To investigate planning policies that deliver positive social outcomes in hyper-dense, high-rise residential environments

Construction of skyscrapers in central Melbourne should be supported because a big jump in CBD population has many benefits for residents including easy access to jobs, shops and entertainment, according to this report. Executive Summary High-rise apartment towers are being built in central Melbourne at four times the maximum densities allowed in Hong Kong, New York and Tokyo – some of the highest density cities in the world. This is possible because the policies used to regulate decision-making for high-rise developments in central Melbourne are weak, ineffective or non-existent. This enables the approval of tower developments that are very tall and that squeeze out the space between buildings, with little regard on the effect on the residents within, the impact on the streets below or on the value of neighbouring properties. Increasing the supply of housing in the central city close to jobs and transport brings numerous benefits to the city and should be supported. The high-rise apartment tower plays an important role in delivering this supply. There is legitimate concern, however, that developing at these extreme densities will have negative, long-term impacts for Melbourne, eroding away Melbourne’s celebrated liveability. It will create a legacy of apartments that are of poor quality – homes that lack access to light, air and an outlook - and diminish the quality of the streets and parks below by blocking sunlight, increasing wind drafts and obstructing sky views. The quality of these public spaces is critical – even more so as these city residents retreat from their compact apartments to use the city’s streets and parks as their ‘living room’. At the same time, the density of these developments is resulting in a rapid and unpredictable increase in the population living in the central city. These residents need adequate open space and community services to ensure that they can enjoy a good quality of life. There are currently no policies in place that link the density of developments to the provision of this essential infrastructure, resulting in a significant funding opportunity being missed. Incentivising developers to deliver public benefit through density bonuses is common practice in many cities and has effectively delivered parks, plazas, community facilities like childcare and cultural facilities such as cinemas or performing arts spaces. It also enables the delivery of affordable housing to ensure low-income earners are supported and have good access to their central-city jobs. This is good planning. Instead, Melbourne’s planning controls offer ‘cheap density’ to developers as they are able to build unlimited density with limited need for a community contribution. Not one of the five cities that I studied – New York, Vancouver, Tokyo, Hong Kong and Seoul - is choosing to develop in this way. There was general consensus from the planning and design experts that I interviewed who manage and study these established, globally successful cities that the densities being delivered in central Melbourne are too high and many questioned whether they could deliver long-term liveable outcomes. We have highly competent developers and design and planning professionals in Melbourne. It is the lack of effective policies that is letting Melbourne down. The evidence from these cities is clear. Melbourne would benefit from the introduction of policies that: Establish appropriate density controls in central Melbourne. Establish density bonuses to link development to public benefit and incentivise the delivery of new open spaces, affordable housing and other community facilities. Establish an enforcable tower separation rule. Establish apartment standards. This report also recommends investigating the introduction of two planning streams for large-scale development approvals that developers can choose between – an ‘as-of-right’ approval for meeting these controls (that can provide certainty to developers and the community) or a negotiated outcome (with community review) if the controls are exceeded. Too much attention is given to the height of these towers. What is far more important in delivering good outcomes for residents and the broader city are the overall numbers of people living in a development, whether the apartments enable a good quality of life or not, whether residents have access to the open space and community services that they need and the cumulative impact of these developments on the quality of the public realm below. It is difficult to retrofit or demolish high-rise apartment towers once the apartments are sold. Any negative impacts will therefore be long-lasting and the opportunity to capture a public benefit will be gone. As the proportion of Australians living in high-rise communities in our central cities increases, it is imperative to act now

Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age

The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women's and Children's Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 (n=7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean (s.d.) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01-0.29) and 0.21 (0.13-0.29), respectively. A significant dose-response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score (P<0.001). In conclusion, any maternal smoking in pregnancy, even if mothers quit, is associated with an increase in offspring BMI at 4 to 5 years of age.L. E. Grzeskowiak, N. A. Hodyl, M. J. Stark, J. L. Morrison and V. L. Clifto

Novel insights, challenges and practical implications of DOHaD-omics research

Research investigating the developmental origins of health and disease (DOHaD) has never had the technology to investigate physiology in such a data-rich capacity and at such a microlevel as it does now.A symposium at the inaugural meeting of the DOHaD Society of Australia and New Zealand outlined the advantages and challenges of using "-omics" technologies in DOHaD research.DOHaD studies with -omics approaches to generate large, rich datasets were discussed.We discuss implications for policy and practice and make recommendations to facilitate successful translation of results of future DOHaD-omics studies.Nicolette A Hodyl and Beverly Muhlhausle

The important role for intravenous iron in perioperative patient blood management in major abdominal surgery: a randomized controlled trial

Objective: To determine if preoperative intravenous (IV) iron improves outcomes in abdominal surgery patients. Summary Background Data: Preoperative iron deficiency anemia (IDA) occurs frequently; however if left untreated, increases the risk of blood transfusion allogeneic blood transfusion (ABT). Limited evidence supports IDA treatment with preoperative IV iron. This randomized controlled trial aimed to determine whether perioperative IV iron reduced the need for ABT. Methods: Between August 2011 and November 2014, 72 patients with IDA were assigned to receive either IV iron or usual care. The primary endpoint was incidence of ABT. Secondary endpoints were various hemoglobin (Hb) levels, change in Hb between time points, length of stay, iron status, morbidity, mortality, and quality of life 4 weeks postsurgery. Results: A 60% reduction in ABT was observed in the IV iron group compared with the usual care group (31.25% vs 12.5%). Hb values, although similar at randomization, improved by 0.8 g/dL with IV iron compared with 0.1 g/dL with usual care (P = 0.01) by the day of admission. The IV iron group had higher Hb 4 weeks after discharge compared with the usual care group (1.9 vs 0.9 g/dL, P = 0.01), and a shorter length of stay (7.0 vs 9.7 d, P = 0.026). There was no difference in discharge Hb levels, morbidity, mortality, or quality of life. Conclusions: Administration of perioperative IV iron reduces the need for blood transfusion, and is associated with a shorter hospital stay, enhanced restoration of iron stores, and a higher mean Hb concentration 4 weeks after surgery.Bernd Froessler, Peter Palm, Ingo Weber, Nicolette A. Hodyl, Rajvinder Singh and Elizabeth M. Murph

Reproducibility of neuroplastic responses induced by continuous theta-burst stimulation

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MicroRNAs regulating Toll Like Receptor inflammatory pathways in preterm and term placenta and cord blood

Abstracts - P1.49Abstract not availableNatalie Aboustate, Vicki Clifton, Michael Stark, Nicolette Hody

Effect of washed versus unwashed red blood cells on transfusion‐related immune responses in preterm newborns

Objectives. Transfusion with washed packed red blood cells (PRBCs) may be associated with reduced transfusion-related proinflammatory cytokine production. This may be because of alterations in recipient immune responses. Methods. This randomised trial evaluated the effect of transfusion with washed compared with unwashed PRBCs on pro-inflammatory cytokines and endothelial activation in 154 preterm newborns born before 29 weeks’ gestation. Changes in plasma cytokines and measures of endothelial activation in recipient blood were analysed after each of the first three transfusions. Results. By the third transfusion, infants receiving unwashed blood had an increase in IL-17A (P = 0.04) and TNF (P = 0.007), whereas infants receiving washed blood had reductions in IL-17A (P = 0.013), TNF (P = 0.048), IL-6 (P = 0.001), IL-8 (P = 0.037), IL-12 (P = 0.001) and IFN-c (P = 0.001). The magnitude of the post-transfusion increase in cytokines did not change between the first and third transfusions in the unwashed group but decreased in the washed group for IL-12 (P = 0.001), IL-17A (P = 0.01) and TNF (P = 0.03), with the difference between the groups reaching significance by the third transfusion (P < 0.001 for each cytokine). Conclusion. The proinflammatory immune response to transfusion in preterm infants can be modified when PRBCs are washed prior to transfusion. Further studies are required to determine whether the use of washed PRBCs for neonatal transfusion translates into reduced morbidity and mortality.Tara M Crawford, Chad C Andersen, Nicolette A Hodyl, Sarah A Robertson and Michael J Star

Developmental perturbation induced by maternal asthma during pregnancy: The short- and long-term impacts on offspring

Extent: 8p.Maternal asthma is a common disease to complicate human pregnancy. Epidemiological studies have identified that asthma during pregnancy increases the risk of a number of poor outcomes for the neonate including growth restriction, lower birthweight, preterm delivery, neonatal resuscitation, and stillbirth. Asthma therefore represents a significant health burden to society and could have an impact on the lifelong health of the children of women with asthma. Our research has identified that maternal asthma in pregnancy induces placental dysfunction and developmental perturbation in the fetus in a sex specific manner. These alterations in development could increase the risk of metabolic disease in adulthood of children of asthmatic mothers, especially females. In this paper, we will discuss the evidence currently available that supports the hypothesis that children of mothers with asthma may be at risk of lifelong health complications which include diabetes and hypertension.Vicki L. Clifton, Michael Davies, Vivienne Moore, Ian M. R. Wright, Zainab Ali, and Nicolette A. Hody

Developmental perturbation induced by maternal asthma during pregnancy: The short- and long-term impacts on offspring

Extent: 8p.Maternal asthma is a common disease to complicate human pregnancy. Epidemiological studies have identified that asthma during pregnancy increases the risk of a number of poor outcomes for the neonate including growth restriction, lower birthweight, preterm delivery, neonatal resuscitation, and stillbirth. Asthma therefore represents a significant health burden to society and could have an impact on the lifelong health of the children of women with asthma. Our research has identified that maternal asthma in pregnancy induces placental dysfunction and developmental perturbation in the fetus in a sex specific manner. These alterations in development could increase the risk of metabolic disease in adulthood of children of asthmatic mothers, especially females. In this paper, we will discuss the evidence currently available that supports the hypothesis that children of mothers with asthma may be at risk of lifelong health complications which include diabetes and hypertension.Vicki L. Clifton, Michael Davies, Vivienne Moore, Ian M. R. Wright, Zainab Ali, and Nicolette A. Hody

Developmental perturbation induced by maternal asthma during pregnancy: The short- and long-term impacts on offspring

Extent: 8p.Maternal asthma is a common disease to complicate human pregnancy. Epidemiological studies have identified that asthma during pregnancy increases the risk of a number of poor outcomes for the neonate including growth restriction, lower birthweight, preterm delivery, neonatal resuscitation, and stillbirth. Asthma therefore represents a significant health burden to society and could have an impact on the lifelong health of the children of women with asthma. Our research has identified that maternal asthma in pregnancy induces placental dysfunction and developmental perturbation in the fetus in a sex specific manner. These alterations in development could increase the risk of metabolic disease in adulthood of children of asthmatic mothers, especially females. In this paper, we will discuss the evidence currently available that supports the hypothesis that children of mothers with asthma may be at risk of lifelong health complications which include diabetes and hypertension.Vicki L. Clifton, Michael Davies, Vivienne Moore, Ian M. R. Wright, Zainab Ali, and Nicolette A. Hody