Background: Inappropriate Clostridioides difficile (C. difficile) laboratory testing is common in hospitals and leads to over diagnosis, unnecessary treatment, and elevated hospital onset C. difficile infection (HO-CDI) metrics. Diagnostic stewardship is essential to avoid inappropriate testing, but limited data exists on optional interventions. Methods: A diagnostic stewardship intervention targeting CDI testing comprised of education and prospective audit with feedback was performed a VA facility (inpatient, outpatient, and long-term care units). Education on appropriate indications for CDI testing was provided in pre-intervention (9/2022 to 5/2023) and intervention periods (6/2023 to 12/2023). During the intervention period, all CDI tests (positive or negative) were audited after completion in real-time by an Infectious Diseases physician and feedback was given to ordering providers and/or their supervising physician (if trainee) for all tests not meeting an appropriate indication. Appropriate indication was defined as ≥3 liquid stools in 24 hours or symptoms of fulminant disease. Testing was considered inappropriate if no clinical symptoms, patient received laxatives within 48 hours, test was performed for test-of-cure or within 7 days of a prior test with no clinical change, or delayed testing in patients with diarrhea on admission. The rate of HO-CDI per 10,000 bed days of care (BDOC) per LabID event was compared during the pre-intervention and intervention periods, and ordering appropriateness was compared for all tests and hospital onset tests before (3/2023-5/2023) and after (6/2023-12/2023) feedback was performed. Results: After starting audit and feedback, HO-CDI rate decreased from 3.92 per 10,000 BDOC to 0.99 per 10,000 BDOC (p=0.03). HO-CDI rate among tests that were inappropriate was 2.19 and 0.80 per 10,000 BDOC during the pre-intervention and intervention periods, respectively (p=0.40). Average overall tests per month decreased from 37.8 to 28.1 after the intervention. Rate of all inappropriate tests decreased from 16.25 to 7.96 per 10,000 BDOC (p=0.04) and rate of hospital onset inappropriate tests trended toward decrease from 9.29 to 4.77 tests per 10,000 BDOC (p=0.07). The most common reasons for inappropriate testing were < 3 episodes of diarrhea in 24 hours (54% pre-intervention, 65% intervention) and laxative use (57% pre-intervention, 45% intervention). No cases of delayed testing leading to worsened disease were identified during the intervention. Cost savings for decreased tests were estimated at $150-300 per month. Conclusion: An intervention comprised of education and real-time audit and feedback of all CDI tests obtained at a VA facility resulted in decreased inappropriate testing and reduced the rate of HO-CDI.

The Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) is a landmark prospective, longitudinal study of human development focused on a sample of mothers experiencing poverty and their firstborn children. Although the MLSRA pioneered a number of important topics in the area of social and emotional development, it began with the more specific goal of examining the antecedents of child maltreatment. From that foundation and for more than 40 years, the study has produced a significant body of research on the origins, sequelae, and measurement of childhood abuse and neglect. The principal objectives of this report are to document the early history of the MLSRA and its contributions to the study of child maltreatment and to review and summarize results from the recently updated childhood abuse and neglect coding of the cohort, with particular emphasis on findings related to adult adjustment. While doing so, we highlight key themes and contributions from Dr Dante Cicchetti’s body of research and developmental psychopathology perspective to the MLSRA, a project launched during his tenure as a graduate student at the University of Minnesota.

Previous genetic studies on hair morphology focused on the overall morphology of the hair using data collected by self-report or researcher observation. Here, we present the first genome-wide association study (GWAS) of a micro-level quantitative measure of hair curvature. We compare these results to GWAS results obtained using a macro-level classification of observable hair curvature performed in the same sample of twins and siblings of European descent. Observational data were collected by trained observers, while quantitative data were acquired using an Optical Fibre Diameter Analyser (OFDA). The GWAS for both the observational and quantitative measures of hair curvature resulted in genome-wide significant signals at chromosome 1q21.3 close to the trichohyalin (TCHH) gene, previously shown to harbor variants associated with straight hair morphology in Europeans. All genetic variants reaching genome-wide significance for both GWAS (quantitative measure lead single-nucleotide polymorphism [SNP] rs12130862, p = 9.5 × 10–09; observational measure lead SNP rs11803731, p = 2.1 × 10–17) were in moderate to very high linkage disequilibrium (LD) with each other (minimum r2 = .45), indicating they represent the same genetic locus. Conditional analyses confirmed the presence of only one signal associated with each measure at this locus. Results from the quantitative measures reconfirmed the accuracy of observational measures.

The principal aim of this study was to optimize the diagnosis of canine neuroangiostrongyliasis (NA). In total, 92 cases were seen between 2010 and 2020. Dogs were aged from 7 weeks to 14 years (median 5 months), with 73/90 (81%) less than 6 months and 1.7 times as many males as females. The disease became more common over the study period. Most cases (86%) were seen between March and July. Cerebrospinal fluid (CSF) was obtained from the cisterna magna in 77 dogs, the lumbar cistern in f5, and both sites in 3. Nucleated cell counts for 84 specimens ranged from 1 to 146 150 cells μL−1 (median 4500). Percentage eosinophils varied from 0 to 98% (median 83%). When both cisternal and lumbar CSF were collected, inflammation was more severe caudally. Seventy-three CSF specimens were subjected to enzyme-linked immunosorbent assay (ELISA) testing for antibodies against A. cantonensis; 61 (84%) tested positive, titres ranging from <100 to ⩾12 800 (median 1600). Sixty-one CSF specimens were subjected to real-time quantitative polymerase chain reaction (qPCR) testing using a new protocol targeting a bioinformatically-informed repetitive genetic target; 53/61 samples (87%) tested positive, CT values ranging from 23.4 to 39.5 (median 30.0). For 57 dogs, it was possible to compare CSF ELISA serology and qPCR. ELISA and qPCR were both positive in 40 dogs, in 5 dogs the ELISA was positive while the qPCR was negative, in 9 dogs the qPCR was positive but the ELISA was negative, while in 3 dogs both the ELISA and qPCR were negative. NA is an emerging infectious disease of dogs in Sydney, Australia.

Research suggests intergenerational links between childhood abuse and neglect and subsequent parenting quality, but little is known about the potential mechanisms underlying intergenerational continuities in parenting. Adult romantic functioning may be one plausible mechanism, given its documented associations with both adverse caregiving in childhood and parenting quality in adulthood. The present study used data from the Minnesota Longitudinal Study of Risk and Adaptation to (a) investigate prospective associations between childhood experiences of abuse and neglect and multiple parenting outcomes in adulthood, and (b) evaluate the degree to which adult romantic functioning mediates those associations. Information regarding childhood abuse and neglect was gathered prospectively from birth through age 17.5 years. Multimethod assessments of romantic functioning were collected repeatedly through early adulthood (ages 20 to 32 years), and parenting quality was assessed as participants assumed a parenting role (ages 21 to 38 years). As expected, childhood abuse and neglect experiences predicted less supportive parenting (observed and interview rated) and higher likelihood of self-reported Child Protective Services involvement. The association with interview-rated supportive parenting was partially mediated by lower romantic competence, whereas the association with Child Protective Services involvement was partially mediated by more relational violence in adult romantic relationships. Implications of these novel prospective findings for research and clinical intervention are discussed.

The ‘Landscapes of Production and Punishment’ project aims to examine how convict labour from 1830–1877 affected the built and natural landscapes of the Tasman Peninsula, as well as the lives of the convicts themselves.

Music notation is intrinsic in the composition and performance of Western art music and also in its analysis and research. The process of writing about music remains underexplored, in particular how excerpts of music notation are selected and arranged in a written text, and how that text describes and contextualises the excerpts. This article applies ‘semantic gravity’ from Legitimation Code Theory to characterise notational excerpts and their integration in a written text, by focusing on how closely they are connected to a particular performance or generalised across performances. It illustrates these concepts with case studies of tertiary students’ research projects to reveal how different purposes drive different notational usage when writing about music. This provides insight for music educators on how to support writing about music and the use of notational quotes.

The present report used data from the Minnesota Longitudinal Study of Risk and Adaptation to investigate the factor structure and childhood abuse and/or neglect related antecedents of adults’ attachment states of mind in a high-risk sample. Adult Attachment Interviews (AAIs) were collected when participants were age 26 years (N = 164) and Current Relationship Interviews (CRIs) were collected from participants (N = 116) and their romantic partners when target participants were between ages 20 and 28 years (M = 25.3 years). For both the AAI and the CRI, exploratory factor analyses revealed that (a) attachment state of mind scales loaded on two weakly correlated dimensions reflecting dismissing and preoccupied states of mind and (b) ratings of unresolved discourse loaded on the same factor as indicators of preoccupied states of mind. Experiencing any subtype of abuse and/or neglect, especially during multiple developmental periods, and experiencing multiple subtypes of abuse and/or neglect during childhood were associated with risk for preoccupied (but not dismissing) AAI states of mind regarding childhood relationships with caregivers. Analyses focused on the particular subtypes, and perpetrators indicated that the predictive significance of childhood abuse/neglect for adult's AAI preoccupied states of mind was specific to experiences of abuse (but not neglect) perpetrated by primary caregivers. In addition, experiencing chronic or multiple subtypes of childhood abuse and/or neglect increased risk for dismissing (but not preoccupied) CRI states of mind regarding adult romantic partners.

In this investigation the factor structure of the Adult Attachment Interview was studied in a partially at-risk sample of 120 young adults. More specifically, 60 participants had engaged in nonsuicidal self-injury (NSSI; 53 females, M age = 20.38 years), and 60 were non-self-injuring controls matched by age and sex. Theoretically anticipated differential associations between preoccupied (but not dismissing) states of mind and NSSI were then examined. Exploratory factor analyses identified evidence for two weakly correlated state of mind dimensions (i.e., dismissing and preoccupied) consistently identified in factor analyses of normative-risk samples. As hypothesized, results further showed that preoccupied (but not dismissing) states of mind were associated with NSSI behavior. Findings support existing arguments suggesting that the regulatory strategy adults adopt when discussing attachment-related experiences with primary caregivers, particularly passive, angry, or unresolved discourse patterns, is uniquely correlated with NSSI.

A survey of nearshore areas in the Vestfold Hills, Antarctica, using high-resolution multibeam swath bathymetry provided both a detailed digital bathymetric model and information on sediment acoustic backscatter. Combined with underwater video transects and sediment sampling, these data were used to identify and map geomorphic units. Six geomorphic units identified in the survey region include: rocky outcrops, basins, pediments, valleys, scarps and embayments. In addition to geomorphic units, the data revealed sedimentary features that provide insights into post-glacial sediment transport and erosion in the area. Ice keel pits and scours are common, and sea floor channels, scour depressions and sand ribbons indicate transport and deposition by wind-driven currents and oceanographic circulation. Gullies and sediment lobes observed on steep slopes indicate mass movement of sediment. Some of these processes have not been directly observed to date, but their effectiveness in shaping the modern sea floor is clearly indicated by the sea floor mapping data. The embayments preserve a mantle of boulder sand probably deposited by cold-based glaciers which were flanked by faster-flowing ice in adjoining regions.

Live-shearing of wild guanacos Lama guanicoe may affect their reproductive success and population resilience, and therefore it is important to assess the biological sustainability of obtaining their wool. We evaluated effects of capture and shearing on survival and reproduction, population parameters, daily movements, ranging behaviour and spatial distribution in sedentary and migratory populations. We assessed population variables by radio-telemetry and line-transect surveys before and after capture. We estimated high post-shearing survival rates in both populations and similar yearling production in shorn and non-shorn females in the migratory population. We did not find significant variations in density and population structure before and after shearing in the sedentary population, whereas in the migratory population density decreased and the population structure changed significantly after assembly of the capture structure, returning to pre-assembly levels 1 month later. The mean daily distance moved by radio-collared guanacos during the first 2 days after shearing was three times longer than during the following 30 days. There was a 25% decrease in the mean home-range size of shorn guanacos between the first and second month after shearing but this decline appeared to be associated with a seasonal change in movement, because a similar reduction occurred during the same period the following year, when the guanacos were not shorn. Live-shearing modified the spatial distribution pattern in the sedentary population but did not have a significant effect on the migratory population. Management of guanacos may contribute towards developing a biologically sustainable economic activity that promotes conservation of wildlife and habitats.

Genes in the TGF9 signaling pathway play important roles in the regulation of ovarian follicle growth and ovulation rate. Mutations in three genes in this pathway, growth differentiation factor 9 (GDF9), bone morphogenetic protein 15 (BMP15) and the bone morphogenetic protein receptor B 1 (BMPRB1), influence dizygotic (DZ) twinning rates in sheep. To date, only variants in GDF9 and BMP15, but not their receptors transforming growth factor ß receptor 1 (TGFBR1), bone morphogenetic protein receptor 2 (BMPR2) and BMPR1B, have been investigated with respect to their roles in human DZ twinning. We screened for rare and novel variants in TGFBR1, BMPR2 and BMPR1B in mothers of dizygotic twins (MODZT) from twin-dense families, and assessed association between genotyped and imputed variants and DZ twinning in another large sample of MODZT. Three novel variants were found: a deep intronic variant in BMPR2, and one intronic and one non-synonymous exonic variant in BMPRB1 which would result in the replacement of glutamine by glutamic acid at amino acid position 294 (p.Gln294Glu). None of these variants were predicted to have major impacts on gene function. However, the p.Gln294Glu variant changes the same amino acid as a sheep BMPR1B functional variant and may have functional consequences. Six BMPR1B variants were marginally associated with DZ twinning in the larger case-control sample, but these were no longer significant once multiple testing was taken into account. Our results suggest that variation in the TGF9 signaling pathway type II receptors has limited effects on DZ twinning rates in humans.

Self-rated health questions have been proven to be a highly reliable and valid measure of overall health as measured by other indicators in many population groups. It also has been shown to be a very good predictor of mortality, chronic or severe diseases, and the need for services, and is positively correlated with clinical assessments. Genetic factors have been estimated to account for 25–64% of the variance in the liability of self-rated health. The aim of the present study was to identify Single Nucleotide Polymorphisms (SNPs) underlying the heritability of self-rated health by conducting a genome-wide association analysis in a large sample of 6,706 Australian individuals aged 18–92. No genome wide significant SNPs associated with self-rated health could be identified, indicating that self-rated health may be influenced by a large number of SNPs with very small effect size. A very large sample will be needed to identify these SNPs.

Bullying is a stressful event for adolescents at school and was the fourth most common reason for calls to Kids Help Line in 2002. This study sought to examine coping styles used by students affected by bullying in Years 8 and 10 attending three Queensland high schools. Eighty-eight students completed the Bully Survey containing questions about bullying experiences and the way they coped in those situations. No year level differences were found in terms of the type of bullying experienced or the way in which students coped with these experiences. A significant interaction was found between duration of bullying and perceived control for the proportional use of disengagement coping (i.e., denial, avoidance and wishful thinking strategies). A significant simple main effect was found between perceived stressfulness and proportional use of involuntary engagement coping (i.e., rumination, intrusive thoughts, emotional arousal, physiological arousal and impulsive actions). Implications of these findings for schools are discussed.