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Dystocia, a prolonged or non-progressive birth event, is the main contributor to lamb mortality in Australia and across the world. Dystocia can cause neonatal hypoxia, central nervous system (CNS) damage leading to increased risk of starvation, exposure and mismothering, and death. These prolonged birth events can also cause fatigue, injury and death in the ewe. Dystocia may interrupt the expression of maternal behaviour and the strength of the ewe-lamb bond, and consequently lamb survival. This study focused on the effect of dystocia on ewe behaviour in the 2 h post-lambing. A total of 18 ewes were chosen for continuous behaviour annotation and analysis (dystocic (n = 9) and eutocic (n = 9)) based on the quality of video recordings, length of stage 2 parturition and classification by a single experienced observer. Dystocic ewes showed significantly lower expression of maternal behaviours and a significantly greater expression of avoidance behaviours compared to eutocic ewes. Additionally, dystocic ewes performed fewer behaviours in total compared to eutocic ewes. Dystocia can significantly affect the quality and quantity of ewe maternal behaviour expression, leading to increased avoidance of the lamb, increased risk of maternal disinterest, and increased risk of death for the lamb. If dystocic events can be identified quickly and accurately, measures can be taken to ensure the ewe and lamb recover successfully.

The Eemian (~130 to 115 ka yr BP), also called Marine Isotope Stage (MIS) 5 or the Last Interglacial, was the most recent interglacial period prior to the Holocene. Since temperatures during the Eemian were, on average, ~2 °C warmer than today, studies of this period offer insights into how variables like effective moisture may change under near-future warming scenarios. Such information could improve climate projections for drought-prone regions like the Mediterranean that are particularly vulnerable to future warming. Therefore, a study was initiated to investigate carbonate-rich, Eemian-aged sediments from Padul Wetland (southern Iberia), a site which contains one of the oldest (>200 ka yr) continuous sediment records in the Mediterranean. The resulting proxy record includes stable isotope (δ13C and δ18O) and clumped isotope (Δ47) compositions of aquatic gastropods (e.g., Radix balthica, Anisus spirorbis) and bivalves (e.g., Pisidium sp.). An age-depth model for the entire 200 000-year record was previously established using a mixture of 43 Accelerator Mass Spectrometry (AMS) radiocarbon dates, 10 Amino Acid Racemization (AAR) dates from gastropods (hydrobiid Milesiana schuelei), and two different sediment accumulation rates (SAR) for peat and carbonate/marl lithologies. Variations in δ18O and δ13C closely correspond with the Pollen Climate Index (PCI) for Padul, which is used to discriminate between cold/arid and warm/humid conditions. The close resemblance of these records suggests that variations in δ18O and δ13C at Padul are also sensitive to moisture changes. Variations in δ18O and δ13C of shelly fauna at Padul also resemble shifts in δ18O from the NGRIP ice core(Greenland) and alkenone-based marine sea surface temperature (SST) records of the western Mediterranean region. Similarities among these records underscore the sensitivity of Padul Wetland to regional- and global-scale climatic changes as well as more local moisture variations. One measurement of Δ47 in the aquatic gastropod Radix balthica suggests that average temperatures at Padul during the Eemian were 19.7 ± 2.6 °C, which is consistent with marine records from the Iberian margin. The interpretation of Δ47 in Pisidium sp. is more complicated, perhaps due to vital effects or because Pisidium sp. have highly variable lifespans and individuals that lived only a few months may not reflect average annual conditions. In summary, the stable and clumped isotope records generated in this ongoing study build on previous Eemian-aged reconstructions from southern Iberia by providing higher resolution proxy data constrained by quantitative temperature reconstructions. This research deepens our understanding of how effective moisture in southern Iberia may change in the near future.

Significance This report outlines a case of progressive bilateral granulomatous panuveitis secondary to syphilis. Purpose To describe the management of a case of progressive uveitis secondary to syphilis. Case Report A 60-year-old male with a three-month history of redness and floaters presented with bilateral chronic granulomatous anterior uveitis. He was started on difluprednate emulsion four times a day in each eye. The patient’s clinical course improved until he tapered off the drops, upon which he presented with a progressive bilateral panuveitis. A diagnostic work-up in collaboration with the hospital infectious disease department led to a diagnosis of neurosyphilis. The patient was treated with intravenous penicillin with eventual resolution of his ocular inflammation. Conclusions This case report underscores the importance of obtaining a detailed case history and taking a multi-disciplinary approach to patients with progressive uveitis. CE Notification This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/ocular-syphilis-a-case-of-progressive-bilateral-panuveitis) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.

In developing countries, animal welfare concerns do not receive the same recognition as they do in higher-income countries, from policy and law, through to consumer awareness and purchasing options.While traditional farmers often have close bonds with their animals, knowledge and action gaps often limit more animal-friendly production.In some developing countries, livestock production has already largely commercialized and intensified. In these countries, citizens are becoming increasingly aware and sensitive to animal welfare issues, but animal welfare does not yet affect purchasing decisions.Future scenarios with higher animal welfare are possible, but will require joint efforts by various stakeholders in the livestock sector.Overall, much more research on animal welfare perceptions in developing countries is needed.

This research provides a critical baseline for chemical and macromolecular characteristics of organic matter (OM) sources in high-elevation lake sediments. Such studies are essential for accurate paleoenvironmental interpretation of organic matter characteristics, particularly in mountain regions where steep environmental gradients lead to spatially variable OM inputs among lakes. We analyzed the carbon- and nitrogen-isotope compositions (δ13CTOC, δ15NTN), and total organic carbon to total nitrogen atomic ratios (TOC:TN), of whole tissues of modern vegetation, lichen and algae from Uinta Mountain lakes, along with the abundances and carbon- and hydrogen-isotope compositions of n-alkanes (δ13Cn-alkane, δ2Hn-alkane). TOC:TN can be used to distinguish between aquatic and terrestrial sources, but the differentiating values are higher in the Uinta Mountains than in low-elevation regions. Chain lengths of n-alkanes are more useful than n-alkane isotope compositions for differentiating between terrestrial and semi-aquatic sources in the Uinta Mountains. The ratio of n-alkanes C23 to C27 in mountain lake sediment OM can be used to detect inputs from coniferous krummholz trees and may serve as a proxy for treeline position. We used the isotope data from n-alkanes to calculate the carbon-isotope fractionation between atmospheric carbon dioxide and the n-alkane C23 (ɛbulk), and the hydrogen-isotope fractionation between source water and the n-alkane C25 (ɛwater). These fractionation factors, and the isotope compositions of n-alkanes extracted from lake sediments, suggest that the δ13C of atmospheric CO2 was − 7.0 ± 2‰ and the δ2H of precipitation was − 133 ± 7‰ at ~ 1400 CE in this region. These calculations demonstrate potential applications of our results for obtaining additional paleoclimatic information from paleolimnological organic matter archives.

Human parechovirus (HPeV) is an increasingly recognised cause of severe illness and central nervous system infection in infants. Medium- to long-term neurodevelopmental outcomes post-HPeV infection remain unknown. This study aims to assess neurodevelopmental outcomes for children hospitalised as infants with HPeV infection in their second and third years of life.This prospective cohort study followed children hospitalised with HPeV in Brisbane, Queensland during the 2017/2018 outbreak. Serial application of Ages and Stages Questionnaire (ASQ) was used to assess developmental progress in the second and third years of life. Data from clinical follow-up, audiology and neuroradiology were included.In the second year of life, 63% (n = 29) of children showed some or significant concerns for developmental delay. This had largely been ameliorated by the third year of life when only 30% (n = 14) reported developmental concerns. Prematurity and apnoeas were associated with developmental concerns at 27-36 months of age. Communication was the most common domain of concern.The majority of infants hospitalised with HPeV infection in 2017-2018 showed normalisation of developmental progress by 27-36 months of age. Further investigation into more subtle neurological impairments in later childhood is required. These results can help guide clinicians in counselling parents during the acute illness and in planning appropriate follow-up.

Background: Social isolation and loneliness are more common in older adults and are associated with a serious impact on their well-being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID-19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID-19 restrictions. Objectives: To map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings. Search methods: We searched the following databases from inception to 16 May 2021 with no language restrictions: Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos. Selection criteria: Titles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria. Data collection and analysis: We developed and pilot tested a data extraction code set in Eppi-Reviewer and data was individually extracted and coded. Main results:We included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID-19 pandemic.The evidence is unevenly distributed with clusters predominantly in high-income countries and none in low-income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews.No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at-risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS-Plus categories. Authors' conclusions: The restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high-quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.

Background: Lyme Borreliosis accounts for less than 1% of all uveitis cases. The challenge in diagnosing Lyme-associated uveitis in a seropositive patient is determining whether the serology status is causative or incidental. We describe a case that illustrates this challenge: a post-fever retinitis in a patient with persistent positive Lyme serology. Case Presentation: A patient presented to the eye clinic with complaints of blur and foreign body sensation in his right eye after getting sawdust in his eye. Further lab workup was only remarkable for Lyme IgG and IgM and the patient was subsequently diagnosed with a post-fever retinitis. Management and Outcomes: The patient was treated with oral prednisone, and a subsequent IOP spike was managed with topical ocular hypotensive drops until the course of steroid therapy was completed. The uveitis resolved over seven weeks. Conclusions: Post-fever retinitis is a diagnosis of exclusion, and diagnosis can be challenging in the presence of positive serology for other known causes of uveitis. This case highlights the importance of detailed case history and clinical findings in determining alternative causes of uveitis in patients with positive LB serology. CE Notification: This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/a-case-of-post-fever-retinitis-in-a-patient-with-positive-lyme-borreliosis-serology) Please check COPE course expiry date prior to enrollment. The COPE course test must be taken before the course expiry date.

Status epilepticus is associated with significant morbidity and mortality. While vaccine-proximate status epilepticus (VP-SE) has rarely been associated with cases of Dravet syndrome, it is not known whether VP-SE differs clinically from non-vaccine proximate status epilepticus (NVP-SE).Medical records of children aged ≤24 months, presenting to one of five Australian tertiary pediatric hospitals with their first episode of status epilepticus from 2013 to 2017 were identified using ICD-coded discharge diagnoses. Vaccination history was obtained from the Australian Immunisation Register. Hospitalization details, subsequent epilepsy diagnosis, and vaccination uptake were compared between VP-SE and NVP-SE cases.Of 245 first status epilepticus hospitalization with immunization records, 35 (14%) were VP-SE and 21 (60%) followed measles-containing vaccines. Vaccine-proximate status epilepticus cases had a median age of 12.5 months [IQR 7.1-14.73], 23 (66%) were in males, 15 (43%) were febrile status epilepticus and 17 (49%) had an infection confirmed. There were no significant differences in hospitalization duration (P = 0.50) or intensive care unit admission (P = 0.42) between children with VP-SE compared to children with NVP-SE. Children with no history of seizures at their first VP-SE had longer hospitalizations, were more likely to require intensive care unit admission, but were less likely to have a subsequent diagnosis of epilepsy than children with previous seizures at their first VP-SE.First VP-SE was predominantly associated with a measles-containing vaccine at 12-months of age. Seizure severity was no different between first VP-SE and first NVP-SE. In children with VP-SE, subsequent seizure admissions and epilepsy diagnosis were associated with having seizure prior to their first SE.

Children with severe needle phobia find vaccination extremely distressing and can remain unvaccinated, which puts them at an increased risk of contracting and transmitting vaccine preventable disease. Referral to a specialist or hospital service may occur when they cannot be safely vaccinated in the community, but engagement of allied health services can be inconsistent. The aim of the study was to assess the impact of a multidisciplinary, consumer-oriented model of care on vaccinations for needle phobic children.Needle phobic children aged between 6 and 16 years attended multidisciplinary consultation, as part of a care package, to assess previous experiences and determine the level of intervention that was required to support vaccination. A multidisciplinary case meeting followed this appointment and an individualised plan formulated for each patient. The main outcome of the project was rate of successful vaccination.The care package resulted in a successful vaccination rate of 83% (n = 20) with 69 vaccines administered across three clinics. Of those successful, 90% required multiple injections per visit. The majority of patients indicated moderate to high level of anxiety. Supportive care was escalated and de-escalated as tolerated.Results demonstrate the diversity of patients presenting with needle phobia and indicate an individualised, collaborative approach is preferable to a 'one size fits all' model of care. The study highlights a need for the development of guidelines that streamline the assessment and individualisation of procedural anxiety plans to meet patient needs and embed these processes into standard care.

Background The COVID-19 era has been characterized by the politicization of health-related topics. This is especially concerning given evidence that politicized discussion of vaccination may contribute to vaccine hesitancy. No research, however, has examined the content and politicization of legislator communication with the public about vaccination during the COVID-19 era. Objective The aim of this study was to examine vaccine-related tweets produced by state and federal legislators during the COVID-19 era to (1) describe the content of vaccine-related tweets; (2) examine the differences in vaccine-related tweet content between Democrats and Republicans; and (3) quantify (and describe trends over time in) partisan differences in vaccine-related communication. Methods We abstracted all vaccine-related tweets produced by state and federal legislators between February 01, 2020, and December 11, 2020. We used latent Dirichlet allocation to define the tweet topics and used descriptive statistics to describe differences by party in the use of topics and changes in political polarization over time. Results We included 14,519 tweets generated by 1463 state legislators and 521 federal legislators. Republicans were more likely to use words (eg, “record time,” “launched,” and “innovation”) and topics (eg, Operation Warp Speed success) that were focused on the successful development of a SARS-CoV-2 vaccine. Democrats used a broader range of words (eg, “anti-vaxxers,” “flu,” and “free”) and topics (eg, vaccine prioritization, influenza, and antivaxxers) that were more aligned with public health messaging related to the vaccine. Polarization increased over most of the study period. Conclusions Republican and Democratic legislators used different language in their Twitter conversations about vaccination during the COVID-19 era, leading to increased political polarization of vaccine-related tweets. These communication patterns have the potential to contribute to vaccine hesitancy.

BACKGROUND The COVID-19 era has been characterized by the politicization of health-related topics. This is especially concerning given evidence that politicized discussion of vaccination may contribute to vaccine hesitancy. No research, however, has examined the content and politicization of legislator communication with the public about vaccination during the COVID-19 era. OBJECTIVE The aim of this study was to examine vaccine-related tweets produced by state and federal legislators during the COVID-19 era to (1) describe the content of vaccine-related tweets; (2) examine the differences in vaccine-related tweet content between Democrats and Republicans; and (3) quantify (and describe trends over time in) partisan differences in vaccine-related communication. METHODS We abstracted all vaccine-related tweets produced by state and federal legislators between February 01, 2020, and December 11, 2020. We used latent Dirichlet allocation to define the tweet topics and used descriptive statistics to describe differences by party in the use of topics and changes in political polarization over time. RESULTS We included 14,519 tweets generated by 1463 state legislators and 521 federal legislators. Republicans were more likely to use words (eg, “record time,” “launched,” and “innovation”) and topics (eg, Operation Warp Speed success) that were focused on the successful development of a SARS-CoV-2 vaccine. Democrats used a broader range of words (eg, “anti-vaxxers,” “flu,” and “free”) and topics (eg, vaccine prioritization, influenza, and antivaxxers) that were more aligned with public health messaging related to the vaccine. Polarization increased over most of the study period. CONCLUSIONS Republican and Democratic legislators used different language in their Twitter conversations about vaccination during the COVID-19 era, leading to increased political polarization of vaccine-related tweets. These communication patterns have the potential to contribute to vaccine hesitancy.

Proliferative diabetic retinopathy (PDR) is the leading cause of preventable vision loss and visual disability amongst working-age adults in the United States. Complications include neovascularization of the iris, retina, and optic disc, which can lead to vitreous hemorrhage, tractional retinal detachment, and neovascular glaucoma. Treatment options for PDR include pan-retinal photocoagulation (PRP) and intravitreal antivascular endothelial growth factor (VEGF) injection. The case of a 48-year-old male Caucasian with PDR and associated complications is presented. CE Notification This article is available as a COPE accredited CE course. You may take this course for 1-hour credit. Read the article and take the qualifying test to earn your credit. Click here to Enroll (https://www.crojournal.com/proliferative-diabetic-retinopathy-a-case-review)

Introduction: Studies in critically ill children within paediatric intensive care units (PICU) experience an ethical dilemma in that life-saving interventions may not allow time for prospective consent to be obtained from legal guardians. In certain circumstances there is insufficient time to consent before the intervention is performed. Objectives/Aims: This descriptive analysis aimed to identify the most common challenges to obtaining prospective consent in a randomised controlled trial (RCT) conducted within a tertiary PICU and examine how these challenges may affect recruitment of suitable study participants. Methods: Data pertaining to consent was collected at the recruitment stage of a large RCT conducted within Queensland Children’s Hospital PICU. Data included whether recruitment was via prospective or deferred consent. In the deferred consent group, researchers specified whether the parent had a prior awareness of the study and recorded reason/s why if the parent was unaware. Results: At the 2-year mark, results indicated 16% (n=49) of participants were recruited using prospective consent, with the remainder (n=252) recruited using deferred consent. Eighty-nine parents in this group had no knowledge of the study prior to the intervention occurring. Sixteen (18%) parents were too distressed to approach, 61 (69%) parents were not at the bedside, and 19 (21%) patients experienced a rapid or unexpected deterioration. Eight had “other” or “unknown” reasons recorded by research staff. Conclusion: Commonly cited challenges to prospective consent included the emergent nature of the intervention, the absence of a legal guardian, and parental distress indicating a lack of capacity to provide informed consent. This information highlights the need to consider alternate methods of consent in clinical trials within PICU. Although it should be the preferred option, prospective consent is not always possible. Deferred consent was well accepted with an absence of parental complaints regarding the consent process.

The aim of this pilot study was to explore the prevalence and quality of violent thoughts and fantasies of a non-violent community sample. A secondary aim was to identify the extent to which violent thoughts and fantasies were related to anger.Nineteen adults took part in the study which used a repeated measures design. Participants were asked to complete an anger assessment (STAXI-2; Spielberger, 1999) and to take part in two semi-structured interviews which enquired about the experience of violent thoughts and fantasies.A thematic analysis (Braun & Clark, 2006) yielded a number of themes including ‘desire’ and ‘elaboration’. When paired with psychometric results a relationship between violent thoughts and fantasies and high experience/low control of anger was found. This study provides evidence that violent thoughts and fantasies are associated with anger control rather than anger expression. A model designed to expand on the analysis and explore in more detail the antecedents and progressive links between anger, violent thought and fantasies has been developed and is presented herein and may be of use to professionals working with violent fantasies in clinical and non-clinical settings.

Porphyromonas gingivalis is a bacterium associated with chronic periodontitis that possesses a family of genes encoding hemagglutinins required for heme acquisition. In this study we generated ΔhagB and ΔhagC mutants in strain W83 and demonstrate that both hagB and hagC are required for adherence to oral epithelial cells. Unexpectedly, a double ΔhagB/ΔhagC mutant had less severe adherence defects than either of the single mutants, but was found to exhibit increased expression of the gingipain-encoding genes rgpA and kgp, suggesting that a ΔhagB/ΔhagC mutant is only viable in populations of cells that exhibit increased expression of genes involved in heme acquisition. Disruption of hagB in the fimbriated strain ATCC33277 demonstrated that HagB is also required for stable attachment of fimbriated bacteria to oral epithelial cells. Mutants of hagC were also found to form defective single and multi-species biofilms that had reduced biomass relative to biofilms formed by the wild-type strain. This study highlights the hitherto unappreciated importance of these genes in oral colonization and biofilm formation.

This article is a case study of a five year old boy, Peter, and his entry and development within a classic Boxall Nurture Group. The author explores nurture groups in general as well as describing Peter's assessment, his challenging behaviour, the support he received and the final outcomes of the work.

Rebecca Doyle set up the first nurture group in Thetford Education Action Zone in 2000. In 2001, she published an account of her work to reintegrate pupils from the nurture group into the mainstream of their infant school in the pages of BJSE. In this article, Rebecca Doyle describes how mainstream class teachers requested further support in working with socially and emotionally vulnerable children in their classes using the principles and practices from the nurture group. A social development curriculum was written to support this interest, offering mainstream staff a planning tool to complement their existing schemes of work and to help in the drive to make the curriculum appropriate for every child, regardless of their barriers to learning. This article indicates that mainstream staff are now able to bring the increasing knowledge of nurture group working to the fore in their planning, supporting the development of whole-school nurturing approaches. The social development curriculum has become a well-used document alongside current planning frameworks, supporting staff in meeting the diverse needs of pupils within mainstream classrooms with minimal cost and little additional workload. In closing her article, Rebecca Doyle argues that the social development curriculum has had a positive impact upon the pupils in her school and upon her colleagues on the staff. She is pursuing her research into nurturing approaches through her membership of the National Nurture Group Network and her studies for a higher degree at the University of East Anglia.

This article describes how establishing a nurture group in a challenging infant school had a profound effect on whole school development. Since May 2000 the nurture group has been the hub of an evolutionary process, which the author was able to experience at first hand as the nurture group teacher. Under her guidance, all mainstream classrooms became increasingly nurturing and the impact of the nurture group practices became entrenched in the policies and practices of the whole school. This has had a significant, positive impact for a number of the most vulnerable pupils with social, emotional and behavioural difficulties and their mainstream peers. The mainstream application of these principles supported the school's evolution from special measures in 1997 to its current position, judged by Ofsted as a good school, representing good value for money and very effective in helping pupils with special educational needs.

The aim of this manual is to improve the welfare of dairy cattle in tropical developing countries, and by doing so, optimise cow and herd performance. It gives the stockmen and farmers directly concerned with the cattle a better understanding of animal behaviour and the ways cattle communicate their comfort or distress. The book discusses normal cattle behaviour and shows how domestication and breeding can affect behaviour to achieve high levels of production of milk, live weight gain and fertility. Animal welfare is important for producers because it can affect the health, production and contentment of cows. Animal welfare practices which adversely affect cow and herd performance on tropical small holder dairy farms are identified. Advice is then given to change the animal's environment or modify a handler's technique to ensure cattle have the degree of comfort needed to achieve more profitable and sustainable systems of livestock farming. Cow Talk will be a beneficial resource for farmers who want to improve animal welfare, farm advisers who can assist farmers to improve their welfare practices, educators who develop training programs for farmers and dairy advisers, and other stakeholders in tropical dairy production such as local agribusiness, policy makers and research scientists.

The development of a Nurture Group can help a whole school to become ‘a more inclusive, nurturing establishment’, according to Rebecca Doyle. In this article she describes the evolution of a detailed Reintegration Readiness Scale, building on Nurture Group principles and practices. Two case studies illustrate the kinds of progress that can be made by individual pupils. This article goes on to note the benefits that nurturing approaches can bring to the whole school community and to indicate further developments for the future. Rebecca Doyle runs the Nurture Group at Canterbury Infant School in Thetford and used a DfEE-funded Best Practice Research Scholarship to develop the approaches she details in this practical and thought-provoking report.

Objective: The aim of this paper is to present the Mental Health Consumer Perceptions and Experiences of Services (MH-CoPES) Framework and discuss its development. The Framework was developed to address the need for a consistent approach across New South Wales mental health services for consumer involvement in service evaluation and planning. Conclusions: A four step Framework has been developed for implementation across adult public mental health services in NSW. The Framework focuses not only on collecting consumers’ views of mental health services but on ensuring that procedures to report on and make changes based on this information are in place.

Melting of the Laurentide Ice Sheet led to a freshening of the North Atlantic Ocean that may have caused brief periods of global cooling. The pathways of this meltwater flow across North America remain contested. One proposed route is through the modern-day Georgian Bay, followed by the Kirkfield-Fenelon Falls (K-FF) outlet, Lake Ontario and the St. Lawrence River. We attempted to better constrain the timing of glacial meltwater travelling along this route by collecting a piston core (PC-5) from the Lake Simcoe basin, which is between the Georgian Bay and K-FF outlet. Ostracod species from PC-5 were enumerated and analyzed to determine their oxygen isotope composition (δ18Ovalve), which was used to estimate δ18Olake water. The basal sections of PC-5 were likely deposited by glacial Lake Algonquin because (i) these sections were comprised of grey, laminated clays typical of glacial lakes; (ii) ostracod assemblages in this section were dominated by the cold-tolerant species Candona subtriangulata; and the meanδ18Olake water of ostracods in this section was ~ –16 ‰, consistent with previous estimates of δ18Olake water of glacial Lake Algonquin. A ~12 ‰ rise in δ18Olake water, the disappearance of C. subtriangulata, and an increase in grain size suggest that Lake Algonquin began to stop flowing through the Lake Simcoe basin ~12 050 cal yr BP. A reappearance of C. subtriangulata between ~10 699 and 10 591 cal yr BP is indicative of a final meltwater pulse. The timing of this meltwater pulse, coupled with the return to low δ18Olake water (–16.1±1.6 ‰ to –13.6±1.6 ‰), is consistent with the discharge of Early Lake Mattawa through the Lake Simcoe basin. This finding suggests that meltwaters may have passed though the K-FF corridor as late as ~10 591 cal yr BP, although additional research is needed to confirm this possibility.