Curriculum implementation exploratory studies: Final report

Throughout the history of schooling in New Zealand the national curriculum has been revised at fairly regular intervals. Consequently, schools are periodically faced with having to accommodate to new curriculum. In between major changes other specifically-focused changes may arise; for example, the increased recent emphasis upon numeracy and literacy

Whiteness and diasporic Irishness: nation, gender and class

Whiteness is often detached from the notion of diaspora in the recent flurry of interest in the phenomenon, yet it is a key feature of some of the largest and oldest displacements. This paper explores the specific contexts of white racial belonging and status over two centuries in two main destinations of the Irish diaspora, the USA and Britain. Its major contribution is a tracing of the untold story of ‘How the Irish became white in Britain’ to parallel and contrast with the much more fully developed narrative in the USA. It argues that, contrary to popular belief, the racialisation of the Irish in England did not fade away at the end of the nineteenth century but became transmuted in new forms which have continued to place the ‘white’ Irish outside the boundaries of the English nation. These have been strangely ignored by social scientists, who conflate Irishness and working-class identities in England without acknowledging the distinctive contribution of Irish backgrounds to constructions of class difference. Gender locates Irish women and men differently in relation to these class positions, for example allowing mothers to be blamed for the perpetuation of the underclass. Class and gender are also largely unrecognised dimensions of Irish ethnicity in the USA, where the presence of ‘poor white’ neighbourhoods continues to challenge the iconic story of Irish upward mobility. Irishness thus remains central to the construction of mainstream ‘white’ identities in both the USA and Britain into the twenty-first century

Analysis of exome data for 4293 trios suggests GPI-anchor biogenesis defects are a rare cause of developmental disorders.

Over 150 different proteins attach to the plasma membrane using glycosylphosphatidylinositol (GPI) anchors. Mutations in 18 genes that encode components of GPI-anchor biogenesis result in a phenotypic spectrum that includes learning disability, epilepsy, microcephaly, congenital malformations and mild dysmorphic features. To determine the incidence of GPI-anchor defects, we analysed the exome data from 4293 parent-child trios recruited to the Deciphering Developmental Disorders (DDD) study. All probands recruited had a neurodevelopmental disorder. We searched for variants in 31 genes linked to GPI-anchor biogenesis and detected rare biallelic variants in PGAP3, PIGN, PIGT (n=2), PIGO and PIGL, providing a likely diagnosis for six families. In five families, the variants were in a compound heterozygous configuration while in a consanguineous Afghani kindred, a homozygous c.709G>C; p.(E237Q) variant in PIGT was identified within 10-12 Mb of autozygosity. Validation and segregation analysis was performed using Sanger sequencing. Across the six families, five siblings were available for testing and in all cases variants co-segregated consistent with them being causative. In four families, abnormal alkaline phosphatase results were observed in the direction expected. FACS analysis of knockout HEK293 cells that had been transfected with wild-type or mutant cDNA constructs demonstrated that the variants in PIGN, PIGT and PIGO all led to reduced activity. Splicing assays, performed using leucocyte RNA, showed that a c.336-2A>G variant in PIGL resulted in exon skipping and p.D113fs*2. Our results strengthen recently reported disease associations, suggest that defective GPI-anchor biogenesis may explain ~0.15% of individuals with developmental disorders and highlight the benefits of data sharing

Capillary refill time in adults has poor inter-observer agreement

Objectives: Capillary refill time (CRT) has been taught as a rapid indicator of circulatory status but to be a useful clinical test, CRT needs to be reproducible when performed by another health care worker. No inter-rater agreement studies have been reported for adult patients. The aim of this study was to determine the inter-observer reliability of CRT in a sample of adult emergency department (ED) patients. Methods: This prospective observational study included clinically stable ED patients with a variety of conditions from two community EDs. A doctor and a nurse each measured CRT by estimation to the nearest half-second using a standard method on each patient. They were blinded to each other's measurements. The primary outcome of interest was inter-rater agreement. Secondary outcome was agreement in classification as normal or abnormal according to accepted definitions. Data was analysed using bias plot analysis, correlation, absolute percent agreement and kappa analysis. Results: Totally, 209 patients were enrolled; 51% were female and 86% were Caucasian. Median CRT was 2 seconds (95% CI 2-2.35 seconds). The mean difference between measurements by the different observers was 0 second, however the 95% limits of agreement were very wide (-1.7 to +1.9 seconds). Agreement was 70% for classification of 'normal' or 'abnormal' using the 2-second definition of normal, with a kappa of 0.38. Conclusion: Interobserver agreement in measurement of CRT was poor in adult subjects with wide limits of agreement. This is a serious threat to the appropriateness of this test for use in clinical practice

Optimal Care Pathways for People in Suicidal Crisis Who Interact with First Responders: A Scoping Review

Background: First responders play a vital role in attending to people in suicidal crisis and influencing their care. Aims: To examine existing care pathways and models of care that could be used for people in a suicidal crisis who have come to the attention of first responders. Methods: A scoping review of academic and grey literature published between 2009 and 2019 was conducted, supplemented by consultation with experts, service providers and people with lived experience. Results: The search identified 703 studies. Twenty-three peer reviewed and grey literature articles, as well as one personal communication, were considered eligible for inclusion. Six models, covering 22 programs, were identified. No studies were identified that described care pathways, per se. Co-responder and safe haven models were associated with reduced hospital use and police detentions. Aftercare models were associated with improved well-being and reduction in symptoms. Co-responder, safe haven, and aftercare models were all rated positively by service users. No studies measured the impact on longer term suicidality. Limitations: Inclusion criteria were broad resulting in heterogeneity of studies and designs, limiting comparisons. Few studies employed standardised measurement protocols, reducing the ability to draw sound conclusions. Conclusion: Several novel programs have the potential to support individuals in crisis who encounter first responders

The determinants of dietary diversity and nutrition: ethnonutrition knowledge of local people in the East Usambara Mountains, Tanzania

Abstract Background Diet and nutrition-related behaviours are embedded in cultural and environmental contexts: adoption of new knowledge depends on how easily it can be integrated into existing knowledge systems. As dietary diversity promotion becomes an increasingly common component of nutrition education, understanding local nutrition knowledge systems and local concepts about dietary diversity is essential to formulate efficient messages. Methods This paper draws on in-depth qualitative ethnographic research conducted in small-scale agricultural communities in Tanzania. Data were collected using interviews, focus group discussions and participant observation in the East Usambara Mountains, an area that is home primarily to the Shambaa and Bondei ethnic groups, but has a long history of ethnic diversity and ethnic intermixing. Results The data showed a high degree of consensus among participants who reported that dietary diversity is important because it maintains and enhances appetite across days, months and seasons. Local people reported that sufficient cash resources, agrobiodiversity, heterogeneity within the landscape, and livelihood diversity all supported their ability to consume a varied diet and achieve good nutritional status. Other variables affecting diet and dietary diversity included seasonality, household size, and gender. Conclusions The results suggest that dietary diversity was perceived as something all people, both rich and poor, could achieve. There was significant overlap between local and scientific understandings of dietary diversity, suggesting that novel information on the importance of dietary diversity promoted through education will likely be easily integrated into the existing knowledge systems

Additional file 1: of The determinants of dietary diversity and nutrition: ethnonutrition knowledge of local people in the East Usambara Mountains, Tanzania

Info Brief: Diet and Nutrition in the East Usambaras (in Swahili). (PDF 242 kb

The B subunit of Escherichia coli heat-labile enterotoxin inhibits Th1 but not Th17 cell responses in established experimental autoimmune uveoretinitis

PURPOSE. To investigate the efficacy of the B subunit of Escherichia coli heat-labile enterotoxin (EtxB) in the treatment of ocular autoimmune disease. Murine experimental autoimmune uveoretinitis (EAU) is an animal model of autoimmune posterior uveitis initiated by retinal antigen-specific Th1 and Th17 CD4 T cells, which activate myeloid cells, inducing retinal damage. EtxB is a potent immune modulator that ameliorates other Th1-mediated autoimmune diseases, enhancing regulatory T-cell activity. METHODS. EAU was induced in B10.RIII mice by immunization with peptide hIRBP. Disease severity was measured by clinical and histologic assessment, and functional responses of macrophages (Mφs) and T cells were assessed, both in vivo and in cocultures in vitro. EtxB was administered intranasally daily for 4 days, starting either 3 days before or 3 days after EAU induction. RESULTS. Preimmunization treatment with EtxB protected mice from EAU, limiting both the number and the activation status of retinal infiltrating immune cells. Treatment after EAU induction did not alter the disease course, despite suppression of IFN-γ. Although EtxB treatment of in vitro cocultures of T cells and Mφs increased IL-10 production, EtxB treatment in vivo increased the proportion and number of IL-17-producing CD4 cells infiltrating the eye. CONCLUSIONS. EtxB preimmunization protects mice from EAU induction by inhibiting Th1 responses, but the resultant reduction in IFN-γ responses by EtxB does not effect infiltration or structural damage in established EAU, where Th17 responses predominate. These data highlight the critical importance of the dynamics of T-cell phenotype and infiltration during EAU when considering immunomodulatory therapy

Priority populations' experiences of isolation, quarantine and distancing for COVID-19 : protocol for a longitudinal cohort study (Optimise Study)

Introduction: Longitudinal studies can provide timely and accurate information to evaluate and inform COVID-19 control and mitigation strategies and future pandemic preparedness. The Optimise Study is a multidisciplinary research platform established in the Australian state of Victoria in September 2020 to collect epidemiological, social, psychological and behavioural data from priority populations. It aims to understand changing public attitudes, behaviours and experiences of COVID-19 and inform epidemic modelling and support responsive government policy. Methods and analysis: This protocol paper describes the data collection procedures for the Optimise Study, an ongoing longitudinal cohort of ~1000 Victorian adults and their social networks. Participants are recruited using snowball sampling with a set of seeds and two waves of snowball recruitment. Seeds are purposively selected from priority groups, including recent COVID-19 cases and close contacts and people at heightened risk of infection and/or adverse outcomes of COVID-19 infection and/or public health measures. Participants complete a schedule of monthly quantitative surveys and daily diaries for up to 24 months, plus additional surveys annually for up to 48 months. Cohort participants are recruited for qualitative interviews at key time points to enable in-depth exploration of people's lived experiences. Separately, community representatives are invited to participate in community engagement groups, which review and interpret research findings to inform policy and practice recommendations. Ethics and dissemination: The Optimise longitudinal cohort and qualitative interviews are approved by the Alfred Hospital Human Research Ethics Committee (# 333/20). The Optimise Study CEG is approved by the La Trobe University Human Ethics Committee (# HEC20532). All participants provide informed verbal consent to enter the cohort, with additional consent provided prior to any of the sub studies. Study findings will be disseminated through public website (https://optimisecovid.com.au/study-findings/) and through peer-reviewed publications.Trial registration number NCT05323799