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We conducted an analysis of a nationwide survey of US physician offices between 2016 and 2019 and calculated annualized prevalence rates of urinary tract infections (UTIs). During the 3-year study period, UTI was the most common infection in US physician offices, accounting for approximately 10 million annualized encounters.
When Mr Cyril Worthing fell and suffered InjUrieS during his inspection of building work at the Richmond Air Force Base there was not only an alleged gap in the scaffolding but also a very significant gap in the law. For when he sued the defendant contractors for damages for breach of alleged statutory duty under the Scaffolding and Lifts Act, 1912-1965 of New South Wales, the High Court held in Worthing v. Rowell and Muston Pty Ltd and Others that the State scaffolding regulations, made after the Commonwealth's acquisition, did not apply in “places acquired by the Commonwealth for public purposes” within the meaning of section 52(i.) of the Constitution.
Section 52(i.) of the Constitution provides as follows:
52. The Parliament shall, subject to this Constitution, have exclusive power to make laws for the peace, order, and good government of the Commonwealth with respect to—
(i) The seat of government of the Commonwealth, and all places acquired by the Commonwealth for public purposes.
Adolescent disclosure and information management with parents have been significantly examined within the last two decades for good reason, as it allows researchers to understand how adolescents are balancing both autonomy and relatedness within this important relationship and developmental period. However, parents are not the only close relationship partners that adolescents must learn to navigate this balance with; siblings and friends are also important confidants throughout adolescence and disclosure to these more egalitarian relationships is both similar to and different from disclosure to parents. In this chapter, we compare and contrast the frequency and content of adolescent disclosure to parents, siblings, and friends, as well as the ways in which disclosure affects each of these relationships and adolescent well-being. Finally, we examine the limitations of the current information management literature across these relationships and offer future directions toward integrating these literatures.
Validated computerized assessments for cognitive functioning are crucial for older individuals and those at risk of cognitive decline. The National Institutes of Health (NIH) Toolbox Cognition Battery (NIHTB-CB) exhibits good construct validity but requires validation in diverse populations and for adults aged 85+. This study uses data from the Assessing Reliable Measurement in Alzheimer’s Disease and cognitive Aging study to explore differences in the factor structure of the NIHTB-CB for adults 85 and older, Black participants versus White participants, and those diagnosed as amnestic Mild Cognitive Impairment (aMCI) vs cognitively normal (CN).
Method:
Subtests from the NACC UDS-3 and NIHTB-CB were administered to 503 community-dwelling Black and White adults ages 55–99 (367 CN; 136 aMCI). Confirmatory factor analyses were used to investigate the original factor structure of NIHTB-CB that forms the basis for NIHTB-CD Index factor scores.
Results:
Factor analyses for all participants and some participant subsets (aMCI, White, 85+) substantiated the two anticipated factors (Fluid and Crystallized). However, while Black aMCI participants had the expected two-factor structure, for Black CN participants, the List Sorting Working Memory and Picture Sequence tests loaded on the Crystallized factor.
Conclusions:
Findings provide psychometric support for the NIHTB-CB. Differences in factor structure between Black CN individuals and Black aMCI individuals suggest potential instability across levels of cognitive impairment. Future research should explore changes in NIHTB-CB across diagnoses in different populations.
Most of the Ross Sea has been designated a marine protected area (MPA), proposed ‘to protect ecosystem structure and function’. To assess effectiveness, the Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR) selected Adélie (Pygoscelis adeliae) and emperor (Aptenodytes forsteri) penguins, Weddell seals (Leptonychotes weddellii) and Antarctic toothfish (Dissostichus mawsoni) as ecosystem change ‘indicator species’. Stable for decades, penguin and seal populations increased during 1998–2018 to surpass historical levels, indicating that change in ecosystem structure and function is underway. We review historical impacts to population trends, decadal datasets of ocean climate and fishing pressure on toothfish. Statistical modelling for Adélie penguins and Weddell seals indicates that variability in climate factors and cumulative extraction of adult toothfish may explain these trends. These mesopredators, and adult toothfish, all prey heavily on Antarctic silverfish (Pleuragramma antarcticum). Toothfish removal may be altering intraguild predation dynamics, leading to competitive release of silverfish and contributing to penguin and seal population changes. Despite decades of ocean/weather change, increases in indicator species numbers around Ross Island only began once the toothfish fishery commenced. The rational-use, ecosystem-based viewpoint promoted by CCAMLR regarding toothfish management needs re-evaluation, including in the context of the Ross Sea Region MPA.
This paper addresses challenges in pediatric urotherapy, focusing on low patient compliance and motivation. Informed by creative sessions with children aged 9-13y, a novel urotherapy ecosystem concept is designed. It includes a smart drinking bottle, context-aware reminder watch, home uroflowmeter, smartphone app, and clinician portal. Interconnected products, embodied interaction, stigma-free design, and a digital training buddy aim to enhance engagement, motivation, and patient experience. This concept showcases the potential of integrating diverse design methodologies in healthcare design.
Type 1 diabetes (T1D) is a chronic autoimmune disease characterised by a deficiency in insulin production and consequent hyperglycaemia. A glycated haemoglobin (HbA1c) value < 53 mmol/mol (< 7%) is recommended to reduce the risk for diabetes-specific complications(1). However, most adolescents and young adults (AYAs) have an HbA1c above the target(2). Dietary behaviours, including a routine meal plan with snacks, play a significant role in self-management(3). Snacks without an insulin bolus, grazing or snacking to cope with stress contribute to out-of-target glucose levels. Although modifying AYAs’ snacking behaviours could be a low-cost, equitable, and effective approach to improving glycaemic control, there is a dearth of evidence to inform effective snacking interventions. Importantly, no brief, validated tool exists to assess snacking behaviour among individuals with T1D. This research explored the acceptability and feasibility of validating a snacking questionnaire adapted for AYAs with T1D; a crucial step before a larger validation study. Twenty-five AYAs (aged 13-20 years) with T1D and receiving diabetes care through Te Whatu Ora Southern were invited to participate in a feasibility study. Purposive sampling was used for maximum variability in participants’ demographic characteristics. All study procedures were completed remotely, with electronic questionnaires administered in the morning via a secure web platform. On days 1 and 8 of the 8-day study, participants completed a 30-item snacking questionnaire that assessed the timing and frequency of snacking and types of food or drinks consumed as a snack in the past seven days. The snacking questionnaire was adapted from questionnaires previously used in population-level surveys. An experienced diabetes dietitian ensured that items reflected foods commonly consumed by AYAs with T1D. Before recruitment, two diabetes dietitians and a young adult with T1D critically reviewed the adapted snacking questionnaire. On days 2-8, participants recalled their snacking behaviour (timing, frequency, food/drink consumed) over the previous day. The proportion of completed snacking questionnaires assessed feasibility, defined as a response rate ≥ 80%. The ease of completing the snacking questionnaires was self-reported on a Likert-type scale (1-completely agree, 5-completely disagree) to assess acceptability, defined as ≤ 20% of participants reporting the questionnaires were not easy to complete. Participants (n = 10) were aged 16.2 ± 1.69 years, 60% male, and 90% self-identified as New Zealand or Other European. All participants completed the proposed validation study. Most (95%) of the snacking questionnaires were completed. All (100%) daily snacking behaviour questionnaires were completed. All participants (100%) agreed that the questionnaires were easy to complete. The snacking behaviours questionnaire validation procedures are feasible and acceptable to New Zealand and Other European AYAs with T1D. Feasibility and acceptability must be explored among ethnically diverse AYAs before conducting a larger rigorous validation study.
Aortopathy in Turner syndrome is associated with aortic dilation, and the risk of dissection is increased when the aortic size index is ≥ 2–2.5 cm/m2. We evaluated the aortic biophysical properties in paediatric Turner syndrome using cardiac MRI to determine their relationship to aortic size index.
Methods:
Turner syndrome patients underwent cardiac MRI to evaluate ventricular function, aortic dimensions, and biophysical properties (aortic stiffness index, compliance, distensibility, pulse wave velocity, and aortic and left ventricular elastance). Spearman correlation examined correlations between these properties and aortic size index. Data was compared to 10 controls.
Results:
Of 25 Turner syndrome patients, median age 14.7 years (interquartile range: 11.0–16.8), height z score −2.7 (interquartile range: −2.92 – −1.54), 24% had a bicuspid aortic valve. Turner syndrome had increased diastolic blood pressure (p < 0.001) and decreased left ventricular end-diastolic (p < 0.001) and end-systolic (p = 0.002) volumes compared to controls. Median aortic size index was 1.81 cm/m2 (interquartile range: 1.45–2.1) and 7 had an aortic size index > 2 cm/m2. Aortic and left ventricular elastance were greater in Turner syndrome compared to controls (both p < 0.001). Increased aortic size index correlated with increased aortic elastance (r = 0.5, p = 0.01) and left ventricular elastance (r = 0.59, p = 0.002) but not aortic compliance. Higher ascending aortic areas were associated with increased aortic compliance (r = 0.44, p = 0.03) and left ventricular elastance (r = 0.49, p = 0.01).
Conclusion:
Paediatric Turner syndrome with similar aortic size index to controls showed MRI evidence of abnormal aortic biophysical properties. These findings point to an underlying aortopathy and provide additional parameters that may aid in determining risk factors for aortic dissection.
We took a multilevel developmental contextual approach and characterized trajectories of alcohol misuse from adolescence through early midlife, examined genetic and environmental contributions to individual differences in those trajectories, and identified adolescent and young adult factors associated with change in alcohol misuse. Data were from two longitudinal population-based studies. FinnTwin16 is a study of Finnish twins assessed at 16, 17, 18, 25, and 35 years (N = 5659; 52% female; 32% monozygotic). The National Longitudinal Study of Adolescent to Adult Health (Add Health) is a study of adolescents from the United States, who were assessed at five time points from 1994 to 2018 (N = 18026; 50% female; 64% White, 21% Black, 4% Native American, 7% Asian, 9% Other race/ethnicity). Alcohol misuse was measured as frequency of intoxication in FinnTwin16 and frequency of binge drinking in Add Health. In both samples, trajectories of alcohol misuse were best described by a quadratic growth curve: Alcohol misuse increased across adolescence, peaked in young adulthood, and declined into early midlife. Individual differences in these trajectories were primarily explained by environmental factors. Several adolescent and young adult correlates were related to the course of alcohol misuse, including other substance use, physical and mental health, and parenthood.
Iodine is a trace element required to produce the thyroid hormones, which are critical for development, growth and metabolism. To ensure appropriate population iodine nutrition, convenient and accurate methods of monitoring are necessary. Current methods for determining iodine status either involve a significant participant burden or are subject to considerable intra-individual variation. The continuous secretion of iodide in saliva potentially permits its use as a convenient, non-invasive assessment of status in populations. To assess its likely effectiveness, we reviewed studies analysing the association between salivary iodide concentration (SIC) and dietary iodine intake, urinary iodide concentration (UIC) and/or 24-h urinary iodide excretion (UIE). Eight studies conducted in different countries met the inclusion criteria, including data for 921 subjects: 702 healthy participants and 219 with health conditions. SIC correlated positively with UIC and/or UIE in four studies, with the strength of relationship ranging from r = 0·19 to r = 0·90 depending on sampling protocol, age, and if salivary values were corrected for protein concentration. Additionally, SIC positively correlated with dietary intake, being strongest when saliva was collected after dinner. SIC varied with external factors, including thyroid function, use of some medications, smoking and overall health status. Evidence provided here supports the use of SIC as a viable, low-burden method for determining iodine status in populations. However, small sample sizes and high variability indicates the need for more extensive analyses across age groups, ethnicities, disease states and dietary groups to clarify the relative accuracy and reliability in each case and standardise procedure.
Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately.
Aims
To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective).
Method
We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI).
Results
The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure.
Conclusions
This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.
We have employed the VULCAN laser facility to generate a laser plasma X-ray source for use in photoionization experiments. A nanosecond laser pulse with an intensity of order 1015 Wcm−2 was used to irradiate thin Ag or Sn foil targets coated onto a parylene substrate, and the L-shell emission in the 3.3–4.4 keV range was recorded for both the laser-irradiated and nonirradiated sides. Both the experimental and simulation results show higher laser to X-ray conversion yields for Ag compared with Sn, with our simulations indicating yields approximately a factor of two higher than those found in the experiments. Although detailed angular data were not available experimentally, the simulations indicate that the emission is quite isotropic on the laser-irradiated side but shows close to a cosine variation on the nonirradiated side of the target as seen experimentally in the previous work.
Megasphaera elsdenii has been correlated with gas production by human faecal microbiota during fermentation. The objective of this study was to determine the role of M. elsdenii in gas production by the microbiome. Kidney beans and sweet potatoes were subjected to in vitro digestion and dialysis followed by fermentation with ten faecal microbiomes: three with detectable M. elsdenii (Me_D) and seven with no detectable M. elsdenii (Me_ND). Me_D microbiomes produced more gas than the Me_ND microbiomes (p < 0.001). Me_D microbiomes produced more gas during fermentation of sweet potatoes than kidney beans (p < 0.001), while the opposite was true for the Me_ND microbiomes (p < 0.001). Among amplicon sequence variants that were associated with gas production, M. elsdenii had the strongest association (p < 0.001). Me_D microbiomes consumed more acetate and produced more butyrate than Me_ND microbiomes (p < 0.001). Gas production by M. elsdenii was confirmed by fermentation of sweet potatoes and acetate with human and rumen M. elsdenii isolates. The human isolate produced gas on sweet potatoes and acetate. This study suggests that M. elsdenii may be involved in gas production during the fermentation of flatulogenic foods through utilisation of undigestible substrates or cross-feeding on acetate.
The Australian SKA Pathfinder (ASKAP) has surveyed the sky at multiple frequencies as part of the Rapid ASKAP Continuum Survey (RACS). The first two RACS observing epochs, at 887.5 (RACS-low) and 1 367.5 (RACS-mid) MHz, have been released (McConnell, et al. 2020, PASA, 37, e048; Duchesne, et al. 2023, PASA, 40, e034). A catalogue of radio sources from RACS-low has also been released, covering the sky south of declination $+30^{\circ}$ (Hale, et al., 2021, PASA, 38, e058). With this paper, we describe and release the first set of catalogues from RACS-mid, covering the sky below declination $+49^{\circ}$. The catalogues are created in a similar manner to the RACS-low catalogue, and we discuss this process and highlight additional changes. The general purpose primary catalogue covering 36 200 deg$^2$ features a variable angular resolution to maximise sensitivity and sky coverage across the catalogued area, with a median angular resolution of $11.2^{\prime\prime} \times 9.3^{\prime\prime}$. The primary catalogue comprises 3 105 668 radio sources, including those in the Galactic Plane (2 861 923 excluding Galactic latitudes of $|b|<5^{\circ}$), and we estimate the catalogue to be 95% complete for sources above 2 mJy. With the primary catalogue, we also provide two auxiliary catalogues. The first is a fixed-resolution, 25-arcsec catalogue approximately matching the sky coverage of the RACS-low catalogue. This 25-arcsec catalogue is constructed identically to the primary catalogue, except images are convolved to a less-sensitive 25-arcsec angular resolution. The second auxiliary catalogue is designed for time-domain science and is the concatenation of source lists from the original RACS-mid images with no additional convolution, mosaicking, or de-duplication of source entries to avoid losing time-variable signals. All three RACS-mid catalogues, and all RACS data products, are available through the CSIRO ASKAP Science Data Archive (https://research.csiro.au/casda/).
This chapter aims to synthesize evidence from large-scale studies on the magnitude of disparities in students’ literacy development between students from low socioeconomic and language minority backgrounds and their more advantaged counterparts in the United States and Canada, particularly on reading skills. Among various structural inequalities that are relevant to reading, the focus is on socioeconomic status (SES) differences and linguistic diversity (and their inter-relationships). It is explicitly acknowledged that extensive structural inequalities also exist for indigenous peoples in both countries across a range of education, health, and social outcomes. The focus is on language minority learners in this chapter primarily because the large-scale research that has examined disparities in reading development has provided valuable insight regarding students from immigrant backgrounds. By focusing the lens on reading development in language minority learners, we do not intend to minimize or obscure the very real barriers to equitable education in indigenous communities, nor do we intend to convey that structural forces that affect immigrant students can generalize to indigenous communities. Instead, we echo calls to address the sociocultural context of reading development and education more broadly in indigenous communities in both countries.
The Australian SKA Pathfinder (ASKAP) is being used to undertake a campaign to rapidly survey the sky in three frequency bands across its operational spectral range. The first pass of the Rapid ASKAP Continuum Survey (RACS) at 887.5 MHz in the low band has already been completed, with images, visibility datasets, and catalogues made available to the wider astronomical community through the CSIRO ASKAP Science Data Archive (CASDA). This work presents details of the second observing pass in the mid band at 1367.5 MHz, RACS-mid, and associated data release comprising images and visibility datasets covering the whole sky south of $\delta_{\text{J2000}}=+49^\circ$. This data release incorporates selective peeling to reduce artefacts around bright sources, as well as accurately modelled primary beam responses. The Stokes I images reach a median noise of 198 $\mu$Jy PSF$^{-1}$ with a declination-dependent angular resolution of 8.1–47.5 arcsec that fills a niche in the existing ecosystem of large-area astronomical surveys. We also supply Stokes V images after application of a widefield leakage correction, with a median noise of 165 $\mu$Jy PSF$^{-1}$. We find the residual leakage of Stokes I into V to be $\lesssim 0.9$–$2.4$% over the survey. This initial RACS-mid data release will be complemented by a future release comprising catalogues of the survey region. As with other RACS data releases, data products from this release will be made available through CASDA.