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Patagonian toothfish (Dissostichus eleginoides) is an economically and ecologically important fish species in the family Nototheniidae, found at depths between 70 and 2,500 meters on the southern shelves and slopes around the sub-Antarctic islands of the Southern Ocean. Genomic sequence data for this species is limited. Here, we report a high-quality assembly and annotation of theD. eleginoidesgenome, generated using a combination of Illumina, PacBio and Omni-C sequencing technologies. To aid the genome annotation, the transcriptome derived from a variety of toothfish tissues was also generated using both short and long read sequencing methods. The final genome assembly was 797.8 Mb with a N50 scaffold length of 3.5 Mb. Approximately 31.7% of the genome consisted of repetitive elements. A total of 35,543 putative protein-coding regions were identified, of which 50% have been functionally annotated. Transcriptomics analysis showed that approximately 64% of the predicted genes (22,617 genes) were found to be expressed in the tissues sampled. Comparative genomics analysis revealed that the anti-freeze glycoprotein (AFGP) locus ofD. eleginoidesdoes not contain any AFGP proteins compared to the same locus in the Antarctic toothfish (Dissostichus mawsoni). This is in agreement with previously published results looking at hybridization signals and confirms that Patagonian toothfish do not possess AFGP coding sequences in their genome. The high-quality genome assembly of the Patagonian toothfish will provide a valuable genetic resource for ecological and evolutionary studies on this and other closely related species.

Debates over the value and contribution of community hospitals are hampered by a lack of empirical assessment of the experience of patients using these services. This paper presents findings from a study which included a focus on patient and family-carer experiences of community hospitals in England. We adopted a qualitative design involving nine case study hospitals. Data collection included interviews with patients (n = 60), carers (n = 28) and staff (n = 89). Through patients and carers highlighting the value of community hospitals feeling 'close to home', providing holistic and personalised care and supporting them through difficult transitions, the study confirms the importance of functional and interpersonal aspects of care, while also highlighting the importance of social and psychological aspects. These included having family, friends and the community close, maintaining social connections during periods of hospital treatment, and feeling less anonymous and anxious when attending the hospital due to the high levels of familiarity and connectedness. Although the experiences uncovered in this study were not uniformly positive, patients and carers placed a high overall value on the care provided by community hospitals, often arguing that these were distinctive when compared to their experiences of using other health and care services. The study suggests the need to weigh the full range of these dimensions of patient experience-functional, interpersonal, social and psychological-when assessing the role and contribution of community hospitals.

Patients are routinely advised to follow hip precautions following their total hip arthroplasty (THA) surgery. There is lack of evidence regarding compliance with these precautions and when patients return to activities of daily living following their surgery. We designed a new questionnaire to discover when patients return to their activities of daily living. Two hundred and ninety seven consecutive patients who attended 12 week follow up arthroplasty clinic following their primary elective THA were asked to complete the questionnaire. All patients who attended the follow up clinic at 12 weeks responded to the questionnaire. Only 6.3% (n = 19) of the patients reported that they restricted their daily activities, as prescribed for the full 12 week period, while 50% (n = 148) of patients stopped using prescribed adaptive equipment by 6 weeks after their operation. There were no dislocations recorded among the study group. We found that the majority of patients do not adhere to hip precautions advice. They return to their activities of daily living prior to the end of prescription period based on their pain and activity level. Lack of adherence to hip precautions do not predispose to hip dislocation in the immediate post-operative period.

A memorial tattoo is a tattoo that honors a person who has died. We aimed to understand how memorial tattoos could be an expression of a bereaved person's continuing relationship with the deceased person that the tattoo memorializes. We interviewed 41 people and used qualitative description grounded in a symbolic interactionist framework to analyze the transcripts. This research expands on continuing bonds theory by showing that memorial tattoos are an expression of the bond with the deceased as well as a way to communicate with others about their ongoing connection and to challenge stigma.

The 1980s and 1990s saw the remaking of the meaning of perinatal death in Canadian hospitals from that of the silencing to the recognition and attention to women’s grief (Davidson, 2007). By the mi...

BackgroundThe community hospital sector is characterised by high levels of upheaval, variation and dispute. Debates over the value and contribution of community hospitals are hampered by a lack of empirical assessment of the experience of patients using these services. This paper presents findings from a study of patient and family experiences in community hospitals in England.MethodsWe adopted a qualitative design involving nine case study hospitals, selected to represent a range of characteristics. Case study data collected included discovery interviews with patients (n=60) and semi-structured interviews with carers (n=28). We conducted thematic analysis of interview data.ResultsThe study confirms some of the distinctive functional and technical aspects of care associated with community hospitals, including: access to services facilities and equipment; the environment and atmosphere; information sharing; continuity, and; the potential for longer lengths of stay. The study also finds high reported levels of personalised care in community hospitals. Our study suggests the importance of additional social and psychological aspects of patient experience. Social aspects included having family and friends close, and the importance of being known and maintaining social connections during periods of hospital treatment. Psychological aspects included feeling less anonymous and frightened than they would in an acute setting, especially when coming to terms with loss and change. Conclusions Although the experiences uncovered in this study were not uniformly positive, patients and carers placed a high overall value on the distinctive qualities of the care provided by community hospitals. The study suggests the need to weigh the full range of these dimensions of patient experience – including functional, relational, social and psychological – when assessing the role and contribution of community hospitals.

We discuss strategies to promote the inclusion of people with developmental disabilities (DDs) in qualitative community-based research studies. Strategies were applied in three projects conducted between 2012 and 2017 that addressed issues of socioeconomic challenges, discrimination, and exclusion of children and young adults with developmental disabilities (YADD). Strategies included partnership with community organizations; inclusion of YADD, family caregivers (FCs), and service providers in advisory committees (ACs); and strategies to accommodate YADD. As part of our contribution, we discuss issues of invisibility and exclusion of individuals with DDs who have “low” functioning capacities. There is a need to review studies sampling inclusion criteria as they may constitute a barrier for participation. Preference for sampling “high” functioning individuals may reinforce exclusion in research, and replicate broader patterns of socioeconomic exclusion of individuals with disabilities. Our discussion of inclusive research is informed by critical disability studies and the underlying principle “nothing about us without us.”

Together and apart, we have adopted an auto/biographical approach to the work that we do and continue to engage with new (to us at least) and different ways to collect, present and archive data. Our relationship as close friends as well as colleagues is relevant here, in that not only do we support each other in our work, but we also provide each other with a safe space to make mistakes, to share ideas to experiment. In our chapter, we reflect on our individual and collective selves and focus on some of our projects—The Tattoo Project (Deborah), Doing Griefwork Through Fiction and Memoir (Gayle) and Stepford Academics (Deborah and Gayle)—to highlight our collective, creative approach and our challenge to rather than compliance with ‘expected’ approaches and practices within the academy.

My first encounter with the experience of sibling loss was with a nurse administrator in a neonatal unit that I was interviewing for my dissertation on grief and bereavement. While examining the em...

We present findings of a qualitative study exploring what constitutes relevant health promotion initiatives for immigrant mothers of children with developmental disabilities. We apply a social ecological approach, with a focus on gender-specific and transformative health promotion, to examine factors impacting mothers' health and wellbeing. Twenty-eight semi-structured and open-ended interviews were conducted with immigrant mothers in the greater Toronto area, Canada. Mothers identified facilitators, challenges, and strategies for their health promotion, providing relevant insights for meaningful intervention. Our findings show that immigrant mothers' health is influenced by intersecting social determinants of health, including migration status, gender, and disability.

… profound loss, is one fraught with a considerable degree of silence and invisibility in so much that what is often experienced is considered to be unspeakable and beyond representation (Kitzmann,...

ObjectiveTo examine the forms, scale and role of community and voluntary support for community hospitals in England.DesignA multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups.SettingCommunity hospitals in England and their surrounding communities.ParticipantsCharity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents).ResultsCommunities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers.ConclusionsCommunities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or ‘renewable’.

BackgroundGPs were a key driving force for the development of a network of community hospitals across England, and have provided medical cover for most of them. However, during the past decade there has been a significant shift, with the dominant trend appearing to be one of declining GP involvement.AimTo explore how and why the role of GPs within community hospitals in England is changing.Design and settingQualitative study in a sample of nine diverse community hospitals in England.MethodQualitative interviews with community hospital clinical staff.ResultsIn all, 20 interviews were conducted and two models of medical care observed: GPs employed by a practice and trust-employed doctors. Interviewees confirmed the trend towards declining GP involvement, with the factors driving change identified as being GP workload and recruitment challenges, a change from ‘step-up’ admissions from the community to ‘step-down’ admissions from acute hospitals, fewer local patients being admitted, increased medical acuity of patients admitted, increased burden of medical support required, and inadequate remuneration. The majority of doctors viewed community hospital work in a positive light, welcoming the opportunities for personal development and to acquire new clinical skills. GPs viewed community hospital work as an extension of primary care, adding to job satisfaction.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital work.

BackgroundCommunity hospitals have been part of England’s health-care landscape since the mid-nineteenth century. Evidence on them has not kept pace with their development.AimTo provide a comprehensive analysis of the profile, characteristics, patient experience and community value of community hospitals.DesignA multimethod study with three phases. Phase 1 involved national mapping and the construction of a new database of community hospitals through data set reconciliation and verification. Phase 2 involved nine case studies, including interviews and focus groups with patients (n = 60), carers (n = 28), staff (n = 132), volunteers (n = 68), community stakeholders (n = 74) and managers and commissioners (n = 9). Phase 3 involved analysis of Charity Commission data on voluntary support.SettingCommunity hospitals in England.ResultsThe study identified 296 community hospitals with beds in England. Typically, the hospitals were small (LimitationsThere were limitations to the secondary data available for mapping community hospitals and tracking charitable funds and to the sample of case study respondents, which concentrated on people with a connection to the hospitals.ConclusionsCommunity hospitals are diverse but are united by a set of common characteristics. Patients and carers experience community hospitals as qualitatively different from other settings. Their accounts highlight the importance of considering the functional, interpersonal, social and psychological dimensions of experience. Community hospitals are highly valued by their local communities, as demonstrated through their active involvement as volunteers and donors. Community hospitals enable the provision of local intermediate care services, delivered through an embedded, relational model of care, which generates deep feelings of reassurance. However, current developments may undermine this, including the withdrawal of GPs, shifts towards step-down care for non-local patients and changing configurations of services, providers and ownership.Future workComparative studies of patient experience in different settings; longitudinal studies of community support and value; studies into the implications of changes in community hospital function, GP involvement, provider-mix and ownership; and international comparative studies could all be undertaken.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Art, music, literature, and drama are acknowledged to have a place in the embodied experience of bereavement and increasingly are also utilized for the collection and presentation of data in the social sciences and humanities. Such work tells us much about ourselves as individuals and about our relationships with others. The concept of griefwork, which acknowledges and values the collective work the bereaved do with others, is one way to frame such endeavors during bereavement. Here, we outline some of our individual, and yet connected, creative work with reference to both our own experiences of loss and our relationship with each other. Specifically, we reflect on Deborah’s development of an online community for people with commemorative tattoos and Gayle’s exploration of new ways of writing (fiction or faction). We share examples from each project and reflect on their significance to the embodied experience of bereavement.

The biology of littoral fauna of the Falkland Islands is largely unknown. This pilot study was launched by Shallow Marine Surveys Group and was aimed at investigating life history of the Antarctic starfish, Anasterias antarctica, a dominating invertebrate predator of intertidal and subtidal, including its distribution, seasonal and ontogenetic migrations, spawning seasonality, fecundity, growth, and feeding habits. A total of 3,426 starfish were sampled in different habitats around the Falkland Islands at low tide using SCUBA diving. Sampling included measuring arm length, presence/absence of brooding and feeding; the prey was identified to the lowest taxa and measured if condition permitted. In a total of 48 broods, eggs were counted and embryonic stage assigned. This medium-sized species attains an arm length of 96 mm (85.4 g). The size increased with depth and starfish carry out seasonal bathymetric migrations with smaller animals ( 10 m depth in winter. Egg laying occurs between March and July, and juvenile dispersal—mostly in October–November. Fecundity (52–363 eggs) and egg/offspring size increase with maternal size. Juvenile starfish are of ca. 2 mm arm length and grow to 9–11 mm in 1 year. Feeding intensity is at a maximum before and after the reproductive period. Females might occasionally resume feeding when they are still brooding a small number of juveniles. The starfish prey upon isopods (Sphaeromatidae), molluscs Pareuthria spp. and variety of gastropods, bivalves chitons, barnacles, and also scavenges. Prey size increases with starfish size.

Light reflecting structures (iridophores) were examined in live Doryteuthis gahi with mantle lengths (ML) between 50 and 420 mm, both during trawl surveys onboard ship and in shallow-water spawning grounds (10–15 m depth) by SCUBA divers around the Falkland Islands. Several types of iridophores were distinguished based on their shape, colour reflection and position on the body. Ventrally, silvery iridophores cover pigmented organs such as the eyeballs and ink sac and might be used for countershading the squid body. Pink iridophores (splotches) cover the whole mantle, head, fins and arm bases. Green-red iridophores on the dorsal side of the eyeballs, as well as pink splotches on the dorsal and lateral mantle, head and arm bases can be either uncovered or masked by overlaying chromatophores. Two specific bright green stripes of iridophores develop under the fins only in females with ML .80 mm; these may be involved with distant sex recognition, both in forming unisex schools and in ‘preliminary mating’ in the twilight feeding grounds located at the shelf edge. During solitary egg laying in shallow waters, females mask these green stripes almost completely using the overlying chromatophores.

This article, derived from my doctoral dissertation ( DAVIDSON 2007 ) examining the emergence of hospital protocols for perinatal bereavement during the last half of the twentieth century in Canada, focuses on the methodological complexities – the draw, the drain, and the delight of doing qualitative research grounded in my own experience of perinatal loss. With my dissertation now a fait a complete, reflecting back on my research, my use of autoethnography at this point allows a return to a story that has already happened and involves “the construction and reconstruction’ of my personal experiences as narratives’ ( AUTREY 2003 : 10). Taking this narrative turn, my enquiry here shifts auto/biography to autoethnography as a mode of enquiry.

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

Synopsis Highly technologized care of pregnancy and childbirth, both lauded and vilified, has also seeded a countermovement of high-touch perinatal care. Employing a feminist symbolic interactionist account, this article examines the relationship between high technology and caregiver response in the high-touch care of dying or dead babies and the grief experienced by their mothers. Recognizing the distancing effects technology has on both caregiver–patient and mother–baby relationships, caregivers engaged in a countermovement of high-touch and thus repositioned themselves closer to women's experiences where they were better able to meet women's needs. When technology brings unfavourable consequences humans can, in their innovation and concern for others, reposition themselves in relation to technology, thereby modifying those unfavourable consequences.

This paper describes an action research study which focused on an exploration of the aspirations for and initial achievements of Stratham Mental Health NHS and Social Care Trust. Local leaders perceived that Stratham had a good history of health and social care partnership working and as such, adopted an integrationist view of culture to help shape the context of the new structural form. In doing so, consistency remained a key message to staff throughout this organizational transition and the change did not appear to cause the distraction to core business which the literature suggests it would do so. However, this continuity may have come at a cost, at least initially. In the process of formalizing the previous partnership into a Care Trust, Stratham may not have produced all the beneficial effects of synergy which are usually (albeit eventually) associated with mergers in the private sector. Certainly, local actors could see opportunities that had been missed. By focusing on the structural manifestation of the relationship, the opportunities to broaden informal horizontal linkages may have been underexploited. The study of Stratham serves to confirm that the integrationist conception of culture is limited and that the differentiation of professional groupings and the ambiguity of individual experience will always make contested the meanings that are attributed to organizational change.

The authors describe what happened when feminist teaching came head to breast with mothering. The authors' attempt to impact student responses to feminist theorizing in a third‐year social psychology class met with transgressions when a colleague, who had been invited as a guest‐lecturer to speak about social structure and violence against women, brought her three‐year‐old and five‐month‐old sons with her. During her presentation, when her youngest child started to fuss she breastfed him while she lectured. What followed in later class discussions informed the students about their own contradictory investments in dominant discourses, and informed the authors that a breastfeeding feminist university teacher represents transgressions in the academy. The authors discovered through a reflective and layered analysis of the incident that the breastfeeding feminist university teacher is subjected, not merely to a ‘chilly climate’ or an intellectualized ‘symbolic violence’, but, tersely—to violence—because she is...

Since the 1970s, Tamworth has become well known as Australia's ‘country music capital’. Its annual Country and Western Music Festival has become the leading event of its type in Australia, attracting over 60,000 visitors every year. The festival, and country music more generally, have become central to the town's identity and tourism marketing strategies. This article discusses the social constructions that have surrounded Tamworth's transition to ‘country music capital’—of the ‘rural’, and of ‘country’—within the context of debates about the politics of place marketing. Textual analysis of promotional material and built landscapes reveals representations of rurality (or ‘senses of the rural’). In their most commercial form, representations of rurality converge on a dominant notion of ‘country’, quite different from the ‘countryside’ and ‘rural idyll’ in England. This dominant, or normative ‘country’ forms the basis of imagery for the festival, the Town's marketing strategy, and associated advertising campaigns by major sponsors. It is predominantly masculine, white, working class and nationalist. But links between musical style and discourses of place are complex. Colonial British histories, Celtic musical traditions and North American popular culture all inform ‘country’ in Tamworth, dissipating nationalist interpretations. Normative constructions also contrast with other, heterogeneous ruralities in Australia, that include the lived experiences of rural Australians, and on stage—in country music—where multiple ‘ruralised’ identities are performed. Even those who stand to benefit from place promotion have been uncertain about country music and ‘the country’, because of associated discourses of Tamworth as ‘hick’ and ‘redneck’. In the final section of the paper, reactions of residents to constructions of Tamworth as country music capital are discussed, via the results of a simple resident survey. In contrast to previous studies of the disempowering politics of place marketing, Tamworth residents were on the whole supportive of the new associations and images for the town, despite ‘hick’ connotations, as it has become a centre for ‘country’, and for country music. Reasons for this are explored, and resistances discussed. The result is a complex and entangled politics of national identity, gender, race and class, where meanings for place are variously interpreted and negotiated.

Objectives: To determine whether offspring of centenarians acquired protection from age-related diseases. Design: Case-control study. Setting: The study was part of the Longevity Genes Project at Albert Einstein College of Medicine. Participants: Centenarians (n=145), offspring of centenarians (n=180), and spouses of the offspring of centenarians (n=75) as a control group. Two additional groups served as controls: age-matched Ashkenazi Jews, and an age-matched control group from the Third National Health and Nutrition Examination Survey. Measurements: Self-reported family history of longevity; prevalence of hypertension, diabetes mellitus, heart attacks, and strokes; and objective measurements of body mass index and fat mass. Results: Parents of centenarians (born in approximately 1870) had a markedly greater (∼sevenfold) “risk” for longevity (reaching ages 90–99), supporting the notion that genetics contributed to longevity in these families. The offspring of long-lived parents had significantly lower prevalence of hypertension (by 23%), diabetes mellitus (by 50%), heart attacks (by 60%), and strokes (no events reported) than several age-matched control groups. Conclusion: Offspring of centenarians may inherit significantly better health. The authors suggest that a cohort of these subjects and their spouses is ideal to study the phenotype and genotype of longevity and its interaction with the environment.

BACKGROUND Families of centenarians have high levels of plasma high-density lipoprotein (HDL) cholesterol, which may have neurological as well as cardiovascular protective effects during aging. Because plasma HDL level declines progressively with aging, we examined whether centenarians with higher plasma HDL levels have better cognitive function. METHODS Total plasma cholesterol, low-density lipoprotein (LDL) cholesterol, HDL, triglycerides, and apolipoprotein levels were measured in a group of centenarians (N = 139; older than 95 years) and were correlated with their cognitive function (measured by Mini-Mental State Examination [MMSE]). RESULTS Plasma HDL levels correlated significantly with MMSE (r =.32; p

he growth of the service user/survivor movement over the last 20 years has provided an opportunity for people to speak openly about their experiences of mental health services and to be involved in local health and social care organisations, regional and national initiatives, and to influence Government policy. The Government’s mental health strategy (Department of Health, 1998) and National Service Framework for Mental Health (Department of Health, 1999) emphasise a more user-centred service and state that their commitment to a modern, decent and inclusive society provides the context for mental health services. The first of the guiding values and principles of the National Service Framework states that: ‘People with mental health problems can expect that services will involve service users and their carers in planning and delivery of care.’ This principle is further echoed in the NHS Plan (Department of Health, 2000) and in the Mental Health Policy Implementation Guide (Department of Health, 2001, p6) which states that: ‘Above all, mental health services must place the needs of ... service users at the centre of their planning and their practice.’ Despite government intentions to put the service user at the centre, there is little evidence of this in the application of policy and practice at a local level. The IAHSP’s work with approximately 50 local implementation teams in the South East, North West, South West and Trent regions of England shows that 90% of their plans and actions do not include user involvement. There are pockets of good practice but T in the main this is limited to involvement on the local implementation teams in commissioning services and, in a few cases, on the boards of trusts. There has also been little action on other stated aims of the National Service Framework – promoting mental health, tackling stigma and discrimination, person-centred planning or promoting independence – and no targeted action in relation to a key issue that service users want; that is, involvement in care planning and treatment provision.

This article describes and reflects on the standards set out in the new National Service Framework for Mental Health, as they relate to policy development in mental health and social inclusion. It highlights both positive contributions and missed opportunities.

Purpose: High grade prostatic intraepithelial neoplasia is considered the most likely precursor of prostatic adenocarcinoma. However, the natural history and predictive value of prostatic i...

Background Gaps between research knowledge and practice have been consistently reported. Traditional ways of communicating information have limited impact on practice changes. Strategies to disseminate information need to be more interactive and based on techniques reported in systematic reviews of implementation of changes. There is a need for clarification as to which dissemination strategies work best to translate evidence into practice in neonatal units across England. The objective of this trial is to assess whether an innovative active strategy for the dissemination of neonatal research findings, recommendations, and national neonatal guidelines is more likely to lead to changes in policy and practice than the traditional (more passive) forms of dissemination in England. Methods/design Cluster randomised controlled trial of all neonatal units in England (randomised by hospital, n = 182 and stratified by neonatal regional networks and neonatal units level of care) to assess the relative effectiveness of active dissemination strategies on changes in local policies and practices. Participants will be mainly consultant lead clinicians in each unit. The intervention will be multifaceted using: audit and feedback; educational meetings for local staff (evidence-based lectures on selected topics, interactive workshop to examine current practice and draw up plans for change); and quality improvement and organisational changes methods. Policies and practice outcomes for the babies involved will be collected before and after the intervention. Outcomes will assess all premature babies born in England during a three month period for timing of surfactant administration at birth, temperature control at birth, and resuscitation team (qualification and numbers) present at birth. Trial registration Current controlled trials ISRCTN89683698

To determine whether offspring of centenarians acquired protection from age-related diseases.Case-control study.The study was part of the Longevity Genes Project at Albert Einstein College of Medicine.Centenarians (n=145), offspring of centenarians (n=180), and spouses of the offspring of centenarians (n=75) as a control group. Two additional groups served as controls: age-matched Ashkenazi Jews, and an age-matched control group from the Third National Health and Nutrition Examination Survey.Self-reported family history of longevity; prevalence of hypertension, diabetes mellitus, heart attacks, and strokes; and objective measurements of body mass index and fat mass.Parents of centenarians (born in approximately 1870) had a markedly greater ( approximately sevenfold) "risk" for longevity (reaching ages 90-99), supporting the notion that genetics contributed to longevity in these families. The offspring of long-lived parents had significantly lower prevalence of hypertension (by 23%), diabetes mellitus (by 50%), heart attacks (by 60%), and strokes (no events reported) than several age-matched control groups.Offspring of centenarians may inherit significantly better health. The authors suggest that a cohort of these subjects and their spouses is ideal to study the phenotype and genotype of longevity and its interaction with the environment.