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s / Placenta 35 (2014) A1eA112 A77 P2.48-N. DOES ALTERED PLACENTAL MORPHOLOGY AND FUNCTION EXPLAIN INCREASED INCIDENCE OF POOR PREGNANCY OUTCOME IN ADVANCED MATERNAL AGE Samantha Lean, Alex Heazell, Jane Boscolo-Ryan, Linda Peacock, Tracey Mills, Rebecca Jones University of Manchester, Manchester, UK Objectives: Advancedmaternal age (AMA; >35 years) is associatedwith an increased risk of fetal growth restriction (FGR) and stillbirth. Although their aetiology is unknown in this population, these pregnancy complications are linked to aberrant placental morphology and function and abnormal utero-placental and feto-placental blood flow. We hypothesised that placentas from AMA pregnancies have altered placental morphology and function. Methods: Placentas were collected from singleton pregnancies of 20-30 (control), 35-39 and 40 year old women (n1⁄415/group). Placental cell turnover was assessed by quantification of syncytial nuclear aggregates (SNAs) and proliferative index (Ki67 immunostaining). Placental nutrient transport was measured by uptake of 14C-MeAIB and 3H-Taurine via System A and TauT. Myometrial and chorionic plate artery (CPA) reactivity to U46619, bradykinin and sodium nitroprusside (SNP) was assessed by wire myography. Progesterone, human chorionic gonadotrophin and human placental lactogen were measured in maternal serum in third trimester by ELISA (n1⁄425-29/group). Results: The number of SNAs was increased in placentas fromwomen aged 35-39 and 40 compared to controls (p

Rurality and rural population issues require consideration when conducting and reporting on rural health research. A first article focused on the planning stage of the research. The objective of this article is to explore conducting and reporting issues that require attention when undertaking rural health research. The privacy of participants, the collection of data, the cultural traditions of Indigenous communities, the dissemination of results, and giving something back to the community, are all aspects of conducting and reporting rural health research that require attention. Procedures such as identifying the characteristics of the population, attention to safety issues when collecting data, the use of local liaison persons and acknowledging the ownership of intellectual property, increase the quality of the research outcomes. They are issues that are relevant to both qualitative and quantitative research methods. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues, and possible solutions, rural localities in many other countries may face similar issues. In any rural setting, paying attention to issues that may affect the conducting and reporting of rural health research will hopefully result in studies that support the continued improvement of health in rural communities.

Background Stillbirth is frequently the result of pathological processes involving the placenta. Understanding the significance of specific lesions is hindered by qualitative subjective evaluation. We hypothesised that quantitative assessment of placental morphology would identify alterations between different causes of stillbirth and that placental phenotype would be independent of post-mortem effects and differ between live births and stillbirths with the same condition. Methods Placental tissue was obtained from stillbirths with an established cause of death, those of unknown cause and live births. Image analysis was used to quantify different facets of placental structure including: syncytial nuclear aggregates (SNAs), proliferative cells, blood vessels, leukocytes and trophoblast area. These analyses were then applied to placental tissue from live births and stillbirths associated with fetal growth restriction (FGR), and to placental lobules before and after perfusion of the maternal side of the placental circulation to model post-mortem effects. Results Different causes of stillbirth, particularly FGR, cord accident and hypertension had altered placental morphology compared to healthy live births. FGR stillbirths had increased SNAs and trophoblast area and reduced proliferation and villous vascularity; 2 out of 10 stillbirths of unknown cause had similar placental morphology to FGR. Stillbirths with FGR had reduced vascularity, proliferation and trophoblast area compared to FGR live births. Ex vivo perfusion did not reproduce the morphological findings of stillbirth. Conclusion These preliminary data suggest that addition of quantitative assessment of placental morphology may distinguish between different causes of stillbirth; these changes do not appear to be due to post-mortem effects. Applying quantitative assessment in addition to qualitative assessment might reduce the proportion of unexplained stillbirths. Electronic supplementary material The online version of this article (doi:10.1186/s12907-016-0023-y) contains supplementary material, which is available to authorized users.

We describe findings from participatory research conducted by a southern-based researcher from Thunder Bay, Ontario, and Nunavut Arctic College’s Teacher Education Program students. Together, they interviewed 128 high school students from 11 communities to determine what attracts Inuit youth to teaching and what might discourage them from becoming teachers. The research was based on the premise that Nunavut’s schools cannot be Inuit schools without many more Inuit teachers. We found that many Inuit youth have considered becoming teachers, but they face barriers to doing so. They expressed concerns about housing, finances, leaving their home communities, and their own academic preparedness. Many lacked information about teacher education programs. We recommend addressing these concerns, in part, by using Nunavut Teacher Education Program students to educate high school students about the program and to encourage them to become teachers., Nous décrivons les résultats d’une recherche participative menée par un chercheur de Thunder Bay en Ontario, et des étudiants du Programme de formation des enseignants du Nunavut (Nunavut Teacher Education Program, Nunavut Arctic College). Ensemble, ils ont interrogé 128 étudiants du secondaire provenant de 11 communautés différentes afin de déterminer ce qui incite ou décourage les jeunes inuit à devenir enseignants. Cette recherche se base sur la prémisse que les écoles du Nunavut ne pourront être qualifiées d’écoles « inuit » sans y augmenter le nombre d’enseignants inuit. Nous avons découvert que de nombreux jeunes avaient effectivement envisagé de devenir enseignants, mais qu’ils ont, ce faisant, fait face à certains obstacles. Leurs préoccupations concernaient le logement, le financement, le fait de quitter leur communauté d’origine ainsi que leur propre préparation scolaire. Plusieurs d’entre eux ne connaissaient pas les programmes de formation en enseignement. Afin d’adresser ces problématiques, nous recommandons d’engager les étudiants du Programme de formation des enseignants du Nunavut pour informer les étudiants du secondaire au sujet du programme, et les encourageant à devenir enseignants.

Rurality and rural population issues require special consideration when planning both qualitative and quantitative health research in rural areas. The objective of this article was to explore the issues that require attention when planning the research. This is the first of two articles and focus on issues that require consideration when undertaking rural health research. The diversity of study populations, the feasibility of a research topic, the selection of a research team, and the cultural traditions of Indigenous communities, are all aspects of rural health research planning that require attention. Procedures such as identifying the characteristics of the population, the selection of measures of rurality appropriate for the research topic, the use of local liaison persons, decisions on the use of 'insider' or 'outsider' researchers, and the identification of skills resources available, increase the quality of the research outcomes. These issues are relevant to both qualitative and quantitative research. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues and solutions, rural localities in other countries may face similar issues. Attention to rurality and rural situations when planning rural health research, results in studies that support the continued improvement of health in rural communities.