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Background and objective Patients with prolonged symptoms following COVID-19 infection(s) will increasingly present to general practice. Our research objective was to understand the general practice experience of diagnosing and managing long COVID and to explore recommendations for contributing to the safety and quality of the long COVID response. Methods A two-hour qualitative session involving 11 project stakeholders was held in March 2023. The stakeholders included general practitioners as well as representatives from four Primary Health Networks, Outcome Health and the funding body. Transcripts were analysed using qualitative content analysis. Results Key challenges and practical recommendations emerged relating to diagnosing long COVID, documentation of COVID-19 infections, ongoing management, screening tools and the need for public health messaging. Discussion General practices need more accurate definitions and information about the diagnosis of long COVID. Supporting general practitioners with information to diagnose and manage patients with long COVID is essential. General practice voices need to be heard to enhance our understanding of long COVID and inform policy decisions. [ABSTRACT FROM AUTHOR]

Introduction: Our earlier analysis during the COVID-19 surges in 2020 showed a reduction in general practitioner (GP) in-person visits to residential aged care facilities (RACFs) and increased use of telehealth. This study assessed how sociodemographic characteristics affected telehealth utilisation. Methods: This retrospective cohort consists of 27,980 RACF residents aged 65 years and over, identified from general practice electronic health records in Victoria and New South Wales during March 2020-August 2021. Residents' demographic characteristics, including age, sex, region, and pension status, were analysed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the associations with telehealth utilisation (telephone/video vs. in-person consultations) and with video versus telephone consultations, in mixed-effects multiple level regression models. Results: Of 32,330 median monthly GP consultations among 21,987 residents identified in 2020, telehealth visits accounted for 17% of GP consultations, of which 93% were telephone consults. In 2021, of 32,229 median monthly GP consultations among 22,712 residents, telehealth visits accounted for 11% of GP consultations (97% by telephone). Pension holders (OR: 1.14; 95% CI: 1.10, 1.17) and those residing in rural areas (OR: 1.72; 95% CI: 1.57, 1.90) were more likely to use telehealth. However, residents in rural areas were less likely to use video than telephone in GP consultations (OR: 0.41; 95% CI: 0.29, 0.57). Results were similar in separate analyses for each COVID surge. Discussion: Telephone was primarily used in telehealth consultations among pension holders and rural residents in RACFs. Along with the limited use of video in virtual care in rural RACFs, the digital divide may imply potential healthcare disparities in socially disadvantaged patients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic necessitated a shift in the delivery of patient care, with telehealth rapidly scaled to facilitate access to care while reducing risks of COVID-19 transmission. In this paper, we present an overview of key findings regarding telehealth use from a large program of work examining the impact of the pandemic on general practice activity in Australia. Our findings demonstrate the pivotal role telehealth played in enabling patient access to care during the first two years of the pandemic. Importantly, however, we identified several facets of telehealth use including equitable access, workflow and infrastructure, and adequate funding, which require attention to optimise telehealth services in practice. [ABSTRACT FROM AUTHOR]

This analysis assessed the sociodemographic characteristics of telehealth utilisation during the coronavirus disease 2019 (COVID‐19) pandemic from March 2020 to August 2021 in Australia. Drawing on 860 general practice providers among 3 161 868 patients, 24 527 274 consultations were recorded. Telehealth accounted for 37.6% of the consultations, with 2.4% through videoconferencing and 35.2% through phone consultations. Our multivariate regression analyses indicated low utilisation of videoconferencing compared with phone consultations among older adults, those living in rural communities and migrants from non‐English speaking countries. [ABSTRACT FROM AUTHOR]

The onset of the coronavirus disease 2019 (COVID-19) pandemic, caused by SARS-CoV-2, and the ensuing implementation of response measures directly impacted the delivery of Australian primary care services. Understanding how these measures affected practice activity is important for gauging both their effectiveness and implications for future service planning. During the first 2 years of the COVID-19 pandemic, a research project was undertaken to determine the impact of the pandemic on Australian general practice activity as a collaborative undertaking between researchers, general practitioners, data custodians, and five primary health networks from New South Wales and Victoria, Australia. The project methodology was based on an established research approach called action research, which involves participatory involvement from key stakeholders throughout the research process. The strength and success of the project's methodological approach stemmed from the synergistic interrelationship between the four key elements of: collaboration, repeated action research cycles (utilising electronic general practice data), engaged governance, and the production and dissemination of apposite knowledge outcomes. The project approach, knowledge outputs and lessons learned can be adapted to future research undertakings across any primary care setting and highlight the utility of action research and interdisciplinary research collaboration to produce knowledge directly relevant to clinical practice. The COVID-19 pandemic directly impacted the delivery of primary care services. We detail a research project framework used during the first 2 years of the COVID-19 pandemic to understand how general practice activity was impacted by the pandemic. The knowledge outputs and lessons learned can be adapted to future research undertakings across any primary care setting and highlight the utility of action research and interdisciplinary research collaboration to produce knowledge directly relevant to clinical practice. [ABSTRACT FROM AUTHOR]

Background: Health systems around the world have been forced to make choices about how to prioritize care, manage infection control and maintain reserve capacity for future disease outbreaks. Primary healthcare has moved into the front line as COVID-19 testing transitions from hospitals to multiple providers, where tracking testing behaviours can be fragmented and delayed. Pooled general practice data are a valuable resource which can be used to inform population and individual care decision-making. This project aims to examine the feasibility of using near real-time electronic general practice data to promote effective care and best-practice policy.Methods: The project will utilize a design thinking approach involving all collaborators (primary health networks [PHNs], general practices, consumer groups, researchers, and digital health developers, pathology professionals) to enhance the development of meaningful and translational project outcomes. The project will be based on a series of observational studies utilizing near real-time electronic general practice data from a secure and comprehensive digital health platform [POpulation Level Analysis and Reporting (POLAR) general practice data warehouse]. The study will be carried out over 1.5 years (July 2020-December 2021) using data from over 450 general practices within three Victorian PHNs and Gippsland PHN, Eastern Melbourne PHN and South Eastern Melbourne PHN, supplemented by data from consenting general practices from two PHNs in New South Wales, Central and Eastern Sydney PHN and South Western Sydney PHN.Discussion: The project will be developed using a design thinking approach, leading to the building of a meaningful near real-time COVID-19 geospatial reporting framework and dashboard for decision-makers at community, state and nationwide levels, to identify and monitor emerging trends and the impact of interventions/policy decisions. This will integrate timely evidence about the impact of the COVID-19 pandemic related to its diagnosis and treatment, and its impact across clinical, population and general practice levels. [ABSTRACT FROM AUTHOR]

In Australia, general practice (GP) acts as the gatekeeper to the rest of the healthcare system, and therefore the vast majority of the population have an electronic medical record. It follows that the largest database of the population is therefore on the distributed GP computers. Informed by a comprehensive system-wide data strategy, the Population Level Analysis and Reporting program extracts data from the GP electronic medical records and repurposes it for multiple uses. The program requires the data to be coded and then structured for multiple uses clinical care, clinical governance, research, and policy. [ABSTRACT FROM AUTHOR]

In Australia, general practice (GP) acts as the gatekeeper to the rest of the healthcare system, and therefore the vast majority of the population have an electronic medical record. It follows that the largest database of the population is therefore on the distributed GP computers. Informed by a comprehensive system-wide data strategy, the Population Level Analysis and Reporting program extracts data from the GP electronic medical records and repurposes it for multiple uses. The program requires the data to be coded and then structured for multiple uses clinical care, clinical governance, research, and policy. [ABSTRACT FROM AUTHOR]

Major challenges exist in identifying Long COVID patients from diagnosis texts recorded by general practitioners. A classification framework is proposed that can be used to identify Long COVID patients given these unstructured diagnostic texts. This framework can be leveraged to provide a general understanding of the risk factors, management strategies, and outcomes associated with Long COVID in Australia. [ABSTRACT FROM AUTHOR]

Introduction In Australia, general practitioners usually are the first point of contact for patients with non-urgent medical conditions. Appropriate and efficient utilisation of pathology tests by general practitioners forms a key part of diagnosis and monitoring. However overutilisationand underutilisation of pathology tests have been reported across several tests and conditions, despite evidence-based guidelines outlining best practice in pathology testing. There are a limited number of studies evaluating the impact of these guidelines on pathology testing in general practice. The aim of our quantitative observational study is to define how pathology tests are used in general practice and investigate how test ordering practices align with evidence-based pathology guidelines. Methods and analysis Access to non-identifiable patient data will be obtained through electronic health records from general practices across three primary health networks in Victoria, Australia. Numbers and characteristics of patients, general practices, encounters, pathology tests and problems managed over time will be described. Overall rates of encounters and tests, alongside more detailed investigation between subcategories (encounter year, patient's age, gender, and location and general practice size), will also be undertaken. To evaluate how general practitioner test ordering coincides with evidence-based guidelines, five key candidate indicators will be investigated: full blood counts for patients on clozapine medication; international normalised ratio measurements for patients on warfarin medication; glycated haemoglobin testing for monitoring patients with diabetes; vitamin D testing; and thyroid function testing. Ethics and dissemination Ethics clearance to collect data from general practice facilities has been obtained by the data provider from the RACGP National Research and Evaluation Ethics Committee (NREEC 17-008). Approval for the research group to use these data has been obtained from Macquarie University (5201700872). This study is funded by the Australian Government Department of Health Quality Use of Pathology Program (Agreement ID: 4-2QFVW4M). Findings will be reported to the Department of Health and disseminated in peer-reviewed academic journals and presentations (national and international conferences, industry forums). [ABSTRACT FROM AUTHOR]

After-hours access to general practice (GP) is critical to supporting accessibility and reducing emergency department demand. To understand who utilises after-hours GP services, this study examined the characteristics of presentations to an Eastern Melbourne after-hours clinic between 2005 and 2014. Descriptive analyses of patient and presentation characteristics, diagnoses, medications and pathology were conducted. Across the study period, 39.1% of presentations to the clinic (N = 64,800) were by patients under 18 years of age. Females were found to attend more often than males, and nearly 79% of patients attended only once. The most common diagnoses were respiratory system diseases (13.4%), gastrointestinal system diseases (12.6%) and eye and ear problems (11.6%). Antibacterial medications accounted for over half (53.0%) of all prescriptions, with 34% of antibiotics prescribed to patients under 18 years of age. Seasonal variation in GP demand was also observed. Presenting patients differed from the wider GP patient population, with more young patients, and a higher proportion of prescriptions for antibacterial medications compared to other predominantly non-after-hours practices. Further research is required to understand the health-seeking, decision-making of patients who utilise after-hours GPs over predominantly non-after-hours primary care services, to inform service promotion and delivery strategies. [ABSTRACT FROM AUTHOR]

The article focuses on the use of artificial intelligence (AI), for gathering of medical information with the decision support tools.

We have reported the most comprehensive snapshot of PSA testing in Australia based on electronic general practice data since the release of the current guidelines for PSA testing of asymptomatic men. Keywords: General practice; Prostate; Guidelines as topic; Pathology EN General practice Prostate Guidelines as topic Pathology 228 229 2 09/01/21 20210901 NES 210901 Measuring prostate-specific antigen (PSA) levels is widely used for screening for the early diagnosis of prostate cancer.1 However, the value of PSA testing for reducing prostate cancer-specific or all-cause mortality in asymptomatic men is uncertain.2 The Prostate Cancer Foundation of Australia and the Cancer Council of Australia recommend that men aged 50-69 years be offered biennial PSA testing if they make an informed decision to be tested.1 We investigated age-specific patterns of PSA testing and PSA levels in men aged 40 years or more without symptoms of prostate cancer. Prostate-specific antigen testing of asymptomatic men in Australia: an observational study based on electronic general practice data. [Extracted from the article]

Radio path-loss prediction is an important but computationally expensive component of wireless communications simulation. Models may require significant computation to reach a solution or require that information about the environment between transceivers be collected as model inputs, which may also be computationally expensive. Despite the complexity of the underlying model that generates a path-loss solution, the resulting function is not necessarily complex, and there may be ample opportunity for compression. We introduce a method for rapidly estimating radio path loss with Feed-Forward Neural Networks (FFNNs), in which not only path-loss models but also map topology is implicitly encoded in the network. Since FFNN simulation is amenable to Single Instruction Multiple Data architecture, additional performance can be gained by implementing a trained model in a parallel manner with a Graphical Processing Unit (GPU), such as those found on modern video cards. We first describe the properties of the training data used, which is either taken from measurements of the continental United States, or generated with random processes. Secondly, we discuss the model selection process and the training algorithm used on all candidate networks. Thirdly, we show accuracy evaluations of a number of FFNNs trained to estimate both commercial and public-domain path-loss solution sets. Lastly, we describe the approach used to implement trained networks on a GPU, and provide performance evaluations versus conventional path-loss models running on a Central Processing Unit. [ABSTRACT FROM PUBLISHER]

Low serum ferritin is diagnostic of iron deficiency, yet its published lower cut-off values are highly variable, particularly for pediatric populations. Lower cut-off values are commonly reported as 2.5th percentiles, and is based on the variation of ferritin values in the population. Our objective was to determine whether a functional approach based on iron deficient erythropoiesis could provide a better alternative. Utilizing 64,443 ferritin test results from pediatric electronic health records, we conducted various statistical techniques to derive 2.5th percentiles, and also derived functional reference limits through the association between ferritin and erythrocyte parameters: hemoglobin, mean corpuscular volume, mean cell hemoglobin concentration, and red cell distribution width. We find that lower limits of reference intervals derived as centiles are too low for clinical interpretation. Functional limits indicate iron deficiency anemia starts to occur when ferritin levels reach 10 µg/L, and are largely similar between genders and age groups. In comparison, centiles (2.5%) presented with lower limits overall, with varying levels depending on age and gender. Functionally-derived limits better reflects the underlying physiology of a patient, and may provide a basis for deriving a threshold related to treatment of iron deficiency and any other biomarker with functional outcomes. [ABSTRACT FROM AUTHOR]

The article discusses the role of transforming growth factor beta-1 (TGF-β-1) in radiation fibrosis, focusing on the effects of curcumin, alpha-lipoic acid, and reishi on past-radiation fibrosis.