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Young people are becoming more detached from nature through a number of causes, including their increased use of digital media. This detachment from nature results in a lowering in the sense of ownership of the land and its resources and subsequently results in less motivation to conserve it. In order to reverse such behaviours and attitudes, a new programme termed ‘Lifelong Learning through Nature’ (LLN) was devised. This study is an analysis of the LLN programme and its potential for making links between outdoor learning, fieldwork and education for sustainable development. These results shed light on the effectiveness of the programme in influencing knowledge and attitudes and, in turn, lead to formulate a way forward in the programme’s evolution. Outdoor education is an essential element of Education for Sustainable Development (ESD) which is key to address the current situation for a sustainable future. The data was collected through a number of focus groups with students from a number of different schools from the Maltese islands. Each group of students was researched through a pre-activity focus group and a post-activity focus group. The data was then transcribed and translated and subsequently analysed through a structured thematic analysis. The results revealed a great sense of detachment in the young students and eventually a greater sense of pointlessness in the older students. The post-focus groups indicated excellent improvement in knowledge and a perceptible change towards a more positive attitude across the ages. This study reveals that the LLN programme does have an influential role in the knowledge and attitudes of school children towards nature. This study continues to uphold the vision that outdoor education should be considered as a main activity which involves and results in ESD. In response to these findings, a model illustrating the emerging links between the LLN programme and various factors is presented. This paper directly illustrates how university research in teamwork with non-governmental organisations can impact the local community and the study will be useful to anyone interested in carrying out effective programmes and research into the links between ESD and outdoor education.

Aims This study aimed to evaluate the efficacy of a high (≥12) Finnish diabetes risk (FINDRISC) score in identifying undiagnosed prediabetes and type 2 diabetes (T2D) in an New Zealand population of overweight and obese individuals, across a variety of ethnic groups. Methods We estimated the efficacy of elevated FINDRISC scores in predicting prediabetes and T2D in 424 overweight adults with no prior diagnosis recruited for the PREVention of diabetes through lifestyle Interventions in Europe and Worldwide (PREVIEW) study. All participants who completed the FINDRISC questionnaire during a pre-screening phase with a score of ≥12 were then screened using a 2 h oral glucose tolerance test (2h-OGTT) to identify undiagnosed dysglycaemia. Results Of the 424 participants, 65% (n = 280) were pre-diabetic and 7% (n = 32) had undiagnosed T2D. A higher FINDRISC score was significantly associated with prediabetes and T2D (P = 0.02). There was a significant association between ethnicity and glycaemic status (normal vs prediabetes/T2D, P = 0.02). Increasing the FINDRISC cut-off to ≥15 resulted in a non-significant increase in the proportion of participants correctly classified with dysglycaemia. ROC-AUC = 0.6 with sensitivity = 0.6026 (95% CI: 0.5459–0.6573) and specificity = 0.5536 (95% CI: 0.4567–0.6476). Isolated impaired fasting glucose (IFG) was more efficient in predicting dysglycaemia than isolated impaired glucose tolerance (IGT). Conclusions The FINDRISC questionnaire is a useful and efficacious screening tool to identify unknown prediabetes and T2D in overweight New Zealanders, particularly in Maori individuals.

Pertussis vaccines have been effective at reducing pertussis-associated morbidity and mortality. However, they have a complex array of limitations, particularly associated with the duration of protection against clinical disease and imperfect immunity (carriage and transmission). Little is known about risk factors for pertussis vaccination failure. Understanding pertussis vaccination failure risk is most important in the paediatric population. This study aims to investigate risk factors for pertussis vaccination failure in (1) infants between birth and six weeks of age born to mothers who received pertussis booster vaccinations during pregnancy and (2) infants after the completion of the primary series (approximately five months old) to four years old. This will be achieved in a two-step process for each study group. Pertussis vaccination failure cases will first be described using a case series study design, relevant case characteristics will be sourced from six national administrative datasets. The case series study results will help select candidate risk factors (hypothesis generating step) to be tested in the retrospective cohort study (hypothesis testing step). Pattern analysis will be used to investigate risk factor patterns in the cohort study. The identification of higher risk groups enables targeting strategies, such as additional doses, to better prevent pertussis disease.