title: Developing a core outcome set for future infertility research: an international consensus development study

authors: Duffy, J.M.N.

subjects: Consensus development study

abstract: STUDY QUESTION: Can a core outcome set to standardize outcome selection, collection and reporting across future infertility research be developed? 
SUMMARY ANSWER: A minimum data set, known as a core outcome set, has been developed for randomized controlled trials (RCTs) and systematic reviews evaluating potential treatments for infertility. 
WHAT IS KNOWN ALREADY: Complex issues, including a failure to consider the perspectives of people with fertility problems when selecting outcomes, variations in outcome definitions and the selective reporting of outcomes on the basis of statistical analysis, make the results of infertility research difficult to interpret. 
STUDY DESIGN, SIZE, DURATION: A three-round Delphi survey (372 participants from 41 countries) and consensus development workshop (30 participants from 27 countries). PARTICIPANTS/MATERIALS, SETTING, METHODS: Healthcare professionals, researchers and people with fertility problems were brought together in an open and transparent process using formal consensus science methods. 
MAIN RESULTS AND THE ROLE OF CHANCE: The core outcome set consists of: viable intrauterine pregnancy confirmed by ultrasound (accounting for singleton, twin and higher multiple pregnancy); pregnancy loss (accounting for ectopic pregnancy, miscarriage, stillbirth and termination of pregnancy); live birth; gestational age at delivery; birthweight; neonatal mortality; and major congenital anomaly. Time to pregnancy leading to live birth should be reported when applicable. 
LIMITATIONS, REASONS FOR CAUTION: We used consensus development methods which have inherent limitations, including the representativeness of the participant sample, Delphi survey attrition and an arbitrary consensus threshold. 
WIDER IMPLICATIONS OF THE FINDINGS: Embedding the core outcome set within RCTs and systematic reviews should ensure the comprehensive selection, collection and reporting of core outcomes. Research funding bodies, the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement, and over 80 specialty journals, including the Cochrane Gynaecology and Fertility Group, Fertility and Sterility and Human Reproduction, have committed to implementing this core outcome set. 
STUDY FUNDING/COMPETING INTEREST(S): This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund and Maurice and Phyllis Paykel Trust. The funder had no role in the design and conduct of the study, the collection, management, analysis or interpretation of data, or manuscript preparation. B.W.J.M. is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548). S.B. was supported by University of Auckland Foundation Seelye Travelling Fellowship. S.B. reports being the Editor-in-Chief of Human Reproduction Open and an editor of the Cochrane Gynaecology and Fertility group. J.L.H.E. reports being the Editor Emeritus of Human Reproduction. J.M.L.K. reports research sponsorship from Ferring and Theramex. R.S.L. reports consultancy fees from Abbvie, Bayer, Ferring, Fractyl, Insud Pharma and Kindex and research sponsorship from Guerbet and Hass Avocado Board. B.W.J.M. reports consultancy fees from Guerbet, iGenomix, Merck, Merck KGaA and ObsEva. C.N. reports being the Co Editor-in-Chief of Fertility and Sterility and Section Editor of the Journal of Urology, research sponsorship from Ferring, and retains a financial interest in NexHand. A.S. reports consultancy fees from Guerbet. E.H.Y.N. reports research sponsorship from Merck. N.L.V. reports consultancy and conference fees from Ferring, Merck and Merck Sharp and Dohme. The remaining authors declare no competing interests in relation to the work presented. All authors have completed the disclosure form. TRIAL REGISTRATION NUMBER: Core Outcome Measures in Effectiveness Trials Initiative: 1023.

text: Developing a core outcome set for future infertility research: an international consensus development study STUDY QUESTION: Can a core outcome set to standardize outcome selection, collection and reporting across future infertility research be developed? 
SUMMARY ANSWER: A minimum data set, known as a core outcome set, has been developed for randomized controlled trials (RCTs) and systematic reviews evaluating potential treatments for infertility. 
WHAT IS KNOWN ALREADY: Complex issues, including a failure to consider the perspectives of people with fertility problems when selecting outcomes, variations in outcome definitions and the selective reporting of outcomes on the basis of statistical analysis, make the results of infertility research difficult to interpret. 
STUDY DESIGN, SIZE, DURATION: A three-round Delphi survey (372 participants from 41 countries) and consensus development workshop (30 participants from 27 countries). PARTICIPANTS/MATERIALS, SETTING, METHODS: Healthcare professionals, researchers and people with fertility problems were brought together in an open and transparent process using formal consensus science methods. 
MAIN RESULTS AND THE ROLE OF CHANCE: The core outcome set consists of: viable intrauterine pregnancy confirmed by ultrasound (accounting for singleton, twin and higher multiple pregnancy); pregnancy loss (accounting for ectopic pregnancy, miscarriage, stillbirth and termination of pregnancy); live birth; gestational age at delivery; birthweight; neonatal mortality; and major congenital anomaly. Time to pregnancy leading to live birth should be reported when applicable. 
LIMITATIONS, REASONS FOR CAUTION: We used consensus development methods which have inherent limitations, including the representativeness of the participant sample, Delphi survey attrition and an arbitrary consensus threshold. 
WIDER IMPLICATIONS OF THE FINDINGS: Embedding the core outcome set within RCTs and systematic reviews should ensure the comprehensive selection, collection and reporting of core outcomes. Research funding bodies, the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) statement, and over 80 specialty journals, including the Cochrane Gynaecology and Fertility Group, Fertility and Sterility and Human Reproduction, have committed to implementing this core outcome set. 
STUDY FUNDING/COMPETING INTEREST(S): This research was funded by the Catalyst Fund, Royal Society of New Zealand, Auckland Medical Research Fund and Maurice and Phyllis Paykel Trust. The funder had no role in the design and conduct of the study, the collection, management, analysis or interpretation of data, or manuscript preparation. B.W.J.M. is supported by a National Health and Medical Research Council Practitioner Fellowship (GNT1082548). S.B. was supported by University of Auckland Foundation Seelye Travelling Fellowship. S.B. reports being the Editor-in-Chief of Human Reproduction Open and an editor of the Cochrane Gynaecology and Fertility group. J.L.H.E. reports being the Editor Emeritus of Human Reproduction. J.M.L.K. reports research sponsorship from Ferring and Theramex. R.S.L. reports consultancy fees from Abbvie, Bayer, Ferring, Fractyl, Insud Pharma and Kindex and research sponsorship from Guerbet and Hass Avocado Board. B.W.J.M. reports consultancy fees from Guerbet, iGenomix, Merck, Merck KGaA and ObsEva. C.N. reports being the Co Editor-in-Chief of Fertility and Sterility and Section Editor of the Journal of Urology, research sponsorship from Ferring, and retains a financial interest in NexHand. A.S. reports consultancy fees from Guerbet. E.H.Y.N. reports research sponsorship from Merck. N.L.V. reports consultancy and conference fees from Ferring, Merck and Merck Sharp and Dohme. The remaining authors declare no competing interests in relation to the work presented. All authors have completed the disclosure form. TRIAL REGISTRATION NUMBER: Core Outcome Measures in Effectiveness Trials Initiative: 1023.

year: 2020

title: Procreate and cherish: A note on Australia’s abrupt shift to Pro-Natalism

authors: Jackson, Natalie

subjects: Australia

abstract: After a long history of arguing that Australian governments do not intervene in the bedrooms of the nation, in 2004 the Howard Government did exactly that. Under the enthusiastic choreographing of then Treasurer Peter Costello, it implemented an explicit and indirect fertility policy in the form of a maternity payment, commonly known as the ‘Baby Bonus’. Rising fertility in Australia since that time has been widely claimed as evidence of the policy’s success. Hailed as a mini ‘baby boom’, Costello was moved to describe the policy as a shift from ‘population or perish’ to ‘procreate and cherish’. Despite arguing against it while in Opposition, the policy has been continued with only a few changes by the incumbent Rudd Government, seemingly on the grounds that it may indeed be responsible for the recent ‘nudging up’ of birth rates.
This paper traces the policy shift and concludes with a brief analysis of Australian trends across the period of the Baby Bonus (2004-2008), showing that one quarter of the increase in numbers is due to cohort size, but noting that fertility has also risen in many developed countries across the same period and thus trends in Australia may just be part of a broader trend – and/or in part an artifact of the index used to measure fertility. It also draws attention to the collateral effect of an increased dependency ratio, with the mini ‘boom’ reaching school age at the very moment the post war baby boomers reach retirement age – as forewarned by Costello in 2002 when initially rejecting the idea of a Baby Bonus.

text: Procreate and cherish: A note on Australia’s abrupt shift to Pro-Natalism After a long history of arguing that Australian governments do not intervene in the bedrooms of the nation, in 2004 the Howard Government did exactly that. Under the enthusiastic choreographing of then Treasurer Peter Costello, it implemented an explicit and indirect fertility policy in the form of a maternity payment, commonly known as the ‘Baby Bonus’. Rising fertility in Australia since that time has been widely claimed as evidence of the policy’s success. Hailed as a mini ‘baby boom’, Costello was moved to describe the policy as a shift from ‘population or perish’ to ‘procreate and cherish’. Despite arguing against it while in Opposition, the policy has been continued with only a few changes by the incumbent Rudd Government, seemingly on the grounds that it may indeed be responsible for the recent ‘nudging up’ of birth rates.
This paper traces the policy shift and concludes with a brief analysis of Australian trends across the period of the Baby Bonus (2004-2008), showing that one quarter of the increase in numbers is due to cohort size, but noting that fertility has also risen in many developed countries across the same period and thus trends in Australia may just be part of a broader trend – and/or in part an artifact of the index used to measure fertility. It also draws attention to the collateral effect of an increased dependency ratio, with the mini ‘boom’ reaching school age at the very moment the post war baby boomers reach retirement age – as forewarned by Costello in 2002 when initially rejecting the idea of a Baby Bonus.

year: 2009

title: The Māori language revitalisation agenda and Te Whakapiki Reo and Te Whakapiki i te Reo: Meeting the needs of teachers

authors: Kahukura, Hine

subjects: Te reo Māori

abstract: Since 1994, and under contract to the New Zealand Ministry of Education, the University of Waikato has provided teacher professional development programmes in the context of kaupapa matauranga Māori. Because these programmes are designed to play a role in the Māori language revitalisation agenda as it relates to the teaching and learning of te reo Māori in school contexts, we believe that it is important to share our experiences with others. In this article, we discuss the context in which these programmes are delivered, some of the ways in which they have changed over time, and what we have learned from them.

text: The Māori language revitalisation agenda and Te Whakapiki Reo and Te Whakapiki i te Reo: Meeting the needs of teachers Since 1994, and under contract to the New Zealand Ministry of Education, the University of Waikato has provided teacher professional development programmes in the context of kaupapa matauranga Māori. Because these programmes are designed to play a role in the Māori language revitalisation agenda as it relates to the teaching and learning of te reo Māori in school contexts, we believe that it is important to share our experiences with others. In this article, we discuss the context in which these programmes are delivered, some of the ways in which they have changed over time, and what we have learned from them.

year: 2005