Knowing your audience: Investigating stillbirth knowledge and perceptions in the general population to inform future public health campaigns.

BACKGROUND: The prevalence of stillbirth in many high income countries like Australia has remained unchanged for over 30 years. The 2018 Australian government Senate Select Committee on Stillbirth Research and Education highlighted the need for a public health campaign to encourage public conversations and increase awareness. However, there is little evidence about the community's knowledge and perceptions towards pregnancy and stillbirth, nor their aspirations for a public health campaign. AIMS: To assess the general knowledge, perceptions, myths and attitudes towards stillbirth to inform future public health campaigns. METHODS: Australian participants (n = 344; predominately women n = 294 (85.5%)) were recruited via Facebook.com. They completed a cross-sectional online survey designed to assess their knowledge of pregnancy and stillbirth, with additional questions on socio-demographic characteristics. RESULTS: Stillbirth knowledge and awareness of incidence was low in this sample. Prominent myths, such as baby runs out of room in the uterus (n = 112, 33%) and baby slows down when preparing for labour (n = 24, 27%) were endorsed. Only 25% (n = 85) knew the prevalence of stillbirth in Australia (six per day). Almost two-thirds (n = 205; 62%) agreed that there needs to be a public health campaign, however one in five (n = 65; 20%) were concerned that talking about stillbirth with pregnant women may cause them to worry. DISCUSSION AND CONCLUSION: Our findings reinforce the need for a targeted campaign, which educates the general population about the definition and prevalence of stillbirth, stillbirth risks and modifiable health behaviours. Appropriate messaging should target pregnant women during antenatal care as well as their support and care systems (family, friends, and care providers).

The utility of Amies charcoal bacteriology swabs for storage of canine urine prior to culture.

OBJECTIVE: To determine the usefulness of bacteriology swabs as a storage method of canine urine samples and the effect on quantitative bacterial culture. MATERIALS AND METHODS: Two hundred fourteen canine urine samples were collected by cystocentesis. The reference aliquot was placed in a sterile tube and processed for quantitative bacterial culture within 6 hours. A bacteriology swab was then immersed in the urine for 5 seconds and returned to the charcoal Amies media container. The urine samples in the sterile tube and bacteriology swab were stored at room temperature for 48 hours and processed for quantitative bacterial culture. RESULTS: Thirty-seven of the samples were positive on reference culture with a total of 42 bacterial isolates. Samples stored in sterile tube and bacteriology swab had identical sensitivity and specificity for detection of bacteriuria (94.7% and 100%, respectively) with very good agreement (κ = 0.92; 95% CI 0.81 to 1.00). Agreement between the bacterial species of the reference sample and the bacteriology swab was higher (κ = 0.85; 95% CI 0.71 to 0.99) than compared to the sterile tube (κ = 0.78; 95% CI 0.62 to 0.94), but the overlapping confidence intervals mean improved agreement cannot be inferred. CLINICAL SIGNIFICANCE: Bacteriology swabs stored in Amies charcoal transport media should be considered an alternative method to preserve canine urine sample when immediate processing for quantitative bacterial culture is not possible. The sensitivity of culturing plain urine, stored for 48 hours in a sterile tube, for detection of bacteriuria, was higher than previously reported.

A retrospective review of treatment and response of high-risk mast cell tumours in dogs.

This retrospective case series evaluates survival outcome of 94 dogs with high metastatic risk mast cell tumours (MCT). Patients were treated with a cytotoxic chemotherapy protocol or the tyrosine kinase inhibitor masitinib, in the presence of gross disease or as an adjunct to surgical resection of the primary tumour. In patients presenting with metastatic disease, surgical resection of the primary tumour with adjunctive therapy with any chemotherapy incurred a significant survival advantage [median survival time (MST): 278 days] compared to patients receiving chemotherapy without surgical excision of the primary tumour (MST: 91 days, P < 0.0001). Patients with a surgically excised Patnaik grade II tumour and high Ki-67 in the absence of metastatic disease treated with vinblastine and prednisolone showed a significantly longer survival (MST: 1946 days) than those treated with masitinib (MST: 369 days, P = 0.0037). Further prospective case-controlled clinical trials of high-risk MCTs are required to make precise evidence-based treatment decisions for individual patients.

Comparison between Ki-67 index and mitotic index for predicting outcome in canine mast cell tumours.

OBJECTIVES: To assess correlation between Ki67 index and mitotic index and determine which more accurately predicts survival in canine mast cell tumours. METHODS: Retrospective analysis of cases from three UK referral hospitals. Correlation between Ki67 index and mitotic index was assessed and survival analysis performed. RESULTS: A total of 162 dogs were included: 57 dogs died with 37 due to mast cell tumour. Correlation between Ki67 index and mitotic index was moderate, while the agreement was poor. A high Ki67 index was considered sensitive (86 · 5%) at predicting mast cell tumour-related death, but poorly specific (57 · 9%). Mitotic index(>5) was poorly sensitive (32 · 4%), but highly specific (96%). A mitotic index of ê2 had a 75 · 7% sensitivity and an 80 · 0% specificity. Ki67 index showed a statistically significant survival difference within the mitotic index <2 (P = 0 · 009) group. Ki67 index did not predict survival rate in tumours with mitotic index of ê2. CLINICAL RELEVANCE: Correlation between Ki67 and mitotic index is moderate. High mitotic index accurately predicted death, but many dogs with low mitotic index also died. Low Ki67 accurately predicted survival, but high Ki67 should not be considered a poor prognostic indicator. A three-tier mitotic index assessment may more accurately predict death due to mast cell tumour.

The utility of staging in canine mast cell tumours.

Current staging of canine mast cell tumours (MCTs) practiced by many veterinarians involves a minimum of lymph node (LN) assessment, abdominal ultrasound and thoracic radiography. Historically, some have advocated buffy coat and bone marrow evaluation. Two hundred and twenty dogs with MCT seen at a referral clinic were staged using LN palpation/cytology, thoracic radiography and abdominal ultrasound. The utility of each method was evaluated by considering prevalence of spread and future behaviour. At presentation, 30.9% of dogs had metastases to the local LN; 6.8% of all the dogs also had distant metastases. No dog had or developed distant metastasis in the absence of LN metastasis. No dog had convincing evidence of pulmonary metastasis. In this series, the local LN was sentinel to metastasis and in the absence of local LN metastasis, the utility of further staging was low. Thoracic radiography was not useful in the staging of canine MCT.

A novel approach to treatment of lymphangiosarcoma in a boxer dog.

A five-year-old female boxer presented with a swelling in the area of the caudal mammary gland. The mass was surgically excised and histopathological examination revealed a poorly demarcated lesion, extending into mammary tissue and infiltrating the sinuses of adjacent lymph nodes. The diagnosis was lymphangiosarcoma. Full blood work, thoracic radiographs, abdominal and scar ultrasound were unremarkable, apart from possible inflammatory reactions in the latter and reactive/metastatic changes in inguinal lymph nodes. Doxorubicin treatment resulted in a 6-month recurrence free interval. At relapse, the dog was treated with metronomic chemotherapy using chlorambucil and meloxicam, which failed to adequately control the disease. Toceranib phosphate was introduced and resulted in almost complete regression of the mass, leaving just a skin plaque. To the authors' knowledge this is the first report describing the use of two novel therapeutic approaches to treat canine lymphangiosarcoma that resulted in a higher than previously described survival time.

Improved predictive ability of climate-human-behaviour interactions with modifications to the COMFA outdoor energy budget model.

The purpose of this paper is to implement current and novel research techniques in human energy budget estimations to give more accurate and efficient application of models by a variety of users. Using the COMFA model, the conditioning level of an individual is incorporated into overall energy budget predictions, giving more realistic estimations of the metabolism experienced at various fitness levels. Through the use of VO(2) reserve estimates, errors are found when an elite athlete is modelled as an unconditioned or a conditioned individual, giving budgets underpredicted significantly by -173 and -123 W m(-2), respectively. Such underprediction can result in critical errors regarding heat stress, particularly in highly motivated individuals; thus this revision is critical for athletic individuals. A further improvement in the COMFA model involves improved adaptation of clothing insulation (I (cl)), as well clothing non-uniformity, with changing air temperature (T (a)) and metabolic activity (M (act)). Equivalent T (a) values (for I (cl) estimation) are calculated in order to lower the I (cl) value with increasing M (act) at equal T (a). Furthermore, threshold T (a) values are calculated to predict the point at which an individual will change from a uniform I (cl) to a segmented I (cl) (full ensemble to shorts and a T-shirt). Lastly, improved relative velocity (v (r)) estimates were found with a refined equation accounting for the degree angle of wind to body movement. Differences between the original and improved v (r) equations increased with higher wind and activity speeds, and as the wind to body angle moved away from 90°. Under moderate microclimate conditions, and wind from behind a person, the convective heat loss and skin temperature estimates were 47 W m(-2) and 1.7°C higher when using the improved v (r) equation. These model revisions improve the applicability and usability of the COMFA energy budget model for subjects performing physical activity in outdoor environments. Application is possible for other similar energy budget models, and within various urban and rural environments.

Laboratory-scale measurements of N2O and CH4 emissions from hybrid poplars (Populus deltoides x Populus nigra).

The purpose of this study was to determine whether or not young hybrid poplar (Populus deltoides x Populus nigra) could transport landfill biogas internally from the root zone to the atmosphere, thereby acting as conduits for landfill gas release. Fluxes of methane (CH4) and nitrous oxide (N2O) from the seedlings to the atmosphere were measured under controlled conditions using dynamic flux chambers and a tunable diode laser trace gas analyser (TDLTGA). Nitrous oxide was emitted from the seedlings, but only when extremely high soil N2O concentrations were applied to the root zone. In contrast, no detectable emissions of CH4 were measured in a similar experimental trial. Visible plant morphological responses, characteristic of flood-tolerant trees attempting to cope with the negative effects of soil hypoxia, were observed during the CH4 experiments. Leaf chlorosis, leaf abscission and adventitious roots were all visible plant responses. In addition, seedling survival was observed to be highest in the biogas 'hot spot' areas of a local municipal solid waste landfill involved in this study. Based on the available literature, these observations suggest that CH4 can be transported internally by Populus deltoides x Populus nigra seedlings in trace amounts, although future research is required to fully test this hypothesis.

A tunable diode laser system for ammonia flux measurements over multiple plots.

This paper reports on the field testing of a tunable diode laser trace gas analyzer system for micrometeorological monitoring of ammonia fluxes. This system uses infrared absorption spectroscopy to measure atmospheric ammonia concentrations and the fluxgradient method to relate the measured concentration gradient to a flux of ammonia. For the field tests, we monitored ammonia fuxes over three plots receiving different manure applications. Each plot was sampled for 15 or 30 min of each hour, producing a high-temporal resolution data set. Analysis of the system response showed that ammonia adsorption to the tubing walls was greatly reduced by the system design and did not interfere with the flux measurement.

Effects of reserpine and 6-hydroxydopamine on the adrenergic and purinergic components of sympathetic nerve responses of the rabbit saphenous artery.

1 The effects of reserpine and of 6-hydroxydopamine on the contractions of the rabbit isolated saphenous artery produced by stimulation of the sympathetic nerves were studied. 2 In vessels exposed to reserpine, substantial contractions to nerve stimulation were recorded despite a 95.7% reduction in the noradrenaline content of the tissue. These responses of the vessel were not significantly affected by the alpha 1-antagonist, prazosin, whereas after desensitization of the P2-purinoceptor with alpha, beta-methylene ATP, no response to nerve stimulation remained. 3 In vessels exposed to 6-hydroxydopamine, no nerve-mediated responses were observed. 4 Noradrenaline-containing nerves were observed by fluorescence histochemistry in control tissues, but were not observed in tissues treated with reserpine or 6-hydroxydopamine. 5 The potencies of ATP and histamine were not significantly affected by reserpine or 6-hydroxydopamine treatment. However, there was a slight supersensitivity to noradrenaline in reserpine-treated and 6-hydroxydopamine-treated vessels compared with that of control vessels. Prazosin was selective for alpha-adrenoceptors, while alpha, beta-methylene ATP was selective for P2-purinoceptors. 6 These results substantiate the finding that ATP and noradrenaline are sympathetic cotransmitters in the rabbit isolated saphenous artery, and demonstrate that ATP can act as a transmitter independently of noradrenaline in this vessel.

P2-purinoceptors of two subtypes in the rabbit mesenteric artery: reactive blue 2 selectively inhibits responses mediated via the P2y-but not the P2x-purinoceptor.

alpha,beta-Methylene ATP and ATP both produced concentration-dependent contractions of the isolated mesenteric artery of the rabbit that were not inhibited by reactive blue 2. In preparations where the tone had been raised with noradrenaline, ATP and 2-methylthio ATP, but not alpha,beta-methylene ATP, produced relaxations of the vessel. These relaxations were inhibited in the presence of reactive blue 2. Reactive blue 2 did not inhibit the contractions to noradrenaline, and only slightly inhibited relaxations to adenosine and acetylcholine. The rank order of potency of purine nucleotide analogues in contracting the vessel was: alpha,beta-methylene ATP greater than beta,gamma-methylene ATP = 2-methylthio ATP greater than ATP, and in relaxing the vessel at raised tone was: 2-methylthio ATP greater than ATP greater than beta,gamma-methylene ATP greater than alpha,beta-methylene ATP. It is concluded from this study that in the isolated mesenteric artery of the rabbit, purine nucleotides act via P2y-purinoceptors to cause the muscle to relax and via P2x-purinoceptors to cause the muscle to contract. The results also suggest that reactive blue 2 selectively inhibits responses mediated via the P2y-purinoceptor, at least within a limited concentration range.

A pharmacological study of the rabbit saphenous artery in vitro: a vessel with a large purinergic contractile response to sympathetic nerve stimulation.

Mechanical responses to transmural electrical stimulation were recorded in isolated transverse ring preparations of rabbit saphenous artery. Electrical stimulation for a period of 1 s produced a rapid monophasic contraction and, for a period of 1 min, a biphasic contraction consisting of a rapid constriction followed by a slower sustained constriction. All contractions were abolished in the presence of tetrodotoxin (1 microgram ml-1) or guanethidine (4 microM). After desensitization of the P2-purinoceptor with alpha,beta-methylene ATP, contractions to electrical stimulation for 1 s were reduced significantly at all frequencies tested: responses evoked by stimulation at 4 Hz were usually almost completely inhibited, whereas those evoked by stimulation at 64 Hz were only partially inhibited. On the other hand, in the presence of the alpha-adrenoceptor antagonist, prazosin, neurogenic contractions were only partially reduced: at 4 Hz there was no significant reduction in the neurogenic contractions while at 32 and 64 Hz, contractions were reduced by an average of 20 and 28% respectively. Usually all contractions were abolished by a combination of the two drugs. Prazosin antagonized contractions of the vessel to exogenously applied noradrenaline but not to ATP, whereas desensitization of the P2-purinoceptor with alpha,beta-methylene ATP blocked responses to ATP but not those to noradrenaline. The concentration response curve to histamine was not affected by treatment of the vessel with prazosin, or after desensitization of the P2-purinoceptor with alpha,beta-methylene ATP. These results suggest that noradrenaline and ATP are co-released from sympathetic nerves supplying the rabbit saphenous artery, both substances being involved in the mechanical contractions of this tissue. Further, the ratio of ATP to noradrenaline involved in these mechanical contractions is dependent upon the frequency of stimulation, but at all frequencies tested the purinergic component is greater than the adrenergic component.

Amblyopia in bilateral infantile and juvenile cataract. Relationship to timing of treatment.

Contact lenses were fitted for 51 aphakic infants. From this group data were obtained that support the hypothesis that much of the visual defect in cases of congenital cataract is due to functional amblyopia, and that it is therefore largely preventable and even treatable. The implications of the results for the management of these patients and for human amblyopia are that early treatment and optical correction are essential, since the effects of deprivation start at about 4 months of age and continue to a cumulative but decreasing degree throughout the first decade of life.