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Aim: Perinatal stroke is one of the main causes of hemiplegia and seizure disorder. This study aimed to analyse the clinical characteristics and outcomes of perinatal stroke in a cohort of Australian children for its early detection. Methods: A population‐based prospective longitudinal study on perinatal stroke up to 2 years of age, was conducted from 2017 to 2019. Results: Eighty‐seven children with perinatal stroke included 79% (69/87) acute and 21% (18/87) presumed perinatal stroke. Seventy‐four per cent (51/69) acute symptomatic perinatal strokes presented in the first 3 days of life and 78% (14/18) presumed perinatal strokes presented by 6 months of age. 62% had an arterial stroke, 29% had a venous stroke and 5% had a combined arterial and venous stroke. Unexpectedly, 35% (24/69) acute symptomatic perinatal stroke had only respiratory symptoms and 50% (9/18) presumed perinatal stroke were asymptomatic. The incidence of cerebral palsy was 29% (20/69) with acute symptomatic perinatal stroke and 72% (13/18) with presumed perinatal stroke. Conclusions: The first week of a child's life is the most critical period in terms of lifelong disability from perinatal stroke. Recognising diverse clinical presentations will ensure early diagnosis and timely intervention treatments. [ABSTRACT FROM AUTHOR]

Introduction: Sufficient levels of vitamin D have been associated with higher chances for both clinical pregnancy and live birth among women undergoing assisted reproductive techniques, whereas low levels of maternal vitamin D have been associated with preeclampsia and late miscarriage. In Denmark, subgroups at risk for low vitamin D levels, including neonates and toddlers, are recommended to use supplementation. The aim was to study the level of vitamin D3 among neonates born after in vitro fertilization compared with neonates from the general population. Material and methods: In this cohort study a random sample of 1326 neonates representing the general population and 1200 neonates conceived by in vitro fertilization born in Denmark from 1995 to 2002 were identified from registries covering the whole Danish population. Information on use of assisted reproduction was collected from the Danish In Vitro Fertilization register, ICD‐10 code: DZ358F. 25‐Hydroxyvitamin D was measured from dried blood spots routinely collected by heel prick 48–72 h after birth and corrected according to the hematocrit fraction for capillary blood of neonates. Linear regression analysis was performed, both crude and adjusted, for predefined putative confounders, identified through directed acyclic graphs. Results: Vitamin D3 analysis could be performed from a total of 1105 neonates from the general population and 1072 neonates conceived by in vitro fertilization that were subsequently included in the study. The median vitamin D3 was 24.0 nmol/L (interquartile range [IQR] 14.1–39.3) and 33.0 nmol/L (IQR 21.3–48.8) among neonates from the general population and neonates conceived by in vitro fertilization, respectively. The adjusted mean difference between neonates from the general population and those conceived by in vitro fertilization was 6.1 nmol/L (95% confidence interval 4.1–8.1). Conclusions: In this study, children born after in vitro fertilization have a higher vitamin D3 than a random sample of neonates in Denmark. [ABSTRACT FROM AUTHOR]

Aim: The aetiology of perinatal stroke is poorly understood. This study aimed to prospectively confirm the risk factors and identify any previously unknown variables. Methods: A prospective case–control study was conducted in Australia. Univariate odds ratios (ORs), associated 95% confidence intervals (CIs) and multivariable logistic regression models fitted with backwards stepwise variable selection were used. Results: Sixty perinatal stroke cases reported between 2017 and 2019 included 95% (57/60) with multiple risk factors. Univariate analysis identified emergency caesarean section rather than NVD (P < 0.01), low Apgar score (<7) at 1, 5 and 10 min of age (P < 0.01), resuscitation at birth (P < 0.01), abnormal cord blood gas (P < 0.01), neonatal infection/sepsis (P < 0.01), congenital heart disease (P < 0.01) and hypoglycaemia (P < 0.01) as significant risk factors. Multivariate analysis found smoking during pregnancy (OR: 1.48; 95% CI: 1.09–1.99), 1‐min Apgar score < 7 (OR: 1.54; 95% CI: 1.15–2.08), 10‐min Apgar score < 7 (OR: 1.26; 95% CI: 1.02–1.54) and hypoglycaemia (OR: 1.49; 95% CI: 1.07–2.06). Conclusions: Perinatal stroke is associated with multiple risk factors. Exposure to smoking, 10‐min Apgar score < 7, neonatal infection and hypoglycaemia were independent risk factors. Emergency caesarean section, resuscitation at birth and abnormal cord blood gas were additional risk factors. [ABSTRACT FROM AUTHOR]

Aim: As more infants survive surgery in the newborn period for major congenital anomalies, the focus has shifted to the quality of care for parents as well as infants. In contemporary neonatal intensive care units (NICUs), doctors are encouraged to practice family‐centred care and partner with parents in their infant's care. This study explored doctors' perceptions and parents' self‐reported needs and stressors in a surgical NICU. Methods: From January 2014 to September 2015, parents of infants admitted for general surgery for a major congenital anomaly who were present in the NICU between 48 and 72 h of admission and doctors caring for their infant at the time of data collection were invited to participate. Matched data were provided using the Neonatal Family Needs Inventory and the Parental Stressor Scale:NICU. Results: Matched data for 12 doctor–parent dyads showed that doctors (neonatal medical trainees) consistently under‐rated the importance of parents' needs and identified fewer of mothers' than fathers' most important needs. Doctors also consistently under‐rated parents' stressors. They perceived few of fathers', but all of mothers', greatest stressors. Thematic analysis revealed four themes: infant pain management; parental autonomy; empathy; and communicating reassurance and education to parents. Conclusion: The findings suggest incongruences between doctors' perceptions and parents' self‐reported needs and stressors. While there is hesitation in making recommendations with this sample size, the findings highlight issues that may inform further research and contribute to a dialogue regarding the role of doctors in family‐centred relationship‐based models of care in the NICU. [ABSTRACT FROM AUTHOR]

Aim: Understanding neural responses through functional magnetic resonance imaging (fMRI) to food and food cues in middle‐older adults may lead to better treatment options to address the growing issue of malnutrition. This scoping review aimed to determine the extent, range and nature of research using fMRI, related to reward‐based regions, in response to food cues in middle to older aged adults (50 years and over). Methods: The following databases were systematically searched in July 2019: CINAHL, CENTRAL, Embase, Dissertations and Theses, Ovid Medline, PsycINFO, PsycEXTRA, Scopus and Web of Science. Studies were eligible for inclusion if participants had a mean or median age ≥50 years, utilised and reported outcomes of either a food cue task‐related fMRI methodology or resting‐state fMRI. Data from included studies were charted, and synthesised narratively. Results: Twenty‐two studies were included. Eighteen studies utilised a task‐related design to measure neural activation, two studies measured resting state neural connectivity only and an additional two studies measured both. The fMRI scanning paradigms, food cue tools and procedure of presentation varied markedly. Four studies compared the neural responses to food between younger and older adults, providing no consensus on neural age‐related changes to food cues; two studies utilised longitudinal scans. Conclusion: This review identified significant extent, range and nature in the approaches used to assess neuronal activity in response to food cues in adults aged 50 years and over. Future studies are needed to understand the age‐related appetite changes whilst considering personal preferences for food cues. [ABSTRACT FROM AUTHOR]

Objective: Epilepsy is a nervous system abnormality that may be caused by unknown exposures during fetal development. Studies have shown neuroprotective effects of early exposure to vitamin D in other neurological disorders, and seasonal variation in birth of children with epilepsy. We aimed to investigate if neonatal 25(OH)D3 was associated with risk of childhood epilepsy. Methods: This case‐cohort study compared neonatal 25(OH)D3 levels from children with epilepsy (n = 403) and a random selected cohort of controls (n = 1163), assessing the hazard of first epilepsy diagnosis between 1 and 4 years of age from a weighted Cox proportional hazard model. Analyses were adjusted for parental education, maternal age, maternal epilepsy, maternal ethnicity, and gestational age, and additionally for season of birth and smoking during pregnancy. Results: The mean (standard deviation [SD]) of neonatal 25(OH)D3 levels were 30.8(19.6) nmol/L among cases and 28.5(19.4) nmol/L among the cohort. The hazard ratio (HR) of epilepsy was in a dose‐response pattern higher among children from the highest neonatal 25(OH)D3 quintiles (P‐trend =.004). Results were unchanged after including season of birth in the analysis, where a significantly higher HR of epilepsy was observed among children in the two highest quintiles compared to children in the lowest quintile (Q4: HRadj 1.62, 95% CI 1.07‐2.47 and Q5: HRadj 1.86, 95% CI 1.21‐2.86). Significance: In this study, the risk of childhood epilepsy increased with neonatal 25(OH)D3 categories in a dose‐response pattern, suggesting an association between a high neonatal 25(OH)D3 and the risk of childhood epilepsy. Considering that adjusting for season of birth strengthened the results, we conclude that maternal intake of vitamin D, and not vitamin D from sun exposure, was the vitamin D source associated with epilepsy. Although we cannot, in the present study, control for compounds in the diet like pollutants or heavy metals, which may correlate with dietary vitamin D, future studies investigating fetal origin of epilepsy should focus on compounds correlating with vitamin D. [ABSTRACT FROM AUTHOR]

Introduction: The second edition of the Movement Assessment Battery for Children (M ABC‐2) is a standardised, norm referenced assessment that is frequently used by therapists to identify children with motor difficulties. The norms for the M ABC‐2 were derived from a sample of children in the United Kingdom (UK) and are combined across the age groups for boys and girls. The aims of this research were to investigate gender differences in the performance of 8‐ and 9‐year‐old Australian children and if the norms in our cohort differed from UK‐based M ABC‐2 norms. Methods: Children aged 8 or 9 years of age who underwent major neonatal cardiac or non‐cardiac surgery and healthy controls were assessed using the M ABC‐2 as part of the Development After Infant Surgery (DAISy) study. Results: There were statistically significant differences in the scores for boys and girls aged 8‐ and 9‐years old on the M ABC‐2. Girls performed better than boys in manual dexterity and on total standard scores. Our control group compared to the assessment norms scored significantly poorer in manual dexterity, aiming and catching and total standard scores. Conclusion: Caution should be used when interpreting the results of the M ABC‐2 for Australian 8‐ and 9‐year olds. Contemporary Australian, gender‐specific M ABC‐2 norms should be considered. Further research is required to investigate gender differences and differences in performance of Australian children compared to the assessment norms in other age groups on the M ABC‐2. [ABSTRACT FROM AUTHOR]

Aim: To determine the risk of ocular complications of sildenafil therapy in neonates.Methods: Retrospective case review of neonates with persistent pulmonary hypertension of the newborn who received sildenafil therapy between 2010 and 2015 in a single, tertiary surgical neonatal intensive care unit in Australia. Ophthalmic examination findings in the neonatal intensive care unit and follow-up were examined.Results: Twenty-seven neonates with persistent pulmonary hypertension of the newborn received sildenafil. The median gestational age (GA) was 38 weeks (range 24-41 weeks), and median birthweight was 2690 g (range 454-4270 g). Ophthalmic review was undertaken in 23 neonates, and 16 neonates were term or near-term infants (GA 31-40 weeks). All of them had a normal initial ophthalmic examination; one child was later diagnosed with hypermetropia and another with infantile esotropia. Amongst the seven premature infants (GA 24-30 weeks), three had retinopathy of prematurity (ROP) diagnosed at the first ophthalmic review and the other four had normal initial examinations. Two patients later developed ROP, one of whom was also diagnosed with congenital motor nystagmus. All five patients diagnosed with ROP were extremely preterm (<28 weeks) with low birthweight (454-635 g).Conclusions: There were no short-term complications attributable to sildenafil therapy identified in term or near-term neonates (GA ≥31 weeks). This cohort of neonates does not typically undergo ophthalmic review as part of the ROP screening protocol in our institution. Routine ophthalmic review of neonates on sildenafil therapy, who are not at risk of ROP, is therefore unlikely to be warranted. Further research is required to clarify the relationship between sildenafil and ROP. [ABSTRACT FROM AUTHOR]

Aim: As more babies survive major neonatal surgery, the quality of life of the whole family is a major focus of health care. While there is evidence suggesting that parents of babies admitted to neonatal intensive care units (NICUs) experience high levels of stress, little is known about stressors in parents whose infants also require neonatal surgery. This study identified fathers' and mothers' stressors in a surgical NICU.Methods: Parents of infants admitted for general surgery to the NICU at a tertiary children's hospital from February 2014 to September 2015 were eligible for enrolment. Parents completed the Parental Stressor Scale: NICU to measure levels of stress related to three subscales: sights and sounds, infant appearance and parental role alteration, using a 5-point Likert scale.Results: Data for 111 parents (57% mothers) showed parental role alteration as the greatest stressor for parents (M = 2.98, standard deviation (SD) = 0.89), particularly for mothers, followed by infant appearance (M = 2.84, SD = 0.95). Both fathers and mothers rated feeling helpless (M = 4.1, SD = 1.0), unable to protect their baby (M = 4.1, SD = 0.9) and seeing their baby in pain (M = 3.9, SD = 1.2) the most common, most stressful experiences and highest contributors to overall stress in the surgical NICU environment.Conclusion: Parental role alteration is the greatest stressor for parents in the surgical NICU. Reducing stress for parents of infants undergoing neonatal surgery requires management of the infant's pain and strategies to support parents in their role in the NICU. [ABSTRACT FROM AUTHOR]

Aim: To determine survival of infants with major congenital anomalies (CA) and assess the effect of co-existing anomalies and gestational age.Methods: All liveborn infants with major CA born in New South Wales (NSW), Australia, 2004-2009 were identified from the NSW Register of Congenital Conditions. Deaths were identified via record linkage to death registrations and five-year survival was estimated using Kaplan-Meier methods.Results: There were 8521 liveborn infants with CA of whom 617 (7.2%) died within the first five years of life. Half of deaths occurred in the first week of life. The overall five-year survival rate was 92.8% (95%CI: 92.2-93.3) and 83.2% (95%CI: 79.0-87.4) for syndromes, 83.4% (95%CI: 80.9-85.9) for multiple, 85.1% (95%CI: 82.6-87.5) for chromosomal, 95.3% (95%CI: 94.8-95.8) for isolated and 96.2% (95%CI: 94.3-98.1) for non-Q chapter anomalies. Five-year survival for chromosomal, syndromes and sub-groups was higher for isolated compared with multiple anomalies ranging from 77.5% to 98.9% and 68.6% to 89.5%, respectively. Survival was lower for preterm (79.4%; 95%CI: 77.5-81.4) than for term infants (95.8%; 95%CI: 95.3-96.3).Conclusion: Nine in ten infants with major CA survive up to five years, although there is variability in survival across CA groups. Survival of infants with major congenital anomalies has improved in recent years. [ABSTRACT FROM AUTHOR]

Aim: While there is evidence of parental needs in the neonatal intensive care unit (NICU), parents of newborns admitted for general surgery are an under-researched population. This study aimed to identify needs in parents of newborns admitted to the NICU for general surgery and whether health-care professionals meet these needs.Methods: This was a prospective cohort study of 111 parents (57% mothers) of newborns admitted to a surgical NICU for general surgery in Australia from January 2014 to September 2015. Parents completed the Neonatal Family Needs Inventory (NFNI), comprising 56 items in five subscales (Support, Comfort, Information, Proximity, Assurance) at admission and discharge, as well as the Social Desirability Scale (SDS). Data were analysed using parametric and non-parametric techniques.Results: At both admission and discharge, parents rated Assurance (M = 3.8, standard deviation (SD) = 0.24) needs as the most important, followed by Proximity (M = 3.6, SD = 0.32) and Information (M = 3.5, SD = 0.38). Mothers rated Assurance significantly more important than fathers (P < 0.02). Overall, parents' most important needs were having questions answered honestly (M = 3.96, SD = 0.19), seeing their infant frequently and knowing about the medical treatment (both M = 3.95, SD = 0.23). The 10 most important needs were met for more than 96% of parents, with no evidence of response bias.Conclusions: Reassurance is a priority need for parents in the surgical NICU. Mothers' and fathers' needs may be best met by practices based on family-centred, individualised care principles. [ABSTRACT FROM AUTHOR]

publisher‐imprint‐name Springer volume‐issue‐count 1 issue‐article‐count 46 issue‐toc‐levels 0 issue‐pricelist‐year 2016 issue‐copyright‐holder The Author(s) issue‐copyright‐year 2016 article‐contains‐esm No article‐numbering‐style Unnumbered article‐registration‐date‐year 2016 article‐registration‐date‐month 8 article‐registration‐date‐day 15 article‐toc‐levels 0 toc‐levels 0 volume‐type Regular journal‐product ArchiveJournal numbering‐style Unnumbered article‐grants‐type OpenChoice metadata‐grant OpenAccess abstract‐grant OpenAccess bodypdf‐grant OpenAccess bodyhtml‐grant OpenAccess bibliography‐grant OpenAccess esm‐grant OpenAccess online‐first false pdf‐file‐reference BodyRef/PDF/40169_2016_Article_118.pdf target‐type OnlinePDF issue‐type Regular article‐type OriginalPaper journal‐subject‐primary Medicine & Public Health journal‐subject‐secondary Medicine/Public Health, general journal‐subject‐collection SC11 open‐access true --> Background: Oseltamivir is the only antiviral treatment recommended for influenza in young children over the age of 1 year. There is scant data on oseltamivir pharmacokinetics (PK) in infants <1 year. We set out to perform PK measurements in infants who received oseltamivir. Methods: This study was a prospective, uncontrolled, open label evaluation of the pharmacokinetics of oseltamivir metabolism, safety of oseltamivir, viral clearance in infants <12 months diagnosed with influenza by nasopharyngeal influenza nucleic acid antigen test (NAAT). Blood levels of the prodrug oseltamivir and its active carboxylate were measured prior to a dose of oseltamivir and at 4 time points afterwards, to calculate Cmax (ng/mL), Tmax (h), AUC0−t (ng h/mL) and time for AUC (h). Results: Four children with influenza A received oral oseltamivir, 2.35–3 mg/kg/dose. This dose range produced a target oseltamivir carboxylate plasma concentration in excess of the proposed 12‐h target AUC of 3800 ng h/mL, selected from earlier studies to avert resistance. One patient developed GIT adverse event: dry retching. Conclusion: Oseltamivir was well tolerated at a dose of 2.35–3 mg/kg/dose twice a day in infants under the age of 1 year. In general agreement with earlier data, these doses produced a target oseltamivir carboxylate plasma exposure in excess of the proposed 12‐h target exposure of AUC equal to 3800 ng h/mL in two patients. The limited plasma concentration data in the remaining two patients were not inconsistent with the target exposure being reached. [ABSTRACT FROM AUTHOR]

Chronic wounds cost the Australian health system at least US$2·85 billion per year. Wound care services in Australia involve a complex mix of treatment options, health care sectors and funding mechanisms. It is clear that implementation of evidence-based wound care coincides with large health improvements and cost savings, yet the majority of Australians with chronic wounds do not receive evidence-based treatment. High initial treatment costs, inadequate reimbursement, poor financial incentives to invest in optimal care and limitations in clinical skills are major barriers to the adoption of evidence-based wound care. Enhanced education and appropriate financial incentives in primary care will improve uptake of evidence-based practice. Secondary-level wound specialty clinics to fill referral gaps in the community, boosted by appropriate credentialing, will improve access to specialist care. In order to secure funding for better services in a competitive environment, evidence of cost-effectiveness is required. Future effort to generate evidence on the cost-effectiveness of wound management interventions should provide evidence that decision makers find easy to interpret. If this happens, and it will require a large effort of health services research, it could be used to inform future policy and decision-making activities, reduce health care costs and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: To briefly outline the strengths and limitations of cerebral palsy (CP) registers, and to report on findings of the Australian Cerebral Palsy Register (ACPR) pertaining to a population cohort of children with CP.Method: De-identified data were extracted from the ACPR for people with CP in birth years 1993 to 2006, from South Australia, Victoria, and Western Australia. Live birth prevalence of CP was estimated and risk factors described.Results: The overall birth prevalence of CP (including those whose CP was postneonatally acquired) for the 1993 to 2006 birth cohort was 2.1 per 1000 live births (95% confidence interval [CI] 2.0-2.2). Excluding cases with a known postneonatal cause, the birth prevalence for pre/perinatally acquired CP was 2.0 per 1000 live births (95% CI 1.9-2.1). A downward trend in rates of CP in those born extremely preterm was evident over at least three consecutive periods across all three regions. Most (58.6%) children were born at term (≥ 37 wks). Male sex, early gestational age, low birthweight, and multiple birth were risk factors for CP.Interpretation: Overall rates of CP did not change during this period. The proportion of those with CP born extremely preterm decreased. The ACPR Group will investigate whether this pattern continues when data pertaining to the next birth cohort for all three regions becomes available. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine whether there remain developmental differences between term infants at 3 years of age following major non-cardiac surgery (NCS) and cardiac surgery (CS) compared with healthy control infants in New South Wales (NSW), Australia.Study Design: Between 2006 and 2008, term infants who required NCS or CS within the first ninety days of life were enrolled in a prospective population-based study. Their developmental outcome was then compared with a cohort of healthy term infants. Infants initially assessed at 1 year of age were then re-assessed at 3 years of age using the Bayley scales of infant and toddler development (version-Iii) Results: Of the 539 term infants assessed at 1 year of age, 417 returned for the 3-year assessment, with 378 complete assessments. The mean scores for the infants who underwent CS (P < 0.001) were significantly lower in all subscales of the assessment compared with the controls, while the mean scores for the infants who underwent NCS were significantly lower in three of the subscales (P < 0.05). The infants who underwent CS scored significantly lower in four of the subscales (P < 0.05), compared with the infants who underwent NCS.Conclusion: The second phase of this unique population-based study provides further data on the outcomes of infants who underwent major NCS and CS. Major surgery in infants continues to be associated with developmental delay at 3 years of age compared with control infants; however the majority of the delay is mild. The risk remains higher in CS group with the pattern and severity of delay similar to that observed in the first study. [ABSTRACT FROM AUTHOR]

Aim: There is an identified gap in the literature regarding the use of the General Movements (GMs) Assessment to identify risk in infants post-surgery. This paper aims to examine the GMs for infants who have undergone surgery to identify common risk profiles in the writhing age.Methods: This was a prospective cohort study of 170 infants (99 male, 58%) admitted to a neonatal surgical unit from 2012 until June 2014. Infants were born at a mean age of 38 weeks (standard deviation (SD) 2.3), and writhing GMs were conducted at term (40 weeks, SD 2.6) following either cardiac (n = 84, 49%) or non-cardiac surgery (n = 86, 51%). GMs were categorised by three trained assessors.Results: Normal writhing was recorded in 64 infants (38%). The most common profile was poor repertoire (n = 80, 47%), with 14 (8%) cramped synchronised. There was no difference in scores between infants who had undergone cardiac versus non-cardiac surgery (P = 0.45).Conclusion: This is the first report on the GMs assessment in an infant surgical population. Infants who have undergone surgery most commonly display poor repertoire writhing movements. Research is needed to determine the ability of the GMs to predict neurodevelopmental outcomes in this population. [ABSTRACT FROM AUTHOR]

This study examined specific antibody and T-cell responses associated with experimental malaria infection or malaria vaccination, in malaria-naive human volunteers within phase I/ IIa vaccine trials, with a view to investigating inter-relationships between these types of response. Malaria infection was via five bites of Plasmodium falciparum-infected mosquitoes, with individuals reaching patent infection by 11-12 days, having harboured four or five blood-stage cycles before drug clearance. Infection elicited a robust antibody response against merozoite surface protein-119, correlating with parasite load. Classical class switching was seen from an early Ig M to an Ig G1-dominant response of increasing affinity. Malaria-specific T-cell responses were detected in the form of interferon- γ and interleukin-4 ( IL-4) ELIspot, but their magnitude did not correlate with the magnitude of antibody or its avidity, or with parasite load. Different individuals who were immunized with a virosome vaccine comprising influenza antigens combined with P. falciparum antigens, demonstrated pre-existing interferon- γ, IL-2 and IL-5 ELIspot responses against the influenza antigens, and showed boosting of anti-influenza T-cell responses only for IL-5. The large Ig G1-dominated anti-parasite responses showed limited correlation with T-cell responses for magnitude or avidity, both parameters being only negatively correlated for IL-5 secretion versus anti-apical membrane antigen-1 antibody titres. Overall, these findings suggest that cognate T-cell responses across a range of magnitudes contribute towards driving potentially effective antibody responses in infection-induced and vaccine-induced immunity against malaria, and their existence during immunization is beneficial, but magnitudes are mostly not inter-related. [ABSTRACT FROM AUTHOR]

ABSTRACT In 2011, we initiated a geophysical survey of the Pineland Site Complex. The complex is comprised of two imposing residential midden-mound groups, two sand burial mounds and several linear (and other) middens along previous shorelines, and a canal system that not only integrated features within the site complex, but also served to connect it to the interior of Pine Island and beyond. For 25 years, archaeologists associated with the Florida Museum of Natural History have conducted extensive investigations at the Complex, clarifying the site's intertwined environmental and human histories. Our research presented here provides additional data to confirm some of the hypotheses generated by this previous research. The geophysical results support previous ideas regarding formation and occupation of former shorelines by Pineland's early fisher-gatherer-hunters. Second, they provide better definition of a small, later-period secondary canal, a component of the canal system. Most notably, the geophysical survey provides a basis for studying changes in household composition over time via the identification of house patterns in the resulting imaged data. We provide some speculations regarding this shift in residence patterns, suggesting that alterations may have been coeval with environmental changes. These changes may have set the stage for subsequent large-scale cooperative labour projects, such as Pineland's waterways. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Structured independent reading among students is often a vital missing component in many school districts' literacy curriculum. The nationwide implementation of the Common Core State Standards ( CCSS) requires districts to re-think their literacy curriculum and what instruction might entail in order for students to demonstrate proficiency in literacy by the end of high school. Walker discusses Scaffolded Silent Reading (Sc SR) as a disciplined way for teachers to support adolescents' independent reading at school. She argues that progressive school leaders prioritize independent reading and establish it as a non-negotiable component of a comprehensive literacy program. A Sc SR policy will have greater sustainability as leadership capacity is developed among teachers to implement and facilitate Sc SR. [ABSTRACT FROM AUTHOR]

Aim Long-gap oesophageal atresia ( LGOA) remains a rare variant of a relatively common congenital malformation. Objectives of this study were to review the short-term results including survival, length of stay and post-operative complications for infants with LGOA managed at a single centre in addition to their growth and neurodevelopmental assessment. Methods Retrospective review of the case notes of all infants admitted with oesophageal atresia to our institution from January 2001 to May 2011. Infants with LGOA were selected based on pre-defined criteria. Demographic and clinical variables and details of follow-up visits including developmental assessments were extracted from their case notes. Results Of 101 infants with oesophageal atresia, 15 fulfilled the criteria for LGOA. Overall survival was 80%. Median length of stay was 83 days. Additional congenital anomalies were present in nine (60%). A fall in weight centile during hospitalisation or outpatient follow-up signifying growth failure was seen in a majority with 11 of 13 patients showing this phenomenon. Follow-up at our institution ranged from 6 months to 9 years. Developmental assessments ( Bayley- III) commenced in August 2006 were available in four patients (age 5-13 months) and were abnormal in all, with particular delay in the gross motor domain. Conclusions Infants with LGOA spend a long time in hospital. They remain at significant risk of growth failure during hospitalisation and following discharge. There appears to be a risk of developmental delay that warrants close monitoring. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to explore the association between a Mediterranean-style diet and cognitive performance, dementia, Alzheimer's disease and associated mortality in ageing populations. Methods A systematic search of Ovid Medline, Embase and Cinahl plus databases for papers published from September 1970. Results Ten prospective cohort studies and one cross-sectional study were included in this review. Higher adherence to a Mediterranean-style diet was associated with significantly decreased risks for all-cause dementia, Alzheimer's disease, Alzheimer's disease mortality and infarcts detected by magnetic resonance imaging. Adherence to a Mediterranean-style diet was not, however, consistently associated with tests of cognitive performance and was not associated with the presence of white matter hyper-intensities in the brain. In four of six studies, subjects in the highest tertile for Mediterranean diet adherence had a 28-48% lower risk for development of dementia or Alzheimer's disease than subjects in the lowest tertile. For subjects with Alzheimer's disease, those in the highest tertile of adherence to a Mediterranean-style diet had a 73% lower mortality risk than those in the lowest tertile (fully adjusted hazard ratio 0.27, 95% CIs: 0.10-0.69, P for trend = 0.003). Conclusions There is strong evidence for the protective role of a Mediterranean-style diet against cognitive decline and development of Alzheimer's disease. Strategies should now be sought to promote this eating pattern in older Australians. Support for dietitians in implementing this change has potential to reduce the high health-care costs associated with cognitive decline on ageing. [ABSTRACT FROM AUTHOR]

Aim To compare the developmental outcome of infants with oesophageal atresia with or without trachea-oesophageal fistula ( OA/ TOF) who underwent surgery in early infancy with healthy control infants in New South Wales, Australia. Methods Infants diagnosed with OA/ TOF requiring surgical intervention were enrolled prospectively between 1 August 2006 and the 31 December 2008. Healthy control infants were enrolled in the same time period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development ( Version III). Results Of 34 infants with OA/ TOF that were enrolled, 31 had developmental assessments. The majority (75%) were term infants (≥37 weeks gestation) with a mean birth weight of 2717 g. Fourteen infants (44%) had an associated birth defect and one infant with multiple associated anomalies subsequently died. Developmental assessments were also performed on 62 control infants matched for gestational age. Infants with OA/ TOF had a mean score significantly lower on the expressive language subscale ( P < 0.05) compared with the control infants. Conclusions This study found a lower than expected developmental score for infants following surgery for OA/ TOF in the expressive language subscale compared with the healthy control infants. These findings support concerns over the potential impact of OA/ TOF and its effects on development. Further studies, including continuing developmental review to determine whether these differences persist and their functional importance, should be performed. [ABSTRACT FROM AUTHOR]

Aim Whilst there have been comparisons of the Ages and Stages Questionnaire ( ASQ) with other gold standard developmental assessments, research concerning the free-text comments section of the questionnaire has been limited. The objective of this paper is to assess whether parental concerns expressed in the free-text comments section of the ASQ can accurately predict infant development. Method Data from the Development After Infant Surgery study was analysed post hoc. Free-text comments from the ASQ were analysed qualitatively by thematic analysis and quantitatively in comparison to the Bayley Scales of Infant and Toddler Development, Third Edition ( BSID-III). Infants who underwent cardiac surgery (97), non-cardiac surgery (131) and no surgery (controls; 166) were analysed. Results Parental concern expressed on the ASQ predicted a lower mean BSID- III score when groups were analysed collectively. Medical concern and developmental concern were shown to be predictors of child development, whilst global concerns and behavioural concerns were unrelated to child development. The presence of carer concern was assessed for its value in predicting a BSID-III subscale score less than 8 in all groups. Sensitivity ranged from 22% to 48%, and specificity ranged from 73% to 88%. Conclusions Parental concern was found to predict a lower BSID-III when all groups were analysed collectively. Despite this, parental concern as a screening test for developmental delay failed to meet the National Health and Medical Research Council guidelines for adequate psychometric properties. The findings from this study suggest that there is value in attending to the comments written by carers on the ASQ. [ABSTRACT FROM AUTHOR]

Aim: The study aims to undertake a narrative review examining the indices and references used for the assessment of overweight and obesity in children and adolescents in Australia. This review also summarises current international opinion on choice of indices and reference values. Methods: A systematic search for articles was conducted to examine indices and references used to define overweight and obesity in recent research studies carried out in Australia and published between January 2002 and January 2010. Results: Three hundred ninety papers were retrieved, of which 86 were reviewed. Body mass index (BMI) is the most common method used to measure overweight/obesity in children and adolescents in Australia. The International Obesity Task Force reference charts defining overweight and obesity for gender and age-specific BMI are the most widely used. Waist circumference and the waist-to-height ratio are indices used to determine central adiposity, but these are not yet in widespread use. Conclusions: Body mass index-for-age and -gender is the most common method used in Australia to measure overweight or obesity in children and adolescents and should be used for most future studies. As recommended by the National Health and Medical Research Council, the Centers for Disease Control and Prevention reference charts should be used for children aged 2-18 years. For children aged <2 years, there is a choice between an idealized standard (World Health Organization chart, based on breastfed infants) or a national standard (Centers for Disease Control and Prevention chart, more suitable for formula-fed infants). [ABSTRACT FROM AUTHOR]

Early detection of neurodevelopmental delay and appropriate intervention has been associated with improved academic and social outcomes. Identifying those who are at high risk and might benefit is not straightforward. Approximately 2% of infants are admitted to a neonatal intensive care unit after birth and these babies are known to be at high risk of developmental impairment. While it is well recognised that the extreme preterm infant is at high risk of developmental impairment, there is increasing evidence of a risk in late preterm infants as well as those undergoing major cardiac and non-cardiac surgery. Not all infants are enrolled in multidisciplinary follow-up clinics with easy access to early intervention. These clinics are expensive to run with both limited and conflicting data on their long-term value. This review will concentrate on identifying which infants are at risk, reviewing the aetiology of the risk factors and the efficacy of follow-up clinics. [ABSTRACT FROM AUTHOR]

Although the concept of women as leaders is not a novelty, recent trends have women breaking through traditional 'glass ceilings,' thus pioneering female leadership roles in the workplace and the military. Women in leadership is a movement, a paradigm shift. The author offers a unique leadership model calculated from an instrumental multiple case study analysis of female military officers leading in male-dominated environments. The model proposes four principle dimensions: femininity, self-efficacy, emotional intelligence, and teamwork (F-SET). It has a feminist appeal, although it engages leadership theory from other innovative angles. [ABSTRACT FROM AUTHOR]

Relative to the wealth of information in the medical literature regarding developmental outcome for infants who have had cardiac surgery available, few studies specifically detail how those who have undergone major surgery grow and develop. The few published studies tend to be disease specific, making their results difficult to translate to a more general setting. As mortality for most infants who require surgery in infancy continues to decrease, the focus for researchers and clinicians should be on how these children will grow and develop. As parents realise that their infant will survive, this becomes their next major concern. The most common conditions requiring early major surgery have been reviewed in relation to data on infant developmental outcomes. [ABSTRACT FROM AUTHOR]

To describe the management, morbidity and mortality of infants admitted to a tertiary paediatric hospital in New South Wales, Australia with a diagnosis of sacrococcygeal teratoma (SCT). All neonates admitted to the neonatal intensive care unit with a SCT between January 1996 and December 2008 were included in this retrospective review. Data collected included maternal and neonatal demographics, time of diagnosis, tumour characteristics, surgical treatment, operative complications and outcomes. Seventeen infants with a diagnosis of SCT were included in the study. Of these infants, the majority (70%) were born at term, and eight had a prenatal diagnosis made during the second trimester. Associated anomalies were detected in seven infants (41.8%), with renal anomalies being the most common. Tumour histology included mature (50%, n= 8), yolk sac tumour (18.75%, n= 3), immature (6.25%, n= 1) and mature with mixed elements (25%, n= 4). Recurrent disease occurred in two infants within 4-18 months of the primary resection, with one infant suffering a second recurrence. Only one child died prior to surgery, giving a survival rate of 94%, and mean age at follow-up was 32 months. Long-term sequelae found in four babies included revision of scar, vesicoureteric reflux, post-surgical neurogenic bladder and osteotomy for hip dysplasia. The overall survival of neonatal SCT is high. While this is a small series, our results are consistent with the literature. Important components of management include timely diagnosis, multidisciplinary planning, long-term follow-up and intervention for functional sequelae. [ABSTRACT FROM AUTHOR]

Cerebral palsy (CP) is the most severe physical disability within the spectrum of developmental delay. CP is an umbrella term describing a group of motor disorders, accompanied by many associated impairments. The disability is a result of injuries to the developing brain occurring any time from the first trimester of pregnancy through to early childhood. However, for the great majority, their full etiological causal pathway remains unclear. It is important to discriminate as early as possible between: (a) mild or nonspecific motor delay, (b) developmental coordi- nation disorder, (c) syndromes, (d) metabolic and progressive conditions, and (e) CP with its various motor types and distributions. The most promising predictive tool for CP is the general movements assessment, which assesses the quality of spontaneous movements of infants in the first 4 months of life. We propose a change in diagnostic practice. We recommend a shift away from referral for intervention following a formal (most often late) description of CP, to one of referral for intervention which occurs immediately once an infant is considered "at risk" of CP. © 2013 Wiley Periodicals, Inc. Dev Disabil Res Rev 2011; 17:11 4-i 29. [ABSTRACT FROM AUTHOR]

To describe neurodevelopmental outcomes of neonates following cardiac or non-cardiac surgery for major birth defects. From 1 June 2002 to 31 July 2004, infants born ≥33 weeks gestation who underwent major birth defect surgery were enrolled prospectively. Infants were assessed at a mean corrected age of 24 months (standard deviation (SD) = 8 months, range 18-36 months) using the Bayley Scales of Infant Development: Second Edition. Of the 118 study infants, 79 (66%) were male, the mean gestation was 38.5 weeks (SD 1.9 weeks) and mean birthweight was 3194 g (SD 653 g). Forty-five infants (47%) had undergone general surgery for non-cardiac defects. The majority of infants (73%) performed below average in cognitive and language skills. Mental delay was found in 41% of infants; 16% were significantly delayed. Fine and gross motor skills were below average in 60% of infants. Twenty-six percent of infants had motor delay; 9% were significantly delayed. Both the mean Mental Development Index (M = 88, SD = 19.8) and mean Psychomotor Development Index (M = 93, SD = 19.3) were significantly below the normative mean ( d = 0.8, P < 0.001 and d = 0.5, P < 0.001, respectively). One in five children had global developmental delay. There was no significant difference in outcome between the cardiac and general surgery groups. The majority of infants performed below average on a standardised test of infant development. Our results show that infants requiring newborn surgery for major birth defects are at high risk of adverse neurodevelopmental outcomes. We recommend that follow-up programmes include systematic multidisciplinary developmental monitoring and early intervention. [ABSTRACT FROM AUTHOR]

Aim: To describe the use of a preclinical Objective Structured Clinical Examination for the assessment of clinical skills in undergraduate dietetic students. Methods: The Objective Structured Clinical Examination is a well-established assessment tool in medicine, nursing and some allied health disciplines, but has been rarely used in either formative or summative assessment of dietetic students. This paper describes the development, implementation and evaluation of a preclinical Objective Structured Clinical Examination for dietetic students. Results: Students' performance in a preclinical Objective Structured Clinical Examination was assessed over a six-year period in successive student cohorts. Performance in the Objective Structured Clinical Examination was significantly related to their performance at their first clinical placement. Conclusions: A preclinical dietetic Objective Structured Clinical Examination allows problems arising during the teaching of basic clinical skills to be noted and corrected. In addition, a preclinical Objective Structured Clinical Examination identifies students requiring additional support on placement. [ABSTRACT FROM AUTHOR]

Aim: To survey the use of anthropometry by dietitians. Methods: Respondents to an anonymous online survey were recruited from the dietetic workforce in Victoria, Australia. The survey recorded demographic information, category of dietetic practice and client type. Questions were also asked about use and confidence in taking anthropometric measures and about enablers and barriers for this within dietetic practice. Results: The 151 dietitians who completed the survey resembled the wider Victorian dietetic workforce. Most (93%) considered anthropometry an important tool. Body weight and height were measures most commonly taken. Over 30% used surrogate measures for height such as ulna length. Other measures including circumferences, knee height, sitting height and skinfold thicknesses were taken infrequently. Factors facilitating use of anthropometry were prior experience; training; a mobile consenting client and/or the availability of clear procedures or protocols. Barriers to taking circumferences and skinfold thicknesses included lack of confidence, time and support from senior colleagues. Most respondents indicated the need for additional training in anthropometry. Conclusions: The practice of anthropometry in accordance with practice guidelines would be improved by strengthening professional training and the provision of more supportive, well-resourced systems. [ABSTRACT FROM AUTHOR]

1. It has been argued that all major risk factors for cardiovascular disease have been identified. Yet, epidemiological studies undertaken to identify risk factors have largely focused on populations in developed nations or on the urban or relatively affluent rural populations of developing countries. Poor rural populations are seldom studied. 2. Somewhat different risk factors may operate in poor rural populations. Evidence for this is provided by the finding that, in disadvantaged rural India, the prevalence of hypertension is greater than would be expected based on established risk factors in these populations. One risk factor to be considered is a poor intrauterine environment. 3. In animals, maternal macro- and micronutrient malnutrition can lead to reduced nephron endowment. Nephron deficiency, in turn, can render blood pressure salt sensitive. The combination of nephron deficiency and excessive salt intake will predispose to hypertension. 4. Human malnutrition may have similar effects, particularly in regions of the world where malnutrition is endemic and where women are disadvantaged by existing social practices. 5. Moreover, high salt intake is endemic in many parts of Asia, including India. Therefore, we propose that maternal malnutrition (leading to reduced nephron endowment), when combined with excessive salt intake postnatally, will account, at least in part, for the unexpectedly high prevalence of hypertension in disadvantaged rural communities in India and elsewhere. [ABSTRACT FROM AUTHOR]

Aim: To investigate the learning styles of nutrition and dietetics students to assist in informing nutrition and dietetics curriculum methods, design and review. Methods: A total of 129 students from years one to four of a nutrition and dietetics undergraduate curriculum completed the Index of Learning Styles and the Kolb Learning Style Inventory to reveal their learning style preferences. Results: The Index of Learning Styles identified the students as learners who were intuitive (innovative), verbal (preferring spoken/written explanations) and global (preferring holistic approaches) while the Kolb Learning Style Inventory found that the students had an inclination towards converging (practical) and assimilating (reasoning) learning styles. Conclusions: Analysis of learning styles can assist curriculum change towards teaching strategies that suit students. Teaching and learning activities for dietetics students should be developed to strengthen reflective and emotional learning and to develop students' ability to appreciate different points of view. The finding that learning styles changed with year level requires confirmation via cohort studies. [ABSTRACT FROM AUTHOR]

Aim: To survey nutrient information and claims appearing on packets of breakfast foods (cereals, bars and drinks) and determine how they conform to dietary guidelines and labelling recommendations. Methods: A cross-sectional study based on data collected in August–September 2004 was conducted in a single large supermarket in metropolitan Melbourne. The main outcome measures are cost, nutrient content, fortification, nutrition and function-related claims. Nutrient content with current recommendations, stated versus calculated energy content and consistency of claims made with current regulations and guidelines were analysed. Results: One hundred and eighty-two cereals, 27 bars and 10 drinks were analysed. Only two of six breakfast cereal categories exhibited mean nutrient profiles concordant with present recommendations. Breakfast bars provide more total fat, saturated fat and sugar, while breakfast drinks provide more energy, sugar and sodium, than a serve of cereal eaten with full-cream milk. Bars and drinks were more expensive per gram of protein and per kilojoule than the breakfast cereals. On 15% of cereal labels, stated energy content differed by over 5% from that calculated from the given macronutrients. Fortification with vitamins and minerals was common. Nutrient claims were largely consistent with current regulations. Conclusion: This survey provides baseline data against which future changes in nutrient and health claims and patterns of fortification in breakfast foods may be measured. [ABSTRACT FROM AUTHOR]

Aim: To describe cardiac surgery, survival and outcomes for low-birthweight (≤2500 g) infants undergoing surgery for congenital heart disease. Methods: Using data from a prospectively collected population-based database of admissions to neonatal intensive care units in New South Wales and the Australian Capital Territory, we identified all low-birthweight infants undergoing cardiac surgery between 1992 and 2001. Infants with only a persistent ductus arteriosus were excluded. Two-year cardiac and neurodevelopmental outcome data were sought from hospital medical records. Results: A total of 121 low-birthweight infants underwent cardiac surgery, of whom 34% had a congenital syndrome or non-cardiac birth defect. Most (81%) underwent a palliative surgical procedure in the neonatal period. There were 19 early (15.7%) and 19 late deaths giving a 2-year mortality of 31%. Factors associated with mortality included birthweight below 1500 g ( P = 0.006), low weight at surgery ( P = 0.028) and Apgar score at 1 min ( P = 0.019). No single factor predicted 30-day mortality. By 2 years of age, 27 (33% of survivors) were known to have neurodevelopmental delay. Although 22 children are known to be developing normally, the neurodevelopmental status of 34 children was not known. Conclusions: These surgical data were comparable to previous single-institution studies. This group had a high risk of disability due to prematurity, low birthweight and associated conditions. There is a need to prospectively assess and manage neurodevelopmental outcomes in this group. [ABSTRACT FROM AUTHOR]

Mineral implications in health issues of captive rhinos have received much attention lately. This study was undertaken to establish reference values for the mineral status of rhinos. Serum/plasma samples of free-ranging black ( Diceros bicornis) and white ( Ceratotherium simum) rhinos and of captive black, white, Indian ( Rhinoceros unicornis), and Sumatran ( Dicerorhinus sumatrensis) rhinos, as well as liver tissue samples of captive black, white, and Indian rhinos were analyzed for mineral content. Circulating mineral levels of free-ranging animals were subject to variation according to region. In free-ranging animals, high molybdenum (Mo) values compared to horse normals were striking. Captive animals displayed even higher circulating Mo concentrations. The significance of iron (Fe) overload in captive specimens of the browsing rhinos (black and Sumatran) was confirmed. Hepatic Fe levels increased in blacks with age. Although this Fe overload is suspected to be linked with diets, the data indicate that this is not due solely to an excessive dietary Fe supply. Whereas the grazing species (white and Indian) had high liver copper (Cu) levels, the browsing species had low to marginal liver Cu concentrations. Liver concentrations of K, Mg, Co, and Mo increased with age in captive black rhinos. Additional findings include high circulating Se levels in all rhino species. Future research should be directed at investigating factors leading to high Fe levels, and at investigating Cu metabolism in captive rhinoceros species. Zoo Biol 24:51-72, 2005. © 2005 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Models based on generalized plant physiological theory represent a promising approach for describing vegetation responses to environmental drivers on large scales but must be tested for their ability to reproduce features of real vegetation. We tested the capability of a generalized vegetation model (LPJ-GUESS) to simulate vegetation structural and compositional dynamics under various disturbance regimes at the transition between prairie, northern hardwoods, and boreal forest in the Great Lakes region of the United States. LPJ-GUESS combines detailed representations of population dynamics as commonly used in forest gap models with the same mechanistic representations of plant physiological processes as adopted by a dynamic global vegetation model (the Lund-Potsdam-Jena [LPJ] model), which has been validated from the stand to the global scale. The model does not require site-specific calibration. The required input data are information on climate, atmospheric CO2 concentration, and soil texture class, as well as information on generally recognized species traits (broad-leaved vs. needle-leaved, general climatic range, two fire- resistance classes, shade-tolerance class, and maximum longevity). Model predictions correspond closely to observed patterns of vegetation dynamics and standing biomass at an old-growth eastern hemlock (Tsuga canadensis)/hardwood forest (Sylvania Wilderness, Michigan), an old-growth forest remnant from the "Great Lakes Pines Forest" (Itasca State Park, Minnesota), and a presettlement savanna (Cedar Creek Natural History Area, Minnesota). At all three sites, disturbance (wind or fire) strongly controls species composition and stand biomass. The model could be used to simulate vegetation dynamics on a regional basis or under past or future climates and atmospheric CO2 levels, without a need for reparameterization. [ABSTRACT FROM AUTHOR]

In this paper we summarise previously published evidence indicating that dietary composition can influence patterns of regional fat loss. This novel observation was made initially in the course of an outpatient study comparing the efficacy of two diets commonly prescribed for the treatment of type 2 diabetes: a high carbohydrate, high fibre, low fat diet, and a 'modified fat' diet containing a high proportion of monounsaturated fat. Both diets are low in saturated fat and therefore expected to be associated with a reduction in the risk of coronary heart disease. However, we were concerned that due to its relatively high fat content and energy density, the modified fat diet would be associated with weight gain when consumed in the free-living situation. In order to address this question, a randomised crossover design study was conducted in which subjects with type 2 diabetes consumed each diet for three months. Both diets were associated with moderate weight loss. The unexpected and significant finding was that the low fat diet was associated with a disproportionate loss of lower body fat, resulting in an adverse change in the ratio of upper to lower body fat. Loss of body fat during the modified fat diet was proportional, with no change in the ratio of upper to lower body fat. Furthermore, the modified fat diet was clearly preferred over the low fat diet. Studies are currently underway to elucidate the underlying mechanisms and gain further understanding of the significance of these findings, [Aust J Nutr Diet 1998;55(4 Suppl):S32-S36]. [ABSTRACT FROM AUTHOR]

Using data from semistructured qualitative interviews with 52 working- and middle-class women and men, this paper compares differences in both friendship patterns and expectations of friendship. Working-class respondents' friendships revealed a high degree of reciprocity and interdependence with respect to material goods and services. Norms of working-class friendship emphasized being able to rely on friends for such services. Middle-class respondents, in contrast, celebrated shared leisure and the existence of large networks of interesting friends. Middle-class friendships enhanced the individuality that characterizes contemporary middle-class life. As a result of class differences in the meanings and expectations of friendship, the potential strains and conflicts differed. Working-class respondents reported far more open conflict with friends over the exchange of services than did middle-class respondents. Middle-class respondents reported difficulties in asking friends for help, even though being able to do so was a widely shared ideal of friendship. [ABSTRACT FROM AUTHOR]

Presents information on a simulated Australian diet, which has been developed, based on commonly consumed foods. Details on menus constructed; What the study confirmed.