Frontier Lapita interaction with resident Papuan populations set the stage for initial peopling of the Pacific.

The initial peopling of the remote Pacific islands was one of the greatest migrations in human history, beginning three millennia ago by Lapita cultural groups. The spread of Lapita out of an ancestral Asian homeland is a dominant narrative in the origins of Pacific peoples, and although Island New Guinea has long been recognized as a springboard for the peopling of Oceania, the role of Indigenous populations in this remarkable phase of exploration remains largely untested. Here, we report the earliest evidence for Lapita-introduced animals, turtle bone technology and repeated obsidian import in southern New Guinea 3,480-3,060 years ago, synchronous with the establishment of the earliest known Lapita settlements 700 km away.

Emergence of a Neolithic in highland New Guinea by 5000 to 4000 years ago.

The emergence of agriculture was one of the most notable behavioral transformations in human history, driving innovations in technologies and settlement globally, referred to as the Neolithic. Wetland agriculture originated in the New Guinea highlands during the mid-Holocene (8000 to 4000 years ago), yet it is unclear if there was associated behavioral change. Here, we report the earliest figurative stone carving and formally manufactured pestles in Oceania, dating to 5050 to 4200 years ago.

Heated Humidified High-Flow Nasal Cannula for Preterm Infants: An Updated Systematic Review and Meta-analysis.

Background: Heated humidified high-flow nasal cannula (HHHFNC) is gaining popularity as a mode of respiratory support. We updated a systematic review and meta-analyses examining the efficacy and safety of HHHFNC compared with standard treatments for preterm infants. The primary outcome was the need for reintubation for preterm infants following mechanical ventilation (post-extubation analysis) or need for intubation for preterm infants not previously intubated (analysis of primary respiratory support).

An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist.

This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital. The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts.

A wolf in sheep's clothing? Patients' and healthcare professionals' perceptions of oxygen therapy: An interpretative phenomenological analysis.

Background: Despite emerging evidence and guidelines, poor prescribing and administration of oxygen therapy persists. This study aimed to explore healthcare professionals' (HCPs) and patients' perceptions of oxygen.

Design: Semi-structured interviews with 28 patients and 34 HCPs.

How stressful is the Newborn Life Support airway test? An observational study.

Objectives: To determine whether there is a significant stress response to the Newborn Life Support airway test (NLSAT) among healthcare professionals in the UK.

Design: Quantitative study measuring both stress and anxiety of candidates on Newborn Life Support (NLS) courses measuring salivary cortisol levels along with validated anxiety questionnaires (State Trait Anxiety Inventory).

Setting: UK NLS course centres.

Opening the 'black box': liaison psychiatry services and what they actually do.

Aims and method To develop a simple, pragmatic typology to characterise the nature of liaison interventions delivered by a liaison service in a National Health Service setting. We carried out a retrospective electronic case-note review of referrals to a ward-based liaison psychiatry service. Results Three hundred and forty-four patients were referred to the service over a 12-month period.

The clinical effectiveness and cost-effectiveness of heated humidified high-flow nasal cannula compared with usual care for preterm infants: systematic review and economic evaluation.

Background: Respiratory problems are one of the most common causes of morbidity in preterm infants and may be treated with several modalities for respiratory support such as nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation. The heated humidified high-flow nasal cannula (HHHFNC) is gaining popularity in clinical practice.

Objectives: To address the clinical effectiveness of HHHFNC compared with usual care for preterm infants we systematically reviewed the evidence of HHHFNC with usual care following ventilation (the primary analysis) and with no prior ventilation (the secondary analysis).

Markedly raised levels of C-reactive protein are associated with culture-proven sepsis or necrotising enterocolitis in extremely preterm neonates.

Aim: A serious inflammatory process is suspected when C-reactive protein (CRP) is very high, and we established the causes and outcomes when CRP was >100 mg/L in neonates.

Methods: We retrospectively reviewed all 277 episodes where CRP exceeded 100 mg/L between January 2007 and December 2011 at a tertiary neonatal unit.

Results: Of the 6025 neonates admitted during the study period, 258 had CRP >100 mg/L at least once.

Amnioinfusion in preterm premature rupture of membranes (AMIPROM): a randomised controlled trial of amnioinfusion versus expectant management in very early preterm premature rupture of membranes--a pilot study.

Background: Fetal survival is severely compromised when the amniotic membrane ruptures between 16 and 24 weeks of pregnancy. Reduced amniotic fluid levels are associated with poor lung development, whereas adequate levels lead to better perinatal outcomes. Restoring amniotic fluid by means of ultrasound-guided amnioinfusion (AI) may be of benefit in improving perinatal and long-term outcomes in children of pregnancies with this condition.

An investigation of factors affecting the outcome of the clinical skills assessment (CSA) in general practice specialty training.

Identifying general practice trainees at risk of failing the CSA early in their training is important so that supportive measures can be put in place to ensure training progression. The aim of this study was to determine aspects of the trainee's learning portfolio activity which might predict performance in the CSA. From the Mersey School of General Practice records, details were obtained for trainees who had completed their ST3 year between 1 August and 31 December 2012 with respect to the numbers of entries for the Mini Clinical Evaluation Exercise (Mini-CEX), case-based discussions (CBDs), directly observed procedures (DOPS), learning logs and personal development plans (PDPs) that they had carried out in each of their ST1 and ST2 years.

The first New Zealanders: patterns of diet and mobility revealed through isotope analysis.

Direct evidence of the environmental impact of human colonization and subsequent human adaptational responses to new environments is extremely rare anywhere in the world. New Zealand was the last Polynesian island group to be settled by humans, who arrived around the end of the 13th century AD. Little is known about the nature of human adaptation and mobility during the initial phase of colonization.

A longitudinal cohort study to investigate the retention of knowledge and skills following attendance on the Newborn Life support course.

Aim: To investigate whether airway management and non-invasive ventilatory skills are retained after the Neonatal Life support (NLS) course.

Methods: Candidates who attended and passed the NLS course were retested by two registered instructors using the NLS 'airway testing sheet' unannounced at 3-5 and 12-14 months after their NLS course. Prior to the test, they were also asked to complete a proforma, indicating their own assessment of their competence in being able to effectively carry out all the items used in the NLS airway test.

Randomised controlled trial of the use of an educational board game in neonatology.

Background: Games have been used in healthcare education to encourage active learning.

Aim: To investigate whether an educational board game which had been developed in the speciality of neonatology could influence the learning experience of medical students during their neonatal attachment.

Method: A randomised controlled trial of using the game was conducted amongst 67 student participants.

What is the impact of structured resuscitation training on healthcare practitioners, their clients and the wider service? A BEME systematic review: BEME Guide No. 20.

A large number of resuscitation training courses (structured resuscitation training programmes (SRT)) take place in many countries in the world on a regular basis. This review aimed to determine whether after attending SRT programmes, the participants have a sustained retention of resuscitation knowledge and skills after their initial acquisition and whether there is an improvement in outcome for patients and/or their healthcare organisation after the institution of an SRT programme. All research designs were included, and the reported resuscitation training had to have been delivered in a predefined structured manner over a finite period of time.

Subspecialty neonatal trainees views on being prepared for the consultant role.

Higher specialist training offers an opportunity to focus on non-clinical skills as well as clinical issues. The authors wished to determine whether doctors who complete neonatal higher specialist training in the UK feel prepared for the consultant role with respect to management, research and teaching, as well as clinical activities. A questionnaire related to the preparedness of the consultant to carry out a range of activities was sent to all doctors who were appointed to the UK higher specialist training programme in neonatology from 2002 to 2008 who were currently working as consultants.

What features of educational interventions lead to competence in aseptic insertion and maintenance of CV catheters in acute care? BEME Guide No. 15.

Background: Up to 6000 patients per year in England acquire a central venous catheter (CVC)-related bloodstream infection (Shapey et al. 2008 ). Implementation of Department of Health guidelines through educational interventions has resulted in significant and sustained reductions in CVC-related blood stream infections (Pronovost et al.

WITHDRAWN. Inhaled steroids for neonatal chronic lung disease.

Background: Bronchopulmonary dysplasia (BPD) is a chronic disorder associated with prematurity. Systemic steroids induce at least a temporary improvement in respiratory function, but are associated with adverse side effects. Inhaled steroids have fewer side effects.

Arranging staff away day events to improve motivation.

This article describes the launch of away day events for staff in a neonatal unit. The days have improved staff motivation, teamwork and the services provided to patients and families at the unit.