Children's health and development outcomes follow a social gradient: the further up the socioeconomic spectrum, the better the outcomes. Based upon a review of multiple forms of evidence, and with a specific focus upon Australia, this article investigates the causes of these socially produced inequities, their impact upon health and development during the early years and what works to reduce these inequities. Using VicHealth's Fair Foundations framework, we report upon child health inequity at three different levels: the socioeconomic, political and cultural level; daily living conditions; the individual health-related behaviours. Although intensive interventions may improve the absolute conditions of significantly disadvantaged children and families, interventions that have been shown to effectively reduce the gap between the best and worst off families are rare. Numerous interventions have been shown to improve some aspect of prenatal, postnatal, family, physical and social environments for young children; however, sustainable or direct effects are difficult to achieve. Inequitable access to services has the potential to maintain or increase inequities during the early years, because those families most in need of services are typically least able to access them. Reducing inequities during early childhood requires a multi-level, multi-faceted response that incorporates: approaches to governance and decision-making; policies that improve access to quality services and facilitate secure, stable, flexible workplaces for parents; service systems that reflect the characteristics of proportionate universalism, function collaboratively, and deliver evidence-based programs in inclusive environments; strong, supportive communities; and information and timely assistance for parents so they feel supported and confident.

These findings have important implications for service provision and policy development. There are substantial opportunities to reorient schooling and early childhood systems to better detect and accommodate the needs of these children.

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Objectives-To determine the extent to which variation in rates of referral among general practitioners may be explained by inappropriate referrals and to estimate the effect of implementing referral guidelines.

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Dermal skin substitutes can be used to overcome the immediate problem of donor site shortage in the treatment of major skin loss conditions, such as burn injury. In this study, the biocompatibility, safety, and potential of three variants of NovoSorb (a family of novel biodegradable polyurethanes) as dermal scaffolds were determined in a series of in vitro and in vivo systems. All three polymers exhibited minimal cytotoxic effects on human skin cells, allowing keratinocytes, dermal fibroblasts, and microvascular endothelial cells to grow normally in coculture. Subcutaneous implantation of the polymers in rats demonstrated no systemic toxic effects of the materials or their degradation products. The anticipated local foreign body reaction compared favorably with commercially available medical sutures. Assessment of a three-dimensional polymer matrix followed. The success of sequential culturing of dermal fibroblasts and keratinocytes within the matrix indicated that the generation of a cultured skin substitute is achievable. The polymeric matrix also provided a scaffold for the guided formation of a cultured microvasculature. When engrafted onto a surgically created full-thickness sheep wound, the noncellular matrix integrated, healed with an epidermis supported by a basement membrane, and was capable of withstanding wound contraction. The resistance to contraction compared favorably with a commercially available collagen-based dermal matrix (Integra). These results suggest that the NovoSorb matrix could form the basis of an elegant two-stage burn treatment strategy, with an initial noncellular biodegradable temporizing matrix to stabilize the wound bed followed by the application of cultured skin substitute.

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For reinforcement learning tasks with multiple objectives, it may be advantageous to learn stochastic or non-stationary policies. This paper investigates two novel algorithms for learning non-stationary policies which produce Pareto-optimal behaviour (w-steering and Q-steering), by extending prior work based on the concept of geometric steering. Empirical results demonstrate that both new algorithms offer substantial performance improvements over stationary deterministic policies, while Q-steering significantly outperforms w-steering when the agent has no information about recurrent states within the environment. It is further demonstrated that Q-steering can be used interactively by providing a human decision-maker with a visualisation of the Pareto front and allowing them to adjust the agent's target point during learning. To demonstrate broader applicability, the use of Q-steering in combination with function approximation is also illustrated on a task involving control of local battery storage for a residential solar power system.