Reports suggest that 12–76% of adolescents have experienced parental comments regarding their weight/shape and/or eating behaviours. Parents may engage in conversations about weight/shape and eating out of concern, even without any ill intent; however, the associations of these comments with subsequent problematic psychosocial and eating behaviours are evidenced. Therefore, an in-depth understanding of the content and prevalence of such comments is needed. To date, adolescent-reported prevalence estimates have not included differentiation between mother or father and sons or daughters, nor have they considered eating-focussed comments. This study considered the prevalence of positive and negative parental commentary regarding weight/shape and eating with a focus on parental origin. A total of 2287 Australian male and female adolescents participated via a self-report survey. Adolescents reported frequent positive comments on weight/shape and on eating, most commonly maternal positive comments on weight/shape (78%; 95% CI 77–80). Daughters reported significantly more maternal comments on weight/shape (positive and negative) as well as more negative eating comments from mothers than did sons. Sons reported significantly more negative weight/shape comments from fathers than did daughters. Some negative comments increased significantly with age. These findings support a notable prevalence of reported parental weight/shape and eating comments directed at their offspring, particularly from mothers.

Background: Uterus transplantation is an emerging surgical innovation offering the option of genetic and gestational motherhood to women with absolute uterine factor infertility. More than 15 centres worldwide have now commenced clinical trials, but the procedure has not been performed in Australia. Aim:To explore the awareness, attitudes and perceptions regarding uterus transplantation among Australian women with absolute uterine infertility. Materials and Methods:An online survey targeting Australian women with absolute uterine factor infertility was performed. Data collected included demographic data, infertility circumstances, considered motherhood options and wellbeing, followed by specific questions regarding uterus transplantation. In total, the participants completed 50 items.Results: All 57 respondents (90% response rate) indicated awareness of uterus transplantation. Of the women who desired parenthood, more than two-thirds indicated a strong desire to carry their own child, with an even higher number (80%) endorsing the need for the procedure to be an option in Australia. Which donor model is preferred (deceased or live), requires further exploration. Conclusion:This study indicates that uterus transplantation is desired by the majority of Australian women with absolute uterine factor infertility. Clinical introduction of uterus transplantation in Australia has strong support from the women who would benefit from the procedure. K E Y W O R D S absolute uterine factor infertility, motherhood, quality of life, transplantation, uterus transplantation Not important 8 (19.5) Age Wald χ 2 (1) = 1.905, P = 0.167 1.046 (0.955-1.146) Education Wald χ 2 (1) = 1.341, P = 0.247 0.488 (0.115-1.743) AUFI cause Wald χ 2 (1) = 5.266, P = 0.022 9.778 (1.395-68.57) Previous children Wald χ 2 (1) = 4.728, P = 0.030 0.123 (0.20-0.778) Awareness of UTx worldwide (Q1) Wald χ 2 (1) = 5.902, P = 0.015 0.114 (0.020-0.658) 3. Is there a need a need for UTx in Australia? Responses Yes definitely 24 (60) Yes, but more a desire than a need 8 (20) Unsure 5 (12.5) No 3 (7.5) Age Wald χ 2 (1) = 4.100, P = 0.043 0.878 (0.774-0.996) Education Wald χ 2 (1) = 0.088, P) = 0.767 0.806 (0.194-3.357) AUFI cause Wald χ 2 (1) = 0.109, P) = 0.292 0.333 (0.043-2.579) Previous children Wald χ 2 (1) = 1.786, P) = 0.180 0.197 (0.018-2.119) I have no preference on donor type 12 (36.4) Age Wald χ 2 (1) = 0.663, P = 0.416 0.960 (0.869-1.060) Education Wald χ 2 (1) = 2.015, P = 0.156 2.837 (0.672-11.972) AUFI cause Wald χ 2 (1) = 0.108, P = 0.742 1.333 (0.240-7.421) Previous children Wald χ 2 (1) = 01.056 P = 0.304 2.358 (0.459-12.111) 6. Do you have a potential donor? Responses Yes (friend or relative) 14 (35.9%) No but I would hope for an anonymous donor 13 (33.3%) No but I would consider a deceased donor option. 6 (15.4) Not interested 6 (15.4) Age Wald χ 2 (1) = 7.260, P = 0.205 0.907 (0.780-1.060) Education Wald χ 2 (1) = 1.088 P = 0.297 0.582 (0.210-1.610) AUFI cause Wald χ 2 (1) = 5.791, P = 0.052 1.333 (0.443-4.336) Previous children Wald χ 2 (...

Objective: Previous experimental research has yielded inconclusive findings regarding the effects of Holocaust trauma to survivors' descendants, while qualitative studies have suggested diverse long-term impacts of this traumatic past. While the extant literature has focused mainly on Israeli and North American children of survivors, this study drew on theories of transgenerational trauma transmission to explore the lived experiences of six Jewish Australian grandchildren of Holocaust survivors. Method: Data from semi-structured interviews were analyzed using interpretative phenomenological analysis to investigate how the impacts of historical trauma are experienced across generations in an Australian sample. Results: The impact of their grandparents' Holocaust experiences was found to echo across the participants' affective experiences, their sense of connection to family histories, their understanding of being different to others, and their political and ethical values. An analysis of these findings suggested that the participants define themselves in a collective manner as part of a group of survivors' descendants, with their post-Holocaust positioning existing in a state of tension alongside their Australian identity. Conclusions: This study extends the literature on transgenerational trauma by shedding light on how the identities of Australian grandchildren of Holocaust survivors continue to be profoundly informed by their identification with familial narratives of trauma, despite their generational distance from the Holocaust.

The value of acetylcholinesterase (AChE) analysis as an adjunctive test to amniotic alpha fetoprotein (amAFP) for the diagnosis of fetal abnormality has been investigated in a series of 3785 amniotic fluid samples. Quantitative analysis of AChE performed retrospectively on a selected group of 541 amniotic fluid samples failed to discriminate between normal and open neural tube defect pregnancies. Qualitative analysis of AChE by polyacrylamide gel (PAG) electrophoresis in the same series of 541 fluids correctly identified 251 of the 255 pregnancies with open neural tube defect and 29 of the 31 pregnancies with false positive amAFP results. The failure of the test to diagnose 4 cases of open neural tube defect was probably attributable to the age and condition of the stored AF samples. Routine diagnostic testing of AChE isoenzymes in a further 3244 AF samples successfully identified all 170 cases of open neural tube defect and 20 cases with other fetal defects. Thirteen fluids gave false positive AChE results (0.4 per cent) compared to 59 of the series in which there were false positive amAFP results (1.8 per cent). Six of the 13 false positive AChE cases had AChE bands of low intensity which would not be regarded as diagnostic of fetal abnormality, and in five the AChE band may have been the result of significant blood contamination. False positive AChE results contributed to the decision to abort three apparently normal fetuses, but a normal AChE result undoubtedly helped to save a number of pregnancies with false positive amAFP results. Our experience suggests that repeating the amniocentesis may help in resolving the rare diagnostic difficulty of a positive AChE result with or without an elevated amAFP in the absence of ultrasound evidence of fetal abnormality, particularly where there is blood contamination of the amniotic fluid sample.

Study Design. Cross-sectional survey. Objective. This study surveyed the attitudes and beliefs of physiotherapists and accredited exercise physiologists (AEP) toward chronic low back pain (CLBP), in Australia. The objective of this study was to investigate the effect of biomedical and biopsychosocial attitudes and beliefs toward CLBP on clinical decision making in exercise-based practitioners. Summary of Background Data. The attitudes and beliefs of AEPs toward CLBP have not been studied. Literature regarding physiotherapists suggests a biomedical approach leading to more conservative treatment and on occasion, treatment going against practice guidelines. Methods. Seventy five AEPs and 75 physiotherapists were surveyed using the pain attitudes and beliefs scale for physiotherapists, which consists of both a biomedical and biopsychosocial subscale. Clinical decision making was assessed using two patient vignettes. Results. AEPs held higher biomedical beliefs compared with physiotherapists. No between-group differences were observed on the biopsychosocial subscale. Indeed, biomedical attitudes and beliefs did explain clinical decision making with higher scores reflecting a more conservative approach. However, biomedical beliefs influenced decision making regardless of profession. Conclusion. Biomedical attitudes and beliefs regarding CLBP influence clinical decision making in exercise-based practitioners, regardless of profession. AEPs reported higher biomedical scores, suggesting more frequent choice of conservative care. Thus, patients may receive inconsistent care and advice from practitioners within the same field. Based on clinical practice guidelines and the positive associations on clinical decision making of the biopsychosocial model, it is necessary to understand how best to provide exercise-based practitioners with education on how to apply a biopsychosocial approach to CLBP. Level of Evidence: 3

Background Contemporary management of chronic low back pain involves combined exercise and pain education. Currently, there is a gap in the literature for whether any exercise mode better pairs with pain education. The purpose of this study was to compare general callisthenic exercise with a powerlifting style programme, both paired with consistent pain education, for chronic low back pain. We hypothesised powerlifting style training may better compliment the messages of pain education. Methods An 8-week single-blind randomised controlled trial was conducted comparing bodyweight exercise (n  =  32) with powerlifting (n  =  32) paired with the same education, for people with chronic low back pain. Exercise sessions were one-on-one and lasted 60-min, with the last 5–15 min comprising pain education. Pain, disability, fear, catastrophizing, self-efficacy, anxiety, and depression were measured at baseline, 8-weeks, 3-months, and 6-months. Results No significant between-group differences were observed for pain ( p≥0.40), or disability ( p≥0.45) at any time-point. Within-group differences were significantly improved for pain ( p ≤ 0.04) and disability ( p ≤ 0.04) at all time-points for both groups, except 6-month disability in the bodyweight group ( p  =  0.1). Behavioural measures explained 39–60% of the variance in changes in pain and disability at each time-point, with fear and self-efficacy emerging as significant in these models ( p ≤ 0.001) Conclusions Both powerlifting and bodyweight exercise were safe and beneficial when paired with pain education for chronic low back pain, with reductions in pain and disability associated with improved fear and self-efficacy. This study provides opportunity for practitioners to no longer be constrained by systematic approaches to chronic low back pain.

Background The adolescent years see significant physical and emotional development that lay foundations for patterns of behaviour that can continue into adult life, including the shaping of eating behaviours. Given parents are key socio-environmental drivers and influencers of adolescent behaviours around physical health and wellbeing, it is critical to consider if specific forms of parental communication are potentially contributing to the associated emotional difficulties experienced in the adolescent years. The aim of this research was to systematically review the myriad of literature pertaining to the prevalence of parental weight or appearance-based teasing and adolescent eating problems to examine how the scientific and clinical community currently understands the relationship between these domains. Methods A systematic search of the literature, using the SCOPUS, APA PsycINFO, Medline, CINAHL databases, reference lists and Google Scholar, was undertaken to identify relevant literature for parental teasing and problem eating in adolescents aged 10–19 years, published between January 1980 to October 2020, in English or French. Results Six studies met criteria for inclusion, all were cross-sectional studies and two included additional prospective data. Although parents were not the most common perpetrators of teasing, often subsidiary to that of peers and siblings, the influence and impact of parental teasing remained significant, and in some cases, appeared to interact with sibling-based teasing. This teasing was associated with problem eating behaviours for adolescents. Conclusions There is evidence in the literature to suggest the existence of an association between ‘eating problems’ amongst adolescents and exposure to parental appearance or weight teasing. Parents are unlikely to be aware of the perception or impact of the words they use or the wider influence these words may have. Future research should employ representative longitudinal designs to develop a greater understanding of the relationships between parental communications around their adolescent’s appearance or weight and how that communication is perceived by adolescents within complex family processes. Trial registration PROSPERO 2018 CRD42018109623. Prospectively registered 15th October 2018.

Background Adolescence is a time of rapid emotional and physical development when foundational self-concepts (including beliefs about one’s weight and shape) are established. Parents are key influencers of adolescent beliefs and behaviours. This study aimed to investigate associations between perceived positive and negative parental comments on weight/shape and eating, with sons’ and daughters’ psychological distress and eating disorder cognitions (EDCs). Methods A representative mixed-sex sample of 2204 Australian adolescents (12–19 years) from the EveryBODY Study completed an online survey exploring eating behaviours, psychological wellbeing and experiences of parental comments regarding weight, shape and eating behaviours. Results Correlation analyses revealed that adolescents’ reports of perceived positive parental comments on shape/weight were significantly associated with lower psychological distress and EDCs only for daughters. All perceived negative parental comments on shape/weight or eating were associated with greater psychological distress and EDCs for both sons and daughters. In the final model of the regression analysis, only perceived parental negative shape/weight and maternal negative eating comments, adolescent stage and biological sex were significantly associated with EDCs. When known contributors such as BMI percentile and psychological distress were included in the regression model, adolescent stage and perceived negative paternal comments were no longer significantly associated with EDCs. Conclusions Overall, results show perceived negative comments were associated with poorer adolescent mental health, both their specific EDCs and general distress. Findings highlight the importance of raising awareness of potential negative impacts within family systems of comments around weight/shape and eating in these key formative years. Trial Registration The study was approved by the Macquarie University Human Research Ethics Committee (HREC 5201600312) and the New South Wales Department of Education.