surgery, insurance status, and minimally invasive surgery are associated with AL incidence. [ABSTRACT FROM AUTHOR]

Introduction: Popularity of joint replacement surgery due to ever aging population surges the demand for a proper national joint registry. Our Chinese University of Hong Kong – Prince of Wales Hospital (CUHK-PWH) joint registry has passed the 30th year. The aims of this study are 1) summarize our territory-wide joint registry which has passed the 30th year since establishment and 2) compare our statistics with other major joint registries. Methods: Part 1 was to review the CUHK-PWH registry. Demographic characteristics of our patients who underwent knee and hip replacements had been summarized. Part 2 was a series of comparisons with registries from Sweden, UK, Australia and New Zealand. Results: CUHK-PWH registry captured 2889 primary total knee replacements (TKR) (110 (3.81%) revision) and 879 primary total hip replacements (THR) (107 (12.17%) revision). Median Surgery time of TKR was shorter than THR. Clinical outcome scores were much improved after surgery in both. Uncemented of hybrid in TKR were most popular in Australia (33.4%) and 40% in Sweden and UK. More than half of TKR and THR patients showed the highest percentage with ASA grade 2. New Zealand reflected the best cumulative percentage survival 20 years after surgery of 92.2%, 76.0%, 84.2% survivorship 20 years after TKR, unicompartmental knee replacement (UKR) and Hip. Conclusion: A worldwide accepted patient-reported outcome measure (PROM) is recommended to develop to make comparisons among registries and studies feasible. Completeness of registry data is important and useful to improve surgical performance through data comparisons from different regions. Funding from government on sustaining registries is reflected. Registries from Asian countries have yet to be grown and reported. [ABSTRACT FROM AUTHOR]

Asked college students what information they would glean from drivers (aged 16 to 91) involved in traffic accident for assigning accident responsibility. Found ageist information-seeking across lifespan independent of driver gender, participant age, and participant gender. Participants would ask younger drivers about driving conduct (drinking, speeding) and older drivers about capacity for driving (mental competence, vision, health). (Author/NB)

Objectives: To assess the correlation of pathological radical prostatectomy (RP) specimen features and prostate‐specific antigen (PSA) characteristics to imaging findings on subsequent 18F‐DCFPyL positron emission tomography/computed tomography (PET/CT) in patients with biochemical failure (BF). Patients and Methods: Retrospective analysis of combined 18F‐DCFPyL PET/CT database of patients from centres in Australia and New Zealand was performed. A total of 205 patients presenting with BF after RP were included in this study. Imaging findings on 18F‐DCFPyL PET/CT were recorded and correlated with the PSA characteristics at BF and pathological features of the original tumour. Results: Of the 205 patients, 120 (58.5%) had evidence of abnormal prostate‐specific membrane antigen (PSMA) expression compatible with recurrent prostate cancer. Increasing PSA velocity (P = 0.01), International Society of Urological Pathology (ISUP) Grade Group (P = 0.02), lymphovascular invasion (P = 0.05) and nodal positivity (P = 0.02) at the time of RP were more likely to demonstrate PSMA positivity. Multivariable logistic regression revealed a higher PSA level prior to PSMA PET/CT (P < 0.01), adjuvant radiotherapy (P = 0.09), Gleason score ≥8 (P < 0.01) and nodal positivity (P = 0.05) were all predictive of PSMA positivity. Conclusion: 18F‐DCFPyL PET/CT positivity, both generally and site specific, correlates with PSA and RP pathological factors. Our results echo cohorts focussing on post‐RP patients, those imaged with 68Ga‐PSMA and those concerning biochemical persistence. Nomograms that include risk factors for 'PSMA‐positive recurrence' in the BF population may increase the catchment of patients with disease confined to the prostate bed or pelvis who have a greater probability of prolonged disease‐free survival. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to observe the protective effect of bone marrow mesenchymal stem cell-derived extracellular vesicles (BMSC-EVs) on chondrocytes, and to clarify the possible mechanism of them combined with cartilage regeneration scaffolds in promoting the repair of late full-thickness cartilage defects. METHODS: BMSC-EVs were isolated and extracted from BMSCs through ultracentrifugation and identified. The inflammatory environment of chondrocytes was mediated using tumor necrosis factor-α (TNF-α) in vitro, and chondrocytes were co-cultured with an equivalent amount of phosphate buffered saline (PBS) and BMSC-EVs (80 μg/mL) under inflammatory response. The effects of BMSC-EVs on TNF-α-mediated chondrocyte proliferation and apoptosis were detected via methyl thiazolyl tetrazolium (MTT) assay and Hoechst33342 staining, respectively. The protein expressions of protein kinase B (AKT)/ phosphorylated (p)-AKT, extracellular signal-regulated kinase (ERK)/p-ERK, and p38/pp38 in chondrocytes in the inflammatory environment in each group were determined using Western blotting. Besides, 12 New Zealand white rabbits were randomly divided into 4 groups. The rabbit model of full-thickness knee cartilage defects was established, and an equivalent amount of normal saline, normal saline + scaffolds, and BMSC-EVs+scaffolds were applied to the cartilage defects in the 4 groups, respectively. At 6 weeks after operation, the samples were taken, and the repair effect on knee cartilage defects of laboratory rabbits was compared in each group through gross observation, hematoxylin-eosin (HE) staining, and safranin O-fast green staining. RESULTS: BMSC-EVs were successfully extracted and identified. BMSC-EVs were in an eccentric circular shape with an obvious characteristic cup-like structure, and the average diameter was 71.00 nm. It was found using Western blotting that specific surface markers CD63 and CD9 were expressed in BMSC-EVs. In the inflammatory environment, the number of chondrocyte-derived apoptotic bodies in BMSC-EVs group was smaller than that in TNF-α group, and the proliferation rate was higher in BMSC-EVs group than that in TNF-α group. The results of Western blotting showed that the expressions of p-ERK1/2 and p-p38 in chondrocytes significantly declined, while the expression of p-AKT rose in BMSC-EVs group. In the New Zealand white rabbit model of full-thickness knee cartilage defects, the repair effect on knee cartilage defects was better in BMSC-EVs + scaffold group than that in blank group and scaffold group. CONCLUSIONS: In the inflammatory environment, BMSC-EVs may inhibit chondrocyte apoptosis and promote proliferation through PI3K/ AKT, p38 MAPK and MAPK/ERK signaling pathways. BMSC-EVs can promote the repair of cartilage defects more effectively, which provide new ideas for the clinical repair of knee cartilage defects. [ABSTRACT FROM AUTHOR]

Background: The measurement of height is crucial for weight status assessment. When standing height is difficult to measure, ulna length may offer a convenient and accurate surrogate of height measure. Adolescence is a period of accelerated linear growth; hence, the validation of age‐specific equations that predict height from ulna length in adolescents is warranted. The present study aimed to develop and validate age‐ and sex‐specific equations for predicting height from ulna length in New Zealand adolescents. Methods: Height, weight and ulna length were measured in 364 adolescents (n = 110 males, n = 254 females) aged 15.0–18.8 years, who were enrolled in the SuNDiAL (Survey of Nutrition Dietary Assessment and Lifestyle) project, a cross‐sectional survey performed in 2019 and 2020. Regression models were used to determine equations to predict height from ulna length. Agreement between measured and predicted height, body mass index (BMI) and BMI z‐score was assessed with intra‐class correlation coefficients (ICC) and Bland–Altman plots. Sensitivity and specificity were calculated for classifying obesity. Results: Strong agreement was found between predicted and measured height (ICC = 0.78; mean difference = 0; 95% confidence interval = −0.5 to 0.5 cm) and BMI (ICC = 0.95; mean difference = 0; 95% confidence interval = −0.1 to 0.1 kg m–2). Predicted height was 88.1% accurate when classifiying weight status, showing high sensitivity (93.8%) and specificity (99.4%) for classifying obesity. Conclusions: Ulna length measurement can accurately estimate height and subsequently weight status in New Zealand adolescents aged 15–18 years. [ABSTRACT FROM AUTHOR]

Despite a large number of studies examining the effects of abiotic stress factors on plants, the mechanistic explanations of drought-induced tree mortality remain inconclusive and even less is known about how multiple stressors interact. The role of non-structural carbohydrates (NSCs) in preventing or postponing drought mortality is gaining attention. Here, we tested the role of NSCs in mitigating the effects of drought and salinity in New Zealand mangroves, Avicennia marina subsp. australasica. We experimentally manipulated plant NSC levels, prior to subjecting them to combinations of drought and salinity. Plant growth and survival rates were 2- and 3-fold higher in the high-NSC (H-NSC) group than in the low-NSC (L-NSC) group under high salinity and drought conditions, respectively. After 12 weeks under high salinity–high drought conditions, the H-NSC group showed higher stem hydraulic conductivity (281 ± 50 mmol cm−1 s−1 MPa−1) compared with the L-NSC group (134 ± 40 mmol cm−1 s−1 MPa−1). Although starch levels remained relatively constant, we found a 20% increase in soluble sugars in the stems of H-NSC group under high drought and high salinity in week 8 compared with week 12. Our results suggest (i) an important role of NSCs in mitigating the effects of low soil water potential caused by drought and salinity, and (ii) sink-limited growth under conditions of combined salinity and drought. [ABSTRACT FROM AUTHOR]

Context: In New Zealand, COVID-19-related lockdowns led to the implementation of visiting restrictions in care homes. This placed residents at risk of isolation. The Chinese community is a fast-growing ethnic group and faces additional difficulties, including language and cultural barriers. Information and communication technologies (ICTs) may enhance communication and maintain social connectedness between families and care homes during lockdowns. Objective(s): To explore the role of technology in the experiences of Chinese care home residents living in New Zealand during three lockdown periods from 2020 to mid-2021. Method(s): We performed semi-structured interviews with predominantly Chinese individuals (n = 18) across two Chinese-run care homes in Auckland, New Zealand. Participants included residents (n = 6), family members (n = 6) and facility staff (n = 6). Interviews were conducted and transcribed in either English or Mandarin Chinese, then coded and analysed to synthesise themes. Findings: We identified five themes: (i) an online care home community via WeChat, (ii) benefits of technology, (iii) barriers to technology use, (iv) the infodemic: technology as information overload and (v) the use of technology post-lockdowns. Limitations: Sample sizes for each sub-group were limited. The generalisability of findings is limited to those with no dementia or mild dementia. Residents with more severe dementia were excluded from the study but might also have benefitted from the intervention. Implications: The main finding of this study is that WeChat is an effective means of maintaining social connections in the Chinese care home community, particularly when usage is facilitated by staff. We recommend care homes consider using social media platforms to connect residents with the outside world. Sufficient resources, training and staff are needed to advocate for care home residents to be part of a digital community in a way that is culturally relevant. [ABSTRACT FROM AUTHOR]

Inquiries into mental health related homicides may be held to identify failures in care and areas for improvement, accountability and to enhance public confidence. However, inquiries do not always achieve these aims. The aim of this study was to explore the perspectives of members of inquiry panels who conduct inquiries into mental health related homicides in order to identify elements that would constitute a good inquiry. We selected a sample of inquiry panel members comprising 15 senior clinicians, legal experts and consumer advisors. Semi-structured interviews were audio-recorded, transcribed and analysed using thematic analysis. Participants raised concerns related to: (1) orientation of the panel to the inquiry task; (2) clarity of the process; and (3) impact of the inquiry. Most participants recognised that inquiries require a focus on mental health systems and sensitivity to families and clinicians. They reported difficulties in clarifying purposes, attending to cultural aspects of the case, having a clear method tailored to the mental health context, formulating recommendations and disseminating findings. Our participants perceived a number of weaknesses in the process by which inquiries into mental health related homicides had been conducted, and recommendations formulated and implemented. There is an opportunity to address these and thereby potentially improve the effectiveness and value of inquiries. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is a leading cause of mortality in kidney failure (KF). Patients with KF from atheroembolic disease are at higher risk of cardiovascular disease than other causes of KF. This study aimed to determine survival on dialysis for patients with KF from atheroembolic disease compared with other causes of KF.Methods: All adults (≥ 18 years) with KF initiating dialysis as the first kidney replacement therapy between 1 January 1990 and 31 December 2017 according to the Australia and New Zealand Dialysis and Transplant registry were included. Patients were grouped into either: KF from atheroembolic disease and all other causes of KF. Survival outcomes were assessed by the Kaplan-Meier method and Cox regression analysis adjusted for patient-related characteristics.Results: Among 65,266 people on dialysis during the study period, 334 (0.5%) patients had KF from atheroembolic disease. A decreasing annual incidence of KF from atheroembolic disease was observed from 2008 onwards. Individuals with KF from atheroembolic disease demonstrated worse survival on dialysis compared to those with other causes of KF (HR 1.80, 95% confidence interval [CI] 1.61-2.03). The respective one- and five-year survival rates were 77 and 23% for KF from atheroembolic disease and 88 and 47% for other causes of KF. After adjustment for patient characteristics, KF from atheroembolic disease was not associated with increased patient mortality (adjusted HR 0.93 95% CI 0.82-1.05).Conclusions: Survival outcomes on dialysis are worse for individuals with KF from atheroembolic disease compared to those with other causes of KF, probably due to patient demographics and higher comorbidity. [ABSTRACT FROM AUTHOR]

Background: The strengths model of case management (SMCM), which was developed by Rapp and Goscha through collaborative efforts at the University of Kansas, assists individuals with mental illness in their recovery by mobilizing individual and environmental resources. Increasing evidence has shown that the utilization of the SMCM improves outcomes, including increased employment/educational attainment, reduced hospitalization rates, higher self-efficacy, and hope. However, little is known about the processes through which the SMCM improves outcomes for mental health service users. This study explores the views of case workers and service users on their experience of providing or receiving the SMCM intervention. Methods: A qualitative design was employed using individual interviews with service users and case workers drawn from two study conditions: the SMCM group and the control group (treatment as usual). For both study conditions, service users were recruited by either centres-in-charge or case workers from integrated community centres for mental wellness (ICCMWs) operated by three non-governmental organizations (NGOs) in different districts of Hong Kong. Through purposeful sampling, 24 service users and 14 case workers from the SMCM and control groups joined the study. We used an inductive approach to analyse the qualitative data. Results: We identified two overarching themes: service users' and case workers' (1) perceptions of the impacts of the interventions (SMCM and control group) and (2) experiences of the interventions, such as features of the interventions and the factors that facilitated the outcomes. The results showed that there were improvements in the functional recovery of the SMCM group in areas such as employment and family relationships, how self-identified goals were achieved, and how service users gained a better understanding of their own strengths and weaknesses. Regarding their experience of the interventions, participants in both the SMCM group and the control group reported that a good relationship between service users and case workers was vital. However, some concerns were raised about the use of SMCM tools, including the strengths assessment and the personal recovery plan (PRP) and the risk of case workers being subjective in the presentation of cases in group supervision sessions. Conclusion: The results were promising in terms of supporting the use of the SMCM, with some refinements, in mental health services for Chinese clients. Trial registration: The Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617001435370, registered on 10/10/2017. [ABSTRACT FROM AUTHOR]

Purpose: Prostate-specific membrane antigen (PSMA) PET/CT is increasingly used in patients with biochemical recurrence post prostatectomy to detect local recurrence and metastatic disease at low PSA levels. The aim of this study was to assess patterns of disease detection, predictive factors and safety using [18F]DCFPyL PET/CT versus diagnostic CT in patients being considered for salvage radiotherapy with biochemical recurrence post prostatectomy. Methods: We conducted a prospective trial recruiting 100 patients with detectable PSA post prostatectomy (PSA 0.2–2.0 ng/mL) and referred for salvage radiotherapy from August 2018 to July 2020. All patients underwent a PSMA PET/CT using the [18F]DCFPyL tracer and a diagnostic CT. The detection rates of [18F]DCFPyL PET/CT vs diagnostic CT were compared and patterns of disease are reported. Clinical patient and tumour characteristics were analysed for predictive utility. Thirty-day post-scan safety is reported. Results: Of 100 patients recruited, 98 were suitable for analysis with a median PSA of 0.32 ng/mL. [18F]DCFPyL PET/CT was positive 46.4% and equivocal 5.2%, compared to 15.5% positivity for diagnostic CT. Local recurrence was detected on [18F]DCFPyL PET/CT in 28.5%, nodal disease in 27.5% and bony metastases in 6.1% of patients. Both ISUP grade group (p < 0.001) and pre-scan PSA (p = 0.029) were significant predictors of [18F]DCFPyL PET/CT positivity, and logistic regression generated probabilities combining the two showed improved prediction rates. No significant safety events were reported post [18F]DCFPyL administration. Conclusions: [18F]DCFPyL PET/CT increases detection of disease in patients with biochemical recurrence post prostatectomy compared to diagnostic CT. Patients being considered for salvage radiotherapy with a PSA >0.2 ng/mL should be considered for [18F]DCFPyL PET/CT scan. Trial registration: Australian New Zealand Clinical Trials Registry Number: ACTRN12618001530213 (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375932&isReview=true) [ABSTRACT FROM AUTHOR]

The Radiation Oncology Department at The National Cancer Institute, Singapore (NCIS) and the Royal Australian and New Zealand College of Radiology (RANZCR) has had a well‐established relationship that began as a partnership to grow a pool of local radiation oncologists to meet a nation's demand for radiotherapy services. This journey has surpassed its initial aims and now has produced a generation of radiation oncologists leading a national cancer institute. We recount the history and progress of this partnership here, as well as the unique success of its product; the only RANZCR‐accredited radiation oncology training site outside of Australia and New Zealand since 2002. We outline the mutual benefits through many years of collaboration and deliberate efforts to grow the partnership. We also outline the distinctive specialist training path that our trainees take to meet both the local accreditation body as well as the RANZCR requirements. [ABSTRACT FROM AUTHOR]

Purpose: The primary aim of this retrospective multicenter analysis was to assess the performance of PSMA PET/CT using [18F]DCFPyL in the detection and localization of recurrent prostate cancer post radical prostatectomy (RP). Particular reference is given to low PSA groups < 0.5 ng/mL to aid discussion around the inclusion of this group in PSMA guidelines and funding pathways. Methods: Retrospective analysis of combined PSMA database patients from centers in Australia and New Zealand. Two hundred twenty-two patients presenting with recurrence post RP were stratified into five PSA groups (ng/mL): 0–0.19, 0.2–0.49, 0.5–0.99, 1–1.99, and ≥ 2. Lesions detected by [18F]DCFPyL PET/CT were recorded as local recurrence, locoregional nodes, and metastases. Results: Of 222 patients, 155 (69.8%) had evidence of abnormal uptake suggestive of recurrent prostate cancer. The detection efficacies for [18F]DCFPyL PET/CT were 91.7% (44/48) for PSA levels ≥ 2 ng/mL, 82.1% (23/28) for PSA levels 1–1.99 ng/mL, 62.8% (27/43) for PSA levels 0.5–0.99 ng/mL, 58.7% (54/92) for PSA levels 0.2–0.49 ng/mL, and 63.6% (7/11) for PSA levels ≤ 0.2 ng/mL. In those with PSA < 0.5 ng/mL, 47.6% (49/103) had detectable lesions, 71.4% (35/49) had disease confined to the pelvis, 22.4% (11/49) had prostate bed recurrence, 49.0% (24/49) had pelvic lymph nodes, and 28.6% (14/49) had extra pelvic disease. Conclusion: [18F]DCFPyL PET/CT has a high detection rate in recurrence following RP even at low PSA levels with similar detection levels in the PSA subgroups < 0.5 ng/mL. Employing rigid PSA thresholds when constructing guidelines for PSMA PET/CT funding eligibility may result in a significant number of patients below such thresholds having delayed or inappropriate treatment. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the role of Gelam honey (GH) in accelerating reepithelialization of corneal abrasion. Corneal epithelial cells (CEC) isolated from New Zealand white rabbit corneas, were cultured and circular-shaped wounds were created onto them, representing the corneal abrasion model. These wounds were treated with basal (BM) and cornea media (CM) supplemented with GH. The percentage of wound closure was measured on day 0, 3, and 5. Expressions of cytokeratin 3 (CK3), cluster of differentiation 44 (CD 44), and connexin 43 (Cx43) were analyzed via qRT-PCR and immunocytochemistry. The results showed CEC cultured in GH-enriched media reepithelialized faster compared to control. Corneal abrasion treated with CM supplemented with GH closed completely on day 5. CK3, CD44, and Cx43 expressions correspond to the stages of reepithelialization. In conclusion, GH promotes the healing of the ex vivo corneal abrasion model. Further explorations of its potential as adjuvant therapy in treating corneal injuries are needed. Practical applications: Honey has been reported to have many medicinal properties including antibacterial, anti-inflammatory, and the ability to promote skin wound healing. However, the effects of honey on corneal wound healing have not been fully elucidated. In the present study, we aimed to determine the effects of Gelam honey (GH), well-known local honey obtained from the beehive of Gelam trees (Melaleuca spp.), on the ex vivo corneal abrasion model via cell migration study and analysis of genes and proteins during corneal epithelial wound healing. GH has proven to have accelerated effects on the corneal epithelial cell migration during the closure of the ex vivo corneal abrasion wound model. The expressions of the genes and proteins of the corneal epithelial wound healing markers were in accordance with the stages of healing. Therefore, GH has the potential to be developed as adjuvant therapy in the form of GH-based eye drop in treating corneal injuries. [ABSTRACT FROM AUTHOR]

Background: Increasing age is a well‐recognized risk factor for breast cancer. With an increase in life expectancy of women, more older patients are diagnosed with breast cancer. This study aimed to identify the variations in breast cancer attributes and mortality in different age groups in New Zealand. Methods: This was a retrospective study of data from the Auckland Breast Cancer Register between 1 June 2000 and 28 February 2017. Patients who were diagnosed through Breast Screen were included. Group A included those aged between 45 and 69 years. Group B included individuals with an age of 70 years or above. Results: From June 2000 to February 2017, a total of 6304 new cases of new breast cancer were diagnosed through Auckland Breast Screen, with 5788 patients in group A and 516 patients in group B. Group B was more likely to have the lower grade invasive cancers, with fewer grade 3 cancers. Oestrogen receptor positivity was more pronounced in group B, along with progesterone receptor positivity. Conversely, HER‐2 receptor was less likely to be positive in group B. There was a significantly higher breast cancer‐related mortality in group B (6.0% versus 2.7%). Mortality related to other causes was also much higher in group B as compared to that in group A (12.8% versus 2.5%). Conclusion: Women aged 70 years or above generally tend to have a more favourable type of breast cancer, with a lower tumour grade, oestrogen and progesterone receptor positivity, and lower rate of HER‐2 overexpression. [ABSTRACT FROM AUTHOR]

Background: Alphaviruses, such as Ross River (RRV) and chikungunya virus (CHIKV), cause significant global morbidity, with outbreaks of crippling joint inflammation and pain, leaving patients incapacitated for months to years. With no available vaccine or specific therapeutic for any alphaviral disease, and a growing economic and public health burden, there is a serious need for the development of specific therapies.Methods: This study evaluated the safety and efficacy of pentosan polysulfate sodium (PPS) in subjects with RRV-induced arthralgia in a double-blind, placebo-controlled trial. Twenty subjects were randomized 2:1 to subcutaneous PPS (2 mg/kg) or placebo (sodium chloride 0.9%) twice weekly for 6 weeks. Safety evaluation included physical examination, concomitant medications, and laboratory findings. Efficacy assessments included change from baseline in joint function (hand grip strength and RAPID3) and quality of life (SF-36) at Days 15, 29, 39 and 81 after treatment initiation. Inflammatory and cartilage degradation biomarkers were exploratory endpoints.Results: PPS was well tolerated, with a similar proportion of subjects reporting at least one treatment-emergent adverse event (TEAE) in the treatment and placebo groups. Injection site reactions were the most common TEAE and occurred more frequently in the PPS group. Dominant hand grip strength and SF-36 scores improved with PPS at all time points assessed, with hand grip strength improvement of 6.99 kg (p = 0.0189) higher than placebo at Day 15. PPS showed significant improvements versus placebo in adjusted mean relative change from baseline for RAPID3 Pain (p = 0.0197) and Total (p = 0.0101) scores at Day 15. At the conclusion of the study overall joint symptoms, assessed by RAPID3, showed near remission in 61.5% of PPS subjects versus 14.3% of placebo subjects. Additionally, PPS treatment improved COMP, CTX-II, CCL1, CXCL12, CXCL16 and CCL17 biomarker levels versus placebo.Conclusions: Overall, the improvements in strength and joint symptoms warrant further evaluation of PPS as a specific treatment for RRV-induced and other forms of arthritis.Trial Registration: This trial is registered at the Australian New Zealand Clinical Trials Registry # ACTRN12617000893303 . [ABSTRACT FROM AUTHOR]

Study Question: Can consensus definitions for the core outcome set for infertility be identified in order to recommend a standardized approach to reporting?Summary Answer: Consensus definitions for individual core outcomes, contextual statements and a standardized reporting table have been developed.What Is Known Already: Different definitions exist for individual core outcomes for infertility. This variation increases the opportunities for researchers to engage with selective outcome reporting, which undermines secondary research and compromises clinical practice guideline development.Study Design, Size, Duration: Potential definitions were identified by a systematic review of definition development initiatives and clinical practice guidelines and by reviewing Cochrane Gynaecology and Fertility Group guidelines. These definitions were discussed in a face-to-face consensus development meeting, which agreed consensus definitions. A standardized approach to reporting was also developed as part of the process.Participants/materials, Setting, Methods: Healthcare professionals, researchers and people with fertility problems were brought together in an open and transparent process using formal consensus development methods.Main Results and the Role Of Chance: Forty-four potential definitions were inventoried across four definition development initiatives, including the Harbin Consensus Conference Workshop Group and International Committee for Monitoring Assisted Reproductive Technologies, 12 clinical practice guidelines and Cochrane Gynaecology and Fertility Group guidelines. Twenty-seven participants, from 11 countries, contributed to the consensus development meeting. Consensus definitions were successfully developed for all core outcomes. Specific recommendations were made to improve reporting.Limitations, Reasons For Caution: We used consensus development methods, which have inherent limitations. There was limited representation from low- and middle-income countries.Wider Implications Of the Findings: A minimum data set should assist researchers in populating protocols, case report forms and other data collection tools. The generic reporting table should provide clear guidance to researchers and improve the reporting of their results within journal publications and conference presentations. Research funding bodies, the Standard Protocol Items: Recommendations for Interventional Trials statement, and over 80 specialty journals have committed to implementing this core outcome set.Study Funding/competing Interest(s): This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund and Maurice and Phyllis Paykel Trust. Siladitya Bhattacharya reports being the Editor-in-Chief of Human Reproduction Open and an editor of the Cochrane Gynaecology and Fertility Group. J.L.H.E. reports being the Editor Emeritus of Human Reproduction. R.S.L. reports consultancy fees from Abbvie, Bayer, Ferring, Fractyl, Insud Pharma and Kindex and research sponsorship from Guerbet and Hass Avocado Board. B.W.M. reports consultancy fees from Guerbet, iGenomix, Merck, Merck KGaA and ObsEva. C.N. reports being the Editor-in-Chief of Fertility and Sterility and Section Editor of the Journal of Urology, research sponsorship from Ferring, and a financial interest in NexHand. E.H.Y.N. reports research sponsorship from Merck. A.S. reports consultancy fees from Guerbet. J.W. reports being a statistical editor for the Cochrane Gynaecology and Fertility Group. A.V. reports that he is a Statistical Editor of the Cochrane Gynaecology & Fertility Review Group and of the journal Reproduction. His employing institution has received payment from Human Fertilisation and Embryology Authority for his advice on review of research evidence to inform their 'traffic light' system for infertility treatment 'add-ons'. N.L.V. reports consultancy and conference fees from Ferring, Merck and Merck Sharp and Dohme. The remaining authors declare no competing interests in relation to the work presented. All authors have completed the disclosure form.Trial Registration Number: Core Outcome Measures in Effectiveness Trials Initiative: 1023. [ABSTRACT FROM AUTHOR]