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There is a need for resources to guide informal carers in medication management for people with dementia. Availability of resources on medication management guidance has yet to be explored. A systematic search of MEDLINE, Embase, CINAHL and PsycINFO was performed in May 2022 to identify and evaluate resources for carers of people with dementia that provide guidance in medication management. Google and known repositories were also searched. Readability of text-based resources was examined using the Flesch-Kincaid reading level, the Flesch reading ease and the Gunning-Fog index. Resources were further evaluated using the Patient Education Material Assessment Tool (PEMAT or PEMAT-A/V). Fifteen resources were identified, which largely focused on medication administration with limited discussion of shared decision-making. Current resources do not appear to have included people living with dementia or their carers in their development and did not address high-risk care settings. Codesign of resources with carers and people with dementia would ensure that resources are comprehensive and target their needs. Future research should therefore focus on development of readily available and understandable resources that provide medication management guidance for carers across different health settings, to comprehensively address the multi-faceted nature of dementia.

Appropriately skilled staff are required to meet the health and care needs of aging populations yet, shared competencies for the workforce are lacking. This study aimed to develop multidisciplinary core competencies for health and aged care workers in Australia through a scoping review and Delphi survey. The scoping review identified 28 records which were synthesized through thematic analysis into draft domains and measurable competencies. Consensus was sought from experts over two Delphi rounds (n = 111 invited; n = 59 round one; n = 42 round two). Ten domains with 66 core competencies, to be interpreted and applied according to the worker's scope of practice were finalized. Consensus on multidisciplinary core competencies which are inclusive of a broad range of registered health professionals and unregistered aged care workers was achieved. Shared knowledge, attitudes, and skills across the workforce may improve the standard and coordination of person-centered, integrated care for older Australians from diverse backgrounds.

Objective Research involving people with dementia is vital to appropriately inform policy and practice decisions affecting this population. As dementia-care researchers, we frequently advocate to Human Research Ethics Committees for the right of people with dementia to choose whether to participate in research. This brief report provides some considerations for researchers and ethics committees. Method Descriptive summary of principles that argue for inclusion of people with dementia in research studies. Results Specifically excluding people living with dementia from research because of perceived cognitive impairment is inappropriate in light of human rights principles and the right to contribute to evidence-based care. Conclusion There is a difference between capacity to provide informed consent and ability to provide perspectives that are valid for each individual. Providing the opportunity for a person with dementia to participate in research and offering support to do this is a matter of human rights.

This article considers the pedagogical practice of the Special Collections staff team at the University of Sussex and the impact of the group visit experience on student learning. It addresses our current group visit teaching offer to students at the University of Sussex and our move to a more student-led active learning approach. It considers the use of the ‘pedagogical toolkit’ including technology within the classroom, and the creation of a document identification form to encourage critical thinking. Our aim for any group visit is to provide a positive first experience and get students enthused about using archives. In 2017 we undertook our own impact study, detailed within the article, to follow the student journey with the intention of finding out if students returned to use archives for their studies as a result of their group visit. Moving forward, this article considers our future activities in response to the impact study and institutional initiatives.

Background Strategic collaborative networks between care staff and researchers can be a powerful means of improving the provision of safe and quality care. Aged care staff hold vital information on research practicality and ease of implementation in the clinical setting. Aged care staff are best positioned to advise on a study’s feasibility in the clinical environment and for the particular residents in their care, regardless of the fact that they are often not involved in the research process. Aim To explore aged care staff attitudes towards research particularly the influencing factors that promote and sustain care staff participation in research in the residential aged care facility (RACF) setting. Methods Qualitative semi-structured interviews were conducted at two aged care facility sites in Sydney with 10 aged care staff before and after their participation in a randomised controlled trial on their ward. The interviews explored aged care staff perceptions of the importance of research, staff compliance and factors that influence research conducted in the RACF setting. Findings Aged care staff reported on the importance of conducting research in RACFs. The barriers to staff participation included insufficient time (50%), lack of belief in intervention effect (30%), deficits in research knowledge (40%) or support (30%). Research perceived as practical (40%) that could be conducted unobtrusively (60%), provided tailored education (70%) with effective communication (50%) between researcher and aged care staff, was more favourable for staff participation. Discussion Aged care staff recognised that findings from research when implemented was important for improving quality care provision but it was challenging to conduct research in the RACF setting. Implementing strategies that support aged care staff research time away from clinical tasks, access to research education and foster communication between academic and staff can improve care staff participation in research. Conclusion Focused strategies fostered by collaborative partnerships between aged care staff, academic researcher and industry management can promote and sustain the research capacity of staff caring for older people in RACFs.

Background Adenylosuccinate lyase deficiency (ADSLD) is an ultrarare neurometabolic recessive disorder caused by loss-of-function mutations in the ADSL gene. The disease is characterized by wide clinical variability. Here we provide an updated clinical profiling of the disorder and discuss genotype–phenotype correlations. Results Data were collected through "Our Journey with ADSL deficiency Association" by using a dedicated web survey filled-in by parents. Clinical and molecular data were collected from 18 patients (12 males, median age 10.9 years ± 7.3), from 13 unrelated families. The age at onset ranged from birth to the first three years (median age 0.63 years ± 0.84 SD), and age at diagnosis varied from 2 months to 17 years, (median age 6.4 years ± 6.1 SD). The first sign was a psychomotor delay in 8/18 patients, epilepsy in 3/18, psychomotor delay and epilepsy in 3/18, and apneas, hypotonia, nystagmus in single cases. One patient (sibling of a previously diagnosed child) had a presymptomatic diagnosis. The diagnosis was made by exome sequencing in 7/18 patients. All patients were definitively diagnosed with ADSL deficiency based on pathogenic variants and/or biochemical assessment. One patient had a fatal neonatal form of ADSL deficiency, seven showed features fitting type I, and nine were characterized by a milder condition (type II), with two showing a very mild phenotype. Eighteen different variants were distributed along the entire ADSL coding sequence and were predicted to have a variable structural impact by impairing proper homotetramerization or catalytic activity of the enzyme. Six variants had not previously been reported. All but two variants were missense. Conclusions The study adds more details on the spectrum of ADSLD patients’ phenotypes and molecular data.

Objective Lavender and Lemon Balm essential oils are popular in the management of older person agitation due to their ease of application, minimal side effects and low interaction with concurrent medications. This study addressed limitations in the literature to evaluate and compare effectiveness of Lavender and Lemon Balm essential oils on the agitated behaviour of older people with and without dementia living in residential aged care facilities [RACFs]. Methods Forty-nine nursing home residents with dementia (n=39) and without dementia (n=10) exhibiting agitation participated in this study. Participants were randomised to a counterbalanced, repeated measures design experiment that tests the treatments Lavender, Lemon Balm, and Placebo (Sunflower oil). Treatments were administered once daily for two-weeks followed by a two-week washout period before commencing the subsequent treatment. All participants trialed all three treatments over a 10-week period. Data were collected on the Neuropsychiatric Inventory (NPI) and Cohen-Mansfield Agitation Inventory (CMAI). Results A significant difference was shown when essential oils effect were compared between the cognitive groups. Post hoc analysis reports Lemon Balm more effective in reducing NPI agitation (p = .04) and CMAI physical non-aggressive behaviour (PNAB) (p = .02) in residents without dementia. Lemon Balm less effective in reducing NPI irritability (p = 0.01) and Lavender more effective in reducing CMAI PNAB (p = 0.04) in dementia. Conclusion The findings support an opposing effect of Lemon Balm and Lavender in reducing agitated behaviour between the participant cognitive groups. There was no reduction in agitation with treatments when compared to placebo independent of cognitive groups.

Background Student transition to university may contribute to weight gain, decreased physical activity and unhealthy dietary habits. The ‘freshman 15’ phenomenon reported a 15 pound weight gain (6.8 kg) in US college students during their first year of study. It is unknown whether these findings apply to nursing students in Australia. Aim To explore health behaviours and potential weight change of nursing students during first year university. Methods A dual-method longitudinal study recruited participants from one university. Anthropometric and health questionnaire data were collected at semester commencement and seven months later, and analysed descriptively. Semi-structured interview data were collected from a sub-sample of participants, and examined by thematic analysis. Findings Baseline data was completed by 145 respondents, with 35 (24%) returning for follow up. Median weight gain was 1.9 kg at seven months, with a higher proportion of participants ‘overweight’ or ‘obese’ and reporting ‘very poor to fair’ health. Self-reported physical and dietary behaviours fluctuated, with insufficient time a barrier to achieving a healthy lifestyle while maintaining academic requirements. Emergent themes related to time, perspectives on health and wellbeing, transitioning to university, prior behaviours and adaptability, future supports, and recommendations for improving health behaviours. Discussion Modest weight gains were evident, but not to the extent of the ‘freshman 15’. Transition to university is a critical period of change with reduced engagement in regular physical activity and healthy dietary choices. Conclusion Risk factors associated with transition to university were identified, highlighting opportunities for future interventions in healthy lifestyle support for nursing students.

Background Agitation in older people is commonly associated with cognitive decline, complex medical diagnoses and polypharmacy. Impaired communication and comprehension within a dementia trajectory adds complexity to assessment and management. Despite high prevalence, agitated behaviours remain challenging to manage in residential aged care settings. Aim To explore staff perceptions of agitation in residents of aged care facilities, including the influence of dementia, when selecting management strategies to reduce agitated behaviour. Design Qualitative descriptive. Methods Semi-structured interviews with 11 aged care staff were conducted at two aged care sites. Transcripts were examined using content analysis to identify common issues and categories. The study complied with COREQ guidelines (see. Appendix S1). Results Participants reported managing resident agitation at least once per shift; most frequently manifesting as wandering, restlessness or aggression. Management strategies included distraction, providing space, knowing the resident, identifying causative factors, spending individual time and if necessary medication administration. Agitation management was more challenging for residents with dementia due to impaired communication or comprehension of instruction. Conclusions While participants strived to deliver individualized person-centred care, this was difficult given time and resource constraints. Contemporary management of agitation therefore remains variable in everyday practice, with resident preference used when causative factors were known. Conversely, for residents with impaired communication and/or comprehension, distraction and chemical restraint were commonly used. Nuanced education for assessment and management is recommended to better address this unmet need for some residents. Relevance to clinical practice For optimal care, appropriate allocation of time and resources is necessary to identify causative and contextual factors for individual residents. Recommendations are for additional staff training in communication and attitude, and collaborating with frontline staff to develop a practical guide for management of agitation in aged care. These simple initiatives may help to improve consistency of care delivery and resident outcomes.

For the children in the inclusive early childhood classroom, there are acceptable, but only limited ways to speak about disability, and sometimes no way to speak. Discourses of tragedy and sufferin...

In early childhood education, playing with friends has long been considered developmentally appropriate and an indicator of a child’s growing social competency. ‘We are all friends’ is a familiar mantra heard in classrooms and playgrounds. For children with a diagnosed disability and their families, inclusive settings offer the promise of play experiences with children without a diagnosed disability. However, the expectation of building friendships and the opportunity to play with friends is not always realised. This article problematises and questions the way friendship play for children is discursively produced and normalised. For the most part, it remains unchallenged, leading to exclusions that are often overlooked. As the friendship play discourse is appreciated as legitimate and taken up by children, it produces a marginal Other. Examining data created during a six-month post-structural ethnography, the power of friendship play discourses comes into focus, making visible exclusionary effects that raise questions about the persistent and pervasive use of the statement ‘We are all friends’.

Background Educational institutions and the health care industry agree that graduates from professional programs need to be “work ready” and capable of delivering competent and confident nursing care. One measure of program success is the student's self-efficacy in meeting expected graduate capabilities. In this study student's self-efficacy is related to palliative care graduate capabilities. Aim To explore graduating Bachelor of Nursing Science (BNSc) students' self-efficacy in caring for palliative care patients. Design A qualitative design using semi-structured face-to-face interviews. Setting A regional Australian university. Participants A purposive sample of 10 students in their final semester of study in a Bachelor of Nursing Science degree program. Method Semi-structured face-to-face interviews were conducted. Interview questions were informed by published palliative care graduate capabilities. Interview data were transcribed verbatim and coded by capability. The coded data were then analysed to determine evidence of self-efficacy in caring for palliative care patients. Results All participants had experiences in caring for palliative care patients. However, the responses did not consistently reflect high degrees of self-efficacy in four documented palliative care graduate capabilities required to care for persons with a life-limiting illness. Conclusions The findings support others that have identified gaps between curriculum and health care industry requirements in terms of students' beliefs about their empowerment to deliver nursing care as graduates. Education interventions and approaches to program evaluation require further development to better support students' growth of self-efficacy in undertaking their graduate roles.

Background Approaches to health promotion that are collaborative, support strengths inherent in Aboriginal and Torres Strait Islander culture, and demonstrate respect and understanding for individual communities, have achieved the most positive outcomes to date. Aim To illustrate how the implementation and evaluation of a safe infant sleep health promotion strategy was facilitated by embedding recognised best practice principles for the conduct of research with Aboriginal and Torres Strait Islander peoples and communities. Methods The Pēpi-Pod® Program was introduced across rural, remote and metropolitan locations in Queensland between 2013 and 2017. This case study discusses the partnership between the Pēpi-Pod® Program and one community-controlled maternal and child health service that employed an Aboriginal Health Worker led model of maternal and child health care for remote regions of Queensland. Findings Best practice principles were embedded within the program design and adaptation, and in the approach to community consultation prior to program implementation. Collaborative partnerships based on trust, which established stakeholder expectations through transparent communication processes, together with effective engagement in achieving program goals, led to the implementation of this evidence-based health promotion initiative as intended. Consideration for locally relevant and culturally competent program delivery was key to success. The integrity of the program was maintained and embedded into ongoing service delivery. Conclusions Through adherence to best practice principles for research with Aboriginal and Torres Strait Islander communities, implementation and evaluation of health promotion programs can be conducted in mutually acceptable, feasible and sustainable ways that develop capacity within participating health services.

It is well established in research that early childhood classrooms are one of the most controlled environments during the human life course. When control is discussed, the enactment of regulatory frameworks and various discourses are analysed but less focus is paid on the materialities of classrooms. In this article, we pay attention to ‘special’ non-human actors present in an ‘inclusive’ early childhood classroom. These ‘special’ non-human actors are so named as they operate in the classroom as objects specific for the child with a diagnosis. The ‘special’ non-human actors, in the specific case the wrist band, the lock and the scooter board, take on meaning within discourses in the ‘inclusive’ classroom. We illuminate how these non-human actors contribute to the constitution of the ‘normal’ and the regulation of educators and children. To trouble the working of power and the control these objects effect on all who is present in the classroom, we ask the following questions: What do these non-human actors do in the ‘inclusive’ classroom and with what effects? How do non-human actors reproduce/produce the ‘normal’, impossible/possible ways to be and act, thus control educators and children? The data used in our analyses were produced as part of a 6-month-long ethnographic engagement in three early childhood settings in the broader region of Newcastle, Australia. It includes observations and conversations with children.

Sudden unexpected death in infancy (SUDI) is four times higher for Aboriginal and Torres Strait Islander babies compared to non-indigenous babies (Commission for Children and Young People and Child Guardian 2014). Co-sleeping is a culturally valued practice used by many indigenous families however is associated with an increased risk of infant death in hazardous circumstances (Venneman et al. 2012; Blair et al. 2014).

Problematising the notion of ‘inclusion’ and the ‘truths’ that inform policy and practice. Turning the focus of ‘inclusion’ towards the discursive constitution of the un-interrogated ‘normal’ and its effects on subjectivities in the classroom. Making visible how silences operate as discursive practices to exclude an Other.

Background: The international literature highlights patient safety as a critical issue in contemporary health care. Poor interpersonal relationships and ineffective health care team communication are identified as dominant human factors contributing to clinical errors and adverse events. Of concern is that some students appear to lack the skills to speak up for themselves, their patients and others when witnessing unsafe practice on clinical placement. Study aims: To elicit student and staff perspectives on the quality, effectiveness and appropriateness of an assertiveness-based communication activity prior to clinical placement. Design: The study used a qualitative design. A communication module was offered in the second week of the practice laboratory and involved the use of two graded assertiveness frameworks. Setting: School of Nursing, Midwifery and Paramedicine, at a regional university in South East Queensland, Australia. Participants: Of the 535 first year undergraduate nursing students enrolled in the laboratory courses, 73 (13.6%) completed an anonymous online survey. Individual interviews were conducted with a university student wellbeing coordinator and student mentor to gain their perspectives of the data. Methods: An evaluation survey with seven qualitative questions and individual semi-structured interviews were employed. Data was analysed using a thematic approach. Results: Five major themes emerged from the survey data: vicarious learning, establishing boundaries, support in practice, advocacy awareness and practice utility. Three themes emerged from the interviews: empowerment and confidence; support and preparation for advocacy; and authentic learning. Conclusions: Findings indicate that teaching assertiveness skills and establishing a preparatory framework for ‘speaking up for safety’ early in a nursing student's tertiary education can have important psychosocial implications for their confidence, empowerment and success. The activity provided an authentic learning experience with perceived practical application to the workplace and, has the potential to enhance first year curricula by improving communication tools used for students preparing for practice.

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0–5·5) with an incidence of respiratory critical events of 3·1% (2·9–3·3). Cardiovascular instability occurred in 1·9% (1·7–2·1), with an immediate poor outcome in 5·4% (3·7–7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86–0·90; p

The potent antiretroviral pyrimidinediones IQP-0528 (PYD1) and IQP-0532 (PYD2) were formulated in polyurethane intravaginal rings (IVRs) as prophylactic drug delivery systems to prevent the sexual transmission of HIV-1. To aid in the selection of a pyrimidinedione candidate and the optimal loading of the drug in the IVR delivery system, four pyrimidinedione IVR formulations (PYD1 at 0.5 wt% [PYD1 0.5wt% ], PYD1 1wt% , PYD2 4wt% , and PYD2 14wt% ) were evaluated in pigtail macaques over 28 days for safety and pyrimidinedione vaginal biodistribution. Kinetic analysis of vaginal proinflammatory cytokines, native microflora, and drug levels suggested that all formulations were safe, but only the high-loaded PYD2 14wt% IVR demonstrated consistently high pyrimidinedione vaginal fluid and tissue levels over the 28-day study. This formulation delivered drug in excess of 10 μg/ml to vaginal fluid and 1 μg/g to vaginal tissue, a level over 1,000 times the in vitro 50% effective concentration. The in vitro release of PYD1 and PYD2 under nonsink conditions correlated well with in vivo release, both in amount and in kinetic profile, and therefore may serve as a more biologically relevant means of evaluating release in vitro than typically employed sink conditions. Lastly, the pyrimidinediones in the IVR formulation were chemically stable after 90 days of storage at elevated temperature, and the potent nanomolar-level antiviral activity of both molecules was retained after in vitro release. Altogether, these results point to the successful IVR formulation and vaginal biodistribution of the pyrimidinediones and demonstrate the usefulness of the pigtail macaque model in evaluating and screening antiretroviral IVR formulations prior to preclinical and clinical evaluation.

Review Questions/Objectives: The following question guides the systematic review: What is the efficacy of complementary therapies in the symptom management of agitation in older people living in a RACF? This systematic review aims to identify the efficacy of complementary therapy interventions in reducing the frequency and severity of agitated behaviour among older people in RACF. Specific questions to be addressed include: What type of complementary therapies are been implemented for the symptom management of agitation in older people residing in a RACF? Which complementary therapies are identified as being effective in reducing the frequency and severity of agitation in older people in a RACF? Inclusion Criteria: Types of Participants: Older people living in RACFs will be included regardless of cognitive ability, gender or ethnicity and existing co-morbities. Trials of RCTs investigating symptom management of agitation in older people over the age of sixty five will be examined. Trials undertaken in settings other than RACFs will be excluded. Types of Interventions: The types of interventions to be explored in this review are complementary therapies include: aromatherapy exercise massage music therapy therapeutic touch These interventions are of interest as they are non invasive, have minimal interactions with current medications and require minimal time, resources and training by nurses. Types of Outcome Measures: The outcome measures to be explored include severity and frequency of agitated behaviours. Outcomes will be measured with a variety of standardised and non standardised measurement tools using observation, with long term and short term measures. Measures will review the findings of frequency and severity of agitation.

Aim. This paper is a report of a study conducted to explore the impact of preidentified contextual themes (related to work environment and socialization) on nursing medication practice. Background. Medication administration is a complex aspect of paediatric nursing and an important component of day-to-day nursing practice. Many attempts are being made to improve patient safety, but many errors remain. Identifying and understanding factors that influence medication administration errors are of utmost importance. Method. A cross-sectional survey was conducted with a sample of 278 paediatric nurses from the emergency department, intensive care unit and medical and surgical wards of an Australian tertiary paediatric hospital in 2004. The response rate was 67%. Result. Contextual influences were important in determining how closely medication policy was followed. Completed questionnaires were returned by 185 nurses (67%). Younger nurses aged

Family-centred care philosophies are promoted by policy makers and nurse leaders, although how this ideal is put in practice often remains unclear. Checklists or guidelines may be useful tools to assist nurses in determining a parent's desire for involvement in their child's care. AIM: To evaluate the effectiveness of a documentary tool designed to formalise role negotiation and improve communication between parents and nurses. METHODS: A quasi-experimental pre/post-intervention study design was used to determine nurses' perceptions of the effectiveness of a documentary tool in facilitating nurse-parent discussion about parental desire for involvement in the daily care activities of their child while in hospital. Nurses in randomly selected wards were assigned to usual practice (control group) or the implementation of a Negotiated Care Tool (intervention group) during a three-month period. RESULTS: Pre- and post-intervention surveys were completed by 69 nurses. The tool was associated with attitudinal changes in the desired direction for 12 of the 24 nurse responses: nurses in the intervention group were significantly more likely to include parents in decision making (p = 0.007); encourage parents to ask questions during their child's hospital stay (p = 0.005); and invite extended family members to participate in care with parental permission (p = 0.03). CONCLUSION: The Negotiated Care Tool raised staff awareness of the importance of effective communication and negotiation of care with parents in busy clinical practice areas. Transparent communication and negotiation of roles between nurses and parents are integral to family-centred care provision.

In the ‘inclusive’ early childhood classroom, the gaze of educators, professionals, children, and researchers often focuses on the ‘child with a diagnosis’, their assessment, remediation, and transition into the mainstream. Rarely does this gaze of scrutiny fall on the ‘including space’, the ‘normal’, ‘the children without a diagnosis’. This chapter turns the interrogatory gaze toward the ‘normal’ and its discursive constitution, presenting data from a six-month ethnography in three early childhood settings in Australia. Utilizing a post-structural framework, I examine how children in the classroom take up the available and sanctioned discourses, positioning themselves and others within these discourses. As the children position and reposition themselves, ‘silences’ are observed. In various nuanced ways ‘silence’ is taken up by the children, as they share ‘silences’, perform as ‘silent’ subjects and ‘speak’ only in certain terms. As ‘silences’ are performed by the children, a ‘taboo’ emerges, re/produced around the discursively produced Other. As psy-knowledge circulates and makes meaning in the early childhood classroom, ‘silence’ creates a powerful effect. In this chapter, I theorize how traces of scientific and medical discourses of the past continue to produce ‘silent’ effects in the classroom, perpetuating exclusionary practices.

A new anti-HIV protein, scytovirin, was isolated from aqueous extracts of the cultured cyanobacterium Scytonema varium. The protein displayed potent anticytopathic activity against laboratory strains and primary isolates of HIV-1 with EC50 values ranging from 0.3 to 22 nM. Scytovirin binds to viral coat proteins gp120, gp160, and gp41 but not to cellular receptor CD4 or other tested proteins. This unique protein consists of a single 95-amino acid chain with significant internal sequence duplication and 10 cysteines forming five intrachain disulfide bonds.

In an effort to obtain more insight into the interaction between HIV-1 reverse transcriptase and the alkenyldiarylmethanes (ADAMs), a new series of compounds has been synthesized and evaluated for inhibition of HIV-1 replication. The modifications reported in this new series include primarily changes to the alkenyl chain. The most potent compound proved to be methyl 3',3' '-dibromo-4',4' '-dimethoxy-5',5' '-bis(methoxycarbonyl)-6,6-diphenyl-5-hexenoate (28), which displayed an EC(50) of 1.3 nM for inhibition of the cytopathic effect of HIV-1(RF) in CEM-SS cells. ADAM 28 inhibited HIV-1 reverse transcriptase with an IC(50) of 0.3 microM. Mutations that conferred greater than 10-fold resistance to ADAM 28 clustered at residues Val 106, Val 179, Tyr 181, and Tyr 188. Results derived from this series indicate that ADAMs containing chlorines in the aromatic rings might bind to HIV-1 reverse transcriptase in a slightly different mode when compared with those analogues incorporating bromine in the aromatic rings.

Resin-immobilized aldimines 5 , derived from the condensation of amine-functionalized Rink polystyrene resin with aldehydes, react with Grignard reagents, lithium reagents or LiBH 4 to afford a wide variety of primary amines in good to excellent yields upon trifluoroacetic acid cleavage. In this amine synthesis, Rink resin functions both as a solid support and as a NH protecting group.

Abundant evidence recognises breastfeeding as being associated with significant short and long-term health benefits for both infant and mother. Until recently, the role of breastfeeding as an independent factor in reducing risk for sudden unexpected infant death remained unclear. In October 2010, SIDS and Kids Australia held a consensus forum with international researchers and key stakeholders to review current evidence relating to safe infant sleeping recommendations. Following this forum and the publication of key reviews, the SIDS and Kids National Scientific Advisory Group has supported the decision that a critical threshold had been reached within the evidence that is supportive of breastfeeding as a specific risk reduction measure for sudden unexpected death in infancy. A sixth recommendation, Breastfeed baby if you can, will be included in the 2012 SIDS and Kids Safe Sleeping national public health campaign.

Introduction: Co-sleeping is a culturally valued practice by many Indigenous families, however is associated with sudden unexpected death in infancy (SUDI) in hazardous circumstances. Aim: To evaluate a safe sleep strategy comprising a safe sleep enabler embedded in education in collaboration with Aboriginal and Torres Strait Islander families with high risk for SUDI. Methods: The Pepi-pod Program, comprising a safe sleep enabler, safe sleeping parent education and safety briefing; and family commitment to share safe sleeping messages in social networks, was delivered to Aboriginal and Torres Strait Islander families with identified SUDI risks, recruited through Queensland maternal and child health services (n = 10 services, 25 communities) across metropolitan, regional and rural/remote areas. Parent questionnaires administered face-to-face or by telephone within 2 weeks of receiving the Pepi-pod; then monthly thereafter until pod use ceased. Health service feedback was conducted via focus group at participating sites. Results: The program was acceptable to families (n = 112 recruited to date) and raised awareness of, and improved consistency with, safe sleeping recommendations. All families recruited had identified risk factors. Midwifery and health worker feedback relating to implementation of the program indicated that the program was feasible, flexible, sustainable, and built local workforce capacity with integration into current service models. Conclusion: This is the first evaluation of a safe sleep enabler in Australia. Program principles are applicable to mainstream services which care for vulnerable families and high risk infants. Evaluating innovative and culturally respectful strategies to reduce SUDI risk through enabling safe sleep environments, which support community ownership, develop midwifery and multidisciplinary team skills, and reorient services from safe sleep advice to safe sleep action, will better inform the evidence-base used by educators, clinicians, researchers and policy makers in supporting parents and reducing infant deaths.

1,2,4-Triazoles were synthesized on a solid support in three steps, with excellent yields and purities. The utility of this triazole-functionalized solid support was demonstrated by the solid-phase synthesis of various trisubstituted 1,2,4-triazoles.

The total synthesis of anibamine, the first and only natural product known as a chemokine receptor CCR5 antagonist, is reported herein. Anibamine was synthesized from acetylacetone and cyanoacetamide in 10 steps.

CS spray (2-chlorobenzylidene malononitrile 5% w/v in methyl isobutyl ketone) has been used by the police force in the UK as an incapacitant for nearly a decade. It causes a number of well-recognized cutaneous reactions, which are generally regarded as short-lived. These include skin burning, erythema and blistering. However, a range of unpredictable cutaneous reactions to CS spray may also occur. We have found contact allergy, leukoderma, initiation or exacerbation of seborrhoeic dermatitis, and aggravation of rosacea following CS spray exposure in 6 police officers and 1 doorman. These skin reactions have required long-term changes in working practice for the affected individuals. Police officers may have repeated exposure to CS spray during their training and in their work, and designated police officers carry CS spray canisters daily in the line of duty. They may therefore be at greater risk of exposure to CS spray and its unintended effects than many assailants.

As projects are now a common feature of the libraries, archives, and museums sector, this book brings together the key points of project management throughout the life of a project following the PR...

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship. What is known about the topic? Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this population. What does this paper add? Through consultation with a sample of Indigenous child health workers and child health workers key areas necessary to provide support for the individuals working in these roles have been identified. What are the implications for practitioners? The findings from this study will inform policy and program development in order to more comprehensively support health workers in the community and contribute towards workforce development and satisfaction, recruitment and retention.