Survey of New Zealand consumer attitudes to consumption of meat and meat alternatives.

This study examined consumers' consumption, motivations, and concerns regarding meat and meat alternatives by means of an online survey of 1061 New Zealand consumers and review of literature. Outcomes of the survey indicate New Zealanders are overwhelmingly omnivorous (93%), regard taste as the most important factor in their meat purchasing decision followed by price and freshness and consider environmental impact and social responsibility of less importance. Those surveyed indicated willingness to pay 17-24% more for food safety and sustainability related meat attributes. About half of respondents lowered their meat consumption the previous year, mainly red and processed meats, due to lack of affordability and health concerns. Although those surveyed showed high awareness about meat alternatives, their consumption level of the products was very low and more prevalent for female, younger and more educated individuals. Overall, the outlook for meat consumption and meat industry in New Zealand is positive and is likely to remain so for the foreseeable future.

Demonstration of 220/280 GHz Multichroic Feedhorn-Coupled TES Polarimeter.

We describe the design and measurement of feedhorn-coupled, transition-edge sensor (TES) polarimeters with two passbands centered at 220 GHz and 280 GHz, intended for observations of the cosmic microwave background. Each pixel couples polarized light in two linear polarizations by use of a planar orthomode transducer and senses power via four TES bolometers, one for each band in each linear polarization. Previous designs of this detector architecture incorporated passbands from 27 to 220 GHz; we now demonstrate this technology at frequencies up to 315 GHz. Observational passbands are defined with an on-chip diplexer, and Fourier-transform-spectrometer measurements are in excellent agreement with simulations. We find coupling from feedhorn to TES bolometer using a cryogenic, temperature-controlled thermal source. We determine the optical efficiency of our device is η = 77% ± 6% (75% ± 5%) for 220 (280) GHz, relative to the designed passband shapes. Lastly, we compare two power-termination schemes commonly used in wide-bandwidth millimeter-wave polarimeters and find equal performance in terms of optical efficiency and passband shape.

Optimization of Time- and Code-Division-Multiplexed Readout for Athena X-IFU.

Readout of a large, spacecraft-based array of superconducting transition-edge sensors (TESs) requires careful management of the layout area and power dissipation of the cryogenic-circuit components. We present three optimizations of our time- (TDM) and code-division-multiplexing (CDM) systems for the X-ray Integral Field Unit (X-IFU), a several-thousand-pixel-TES array for the planned Athena-satellite mission. The first optimization is a new readout scheme that is a hybrid of CDM and TDM. This C/TDM architecture balances CDM's noise advantage with TDM's layout compactness. The second is a redesign of a component: the shunt resistor that provides a dc-voltage bias to the TESs. A new layout and a thicker Pd-Au resistive layer combine to reduce this resistor's area by more than a factor of 5. Third, we have studied the power dissipated by the first-stage SQUIDs (superconducting quantum-interference devices) and the readout noise versus the critical current of the first-stage SqUIDs. As a result, the X-IFU TDM and C/TDM SQUIDs will have a specified junction critical current of 5 µA. Based on these design optimizations and TDM experiments described by Durkin, et al. (these proceedings), TDM meets all requirements to be X-IFU's backup-readout option. Hybrid C/TDM is another viable option that could save spacecraft resources.

Demonstration of Athena X-IFU Compatible 40-Row Time-Division-Multiplexed Readout.

Time-division multiplexing (TDM) is the backup readout technology for the X-ray Integral Field Unit (X-IFU), a 3,168-pixel X-ray transition-edge sensor (TES) array that will provide imaging spectroscopy for ESA's Athena satellite mission. X-0IFU design studies are considering readout with a multiplexing factor of up to 40. We present data showing 40-row TDM readout (32 TES rows + 8 repeats of the last row) of TESs that are of the same type as those being planned for X-IFU, using measurement and analysis parameters within the ranges specified for X-IFU. Singlecolumn TDM measurements have best-fit energy resolution of (1.91 ± 0.01) eV for the Al Kα complex (1.5 keV), (2.10 ± 0.02) eV for Ti Kα (4.5 keV), (2.23 ± 0.02) eV for Mn Kα (5.9 keV), (2.40 ± 0.02) eV for Co Kα (6.9 keV), and (3.44 ± 0.04) eV for Br Kα (11.9 keV). Three-column measurements have best-fit resolution of (2.03 ± 0.01) eV for Ti Kα and (2.40 ± 0.01) eV for Co Kα. The degradation due to the multiplexed readout ranges from 0.1 eV at the lower end of the energy range to 0.5 eV at the higher end. The demonstrated performance meets X-IFU's energy-resolution and energy-range requirements. True 40-row TDM readout, without repeated rows, of kilopixel scale arrays of X-IFU-like TESs is now under development.

A randomized controlled trial comparing tapentadol with oxycodone in non-breastfeeding women post elective cesarean section.

BACKGROUND: Tapentadol may allow greater pain relief with reduced "opioid load" compared to oxycodone. Its use has not been studied in the obstetric population. The objective of this study was to compare the efficacy and side effect profile of tapentadol with oxycodone in patients who received spinal anesthesia for elective cesarean section. The trial was registered with EU Clinical Trials Register with CT number 2016-001621-33. METHODS: This was a multicenter, randomized controlled trial. Randomized patients (n = 68) received either 50 mg tapentadol or oxycodone 10 mg 12 hourly postoperatively. The primary endpoint was the sum of pain intensity difference over the first 48 hours of treatment (SPID48). Secondary outcomes included time to rescue medications, SPID36, total pain relief (TOTPAR) scores, patient satisfaction scores, sum of total pain relief and pain intensity difference (SPRID) scores, time to rescue medications and side effects experienced. An analysis of covariance model with baseline pain intensity score as a covariate was used for statistical analysis. RESULTS: There was no significant difference in the primary endpoint of SPID48 with adjusted mean difference -11.45 (95% CI -35.35, 12.45) p = .34). Oxycodone showed significantly greater SPID36 scores compared to tapentadol with increased time to rescue medication. Side effects experienced were similar between groups. CONCLUSION: Tapentadol did not provide superior pain control or improved tolerability compared to oxycodone post cesarean section. Results should be interpreted however with consideration of administration of intrathecal opioids to all patients in this study and debate over the optimal dose of tapentadol for acute pain.

Colorectal cancer and thrombosis.

SIGNIFICANCE: Colorectal cancer (CRC), results in a hypercoagulable state which manifests clinically as venous thromboembolism (VTE), often presenting as a deep vein thrombosis (DVT) or pulmonary embolism (PE). The consequences of VTE in CRC can be devastating, resulting in long-term morbidity and are a frequent cause of death, even amongst those who would have otherwise had a favourable cancer prognosis. The incidence of VTE in all cancers is increasing, whilst the exact incidence of VTE in CRC is likely to be underestimated. All cancer treatments increase the risk of VTE in an already at risk population. CRITICAL ISSUES: CRC-associated VTE is a challenging entity to manage with recurrences occurring more frequently in cancer patients, despite anticoagulation. Anticoagulation, whether treatment or prophylactic, increases the risk of bleeding, especially in patients with cancer. Although strong evidence underpins the initial management of cancer-associated VTE, there is uncertainty with regard optimum treatment duration. For VTE prevention, extended (28 days), pharmacological thromboprophylaxis post CRC surgery is internationally recommended. Pharmacological thromboprophylaxis is not routinely recommended for nonhospitalised patients receiving chemotherapy. FUTURE DIRECTIONS: There is growing evidence of a symbiotic relationship between cancer biology and the clotting system. Tissue factor (TF), the initiator of the clotting pathway, promotes cancer via clotting dependent and independent mechanisms. Clotting pathway factors, including TF, may have utility as biomarkers in CRC, for assessment of VTE risk in addition to cancer prognosis. The clotting system may also be a target for potential anti-cancer therapies, either via existing anticoagulants or experimental direct TF inhibitors.

Using Contingent Reinforcement to Augment Muscle Activation After Perinatal Brachial Plexus Injury: A Pilot Study.

AIM: Examine the feasibility of increasing muscle activation with electromyographically (EMG)-triggered musical-video as reinforcement for children with perinatal brachial plexus injury (PBPI). METHODS: Six children with PBPI (9.3 ± 6.3 months; 5 female, 1 male) and 13 typically developing (TD) controls (7.8 ± 3.5 months; 4 female, 9 males) participated. The left arm was affected in 5/6 children with PBPI. We recorded the integral (Vs) of biceps activation with surface EMG during two conditions per arm in one session: (1) 100 second (s) baseline without reinforcement and (2) 300 s reinforcement (musical-video triggered to play with biceps activation above threshold [V]). We examined the relation between the mean integral with reinforcement and hand preference. RESULTS: Mean biceps activation significantly increased from baseline in the affected arm of the group with PBPI by the 2nd (p < .008) and 3rd (p < .0004) 100 s intervals of reinforcement. Six of 6 children with PBPI and 12/13 TD controls increased activation in at least one arm. A lower integral was linked with hand preference for the unaffected right side in the PBPI group. CONCLUSION: This study supports contingent reinforcement as a feasible method to increase muscle activation. Future work will examine training dose and intensity to increase arm function.

Microwave SQUID Multiplexer Demonstration for Cosmic Microwave Background Imagers.

Key performance characteristics are demonstrated for the microwave SQUID multiplexer (µmux) coupled to transition edge sensor (TES) bolometers that have been optimized for cosmic microwave background (CMB) observations. In a 64-channel demonstration, we show that the µmux produces a white, input referred current noise level of [Formula: see text] at -77 dB microwave probe tone power, which is well below expected fundamental detector and photon noise sources for a ground-based CMB-optimized bolometer. Operated with negligible photon loading, we measure [Formula: see text] in the TES-coupled channels biased at 65% of the sensor normal resistance. This noise level is consistent with that predicted from bolometer thermal fluctuation (i.e. phonon) noise. Furthermore, the power spectral density is white over a range of frequencies down to ~ 100 mHz, which enables CMB mapping on large angular scales that constrain the physics of inflation. Additionally, we report cross-talk measurements that indicate a level below 0.3%, which is less than the level of cross-talk from multiplexed readout systems in deployed CMB imagers. These measurements demonstrate the µmux as a viable readout technique for future CMB imaging instruments.

PO-09 - Incidence of pre-operative and post-operative deep vein thrombosis in colorectal cancer surgery. Interim results of a prospective clinical study.

INTRODUCTION: Venous thromboembolism (VTE) is a major cause of death in patients undergoing colorectal cancer surgery and usually arise from Deep Vein Thrombosis's (DVTs). In patients with cancer below knee and asymptomatic DVTs are at risk of propagating and result in a VTE. Retrospective, population based studies predating extended course venous thromboprophylaxis report an incidence of symptomatic VTE in colorectal cancer patients of approximately 5.5%. Clinical studies have suggested that pre-operative d-dimer may predict the development of post-operative DVTs. AIM: We undertook a multicentre prospective study to screen colorectal cancer patients pre- and post-operatively for the presence of DVTs. The aim of the study was to determine the incidence of DVTs in patients undergoing elective, curative surgery for colorectal cancer. The study also aimed to identify histological and clinical factors that pre-dispose to development of a DVT. The role of pre-operative d-dimer in predicting the development of post-operative DVTs was also analysed. MATERIALS AND METHODS: Patients at four hospitals undergoing elective curative surgery for colorectal cancer were recruited pre-operatively. Exclusion criteria were: previous VTE, previous malignancy, anti-coagulants. Bilateral full leg venous duplex was performed pre-operatively and at six weeks post-surgery. Plasma D-dimer was measured pre-operatively. RESULTS: Of 60 patients undergoing pre-operative duplex, five (8.3%) had below knee, asymptomatic DVTs. These patients were then excluded from further analysis. Of the remaining 55, 48 had post-operative duplex examination. Three (6.3%) developed post-operative DVTs all of which were asymptomatic and below knee. There were no symptomatic DVTs. Two of these patients had received extended course venous thromboprophylaxis and the other received inpatient thromboprophylaxis. Development of post op DVT was associated with lymph node positivity (p=0.02). There were no other histological, surgical or demographical factors that predicted the development of post-operative DVTs. Pre-operative D-dimer was higher in patients who developed a post-operative DVT compared to those who did not [1,275 ng/L (95%CI: 780 - 1770 ng/L) vs 805 ng/L (95% CI: 632 - 980 ng/L) p=0.03]. CONCLUSIONS: Of patients diagnosed with operable colorectal cancer, 8% have pre-operative asymptomatic DVT, and a further 6% develop DVT despite thromboprophylaxis. The subgroup of patients with lymph node involvement may benefit from more aggressive anticoagulation as they are at increased risk of DVT despite extended course anticoagulation. Pre-operative D-dimer may offer a predictive method to identify patients at risk of post-operative DVT.

PO-32 - Patient, tumour and operative factors influencing perioperative hypercoagulability in colorectal cancer.

INTRODUCTION: Up to 6% of patients develop venous thromboembolism (VTE) following elective colorectal cancer surgery despite thromboprophylaxis. Clinical practices for perioperative thromboprophylaxis remains variable, particularly the use and duration of extended thromboprophylaxis. Identification of factors associated with a prolonged postoperative hypercoagulable state may allow the development of algorithms that allow more targeted thromboprophylaxis. AIM: To identify patient, tumour and surgical risk factors for prolonged (two and six weeks) hypercoagulability in colorectal cancer patients undergoing surgical resection. MATERIALS AND METHODS: In a prospective cohort study (Cancer-induced Hypercoagulability As a Marker of Prognosis [CHAMPion]), plasma d-dimer was measured at 2 and 6weeks post-operatively in patients undergoing elective, curative resection for colorectal cancer. Hypercoagulability (raised D-dimer) at 2 and 6weeks was correlated with patient, tumour and operative factors. RESULTS: Of the 62 patients recruited (median age 69years [range 39-90]), 37 were male. D-dimer was increased in females compared to males at six weeks (geometric mean (GM) 1,287ng/ml [95% CI 944 - 1,755 vs. 821ng/ml (95% CI 633 - 1064) p=0.03]. Age, smoking, hypertension, use of antiplatelet medication, BMI and WHO performance status were not associated with a prolonged hypercoagulable state. There were no tumour factors (including size/T stage/lymph node involvement/differentiation) associated with a prolonged hypercoagulable state. D-dimer was increased in patients undergoing open surgery (n=39) compared to laparoscopic surgery (n=23) at 2weeks (GM 2,337ng/ml [95% CI 1,806-3,023] vs. 1,212ng/ml [95% CI 898-1,629], p=0.001) and 6weeks (GM 1,162ng/ml [95% CI 818-1647] vs. 723ng/ml [95% CI 533-982]p=0.04). Operative time was not associated with prolonged hypercoagulability. D-dimer had a trend to be increased at 2weeks in patients receiving perioperative blood transfusions (n=8) compared to those that did not (n=54) (GM 2,618ng/ml [95% CI 1,525-4,536] vs. 1613ng/ml [95% CI 1,236 - 2,100] p=0.08). CONCLUSIONS: Even in this relatively small cohort of patients female gender, open surgery and receiving a blood transfusion are associated with on-going hypercoagulability up to six weeks post operation. This may represent a group where thromboprophylaxis should be targeted.

PO-51 - Expression of proteins of the tissue factor thrombin pathway is upregulated in the stroma and epithelium of colorectal cancer.

INTRODUCTION: Colorectal cancer expression of Tissue Factor (TF), PAR1 and PAR2 is associated with a poor prognosis. Their stromal, rather than epithelial, expression has prognostic significance in other cancers, this has not been explored in colorectal cancer. AIM: We aimed to determine the expression patterns of Tissue Factor (TF), PAR1 and PAR2 and thrombin in colorectal cancer and normal tissue. MATERIALS AND METHODS: Cancer and distant normal tissue were sampled from 37 patients. Expression of TF, Thrombin, PAR1 and PAR2 were determined by immunohistochemistry. Two observers scored expression level (0-3) in individual cells. Percentage of cells having each level of expression was determined and an H-score calculated which are given with 95% CI. RESULTS: Normal epithelium did not express TF, but it was expressed by cancer epithelium (36.5 (95% CI 17.6 - 55.4) p<0.001). Thrombin expression was increased in cancer vs normal epithelium (126.2 (95% CI 110.6 - 141.7) vs 101.6 (95% CI 92.5-110.8) p=0.01) as was PAR2 (172.4 (95% CI 152.9-191.8) vs 123.4 (95% CI 107.8-139.0) p<0.001). The increase in cancer epithelium PAR1 expression compared to normal (105.4 (95%CI 84.3-126.5) vs 89.0 (95% CI 80.4-97.6)) was not significant. Normal stroma did not express TF or thrombin however both were expressed by cancer stroma (TF 46.3 (95% CI 24.6-68.0) p<0.001, thrombin 11.4 (95% CI 6.2-16.7) p<0.001). PAR1 and PAR2 were both expressed in normal stroma but demonstrated increased expression in cancer stroma (cancer vs normal; PAR 1: 130.7 (95% CI 112.2-149.2) vs 19.5 (95% CI 11.24-27.7) p<0.001; PAR2: 21.5 (95% CI 12.9-30.1) vs 2.21 (95% CI 0.49-3.92) p<0.001). CONCLUSIONS: Upregulated expression of tissue thrombin pathway proteins is seen in colorectal cancer in both epithelial and stromal cells. Procoagulant tumour cells and tumour microenvironment may provide a novel therapeutic target for treatment in colorecal cancer.

PO-52 - Effect of tissue factor expression by colorectal cancer on cancer stem cell activity.

INTRODUCTION: Abnormal Tissue factor (TF) expression occurs in many cancers including colorectal and is associated with a poor prognosis. TF expression promotes cancer stem cell (CSC) activity in breast and squamous cell carcinoma (SCC). AIM: The aim of the research is to determine the effect of TF expression by colorectal cancer cell lines on colorectal CSC activity. MATERIALS AND METHODS: Colorectal cancer cell lines with high (DLD-1) and low (SW620) TF expression were stably transduced to knock down (TF-ve) and over express (TF+ve) TF. CSC activity was assessed using the cancer sphere assay (sphere forming efficiency (SFE)=spheres formed / cells plated) and by ALDH1 expression (by florescent activated cell sorting). When comparing transduced cells to their control the ALDH1 expression was normalised to their control. RESULTS: The naturally high TF expressing cell line (DLD-1) compared to the low TF expressing cell line (SW620) had a reduced SFE (0.7 (SD 0.39) vs 1.38 (SD 0.68), p<0.05) and less cells expressed ALDH1 (15.3% (SD 1.2) vs 26.9% (SD 2.1), p=0.02). DLD-1 TF+ve compared to its control had a reduced SFE (0.33 (SD 0.14) vs 0.66 (SD 0.42), p<0.01) and less cells expressed ALDH1 (0.72 (SD 0.069) p=0.001) (normalised to negative control). There was no difference in SFE (1.21 (SD 0.56) vs 1.29 (SD 0.50) p=0.4) and ALDH1 expression (0.81 (SD 1.00) p=0.5) between SW620 TF+ve and its control. DLD-1 TF-ve and SW620 TF-ve had increased SFE compared to their controls (DLD-1: 0.63 (SD 0.27) vs 0.41 (SD 0.35) p<0.01; SW620: 2.03 (SD 0.86) vs 1.21 (SD 0.70) p<0.01), and increased ALDH expression (DLD-1: TF-ve 1.23 (SD 0.74)p=0.04 and SW620: TF-ve 1.31 (SD 0.08) p<0.001 normalised to controls). CONCLUSIONS: Unlike in breast and SCC, in colorectal cancer cell lines TF inhibits CSC activity. This has significance if anti-tissue factor treatments are considered as an anti-cancer treatment as this may increase the cancer stem cell activity.

PO-50 - The effect of tissue factor expression on colorectal cancer cell proliferation.

INTRODUCTION: Tissue factor (TF) is abnormally expressed in many cancers including colorectal and is associated with a poor cancer prognosis. Colorectal cancer cell lines expressing TF produce faster growing tumours. In lung cancer, TF inhibition has been shown to reduce proliferation AIM: We aimed to determine if TF expression and activity increases cellular proliferation in colorectal cancer cell lines. MATERIALS AND METHODS: DLD-1 and SW620 colorectal cell lines were transduced with cDNA to over express TF (TF+ve). Proliferation was determined by Alamar blue assay where level of absorption indicates the number of living cells, expressed as an arbitrary unit of absorption (u). Factor VIIa (TF ligand) at increasing concentrations was used to determine the effect of TF activity on proliferation. Downstream marker of TF activity (MAPK phosphorylation) was assessed by Western blot and correlated with proliferation. RESULTS: There was a significant increase in proliferation in both DLD-1 TF+ve and SW620 TF+ve compared to their negative controls at 42 hours (DLD1 TF+ve: 5,455u (SD 2,485u) vs 2,246u (SD 1,107u) p<0.001); SW620 TF+ve: 414u (SD 96u) vs 286u (SD 114u) p<0.05). When factor VIIa (FVIIa) was added in concentrations from 0nM to the supra-physiological concentration of 25nM there was a dose-dependent increase in proliferation up to physiological levels (0.1nM) which was further increased in the TF+ve cell lines. Fold change from baseline 0 vs 0.1nM FVIIa (DLD-1: 3.22u (SD 0.61u) vs 6.17u (SD 2.21u) p<0.05; SW620 2.33u (SD 2.21u) vs 4.69u (SD 0.61u) p<0.05). The increase in proliferation was reflected in the phosphorylation of MAPK which was increased by TF overexpression alone and further increased by FVIIa in a dose-dependent fashion. CONCLUSIONS: Increased TF expression and activation is associated with increased cellular proliferation. This effect appears to be exerted via MAPK pathways. Tissue factor may provide a therapeutic target in colorectal cancer.

Laparoscopic restorative proctocolectomy: safety and critical level of the ileal pouch anal anastomosis.

AIM: The study reports the longer-term results of laparoscopic-assisted restorative proctocolectomy (RPC), with particular reference to safety and the level of the stapled ileal pouch-anal anastomosis (IPAA). METHOD: Data were collected prospectively from all patients who underwent laparoscopic RP from July 2006 to July 2010. In each patient the operation involved the use of a short (6 cm) Pfannenstiel incision to facilitate placement of the linear stapler for anorectal division. RESULTS: Seventy-five patients underwent RPC either with total proctocolectomy (n = 53) or after previous emergency colectomy (n = 22). Early postoperative morbidity occurred in 18 (24%) patients and readmission within 30 days occurred in 18 (24%). Morbidity during follow up developed in 29 (39%). A pouchogram was carried out in all 75 patients before ileostomy closure with an abnormality shown in eight. The median level of the IPAA was at 3.0 cm (1.0-5.0 cm) above the dentate line. At a median of 33 (9-57) months, there has been one case of small bowel obstruction and no incisional hernia. CONCLUSION: In laparoscopic-assisted RPC a limited Pfannenstiel incision allows safe construction of the IPAA at an appropriate level. Laparoscopic RPC is safe and the emerging long-term follow-up data show the benefit of this approach, with very low rates of small bowel obstruction and incisional hernia formation.

Infliximab and surgical treatment of complex anal Crohn's disease.

AIM: Perianal fistulae in Crohn's disease are frequently complex, involve the anal sphincter complex and surgical treatment can be associated with poor healing of wounds and damage to the mechanism of continence. The aim of this study was to evaluate the efficacy and duration of response to infliximab in the long-term management of perianal fistulae in Crohn's disease in routine clinical practice. METHOD: A prospectively maintained database was used to identify patients with Crohn's disease and complex anal fistulae who were treated with infliximab (primary treatment, three initial infusions followed by maintenance therapy). Patients who received infliximab for luminal disease or for enterocutaneous, peristomal or rectovaginal fistulae were excluded from this study. RESULTS: Fifty-two patients [25 male, median age 24 (range 15-72) years] were treated with infliximab for perianal Crohn's fistulae for a median of 66 (7-124) months. Twenty-six of the patients underwent pre-infliximab MRI scans and 38 had an examination under anaesthetic (EUA) prior to commencement of treatment, 22 of whom had seton(s) inserted into their fistulae. Maintenance therapy was possible in 42 (81%) of 52 patients. Twenty-two (42.3%) patients had a complete response to treatment, 23 (44.2%) had a partial response and 7 (13.5%) had no response. Less than complete response to infliximab was associated with a greater risk of requiring surgical intervention (Fisher's exact test, d.f. 1, P = 0.005). CONCLUSION: The response rates of Crohn's related complex perianal fistulae to infliximab are good. Complete response is associated with a reduced need for surgical intervention.

Saving the child to save the nation: poverty, whiteness and childhood in the Cape Colony, c.1870-1895.

Children were central to efforts to eradicate white impoverishment in the Cape Colony in the late nineteenth century. The education and training of poor, white children were believed to be the most effective ways of breaking cycles of poverty, and of ensuring continuing white control over the Cape's resources. Yet a closer reading of the evidence presented to the 1894 Labour Commission and the committee appointed to investigate the Destitute Children Relief Bill suggests that this interest in poor, white children also stemmed from concerns about the children themselves. Destitute white children - both male and female - were described, frequently, as representing a threat to the social, moral, and even economic order, and this view of poor white children shaped official responses to white poverty. This concern for white children reflected not solely their status as 'children' - that they represented the colony's future, were fairly malleable, and could be more easily 'reached' by projects and schemes to eradicate white poverty - but also their problematic class position in a colonial racial order that sought their reform, direction and education into acceptable productive citizens.

The current status of laparoscopic surgery for colorectal disease.

Laparoscopic surgery has an expanding role in the management of colorectal disease. As technical expertise has increased, selection of patients for laparoscopic procedures has widened without any commensurate increase in operative or postoperative complications. This article aims to summarise the current status of laparoscopic surgery in colorectal disease with particular reference to colorectal cancer, inflammatory bowel disease, diverticular disease and disorders of the pelvic floor.

Laparoscopic excision of a retrorectal schwannoma.

Retrorectal tumors are uncommon and are usually managed by open surgical excision. Recent advances in laparoscopic techniques have led to the use of laparoscopy for a variety of problems in colorectal surgery, including the excision of retrorectal tumours. This case report, which describes the laparoscopic excision of a benign schwannoma arising from the second sacral nerve root, highlights the benefits of accurate preoperative diagnosis with MR imaging and the advantages of a laparoscopic approach while pointing out principles that should be adhered to when using this approach. The tumour was successfully resected without neural compromise and with a prompt and full postoperative recovery.