To determine incidence and outcome of biliary atresia (BA) between ethnic groups in New Zealand (NZ), a retrospective review was undertaken of children with BA born between 2002 and 2014. Prioritized ethnicity was used to determine ethnicity and was compared to population data. Uni- and multivariate analyses were undertaken to determine demographic and biochemical factors associated with outcome. Overall incidence was 1 in 9181 (Māori 1 in 5285; European 1 in 16,228; P < 0.0001). Overall and transplant-free survival rates at 1, 2, and 5 years were 92%, 86%, 82% and 70%, 49%, 30% respectively with Māori having improved transplant-free survival (P < 0.05) despite European children undergoing Kasai earlier (49 vs 63 days). BA is more common in NZ than Europe and North America, which is attributable to a higher incidence in Māori but overall outcome is poorer. Māori have improved transplant-free survival compared to NZ European children but the reason is unknown.

Mass vaccination with the measles-mumps-rubella (MMR) vaccine for children aged 12-15 months was introduced in 1988; schoolgirl vaccination was discontinued in 1996 and replaced by a second dose of MMR for preschool children and post-partum vaccination of susceptible women identified through antenatal testing. In the UK, declining uptake rates due to concerns about the MMR vaccine, and increasing numbers of cases in some European countries where rubella surveillance and preconceptional vaccination are inadequate, coupled with poor uptake rates, has started to show in the number of rubella-susceptible patients presenting at antenatal clinics (ANCs). In this study, samples were collected in serum separator tubes at the West Middlesex University Hospital (WMUH) ANC and sent to the laboratory. Rubella status was determined using a third-generation rubella IgG enzyme immunoassay. Any negative results were retested and confirmed using an alternative method. The concentrations were expressed as iu/mL (World Health Organization [WHO] standard). Over a five-year period, the number of rubella-susceptible patients increased from 4.1% to 6.8% of the total number of specimens tested. The current population susceptibility levels seem to be influenced by a number of factors: the target population, age at vaccination and the level of coverage, and exposure to wild virus.

Background Diagnosis of HIV infection in pregnancy and treatment with antiretrovirals is key to preventing vertical transmission. However, treatment has been shown to be associated with increased incidence of pregnancy complications such as pre-eclampsia, gestational diabetes and preterm labour Objective To review the pregnancy outcome of HIV positive (+ve) pregnant patients in a district general hospital setting. Method A 5-year (2005–2009) prospective population study of all HIV+ve pregnant women delivering at West Middlesex University Hospital. Results 62 cases analysed – 41 diagnosed prepregnancy; 21 during pregnancy. Mean age – 30yrs (16–44) and most (89%) of Black African origin. 61 received HAART with 1 woman receiving zidovudine monotherapy. 74% commenced HAART before 24 weeks – 26 prepregnancy, 20 at <24 weeks. Viral load (VL) was undetectable at start of treatment in 26(42%). Of the 36(58%) with detectable VL, 20(56%) achieved undetectable VL by 36 weeks. 11(18%) delivered preterm (<37weeks) – abruption in 3(5%) with no identifiable cause in 8(13%). 3(5%) women developed preeclampsia and 2(3%) gestational diabetes. There were no side effects from treatment other than asymptomatic transaminitis in 5 women. Vaginal delivery was planned for 20(32%) women – 3(15%) of these needed Emergency Caesarean Sections (1 for abruption; 2 for failure to progress). No vertical transmission occurred. Conclusion With multidisciplinary input to care of HIV+ve pregnant women, most achieve good pregnancy outcomes with a fair proportion achieving vaginal delivery. There is an increased incidence of idiopathic preterm delivery possibly related to HAART; this needs further exploration in larger studies.

Background In the UK, 2.2 per 1000 women giving birth have HIV.1 Routine antenatal screening and BHIVA guidelines1 recommending multidisciplinary input have reduced mother-to-child HIV transmission (MTCT). Antiretroviral therapy (ART) is recommended to prevent MTCT and for maternal welfare. In those with a low viral load, vaginal delivery is safe.1 However, there is growing evidence of an association with idiopathic preterm delivery2 and increasing emergency CS rates.1 Objective To analyse the obstetric outcomes in this population group. Method A 9-year (2005–2013) prospective cohort study of the HIV-positive pregnant women delivering at West Middlesex University Hospital. Abstract PPO.36 Figure Results In total, 101 pregnancies, 93 of which were ongoing with 96 live births (3 sets of twins). The median age of the population was 29 (r16–44). Birth plans were conceived for 85 (91%) women. Antenatally, 4 patients had GDM, 1 had Obstetric Cholestasis, 1 gestational thrombocytopaenia and 1 PET. Mean gestational age of delivery was 38 ± 2 (SD) weeks, 13 (14%) delivered preterm (<37 weeks, r31–36) with abruption in 2, PROM in 1, appendicitis in 1 and idiopathic in 9 (69%). Vaginal delivery was planned for 45 (48%) women; 17 (18%) needed emergency CS resulting in 3 postpartum haemorrhages and 1 neonatal seizure. No vertical transmission was noted at follow up to 18 months. Discussion Multidisciplinary input into the care of HIV-positive pregnancies helps achieve good outcomes in the majority with nearly half achieving vaginal delivery and no vertical transmissions. We confirm the increased incidence of idiopathic preterm delivery needing further exploration.

Purpose The COVID-19 pandemic significantly disrupted the lives of the deaf community, and the implementation of restrictions on face-to-face meetings resulted in the trial introduction of video remote interpreting (VRI) in a secure psychiatric setting. This study aims to use a qualitative research paradigm to explore user experiences to inform potential future technological developments in this area. Design/methodology/approach Twelve deaf patients and three interpreters took part in structured face-to-face interviews and discussed their experiences of the use of VRI, with the results being assessed using thematic analysis. Findings Seven main themes were identified: resource availability, ease of use, technical issues, misunderstandings, medium secure-specific issues, preferences and human factors. All participants agreed that they did not like the VRI technology in the health-care environment in its current format, and their main concern was the difficulty in understanding the information being communicated. It was considered that this had the potential to incur potentially serious medico-legal and safety implications for both staff and patients alike. Practical implications This study has provided detailed users’ feedback about the potential future use in this communication tool and can help guide service developers to review the technology design to tailor it towards the users’ needs. While the existing technology is not currently suitable for this deaf population, particularly because of the potential for error, there is potential scope for further research in this area. Originality/value The COVID-19 pandemic provided a unique opportunity to explore the potential use of VRI for a deaf patient population within a secure psychiatric setting, where such technology is unlikely to have otherwise been used.