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BACKGROUND: The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highlights the need for initiatives that improve workplace satisfaction and retention. In response, mentoring programs aimed at enhancing job satisfaction and retention are being increasingly implemented. AIMS: This study sought to measure the workplace satisfaction of nurses and midwives across five New South Wales local health districts, utilising data captured from a wider study investigating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring program. DESIGN: An exploratory, mixed methods study using purposive sampling was employed. METHODS: A secondary analysis of a modified version of the Nursing Workplace Satisfaction Questionnaire, was used to quantify intrinsic, extrinsic, and relational workplace satisfaction constructs among nursing and midwifery staff. Open ended questions included in the survey were thematically analysed using methods developed by Braun and Clarke (2022). RESULTS: Between June-October 2023, n = 106 participants returned the survey. Differences between intrinsic (items 2 & 5), extrinsic (item 9) relational (items 13-15) constructs were observed for health districts, Aboriginality, age, and professional role characteristics (P < 0.05). Five qualitative themes emerged from the data: Helping people is the priority; Teams make a difference to my workplace satisfaction; Managers impact my satisfaction; Scope and recognition; and Organisational factors. CONCLUSIONS: Overall, our findings indicate noticeable differences in workforce satisfaction and retention across various factors, including workforce areas, Aboriginality, age, and professional roles. For these groups, initiatives aimed at improving satisfaction and retention should prioritise fostering teamwork and a sense of belon

The use of deliberative mini-publics (DMPs), such as citizens’ assemblies, is becoming more common in climate policy-making across many countries. The upsurge of these methods reflects an acknowledgement of the need to engage the publics in policy choices that significantly impact their lives. Many DMPs to date have focused on the general challenge of decarbonization, across a range of policy areas. In this article, we first situate DMPs within the wider field of public engagement methods. We then draw from deliberative democratic theory and practice to argue that the next step for climate DMPs is to focus them on specific climate policy challenges and to embed and routinize their use in existing policy-making institutions. We present a case study of the targeted use of a climate DMP, which we designed and ran in partnership with the UK Climate Change Committee, focused on home energy decarbonization. We use this case study to explore barriers and challenges to embedding such an approach in climate policy-making institutions. Finally, we suggest ways that such challenges can be overcome and identify a number of tensions that must be navigated as DMPs become embedded in climate policy-making.

The design of energy and climate policy is usually seen as an ‘expert’ domain, relying on technical tools such as economic analysis. However, policy requires the support of politicians and citizens alike, through the democratic process. Many policies, such as reducing carbon emissions from homes and transport, also affect people’s lives directly. It is thus necessary to supplement technical analysis with methods that allow an exploration of people’s views, values and behaviours. One such method is codesign, whereby groups of citizens work with policy analysts to develop strategies informed by the lived experience of citizens, as well as the specialist knowledge of analysts. There is a history of co-design approaches in public services such as healthcare, but there have been few attempts to co-design public policy measures. This paper reports on a Citizens’ Panel, a representative group of people working with specialists to create co-designed policy recommendations for reducing carbon emissions from homes. The process revealed that policy co-design can provide detailed, viable proposals. In this case, panellists emphasised the necessity of leadership and support from government; tailored, consistent information; targeted regulation; and financial incentives. Finally, the wider potential role for policy co-design for energy and climate is addressed.

Objective: This study aimed to elucidate the presence, antigen specificities, and potential clinical associations of anti–neutrophil extracellular trap (anti-NET) antibodies in a multinational cohort of antiphospholipid (aPL) antibody–positive patients who did not have lupus. Methods: Anti-NET IgG/IgM levels were measured in serum samples from 389 aPL-positive patients; 308 patients met the classification criteria for antiphospholipid syndrome. Multivariate logistic regression with best variable model selection was used to determine clinical associations. For a subset of the patients (n = 214), we profiled autoantibodies using an autoantigen microarray platform. Results: We found elevated levels of anti-NET IgG and/or IgM in 45% of the aPL-positive patients. High anti-NET antibody levels are associated with more circulating myeloperoxidase (MPO)–DNA complexes, which are a biomarker of NETs. When considering clinical manifestations, positive anti-NET IgG was associated with lesions affecting the white matter of the brain, even after adjusting for demographic variables and aPL profiles. Anti-NET IgM tracked with complement consumption after controlling for aPL profiles; furthermore, patient serum samples containing high levels of anti-NET IgM efficiently deposited complement C3d on NETs. As determined by autoantigen microarray, positive testing for anti-NET IgG was significantly associated with several autoantibodies, including those recognizing citrullinated histones, heparan sulfate proteoglycan, laminin, MPO–DNA complexes, and nucleosomes. Anti-NET IgM positivity was associated with autoantibodies targeting single-stranded DNA, double-stranded DNA, and proliferating cell nuclear antigen. Conclusion: These data reveal high levels of anti-NET antibodies in 45% of aPL-positive patients, where they potentially activate the complement cascade. While anti-NET IgM may especially recognize DNA in NETs, anti-NET IgG species appear to be more likely to target NET-associated

Introduction/Objectives: The aim of this study was to compare a novel small event recorder device, the Carnation Ambulatory Monitor (CAM), with a standard Holter. Animals: Nineteen adult dogs. Material and methods: Comparative and explorative study. The two devices were simultaneously applied for approximately 24 h. Results: Analysis time (P=0.013) and percentage of artefacts (P<0.001) were greater for the CAM (110 min [40–264]; and 9% [0–34], respectively) compared to a standard Holter (30 min [18–270]; and 0.3% [0–9], respectively). The total number of beats (P=0.017) and maximum (P=0.02) and mean (P=0.037) heart rates were lower for the CAM (113,806 ± 23,619 beats; 227 ± 35 bpm; and 88 ± 22 bpm, respectively) compared to the standard Holter (131,640 ± 40,037 beats; 260 ± 64 bpm; and 92 ± 26 bpm, respectively). The minimal heart rate (P=0.725), number of pauses (P=0.078), duration of the longest pause (P=0.087), number of ventricular ectopic complexes (P=0.55), ventricular couplets (P=0.186), ventricular triplets (P=0.203), ventricular tachycardia (P=0.05), Lown grade (P=0.233), presence or absence of ventricular bigeminy, trigeminy, supraventricular tachycardia, and atrial fibrillation (P=0.98) did not differ. The CAM missed some relevant events, like complex ventricular arrhythmias, and the Lown grade did not match in 5/19 dogs when comparing the devices. Conclusions: Cardiac Ambulatory Monitor can be used to record ECG traces in dogs over a prolonged period, allowing to detect arrhythmias. Due to some clinically relevant limitations, including a higher percentage of artefacts, a longer reading time (which precludes quantitative counts of >300ventricular premature complexes), and underestimation of complex ventricular arrhythmias, the CAM appears not suitable for quantitative arrhythmia analysis in dogs.