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Background: Parental beliefs about infant sleep shape caregiving practices, infant development, and parental wellbeing. The Views oN Infant Sleep (VNIS) questionnaire was designed to assess these beliefs across three domains: Closeness, Independence, and Night-Waking. This study aimed to validate the questionnaire for the first time in an Australian context, in a sample of 111 pregnant women. Methods: Women completed an anonymous online questionnaire containing the 12-item VNIS. Confirmatory factor analysis was conducted in MPlus, using a weighted least squares estimator to evaluate the proposed threefactor structure. Results: Findings provided partial support for the three-factor model. Incremental and residual fit indices were strong (comparative fit index = 0.97; Tucker-Lewis index = 0.96; weighted root mean square residual = 0.76) and the chi-square to degrees-of-freedom ratio indicated acceptable fit (1.75). Global fit was borderline (root mean square error of approximation = 0.08, 90% confidence interval = 0.05-0.11). All items loaded significantly onto their intended factors, however item performance varied. Independence items showed consistently strong loadings, while Closeness items ranged from moderate to strong with one weaker indicator. Night-Waking items were more variable, including one item below acceptable thresholds. Inter-factor correlations were strong (r = 0.58-0.71), indicating substantial coherence and limited distinctiveness between components. Conclusion: The VNIS questionnaire captures multidimensional parental beliefs about infant sleep but requires refinement to strengthen reliability and discriminant validity. Further cross-cultural and longitudinal research is needed to support its broader applicability in diverse clinical and research contexts including to fathers and nonbirthing partners.
BACKGROUND AND OBJECTIVE:BRCA1 and BRCA2 pathogenic germline variants (PGVs) are associated with higher risk of prostate cancer (PC). The IMPACT study evaluated the utility of targeted prostate-specific antigen (PSA) screening in BRCA1/BRCA2 PGV carriers. Here we report outcomes after five rounds of PSA screening in IMPACT. METHODS:Between 2005 and 2015, 3063 participants aged 40-69 yr (median 54 yr) were recruited from 65 centres in 20 countries in two cohorts: (1) BRCA1/BRCA2 PGV carriers (915 BRCA1, 901 BRCA2); and (2) age-matched noncarriers for a familial PGV (727 BRCA1 and 520 BRCA2 noncarriers). Annual PSA screening was performed, with PSA >3.0 ng/ml used as the indication for prostate biopsy. Our aim was to identify differences by PGV status in (1) the incidence of PC and of clinically significant PC (csPC; grade group ≥2) and (2) tumour stage and characteristics after five screening rounds. KEY FINDINGS AND LIMITATIONS:There was no statistically significant difference in PC incidence between BRCA1/BRCA2 PGV carriers and noncarriers. csPC incidence was significantly higher for BRCA2 PGV carriers than for noncarriers (3.1% vs 1.3%; p = 0.04). Among men with PC, the proportion of tumours with National Comprehensive Cancer Network intermediate unfavourable/high risk was higher in the BRCA1/BRCA2 PGV groups versus the corresponding group without PGVs (BRCA2: 65% vs 32%, p = 0.029; BRCA1: 56% vs 18%, p = 0.0017). There were no T4 or metastatic PC cases. Pathology after radical prostatectomy revealed tumour upgrading for 7/23 (26%) BRCA1 PGV carriers and 10/34 (26%) BRCA2 PGV carriers, with no tumour upgrading for men without PGVs. Study limitations include the biopsy compliance rate and changes in PC diagnostic pathways since 2005. CONCLUSIONS AND CLINICAL IMPLICATIONS:Annual PSA screening in BRCA2 PGV carriers confirmed a higher incidence of csPC and detection of clinically relevant tumours in comparison to noncarriers. For the first time, we confirm that PSA screening in BRCA1 PGV carriers results in early detection of NCCN IR-U/HR PC. Systematic PSA screening is recommended for BRCA2 PGV carriers and should be considered for BRCA1 PGV carriers.
(1) Background: Medication-related problems (MRPs) are a significant burden on health care systems. Pharmacists play an important role in preventing and reducing MRPs through clinical review, education, and policy governance. This study analyzed pharmacist interventions within a 92-bed neonatal clinical care unit to better understand MRPs and guide targeted medication safety initiatives. (2) Methods: All pharmacist interventions documented in REDCap® between 1 July 2022 and 30 June 2025 were analyzed identifying MRP incidence, types, and acceptability following interventions. (3) Results: A total of 873 pharmacist interventions were recorded during the study period. The most common MRPs were related to dosing errors (320/873, 36.7%), compliance with hospital policy (152/873, 17.4%), no indication apparent (106/873, 12.1%), drug interactions (66/873, 7.6%), and inadequate laboratory monitoring (40/873, 4.6%). Of these, 545/873, 62.4% were accepted by prescribers, while 228/873, 26.1% had unknown outcomes at the time of data entry. 343/873, 39.3% of interventions documented were from the Neonatal Intensive Care Unit, involving medications such as gentamicin (n = 46/343, 13.4%), benzylpenicillin (n = 37/343, 10.8%), caffeine (n = 34/343, 9.9%), parenteral nutrition (n = 23/343, 6.7%), and morphine (n = 16/343, 4.7%) and meropenem (n = 16/343, 4.7%)). (4) Conclusions: Regular analysis of pharmacist interventions provides valuable insights into local MRP trends and highlights opportunities for quality improvement and education.
OBJECTIVES:The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) provides a systematic framework to identify cognitive phenotypes in patients with various epilepsy syndromes and assess their consistency across diverse cultures and regions. Evidence-based consensus on cognitive profiles will enhance diagnostic processes and foster collaborative epilepsy research. This study evaluated the applicability of the IC-CoDE in adults with temporal lobe epilepsy (TLE) in South Africa. METHODS:Neuropsychology data from 301 adults with TLE were analysed and the IC-CoDE taxonomy was applied to derive cognitive phenotypes. Cognitive phenotype distributions, along with demographic and clinical characteristics, were evaluated and compared to findings from cohorts in the US and Mumbai, India. RESULTS:Sixty-six percent of our sample was cognitively intact, 19% had single-domain impairment, 9% bidomain and 6% generalized impairment. Adults with mesial temporal lobe sclerosis (MTS) had higher rates of impairment in all cognitive domains, compared to those without MTS. Significantly more adults with TLE were cognitively intact in our sample than in the US and Mumbai cohorts (p < 0.001) and significantly more presented with single-domain impairment in language. Bidomain impairment most commonly involved language and memory, consistent with the US cohort. SIGNIFICANCE:Differences between our findings and those from other cohorts may be related to varying clinical characteristics, particularly the significantly greater proportion of adults with normal MRIs in our cohort. These results reveal nuanced patterns of cognitive phenotypes in South African adults with TLE but overall provide further support for the cross-cultural application of the IC-CoDE.
Antibiotic exposure in neonatal intensive care units (NICU) is high. This study describes antibiotic use in very preterm infants and examines the association between duration of exposure and outcomes in blood culture negative (CN) infants. Infants <32 weeks’ gestation admitted between January 2012 and June 2022 were included in this retrospective cohort study. Data were extracted from electronic databases. Antibiotic exposure was calculated as duration of treatment (DOT) and antibiotic utilisation rate (AUR) and compared with neonatal outcomes including mortality, late onset sepsis (LOS), necrotising enterocolitis (NEC), chronic lung disease (CLD), severe retinopathy of prematurity (ROP) and/or severe brain injury. There were 3235 CN infants included in the study; 1601 (49.5
