Creatine stores high-energy phosphate bonds in muscle, which is critical for muscle activity. In animals, creatine is synthesized in the liver from guanidinoacetic acid (GAA) with methylation by S-adenosylmethionine. Because methyl groups are used for the conversion of GAA to creatine, methyl group deficiency may occur as a result of GAA supplementation. With this study, the metabolic responses of cattle to post-ruminal supplementation of GAA were evaluated with and without methionine (Met) supplementation as a source of methyl groups. Six ruminally cannulated Holstein heifers (520 kg) were used in a split-plot design with treatments arranged as a 2 × 5 factorial. The main plot treatments were 0 or 12 g/d of l-Met arranged in a completely randomized design; three heifers received each main plot treatment throughout the entire experiment. Subplot treatments were 0, 10, 20, 30, and 40 g/d of GAA, with GAA treatments provided in sequence from lowest to highest over five 6-d periods. Treatments were infused contit increased urinary GAA and creatine concentrations, but 40 g/d GAA did not affect urine concentrations of GAA and creatine when no Met was supplemented. Overall, post-ruminal GAA supplementation increased creatine supply to cattle. A methyl group deficiency, demonstrated by modest increases in plasma homocysteine, became apparent when 30 or 40 g/d of GAA was supplemented, but it was ameliorated by 12 g/d Met. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science.OBJECTIVE Hospital falls are a major cause of costly harm. This descriptive epidemiological study reports the results of a data linkage and medical record review to examine the relative utility of these methods for identifying paediatric in-hospital falls. Type of program or service The study was conducted across two tertiary and quaternary specialist paediatric hospitals in New South Wales (NSW), Australia. METHODS A retrospective audit was conducted of paediatric falls occurring in hospital between 1 July 2015 and 30 June 2016. Falls were identified using two systems the Incident Information Management System (IIMS) and medical records coded data (MRCD). These data were linked, and falls were verified using medical record review. RESULTS Of the 146 in-hospital falls identified, only 28 (19%percnt;) were included in both systems. The IIMS identified 137 falls, with five excluded. The MRCD identified 63 admissions in which falls occurred, with 27 excluded, and screening of clinical notes found 42 falls in the remaining 36 admissions. LESSONS LEARNT There was a discrepancy in the number of falls identified in the two administrative datasets due to different inclusion criteria.  https://www.selleckchem.com/btk.html  The medical record review provided additional practice-relevant information that was unavailable within the two datasets. This descriptive epidemiological study highlights the value of combining data linkage with medical record review, but also the need for more critical reflection on the methods used to collect and report falls data in Australian hospitals, so that comprehensive and accurate data can be used to inform quality and safety interventions. This analysis will inform improvements to data capture methods and provide data to advise paediatric falls prevention strategies within the NSW paediatric hospital context.OBJECTIVE The Live Life Well @ School program aims to establish, reinforce and support primary school students (aged 5-11 years) and their families to adopt healthy eating and physical activity behaviours through the implementation of an evidence-based program that focuses on the school curriculum, the school food and physical activity environment, and teacher professional development. This paper examines Live Life Well @ School monitoring data to provide practical insights into program adoption and changes in primary school environments across NSW, particularly in schools characterised as disadvantaged. Type of program The Live Life Well @ School program provides a universally delivered, state-wide approach to childhood obesity prevention in the primary school setting. The program is a joint initiative between health and education sector agencies. METHODS The program includes health promotion strategies for primary schools relating to physical activity and nutrition. Adoption of the program is indicated by aonal development components were less well adopted. LESSONS LEARNT The desirable practice approach allows health promotion officers to tailor support by building on school strengths and taking a staged approach to change. Ongoing monitoring of the program provides useful insights that inform quality improvements to the program and implementation process, as well as information on progress towards outcomes. State-wide program targets were adjusted to strengthen impact and focus on desirable practices that were less well achieved. Intentional targeting and tailoring in areas of disadvantage are required to achieve equitable adoption of such a universal health promotion program. Strong relationships at the local level between school champions (teachers and principals) and health promotion staff characterise success.BACKGROUND Influenza attack rates in closed population settings, such as residential aged care facilities (RACFs), can be more than 50% during annual epidemics. Uncertainty about the effectiveness of neuraminidase inhibitors (NAIs) as prophylaxis for influenza outbreaks has led to variations in their use in RACFs in New South Wales (NSW), Australia. OBJECTIVES To examine the use of prophylactic NAIs by NSW RACFs for residents during influenza outbreaks in the 2015 influenza season. METHODS A prospective cohort study of influenza outbreaks reported to NSW Public Health Units from 1 June 2015 - 31 October 2015. RESULTS Eighty-eight RACFs reported influenza outbreaks; 86 were included in the study. Fifty-two RACFs used prophylactic NAIs; 34 did not. The median time to start NAI prophylaxis from the onset date of the first case was 8.5 days (range 2-23). The average proportion of residents within a facility that received prophylaxis was 51%percnt; (range 0.7-95). CONCLUSION Variations in the use of prophylactic NAIs exist across RACFs.