It has become universal to claim a relationship between social cohesion and quality public childcare. The more we invest in our children, the better the return later in life. We explore how childcare is used to strengthen social life by comparing the state role in civilising childcare as described in policy and educational guidelines. At one level, we find that policy intentions are framed by the idea of using childcare to reduce inequalities between people and social groups, and at another by the idea of civilising children to adapt to existing social structures. The analysis unfolds these two sets of intentions by showing how pedagogical ideas of child development become linked to the ways two very different states – Brazil and Denmark – formulate and organise ECEC policies as well as using childcare to bridge between people and social groups, and to civilising children to adapt to existing social structures.

The 2022 update of the Canadian Stroke Best Practice Recommendations (CSBPR) for Acute Stroke Management, 7th edition, is a comprehensive summary of current evidence-based recommendations, appropriate for use by an interdisciplinary team of healthcare providers and system planners caring for persons with an acute stroke or transient ischemic attack. These recommendations are a timely opportunity to reassess current processes to ensure efficient access to acute stroke diagnostics, treatments, and management strategies, proven to reduce mortality and morbidity. The topics covered include prehospital care, emergency department care, intravenous thrombolysis and endovascular thrombectomy (EVT), prevention and management of inhospital complications, vascular risk factor reduction, early rehabilitation, and end-of-life care. These recommendations pertain primarily to an acute ischemic vascular event. Notable changes in the 7th edition include recommendations pertaining the use of tenecteplase, thrombolysis as a bridging therapy prior to mechanical thrombectomy, dual antiplatelet therapy for stroke prevention,1 the management of symptomatic intracerebral hemorrhage following thrombolysis, acute stroke imaging, care of patients undergoing EVT, medical assistance in dying, and virtual stroke care. An explicit effort was made to address sex and gender differences wherever possible. The theme of the 7th edition of the CSBPR is building connections to optimize individual outcomes, recognizing that many people who present with acute stroke often also have multiple comorbid conditions, are medically more complex, and require a coordinated interdisciplinary approach for optimal recovery. Additional materials to support timely implementation and quality monitoring of these recommendations are available at www.strokebestpractices.ca.

Transition care programmes (TCP) provide older adults with goal-oriented rehabilitation after hospitalisation. However, limited research has focused on understanding older adults' experiences when undertaking TCP. Using a phenomenological approach, we explored the lived experience of older adults undertaking a TCP at a transition care facility in Australia. A purposive sample (N = 33 participants: 16 older adults, four family members and 13 staff) was recruited. Semi-structured interviews were undertaken at three time-points during admission and inductive thematic analysis was utilised. Older adults reflected on their TCP experiences through an emotional lens through which they deliberated, ‘is my destination home?’ Fear of losing independence and uncertainty about their discharge destination strongly influenced older adults' perspectives regarding their TCP experience. Emotional responses, both positive and negative, were influenced by expectations prior to admission, level of family support and staff behaviour. Staff and family concurred that many older adults were confused about their admission to the facility and initially were unprepared to engage in the rehabilitation provided. Older adults experienced TCP as a time of great uncertainty and feared the unknown when discharged from hospital to transition care. They expressed grief at the loss of existing life roles and anxiety about the possibility of being unable to return home. Health professionals need to inform and tailor rehabilitation for older adults to better support this transient time of life.

Weight loss maintenance is crucial for obesity management, yet optimal dietary patterns for this period are not established. We aimed to explore the relationship between adherence to the Mediterranean diet and weight loss maintenance. Sample includes 565 adults (62 % women) of the MedWeight study. Eligible volunteers were those reporting intentional weight loss of ≥10 %, starting from a BMI ≥ 25 kg/m2, over 12 months prior to enrolment. Based on current weight, participants were characterised as maintainers (≤90 % maximum weight) or regainers (>95 % maximum weight). Socio-demographics and weight history were recorded. Dietary intake was assessed by two non-consecutive 24-h recalls within 10 d and analysed in energy, macronutrient and food group intakes. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Score (MedDietScore) (range 0–55, greater scores showing higher adherence). Protein intake was higher in maintainers than in regainers (P < 0·001). When MedDietScore quartiles were considered, a linear trend for weight loss maintenance was revealed (P < 0·05). After adjustment for basic demographic characteristics, being in the third or fourth quartile of the MedDietScore (v. first) was associated with 2·30 (95 % CI 1·29, 4·09) and 1·88 (95 % CI 1·10, 3·22) increased odds of maintenance. Regarding individual MedDietScore components, only fruit intake is associated with increased odds for maintenance (1·03 (95 % CI 1·01, 1·06)). The leave-one-out approach revealed that at least six MedDietScore components were essential for the observed relationship. Higher adherence to the Mediterranean diet was associated with 2-fold increased likelihood of weight loss maintenance. Future studies should replicate these findings in non-Mediterranean populations as well.

Propositions about street-level bureaucracy run the risk of violating the scientific precept that a theoretical generalisation should be tested by replication in a variety of contexts. Many examples can be found of writings that simply indicate that street-level discretion is pervasive. This prompts the questions, ‘but how’, and under what conditions ‘may’ that happen? Comparison is needed to answer these questions, particularly cross-national ones. It will be argued that good cross-national comparative work must rest upon precise specification of the contexts to be compared and avoiding comparing tasks that seem similar, but in fact serve different functions in different contexts. To explore this one particular task – pre-school child care – is selected. The discussion of this specific example is examined as a model for similar comparative work.

This study aimed to estimate the number of new cancer cases attributable to diet among adults aged 30–84 years in France in 2015, where convincing or probable evidence of a causal association exists, and, in a secondary analysis, where at least limited but suggestive evidence of a causal association exists. Cancer cases attributable to diet were estimated assuming a 10-year latency period. Dietary intake data were obtained from the 2006 French National Nutrition and Health Survey. Counterfactual scenarios of dietary intake were based on dietary guidelines. Corresponding risk relation estimates were obtained from meta-analyses, cohort studies and one case–control study. Cancer incidence data were obtained from the French Network of Cancer Registries. Nationally, unfavourable dietary habits led to 16 930 new cancer cases, representing 5·4 % of all new cancer cases. Low intake of fruit and dietary fibre was the largest contributor to this burden, being responsible for 4787 and 4389 new cancer cases, respectively. If this is expanded to dietary component and cancer pairs with at least limited but suggestive evidence of a causal association, 36 049 new cancer cases, representing 11·6 % of all new cancer cases, were estimated to be attributable to diet. These findings suggest that unfavourable dietary habits lead to a substantial number of new cancer cases in France; however, there is a large degree of uncertainty as to the number of cancers attributable to diet, including through indirect mechanisms such as obesity, and therefore additional research is needed to determine how diet affects cancer risk.

Falls prevention strategies can only be effective in reducing falls amongst older people if they are adopted and enacted in their daily lives. There is limited evidence identifying what older people in residential aged care (RAC) homes understand about falls and falls prevention, or what may limit or enable their adoption of strategies. This study was conducted in two countries and explored older people's knowledge and awareness of falls and their preferences, opportunities and motivation to undertake falls prevention strategies. A cross-sectional survey was administered to participants (N = 70) aged 65 years and over, living in six RAC homes in Perth, Australia and six RAC homes in Swansea, Wales, United Kingdom. Participants had limited knowledge about intrinsic falls risk factors and strategies to address these and frequently expressed self-blame regarding falling. Almost all (N = 67, 95.7%) participants felt highly motivated to maintain their current functional mobility and independence in everyday tasks. Key preferences for receiving falls prevention messages favoured a positive approach promoting wellness and independence (N = 41, 58.6%) via pictorial posters or brochures (N = 37, 52.9%) and small group discussions preferably with demonstrations (N = 18, 25.7%). Findings from this study may assist organisations and staff to more effectively engage with older people living in RAC about falls prevention and design targeted resources to address the motivations and preferences of this population.

Resistance training is an important aspect of healthy ageing, yet participation rates are especially low among older people. Strategies are needed to ensure resistance training programmes are attractive to and appropriate for this target group. To inform the development of such strategies, individual interviews (N = 42) and focus groups (four groups, N = 37) were conducted with 79 Western Australians representing four stakeholder groups: instructors who deliver resistance training programmes to older people, health practitioners, policy makers and seniors. Results indicate that the need for personalised attention in the establishment and maintenance phases of a resistance training programme can constitute both a positive and negative aspect of older people's experiences. The negative aspects were identified as a series of tensions between the need for personalised attention and (a) the desire to participate in physical activity within social groups, (b) a preference for activity variation, (c) a dislike for large centres where personalised guidance is often available yet the surroundings can be considered unappealing, (d) cost issues and (e) the need for flexibility in attendance. Recommended strategies for overcoming these tensions include disseminating information about the benefits of resistance training in later life to increase motivation to participate, identifying additional methods of integrating resistance training into group exercise formats, making gyms more attractive to older people and providing non-gym alternatives for resistance training.

In this brief report, computed tomography perfusion (CTP) thresholds predicting follow-up infarction in patients presenting <3 hours from stroke onset and achieving ultra-early reperfusion (<45 minutes from CTP) are reported. CTP thresholds that predict follow-up infarction vary based on time to reperfusion: Tmax >20 to 23 seconds and cerebral blood flow <5 to 7 ml/min−1/(100 g)−1 or relative cerebral blood flow <0.14 to 0.20 optimally predicted the final infarct. These thresholds are stricter than published thresholds.

We analyze Sun-as-a-star observations spanning over solar cycles 22 – 24 from the ground-based network BiSON and solar cycles 23 – 24 collected by the space-based VIRGO and GOLF instruments on board the SoHO satellite. Using simultaneous observations from all three instruments, our analysis suggests that the structural and magnetic changes responsible for modifying the frequencies remained comparable between cycle 23 and cycle 24 but differ from cycle 22. Thus we infer that the magnetic layer of the Sun has become thinner since the beginning of cycle 23 and continues during the current cycle.

During the seventeenth and eighteenth centuries, Puebloan women (if not entire families) were incorporated into Apache Dismal River communities in western Kansas. In at least one site (14SC1), Puebloan people lived in a small masonry pueblo. We evaluate the timing and nature of the Puebloan occupation at 14SC1 and its relationship to the Dismal River population at the site. We use a Bayesian analytical framework to evaluate different models of the pueblo's use history, constraining 12 radiocarbon dates by their stratigraphic data and then comparing this framework with different temporal models based on the historical record. We conclude that Dismal River people lived at 14SC1 prior to the appearance of Pueblo migrants, sometime between cal AD 1490 and 1650. Construction and early use of the pueblo by migrants from the Rio Grande valley occurred between cal AD 1630 and 1660, and the pueblo was closed by burning sometime between cal AD 1640 and 1690. Site 14SC1 lacks Rio Grande Glaze Ware, and its residents seem rarely to have engaged with the groups in the Southern Plains Macroeconomy. Our results contribute to studies of indigenous community formation and Puebloan residential mobility during the Spanish colonial period.

Translation of falls prevention evidence into practice is problematic. Understanding older adults’ views about falls prevention information could enhance delivery of falls prevention, resulting in better engagement and uptake of recommended activities. The aim of this study was to examine the views and preferences of community-dwelling older adults about seeking and receiving falls prevention information. A community forum using a modified World Café approach was conducted. Participants discussed five topic areas in small groups, under the guidance of table facilitators. Perspectives were captured on paper. Thematic analysis was conducted to identify factors that influence participants’ engagement and uptake of information. Seventy-three older adults participated in the forum covering wide-ranging preferences around falls prevention information. Personal experience was considered the key influence on an older adult's decision to initiate seeking information. While health professionals were often approached, alternative sources such as public libraries, peer educators and seniors’ organisations were also favoured as credible sources of information. Older adults proposed falls prevention information should be delivered with a positive tone, coupled with highly valued qualities of respect, empathy and time to listen to foster motivation to engage in recommended activities. Consumer-focused practical strategies were proposed to potentially improve future design, communication and dissemination of falls prevention information. This improvement could enhance engagement of messages and subsequent uptake of falls prevention recommended strategies.