Macadamia Regional Variety Trials Series 3, Phase 2

The Regional Variety Trials (RVT’s) Series 3 Phase 2 Hort Innovation project aims to evaluate 20 CSIRO breeding lines with industry standards (344, 268, 741, 816 and A16) and five Hidden Valley Plantation bred selections in a range of sites around Queensland and New South Wales. In this project we measured yield, kernel quality and tree performance to ultimately release new varieties to the macadamia industry. Initially, ten sites were planted in 2008 between Macksville in NSW and Mackay in central QLD. Two of those sites have now been abandoned because of management issues and change of ownership. Acacia Plateau near Casino in NSW was decommissioned in 2011 and McLean’s Ridges at the end of 2014, the latter is still being farmed by the new owner under a Material Transfer Agreement. The remaining eight sites include Mackay and Emerald in the north, Childers, Bundy Sugar, Decortes and Booyan in the Bundaberg region, and Macksville and Alstonville in NSW. In 2014, Wirrawilla near Bundaberg, was included in the project. This site was previously an Abnormal Vertical Growth (AVG) trial site that included all the test and standard varieties. In November 2015 the Childers site was devastated by a storm and will not be assessed from 2015 on. All sites have 180 trees with six reps of each variety except for Childers with 120 trees, and Wirrawilla with 160 trees. Trees are strip harvested to year six and harvested five times in years seven, eight and nine. At harvest four, nuts are collected from the ground and bagged, remaining nuts in the tree are stripped out and bagged separately, effectively making harvest five. All nuts from all trees are bagged at each harvest, weighed and then sampled. The nuts are dehusked and weighed again before oven drying to 1.5% moisture content. Individual tree yields are calculated from the sampling process. Samples are stored in air tight barrels at 4C for kernel assessment at the end of the season. Tree heights and widths are measured at each site each year. In this project yield, kernel quality and tree performance were measured. More in-depth studies determined tree susceptibility to insects and pathogens, Abnormal Vertical Growth (AVG), kernel oil profiles and macadamia shelf life to ultimately make decisions on releasing new varieties to the macadamia industry. Four new macadamia varieties have been selected in consultation with the Macadamia Industry Variety Improvement Committee (MIVIC) and commercialised by the Department of Agriculture and Fisheries (DAF) from the CSIRO group of 20 while a further four varieties are being commercialised by HVP. The four DAF varieties are currently known as: MIV1-G. A large, precocious tree with high yields and kernel recovery (KR) of 40%+. Suitable for Bundaberg and Northern Rivers. MIV1-P. A small to medium, precocious tree suitable for high density planting. More suitable to Bundaberg but produces heavy crops in NSW. KR in the high 30’s. MIV1-J. Medium to large tree with large nuts and high KR (44%) more suited to the Bundaberg region. MIV1-R. Medium size tree that crops well in northern NSW with a KR of 37%

Macadamia Regional Variety Trials Series 3, Phase 2

The Regional Variety Trials (RVT’s) Series 3 Phase 2 Hort Innovation project aims to evaluate 20 CSIRO breeding lines with industry standards (344, 268, 741, 816 and A16) and five Hidden Valley Plantation bred selections in a range of sites around Queensland and New South Wales. In this project we measured yield, kernel quality and tree performance to ultimately release new varieties to the macadamia industry. Initially, ten sites were planted in 2008 between Macksville in NSW and Mackay in central QLD. Two of those sites have now been abandoned because of management issues and change of ownership. Acacia Plateau near Casino in NSW was decommissioned in 2011 and McLean’s Ridges at the end of 2014, the latter is still being farmed by the new owner under a Material Transfer Agreement. The remaining eight sites include Mackay and Emerald in the north, Childers, Bundy Sugar, Decortes and Booyan in the Bundaberg region, and Macksville and Alstonville in NSW. In 2014, Wirrawilla near Bundaberg, was included in the project. This site was previously an Abnormal Vertical Growth (AVG) trial site that included all the test and standard varieties. In November 2015 the Childers site was devastated by a storm and will not be assessed from 2015 on. All sites have 180 trees with six reps of each variety except for Childers with 120 trees, and Wirrawilla with 160 trees. Trees are strip harvested to year six and harvested five times in years seven, eight and nine. At harvest four, nuts are collected from the ground and bagged, remaining nuts in the tree are stripped out and bagged separately, effectively making harvest five. All nuts from all trees are bagged at each harvest, weighed and then sampled. The nuts are dehusked and weighed again before oven drying to 1.5% moisture content. Individual tree yields are calculated from the sampling process. Samples are stored in air tight barrels at 4C for kernel assessment at the end of the season. Tree heights and widths are measured at each site each year. In this project yield, kernel quality and tree performance were measured. More in-depth studies determined tree susceptibility to insects and pathogens, Abnormal Vertical Growth (AVG), kernel oil profiles and macadamia shelf life to ultimately make decisions on releasing new varieties to the macadamia industry. Four new macadamia varieties have been selected in consultation with the Macadamia Industry Variety Improvement Committee (MIVIC) and commercialised by the Department of Agriculture and Fisheries (DAF) from the CSIRO group of 20 while a further four varieties are being commercialised by HVP. The four DAF varieties are currently known as: MIV1-G. A large, precocious tree with high yields and kernel recovery (KR) of 40%+. Suitable for Bundaberg and Northern Rivers. MIV1-P. A small to medium, precocious tree suitable for high density planting. More suitable to Bundaberg but produces heavy crops in NSW. KR in the high 30’s. MIV1-J. Medium to large tree with large nuts and high KR (44%) more suited to the Bundaberg region. MIV1-R. Medium size tree that crops well in northern NSW with a KR of 37%

Adolescent inpatient activity 1999–2010: analysis of English Hospital Episode Statistics data

Objective: To investigate patterns and trends of adolescent (10–19 years) inpatient activity in England by sex, disease category, and admitting speciality. Data 9 632 844 Finished Consultant Episodes (FCEs) from English patients aged 1–19 between 1999/2000 and 2010/2011 (Hospital Episode Statistics data). Analyses Age trends by sex and major International Classification of Disease 10 (ICD10) chapter; differences in activity rates by age and sex; inpatient activity trends over the past decade, disaggregated by sex, admitting speciality and ICD10 chapter. Results: Adolescent female patients account for more activity than girls aged 1–9 (139.4 vs 107.2 FCEs/1000). Female inpatient activity increases significantly between age 10 (70.9 FCEs/1000) and 19 (281.7 FCES/1000, of which non-obstetric care accounts for 155.9 FCEs/1000). Male activity increases much less during adolescence, with lower overall rates among adolescents than younger children (93.7 vs 142.9 FCEs/1000). Between 1999 and 2010, total adolescent inpatient activity increased faster among adolescents (10–19 years) (+14.2%) than younger children (1–9 years) (+11.0%). Adolescent FCEs/1000 increased by 12.8%, including higher rates admitted under Paediatrics (+47.5%) and Paediatric Surgery (+23.2%). Adolescents were admitted across a range of specialities. Conclusions: These data challenge the belief that adolescents are a healthy group who rarely use inpatient services. In England, use of inpatient services is higher among female patients aged 10–19 years than those aged 1–9 years, while adolescent activity has increased faster than for younger children over the past 11 years. Improving service quality for adolescents will require engagement of the many different teams that care for them

The health benefits of secondary education in adolescents and young adults: An international analysis in 186 low-, middle- and high-income countries from 1990 to 2013.

BACKGROUND: The health benefits of secondary education have been little studied. We undertook country-level longitudinal analyses of the impact of lengthening secondary education on health outcomes amongst 15-24 year olds. METHODS: Exposures: average length of secondary and primary education from 1980 to 2013.Data/Outcomes: Country level adolescent fertility rate (AFR), HIV prevalence and mortality rate from 1989/90 to 2013 across 186 low-, middle- and high-income countries.Analysis: Longitudinal mixed effects models, entering secondary and primary education together, adjusted for time varying GDP and country income status. Longitudinal structural marginal models using inverse probability weighting (IPW) to take account of time varying confounding by primary education and GDP. Counterfactual scenarios of no change in secondary education since 1980/1990 were estimated from model coefficients for each outcome. FINDINGS: Each additional year of secondary education decreased AFR by 8.4% in mixed effects models and 14.6% in IPW models independent of primary education and GDP. Counterfactual analyses showed the proportion of the reduction in adolescent fertility rate over the study period independently attributable to secondary education was 28% in low income countries. Each additional year of secondary education reduced mortality by 16.9% for 15-19 year and 14.8% for 20-24 year old young women and 11.4% for 15-19 year and 8.8% for 20-24 year old young men. Counterfactual scenarios suggested 12% and 23% of the mortality reduction for 15-19 and 20-24 year old young men was attributable to secondary education in low income countries. Each additional year of secondary education was associated with a 24.5% and 43.1% reduction in HIV prevalence amongst young men and women. INTERPRETATION: The health benefits associated with secondary education were greater than those of primary education and were greatest amongst young women and those from low income countries. Secondary education has the potential to be a social vaccine across many outcomes in low and middle income countries

Impact of The Daily Mile on children's physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol.

Funder: Cancer Research UKFunder: British Heart FoundationIntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children's physical and mental health and educational attainment throughout primary school. METHODS AND ANALYSIS: iMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5-6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from 'below expected' to 'above expected levels'). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings

Impact of The Daily Mile on children's physical and mental health, and educational attainment in primary schools: iMprOVE cohort study protocol.

Funder: Cancer Research UKFunder: British Heart FoundationIntroductionSchool-based active mile initiatives such as The Daily Mile (TDM) are widely promoted to address shortfalls in meeting physical activity recommendations. The iMprOVE Study aims to examine the impact of TDM on children's physical and mental health and educational attainment throughout primary school. METHODS AND ANALYSIS: iMprOVE is a longitudinal quasi-experimental cohort study. We will send a survey to all state-funded primary schools in Greater London to identify participation in TDM. The survey responses will be used for non-random allocation to either the intervention group (Daily Mile schools) or to the control group (non-Daily Mile schools). We aim to recruit 3533 year 1 children (aged 5-6 years) from 77 primary schools and follow them up annually until the end of their primary school years. Data collection taking place at baseline (children in school year 1) and each primary school year thereafter includes device-based measures of moderate-to-vigorous physical activity (MVPA) and questionnaires to measure mental health (Strengths and Difficulties Questionnaire) and educational attainment (ratings from 'below expected' to 'above expected levels'). The primary outcome is the mean change in MVPA minutes from baseline to year 6 during the school day among the intervention group compared with controls. We will use multilevel linear regression models adjusting for sociodemographic data and participation in TDM. The study is powered to detect a 10% (5.5 min) difference between the intervention and control group which would be considered clinically significant.Ethics and disseminationEthics has been approved from Imperial College Research Ethics Committee, reference 20IC6127. Key findings will be disseminated to the public through research networks, social, print and media broadcasts, community engagement opportunities and schools. We will work with policy-makers for direct application and impact of our findings

Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature

Introduction: Robust measures of integration are essential for assessment of the development, design and implementation of integration within healthcare systems. This review aimed to identify measurement instruments for integration within children and young people’s (CYP) healthcare systems (PROSPERO registration number CRD42021235383).Methods: We searched electronic databases (PubMED and Ovid Embase) using three main concepts: ‘(integrated care) AND (child population) AND (measurement)’, along with additional searches.Results: Fifteen studies describing 16 measurement instruments were eligible for inclusion. The majority of studies were conducted in the USA. There was a diversity of health conditions included in the studies. The most frequent type of assessment used was a questionnaire (11 identified), but interviews, patient data and healthcare records, and focus groups were also used. Integration outcomes assessed were quality of care coordination, quality of collaboration, continuity of care, completeness of care, structure of care, quality of communication, and local implementation of integrated care.Conclusion: A variety of instruments for the measurement of integration within CYP healthcare systems were identified. Further work on the standardisation of integrated care measures would be valuable; however, it is important that instruments and measures meet the needs of specific settings, populations and conditions being studied

Measurement Instruments for Integration within Children and Young People Healthcare Systems and Networks: A Rapid Review of the International Literature

Introduction: Robust measures of integration are essential for assessment of the development, design and implementation of integration within healthcare systems. This review aimed to identify measurement instruments for integration within children and young people’s (CYP) healthcare systems (PROSPERO registration number CRD42021235383). Methods: We searched electronic databases (PubMED and Ovid Embase) using three main concepts: ‘(integrated care) AND (child population) AND (measurement)’, along with additional searches. Results: Fifteen studies describing 16 measurement instruments were eligible for inclusion. The majority of studies were conducted in the USA. There was a diversity of health conditions included in the studies. The most frequent type of assessment used was a questionnaire (11 identified), but interviews, patient data and healthcare records, and focus groups were also used. Integration outcomes assessed were quality of care coordination, quality of collaboration, continuity of care, completeness of care, structure of care, quality of communication, and local implementation of integrated care. Conclusion: A variety of instruments for the measurement of integration within CYP healthcare systems were identified. Further work on the standardisation of integrated care measures would be valuable; however, it is important that instruments and measures meet the needs of specific settings, populations and conditions being studied

Impact of COVID-19 on primary care contacts with children and young people in England: longitudinal trends study 2015–2020

BACKGROUND: The NHS response to COVID-19 altered provision and access to primary care. AIM: To examine the impact of COVID-19 on GP contacts with children and young people (CYP) in England. DESIGN AND SETTING: A longitudinal trends analysis was undertaken using electronic health records from the Clinical Practice Research Datalink (CPRD) Aurum database. METHOD: All CYP aged 90%). Remote contacts more than doubled, increasing most in infants (over 2.5-fold). Total contacts for respiratory illnesses fell by 74% whereas contacts for common non-transmissible conditions shifted largely to remote contacts, mitigating the total fall (31%). CONCLUSION: During the COVID-19 pandemic, CYP's contact with GPs fell, particularly for face-to-face assessments. This may be explained by a lower incidence of respiratory illnesses because of fewer social contacts and changing health-seeking behaviour. The large shift to remote contacts mitigated total falls in contacts for some age groups and for common non-transmissible conditions

Mental health and well-being trends among children and young people in the UK, 1995-2014: analysis of repeated cross-sectional national health surveys.

BACKGROUND: There is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales. METHODS: Data were analysed from 140 830 participants (4-24 years, stratified into 4-12, 13-15, 16-24 years) in 36 national surveys in England, Scotland and Wales, 1995-2014. Regression models were used to examine time trends in seven parent/self-reported variables: general health, any long-standing health condition, long-standing mental health condition; Warwick-Edinburgh Mental Wellbeing Score (WEMWBS), above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score. RESULTS: Across all participants aged 4-24, long-standing mental health conditions increased in England (0.8-4.8% over 19 years), Scotland (2.3-6.0%, 11 years) and Wales (2.6-4.1%, 7 years) (all p < 0.001). Among young children (4-12 years), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England [SDQE: odds ratio (OR) 0.97 (0.96-0.98), p < 0.001] and girls in Scotland [SDQE: OR 0.96 (0.93-0.99), p = 0.005]. The proportion with high SDQE scores (13-15 years) decreased in England [OR 0.98 (0.96-0.99), p = 0.006] but increased in Wales [OR 1.07 (1.03-1.10), p < 0.001]. The proportion with high GHQ scores decreased among English women (16-24 years) [OR 0.98 (0.98-0.99), p = 0.002]. CONCLUSIONS: Despite a striking increase in the reported prevalence of long-standing mental health conditions among UK CYP, there was relatively little change in questionnaire scores reflecting psychological distress and emotional well-being