Uptake of the Gout and Crystal Arthritis Network Consensus Statements for Gout Nomenclature.

OBJECTIVE: In 2019, the Gout and Crystal Arthritis Network (G-CAN) published consensus statements for the nomenclature of disease elements and states in gout. The aim of this study was to determine adherence to the G-CAN consensus nomenclature statements since publication. METHODS: American College of Rheumatology and EULAR conference abstracts were searched using online databases for the keywords 'gout,' 'urate,' 'uric acid,' 'hyperuricaemia,' 'tophus,' and/or 'tophi' before and after publication of the consensus statements (January 1, 2016 to December 31, 2017 and January 1, 2020 to December 31, 2021, respectively). Abstracts were manually searched for labels used to reference gout disease elements and states. Use of the G-CAN-agreed labels, as well as alternatives, were compared between the two time periods. RESULTS: There were 988 abstracts included in the analysis: 596 in 2016 to 2017 and 392 in 2020 to 2021. Use of the agreed labels 'urate' and 'gout flare' increased between the two periods. There were 219 of 383 abstracts (57.2%) with the agreed label 'urate' in 2016 to 2017 compared with 164 of 232 (70.7%) in 2020 to 2021 (P = 0.001). There were 60 of 175 abstracts (34.3%) with the agreed label 'gout flare' in 2016 to 2017 compared with 57 of 109 (52.3%) in 2020 to 2021 (P = 0.003). Consistent with the G-CAN statement, use of the label 'chronic gout' reduced between the two time periods. There were 29 of 596 abstracts (4.9%) in 2016 to 2017 that used the label 'chronic gout' compared with 8 of 392 abstracts (2.0%) in 2020 to 2021 (P = 0.02). CONCLUSION: Use of G-CAN-agreed gout labels has increased, but gout nomenclature remains imprecise. Additional efforts are needed to ensure consistent use of agreed nomenclature for gout in the scientific literature.

Engaging mothers: Breastfeeding experiences recounted (EMBER). A pilot study.

BACKGROUND: There is an abundance of published literature that describes the short- and long-term effects of breastfeeding for both the infant and mother. Despite the majority of women having good intentions to breastfeed, challenges that they encounter place their breastfeeding journey in jeopardy. Improving breastfeeding rates and durations is a significant public health priority at a local, national and international level. AIM: This pilot study aimed to identify and describe participating women's breastfeeding experiences in order to better understand why some achieve their breastfeeding goals, despite experiencing challenge and others do not. METHOD: A qualitative methodology was chosen to allow these mothers to have their voices heard. Twenty Australian Breastfeeding Association trainee counsellors, who were undertaking the Certificate IV in Breastfeeding Education, gave permission for the examination and analysis of their de-identified reflections on their own breastfeeding experiences. Data was examined and thematically analysed into identified themes. RESULTS: Participants' breastfeeding experiences were identified into six themes: 1. expectation of breastfeeding, 2. motivation to breastfeed, 3. support to maintain breastfeeding, 4. returning to work, 5. the experience of breastfeeding and 6. social attitude to public breastfeeding. The responses and experiences were varied, with each woman describing a particular event that had a significant impact on her breastfeeding journey. CONCLUSION: It is not completely understood why some mothers continue with their breastfeeding journey, whilst others discontinue earlier than they had planned. Women in this pilot study reported that support, acceptability of breastfeeding to their family and social circle, public breastfeeding, issues around infant sleep and maternal fatigue were all significant issues for them as they navigated breastfeeding for the first time.Findings from this pilot study will be used to inform the development of a larger study which will further explore women's decision making, as well as identify what supports are needed to improve women's experience of breastfeeding.

Modeling long-term risk to environmental and human systems at the Hanford Nuclear Reservation: scope and findings from the initial model.

The Groundwater Protection Project at the US Department of Energy Hanford Site in Washington State is currently developing the means to assess the cumulative impact to human and ecological health and the regional economy and cultures from radioactive and chemical waste that will remain at the Hanford Site after the site closes. This integrated system is known as the System Assessment Capability (SAC). The SAC Risk/Impact Module discussed in the article uses media- and time-specific concentrations of contaminants estimated by the transport models of the integrated system to project potential impacts on the ecology of the Columbia River corridor, the health of persons who might live in or use the corridor or the upland Hanford environment, the local economy, and cultural resources. Preliminary Monte Carlo realizations from the SAC modeling system demonstrate the feasibility of large-scale uncertainty analysis of the complex relationships in the environmental transport of contaminants on the one hand and ecological, human, cultural, and economic risk on the other. Initial impact results show very small long-term risks for the 10 radionuclides and chemicals evaluated. The analysis also helps determine science priorities to reduce uncertainty and suggests what actions matter to reduce risks.