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Nectar analysis has been used to understand pollination systems, but nectar storage methods have rarely been considered as potential sources of inaccuracy in the recovery of data. Prompt nectar sugar analysis is not always possible and storage methods can affect results. We aimed to develop an effective method to store nectar on filter paper. Nectars from two subspecies of Eremophila maculata (Scrophulariaceae) and Strelitzia reginae (Strelitziaceae) were spotted on filter papers. Nectars were redissolved and assayed by high-performance liquid chromatography to determine the masses of sugars recovered from the papers from Day 0 to Day 30. We evaluated the effects of the method of elution, paper type and size, and storage treatments on sugar recovery. Liquid nectars were also stored in the refrigerator. Sugars were best eluted from filter papers in 15 mL of water and agitated for 1 min. Nectar sugars stored on small papers tended to be recovered more successfully than those stored on larger papers (significantly for glucose). Paper performed better than nylon for glucose. Desiccant had a marginal positive effect on nectar sugar recovery, and filter paper performed better than did refrigeration of liquid nectar for storage. If highly accurate measurements are needed, nectars should be eluted with large volumes of water from small filter papers stored with desiccant within a few days of collection. Floral nectar is a primary driver of pollination. Storage of nectar between collection and analysis can greatly affect sugar characteristics. We aimed to develop an effective method to store nectar on filter paper. Nectar is best eluted with large volumes of water from small filter papers stored with desiccant. Nectar storage methods have rarely been considered as sources of inaccuracy; however, we have demonstrated that prompt analysis is necessary for the most reliable results. [ABSTRACT FROM AUTHOR]

Objective: The medical record is critical for documentation and communication between healthcare professionals. This study compared the completeness of orthopaedic documentation between the electronic medical record (EMR) and paper medical record (PMR). Methods: A review was undertaken of 400 medical records (200 EMR, 200 PMR) of patients with operatively managed traumatic lower limb injury. The operative report, discharge summary and first and second out-patient reviews were evaluated using criteria designed by a senior orthopaedic surgeon and senior physiotherapist. The criteria included information deemed critical to the post-operative care of the patient in the first 6 weeks post-surgery. Results: In all cases, an operative report was completed by a senior surgeon. Notable findings included inferior documentation of patient weight-bearing status on the operative report in the EMR than PMR group (P = 0.018). There was a significant improvement in the completion of discharge summaries in the EMR compared with PMR cohort (100% vs 82.5% respectively; P < 0.001). In the PMR group, 70.0% of discharge summaries were completed and adequately documented, compared with 91.5% of those in the EMR group (P < 0.001). At out-patient review, there was an improvement in documentation of weight-bearing instructions in the EMR compared with PMR group (81.1% vs 76.2% respectively; P = 0.032). Conclusion: The EMR is associated with an improvement in the standard of orthopaedic medical record documentation, but deficiencies remain in key components of the medical record. What is known about the topic?: Medical records are an essential tool in modern medical practice and have significant implications for patient care and management, communication and medicolegal issues. Despite the importance of comprehensive documentation, numerous examples of poor documentation continue to be demonstrated. Recently, significant changes to the medical record in Australia have been implemented with the conversion of some hospitals to an EMR and the implementation of the My Health Record. What does this paper add?: Standards of patient care should be monitored continuously and deficiencies identified in order to implement measures for improvement and to close the quality loop. This study has highlighted that although there has been improvement in medical record keeping with the implementation of an EMR, the standard of orthopaedic medical record keeping continues to be below what is expected, and several key areas of documentation require improvement. What are the implications for practitioners?: The implications of these findings for practitioners are to highlight current deficiencies in documentation and promote change in current practice to improve the quality of medical record documentation among medical staff. Although the EMR has improved documentation, there remain areas for further improvement, and hospital administrators will find these observations useful in implementing ongoing change. [ABSTRACT FROM AUTHOR]

Context and aims: Freshly harvested seeds of temperate annual pasture legume species have physiological dormancy (PD), which delays the growth of the next generation and is thus an impediment to speed breeding. The aim of this study was to develop a method or methods of PD breaking that can achieve high germination (≥90%) within 5 days of picking freshly harvested seed. Methods: In a series of experiments, PD breaking methods by themselves and in combination were tested on burr medic (Medicago polymorpha). The most promising methods were then tested on other annual medic species (Medicago spp.), subterranean clover (Trifolium subterraneum), and alternative species from six genera. Key results: The successful PD breaking method involved drying pods overnight at 45°C, extracting and scarifying seed, placing seed on filter paper in a Petri dish along with non-dormant seed, imbibing seed with 4 μM benzylaminopurine, sealing the Petri dish, and incubating in the dark at 15°C. Highly dormant genotypes required the additional treatment of removing the testa. Conclusions: We have developed an effective way of breaking seed PD in the 11 pasture legumes species from the seven genera tested. The rapid breaking of seed PD will assist speed breeding of annual pasture legumes, making it less laborious and time-bound than currently used methods. Implications: The PD breaking methods are expected to assist basic science studies of annual pasture legume species and may be applicable to other species and genera. Freshly harvested seeds of temperate annual pasture legume species have physiological dormancy (PD), which delays the growth of the next generation and is thus an impediment to speed breeding. We report on the development of PD breaking methods that rapidly overcome PD of freshly harvested seed. The rapid breaking of PD assists the speed breeding of annual pasture legumes by making it less laborious and time-bound than previous methods. [ABSTRACT FROM AUTHOR]

Rupert Jethro Best (1903–91), working alone at the Waite Agricultural Research Institute in Adelaide between 1934 and 1937, was among the first to purify tobacco mosaic virus (TMV) and to propose that it was a complex macromolecule containing protein and another reactive group that was responsible for infectivity of the virus. However, his research was completely overshadowed by that of Wendell Stanley and the duo of Frederick Bawden and Norman (aka Bill) Pirie, working in the United States of America and Great Britain, respectively, to the point where Best is not even mentioned in modern histories of TMV. Many factors have contributed to this lack of recognition for Best. Professor James Prescott, a soil scientist and Best's supervisor at the Waite Institute, failed to appreciate the significance of his research, leading to critical delays in publication that prevented him from claiming precedence for purifying TMV. When Best's research was eventually published, it was in Australian journals that were not broadly distributed, resulting in minimal international exposure for his research. The plant virology community within which he worked in Australia was very small and entirely focused on plant disease control, and not concerned with fundamental questions about the composition of viruses. Communication with similarly interested scientists in the Northern Hemisphere was hindered by the great distances involved. In this paper, pioneering research done by Best on TMV is reviewed, and placed in context with that undertaken by Stanley and by Bawden and Pirie, who are best remembered for purifying TMV and characterising its physicochemical properties. Rupert Jethro Best, working alone in Adelaide at the Waite Agricultural Research Institute, was among the first to purify tobacco mosaic virus and to provide evidence that it was a heterogeneous macromolecule, composed mainly of protein but also small prosthetic groups with the properties of a weak acid, wherein lay the activity of the virus. This paper describes the contributions of Rupert Best to early theories on the material nature and mode of reproduction of viruses. Photographer unknown, State Library of South Australia. [ABSTRACT FROM AUTHOR]

What is known about this topic? We discuss a recently published paper that alleges clinicians are causal agents of non-compliant billing of Medicare. What does this paper add? The paper's arguments are partially supported by unreferenced assertions, potential logical fallacies, inaccurate reporting of referenced material and unsubstantiated rhetoric. What are the implications for practitioners? Due to the lack of substantive evidence, it cannot be concluded that clinicians are the causal agents of non-compliant billing of Medicare. [ABSTRACT FROM AUTHOR]

Context. Feeding behaviour is an important tool for the early detection of diseases in dairy cows. Aims. The aim of this study was to evaluate whether the variation in time spent feeding in the prepartum and postpartum periods may be used to detect the occurrence of metritis and subclinical ketosis (SCK) before the onset of the clinical symptoms at the postpartum. Methods. The research was conducted in four electronic databases, including Scopus, Science Direct, Pubmed, and Web of Science. The inclusion criteria for citations were original research, evaluation of daily time spent feeding in dairy cows, and use of this indicator for early identification of metritis and/or SCK in dairy cows in the prepartum and postpartum periods. A random-effect meta-analysis (MA) was conducted for metritis with the time spent feeding means of control (healthy) and treated (sick) groups measured in the prepartum and postpartum periods. The analysis was conducted with the values of daily time spent feeding before and after calving in both groups. Key results. In total, 26 trials from six papers, involving 1037 dairy cows, were included in the statistical analysis. No data were obtained for SCK to conduct a MA, while for metritis, 16 trials from six papers (prepartum) and 10 trials from three papers (postpartum) were considered. The heterogeneity between studies on metritis was moderate (I² = 57.5%) in the prepartum period and low (I² = 10.0%) in the postpartum period. The mean difference feeding time for healthy and unhealthy animals was greater during postpartum (21.14 min/day, P < 0.001) than during prepartum (16.36 min/day, P < 0.001). Meta-regression analysis showed that number of daily milkings, sample size, and the place of running trial significantly influenced the time spent feeding by cows. Conclusion. On the basis of available and suitable scientific literature, time spent feeding is reduced at the prepartum and postpartum periods in dairy cows further affected by metritis. Implications. This study evidenced that feeding time might be incorporated into health-monitoring protocols for early detection of metritis in dairy cows. [ABSTRACT FROM AUTHOR]

Background: The cloud-penetrating and fog-penetrating capability of Synthetic Aperture Radar (SAR) give it the potential for application in forest fire progress monitoring; however, the low extraction accuracy and significant salt-and-pepper noise in SAR remote sensing mapping of the burned area are problems. Aims: This paper provides a method for accurately extracting the burned area based on fully exploiting the changes in multiple different dimensional feature parameters of dual-polarised SAR images before and after a fire. Methods: This paper describes forest fire progress monitoring using dual-polarisation SAR images combined with multi-scale segmentation and unsupervised classification. We first constructed polarisation feature and texture feature datasets using multi-scene Sentinel-1 images. A multi-scale segmentation algorithm was then used to generate objects to suppress the salt-and-pepper noise, followed by an unsupervised classification method to extract the burned area. Key results: The accuracy of burned area extraction in this paper is 91.67%, an improvement of 33.70% compared to the pixel-based classification results. Conclusions: Compared with the pixel-based method, our method effectively suppresses the salt-and-pepper noise and improves the SAR burned area extraction accuracy. Implications: The fire monitoring method using SAR images provides a reference for extracting the burned area under continuous cloud or smoke cover. This paper describes a method to monitor forest fire progress using dual-polarisation Synthetic Aperture Radar (SAR) images combined with multi-scale segmentation and unsupervised classification. We aimed to take full advantage of the many different dimensions of feature parameter changes caused by forest fires, relying on time-series dual-polarised SAR imagery to achieve burned area extraction and forest fire progress monitoring. [ABSTRACT FROM AUTHOR]

The 9th International Conference on Forest Fire Research, organised by the Forest Fire Research Center of the Association for Developmental of Industrial Aerodynamics every 4 years since 1990, was held in November 2022 in Coimbra, Portugal. The conference was held in conjunction with the 17th International Wildland Fire Safety Summit, sponsored by the International Association of Wildland Fire. The number and quality of the submissions for this joint event was very high, and the authors were encouraged to submit a full paper to a special issue of the International Journal of Wildland Fire (IJWF). Given the large number of submissions, the Journal decided to publish the special issue in four parts. Part 1 was published in January 2023, with eight papers, Part 2 in March 2023, with 10 papers and Part 3 in June 2023 with 15 papers. This fourth part presents 10 original papers, in three areas: Decision Support Systems and Tools (3), Risk Assessment & Reduction (3) and the Wildland Urban Interface (4). All the papers in this special issue are published Open Access. Part 4 of the special issue that resulted from the 9th International Conference on Forest Fire Research includes 10 papers on various aspects of wildland fire research. Parts 1, 2 and 3 were published in January, March and June 2023 respectively. All papers in the special issue are published Open Access. [ABSTRACT FROM AUTHOR]

As the number of livestock increased in the years following English colonisation of Australia in 1788, the need for nutritious fodder, including lucerne (Medicago sativa), grew. One of the first diseases found on lucerne was a leaf spot which was collected in 1879 by George Bancroft, a physician and naturalist, in a suburb of Brisbane. The Queensland Government Botanist Frederick Manson Bailey sent a specimen to the prominent English mycologists Miles Joseph Berkeley and Christopher Edmund Broome who in 1883 formally described and named the fungus Sphaerella destructiva. That fungus is now known as Pseudopeziza medicaginis , the causal agent of common leaf spot of lucerne. It was one of over 300 fungi that were included in a 1880 paper co-written by the Reverend Julian Tenison-Woods and Frederick Bailey. At that time almost all of these fungi which had been collected in Australia were identified by overseas mycologists, particularly Berkeley and Broome. It can be argued that their 1880 paper was the first significant one published in Australia which focussed on fungi. Just a decade or so later Australian scientists, in particular Daniel McAlpine, were describing new fungal taxa on their own. Among the fungi recorded in a paper published in the 1880 Proceedings of the Linnaean Society of New South Wales was Sphaerella destructiva , now Pseudopeziza medicaginis , the cause of common leaf spot of lucerne. The paper, co-authored by the naturalist Reverend Julian Tenison-Woods and the Queensland Government Botanist Frederick Manson Bailey was the first known comprehensive list of Australian fungi published by Australian residents. It is a milestone in the evolution of mycology and plant pathology studies in Australia. Photograph by H. H. Baily. [ABSTRACT FROM AUTHOR]

This document is a corrigendum that corrects an error in a previously published paper titled "Monitoring tropical freshwater fish with underwater videography and deep learning." The authors apologize for the mistake, which involves the incorrect color of the bounding box and species name for Ambassis macleayi in Figure 7e. The correct color should have been yellow instead of green. The authors provide a corrected version of the figure and apologize for any confusion caused. [Extracted from the article]

Background: Electronic prescription (e-prescription) was introduced in 2020 in Australia during the COVID-19 pandemic. This research aimed to explore general practitioners (GPs) and community pharmacists' experience with, and facilitators and barriers to, the use of e-prescription. Methods: This qualitative study used semi-structured interviews with GPs and pharmacists in Greater Sydney to explore their experience with e-prescription. Thematic analysis used descriptive and mixed inductive and deductive approaches. The Technology Acceptance Model (TAM) was used to further interpret and organise the themes. Results: Eleven GPs and nine pharmacists were interviewed. Thirteen themes were elicited, seven of which were categorised as benefits (facilitators) and six were challenges (barriers). Four facilitator themes (convenience for healthcare providers (HCPs) and patients, addressing issues with paper prescriptions, contactless nature reducing access barriers during COVID-19 lockdown, and enabling patients to manage multiple prescriptions) were mapped to the TAM construct of 'perceived usefulness'; and one facilitator (an easier process) and two barrier themes (lack of information during implementation, and technological issues) were mapped to the TAM construct of 'perceived ease of use'. Themes that fell outside these constructs were separately categorised: four barrier themes (reluctance of some patients and HCPs to change, patient expectations of 'instant prescription' and lost opportunities for best-practice care, HCPs' perceptions of inadequate governmental governance, and ongoing costs) were 'other issues with e-prescription', and two facilitator themes (providing training on the use of e-prescription for HCPs and patients, and making e-prescription more streamlined) were 'suggestions to improve'. Conclusion: There are many facilitators and barriers to the use of e-prescription. Our findings may inform the future promotion of e-prescription post-COVID-19 pandemic. Further research should focus on consumers' perspectives of e-prescription. It is inevitable that electronic prescriptions will one day supersede paper prescriptions, but there is resistance to their implementation at the practitioner and patient levels. This paper explored GPs and pharmacists' experience and views, and found that while e-prescription improves the quality of patient care, there are several challenges to its effective use. Findings may inform the future promotion of e-prescription, particularly post-COVID-19 pandemic, and guide future research in exploring consumer perspectives. [ABSTRACT FROM AUTHOR]

This paper covers developments from International Embryo Technology Society (IETS) meetings over the past 50 years. The IETS was officially 'born' at a meeting in Denver, Colorado on Sunday 26 May 1974. There have been 51 IETS meetings (the first was in May 1974), and the first conference at which papers were presented was in 1975. The name of the IETS was changed from International Embryo Transfer Society to International Embryo Technology Society in 2016. The annual IETS conferences are held once a year in January. Embryo technology advanced from the laborious and slow techniques of surgical recovery and transfer of bovine embryos to non-surgical recovery and transfer in many species. Cryopreservation of embryos was initially a slow process that met with only moderate technical success before the development of technology that resulted in high embryo survival rates. The polymerase chain reaction was used to determine the sex of embryos following laminar flow cytology, which came into use to separate X- and Y-bearing spermatozoa. IVF has grown to become widely used, and several factors make it more useful than superovulation and embryo recovery/transfer. Perhaps the most important tool of all was the system that allowed the genetic 'mapping' of the genomic sequence of Bos taurus cattle. Charting key DNA differences by scientists, 'haplotypes' are now used routinely to identify animals with desirable traits of economic importance, discover new genetic disorders, and track carrier status of genotyped animals. Future technology is discussed. This paper deals with the 50-year history of embryo transfer technology. It covers the formation of the International Embryo Technology Society, a group of scientists and veterinarians who study or work in the field of embryos and the animals that produce them. These embryos can be frozen, moved from animal to animal, maintained outside the female, and modified by a number of procedures. Photograph by Jenson. [ABSTRACT FROM AUTHOR]

This research prepared a photochromic material of WO3 doped with Mo or Cu through a solvothermal method. The material exhibits selective absorption of UV light in the 200-350-nm range. The crystal structure of WO3 remained unchanged after doping, but the bandgap was reduced, thereby increasing its coloration rate. The doping of Mo or Cu brought different new features to WO3: Mo-doping imparted a purple hue upon UV irradiation, whereas Cu-doping accelerated the bleaching of WO3 due to its multi-valent state. WO3-0.1Mo and WO3-0.1Cu were preferentially selected through a practical photochromic process and bandgap calculations, and further used to prepare photochromic ink. This ink is suitable for the preparation of writing and photochromic rewriting paper and retains good photochromic properties even after 50 uses. [ABSTRACT FROM AUTHOR]

Objective: Lifetime Health Cover (LHC) was introduced in mid-2000 to increase participation in private health insurance that includes hospital cover (PHI-HC) and improve the risk profile of PHI-HC participants. It initially achieved both objectives, but since 2001 the PHI-HC population has aged faster than the general population. The aim of this study was to determine if the excess ageing of the PHI-HC risk pool has been due to passive age-based adverse selection, an inherent risk of LHC. This study has potential implications for the retention of LHC. Methods: A descriptive population-level analysis of publicly available administrative datasets was performed. Data relating to PHI-HC were obtained from the Australian Prudential Regulatory Authority. National population data were obtained from the Australian Bureau of Statistics. Trends in demography, PHI-HC participation rates and LHC loading payments were analysed. Results: By 2021, age-based adverse selection had returned to the pre-LHC level. Based on the available data, this was due to passive age-based adverse selection not active age-based adverse selection. Specifically, it reflected the combination of an avoidable unintended consequence of the introduction of LHC (the over-representation, in 2001, of individuals aged 45–59) and one of LHC's intended effects (incentivisation of insured individuals to retain PHI-HC). Conclusions: This study supports the retention of LHC. Nonetheless, it highlights the risk of passive age-based adverse selection created by incentivising insured individuals to retain PHI-HC in the presence of distortions in the age distribution of the PHI-HC risk pool. Early targeted interventions are required when such distortions arise. What is known about the topic? Since the introduction of Lifetime Health Cover (LHC) in mid-2000, the participation rate for private health insurance that includes hospital cover (PHI-HC) has remained relatively stable, but the PHI-HC population has aged faster than the general population. What does this paper add? This paper makes a novel distinction between 'active' and 'passive' age-based adverse selection to explain LHC's role in the excess ageing of the PHI-HC risk pool. What are the implications for practitioners? Governments need to be vigilant for the emergence of distortions in the age distribution of the PHI-HC risk pool and respond with targeted interventions to normalise the age distribution, or risk problematic passive age-based adverse selection. [ABSTRACT FROM AUTHOR]

Objectives: Unwarranted clinical variations in radical prostatectomy (RP) procedures are frequently reported, yet less attention is given to the variations in associated costs. This issue can further widen disparities in access to care and provoke questions about the overall value of the procedure. The present paper aimed to delve into the disparities in hospital, medical provider and out-of-pocket costs for RP procedures in Australia, discussing plausible causes and potential policy opportunities. Methods: A retrospective cohort study using Medibank Private claims data for RP procedures conducted in Australian hospitals between 1 January 2015 and 31 December 2020 was undertaken. Results: Considerable variations in both medical provider and out-of-pocket costs were observed across the country, with variations evident between different states or territories. Particularly striking were the discrepancies in the costs charged by medical providers, with a notable contrast between the 10th and 90th percentiles revealing a substantial difference of A$9925. Hospitals in Australia exhibited relatively comparable charges for RP procedures. Conclusions: Initiatives such as enhancing transparency regarding individual medical provider costs and implementing fee regulations with healthcare providers may be useful in curbing the variations in RP procedure costs. What is known about the topic? Unwarranted clinical variations in radical prostatectomy procedures are well documented in the literature; however, variations in cost are less widely reported. What does this paper add? This paper aims to highlight the cost variations in radical prostatectomy procedures in Australia, discussing their plausible causes, implications and proposing potential policy opportunities. What are the implications for practitioners? Excessive fees imposed by medical providers may contribute to inequalities in healthcare access. Enhancing transparency of individual medical provider costs and implementing fee regulations may be useful in controlling unwarranted variations in procedure costs. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Value based healthcare beyond the clinical domain is the focus of this case study. We share NSW Health's experiences in achieving value through a focus on outcomes in non-clinical and clinical support services using examples that demonstrate key aspects across the commissioning cycle. These include: the importance of stakeholder engagement in the planning phase to later success; the critical role of non-clinical services in patient experience; the opportunity to facilitate value by introducing new approaches in business areas such as procurement; and the role of clinical supports such as digital enablement to facilitate outcome-focussed clinical models. Applying a value lens to non-clinical services can increase the potential benefits to patients, clinicians and the system. What is known about the topic? Value based healthcare is a way of making transparent and equitable decisions about resource allocation to deliver better outcomes for individuals, health services and the system. What does this paper add? This paper reflects on the opportunity to deliver value based healthcare beyond clinical models of care, including in non-clinical and clinical support services, using a commissioning approach. What are the implications for practitioners? The learnings shared through the case studies presented can be applied by practitioners to their own projects to support value based approaches across all aspects of health care. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

The ninth International Conference on Forest Fire Research, together with the 17th International Wildland Fire Safety Summit was held in November 2022. This joint conference brought together several hundred presentations in the field of wildfire research. This special issue of the International Journal of Wildland Fire includes several papers describing work presented at the conference. Due to the large number and variety of papers submitted, the special issue is being published in several parts. Part 1 of the special issue was published, in January 2023, with a set of eight papers. This Foreword to Part 2 of the special issue introduces 10 new papers on various topics that include: modelling of ignition probability, fire behaviour modelling, wildfire hazard mapping, fire management policies, imagery and mapping, and wildland–urban interface. All papers in the special issue are published Open Access. Part 2 of the Special Issue that resulted from the 9th International Conference on Forest Fire Research includes papers on various aspects of wildland fire research. Part 1 was published in January 2023. All papers in the Special Issue are published Open Access. [ABSTRACT FROM AUTHOR]

The ninth International Conference on Forest Fire Research, organised by the Forest Fire Research Center of the Association for Developmental of Industrial Aerodynamics every 4 years since 1990, was held in November 2022 in Coimbra, Portugal. The conference was held in conjunction with the 17th International Wildland Fire Safety Summit, sponsored by the International Association of Wildland Fire. The number and quality of the submissions for this joint event was very high, and the authors were encouraged to submit a full paper to a special issue of the International Journal of Wildland Fire (IJWF). Given the large number of submissions, the Journal decided to publish the special issue in several parts. Part 1 was published in January 2023, with eight papers, and Part 2 in March 2023, with 10 papers. This third part presents 15 original papers in five topical areas: decision support systems and tools (3), risk reduction (2), risk assessment (3), wildland urban interface (3) and wildfire management and safety (4). All the papers in this special issue are published Open Access. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a global pandemic, however, estimating its burden is a complex process. As a result, many countries rely on global estimates to infer burden within their own setting. With a growing number of recent publications quantifying AMR burden in Australia, and an expansion of surveillance programs, enumerating AMR mortality for Australia is feasible. We aimed to leverage existing published data to assess methodological factors contributing to the considerable variation in AMR-related mortality and provide two reliable estimates of AMR mortality in Australia. This is a necessary step towards generating meaningful measures of AMR burden in Australia. What is known about the topic? Antimicrobial resistance is a significant global health threat, but estimating the burden of disease is complicated by data challenges. What does this paper add? This paper highlights progress in estimating the number of people dying from antimicrobial resistance in Australia and highlights the importance of rigorous antimicrobial resistance mortality estimates in Australia to assess burden of disease. What are the implications for practitioners? Practitioners should use only rigorous estimates of burden of disease to inform actions on reducing the threat of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Objective: To scope how the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) has been applied to measure socio-economic status (SES) in peer-reviewed cardiovascular disease (CVD) research. Methods: The Joanna Briggs Institute's scoping review methodology was used. Results: The search retrieved 2788 unique citations, and 49 studies were included. Studies were heterogeneous in their approach to analysis using SEIFA. Not all studies provided information as to what version was used and how SEIFA was applied in analysis. Spatial unit of analysis varied between studies, with participant postcode most frequently applied. Study quality varied. Conclusions: The use of SEIFA in Australian CVD peer-reviewed research is widespread, with variations in the application of SEIFA to measure SES as an exposure. There is a need to improve the reporting of how SEIFA is applied in the methods sections of research papers for greater transparency and to ensure accurate interpretation of CVD research. What is known about the topic? A socio-economic status (SES) gradient is well established for cardiovascular disease (CVD). Research has generally applied two approaches to classifying SES: at an individual level using income, education or occupation data, and at an area level using a range of existing socio-economic information, including the Australian Bureau of Statistics (ABS) Socio-Economic Indexes for Areas (SEIFA). What does this paper add? This review examined how SEIFA has been applied to measure SES in Australian peer-reviewed CVD research and to identify any variations in research practice. What are the implications for practitioners? It is recommended that researchers provide a clear explanation in the methods section of research papers as to which SEIFA version and index was applied, how it was applied, at what spatial unit, and whether the spatial unit was an ABS or non-ABS unit. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the perspective of healthcare workers on the resources they need to provide quality rehabilitation for people recovering from coronavirus disease 2019 (COVID-19) infection. Methods: A descriptive qualitative approach using reflexive thematic analysis was employed. Focus groups and interviews were performed with nine healthcare workers (one intensive care unit physiotherapist, one respiratory therapist and seven occupational therapists) with experience treating patients recovering from COVID-19 infection within hospital and in the community. Verbatim transcripts were coded and analysed for themes. Results: Healthcare workers perceive an urgent need for resources about recovery from COVID-19 infection to support quality care. They particularly want detailed guidance about potential trajectories of recovery, and what should be expected over time for people with long COVID. Many observed that this group of patients had higher oxygen requirement and experienced slower recovery than others with serious respiratory conditions. Supports for quality care do exist but were not perceived as sufficient by participants. They want any new resources developed to be accessible, quick to access and targeted to specific healthcare worker roles and services settings. Participants identified several barriers to accessing practice supports, including the time poor nature of health care and financial costs to both patients and healthcare workers. Conclusion: Healthcare workers perceive an urgent need for the development of resources to support quality rehabilitation for people recovering from COVID-19 infection, to support best outcomes for this group of patients. Any resources developed must consider identified barriers to their access and use to maximise their impact. What is known about the topic? Workforce development needs related to the management of people recovering from coronavirus disease 2019 (COVID-19) are relatively unknown, due to the novelty of the virus and sustained pressure on the healthcare system due to the pandemic. What does this paper add? The paper identifies resource gaps and potential improvements from the clinician perspective. It also emphasises the urgent need for tailored, multidisciplinary resources and workforce capacity building. What are the implications for practitioners? Access to accessible updated resources and continuing professional development is critical for allied health clinicians in the evolving field of COVID-19 rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Sonder's In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multidisciplinary, wraparound withdrawal option for people with low-to-moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service's overall impact on reducing substance use among clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder, and staff perspectives. Methods: A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys were analysed thematically. Results: Overall, 1166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their alcohol and other drugs (AOD) use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service's home-based setting, multidisciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions: The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post-withdrawal support and the inclusion of multidisciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers. Individuals with low-to-moderate levels of substance dependence require targeted services to safely manage their withdrawal. This paper evaluates a holistic approach to withdrawal that broadens the common medicalised approach through pre- and post-withdrawal stages of care and support from a multidisciplinary team including lived experience practitioners. The service reduces levels of substance use while also improving overall quality of life, demonstrating the need for more withdrawal services to consider the inclusion of holistic approaches to substance dependence support. [ABSTRACT FROM AUTHOR]

Species of the genus Eubranchus Forbes, 1838 (Mollusca: Gastropoda: Nudibranchia) are common faunistic elements of boreal benthic ecosystems, associated with hydroid communities. Recent studies have suggested that the widely distributed trans-Arctic E. rupium (Møller, 1842) constitutes a complex of at least three candidate species, but the detailed taxonomy of the complex remains unresolved. The purpose of the present paper is to conduct an integrative taxonomic study including molecular genetic methods (a phylogenetic analysis using COI , 16S rRNA and histone H3 with application of species delimitation methods) and morphological study (light and scanning electron microscopy) of E. rupium and closely related species. The specific aims of this study were to establish the species boundaries, morphological variability, and the phylogeographic structure within this group. The phylogeographic analysis included a TCS -based network analysis, an analysis of molecular variance (AMOVA), divergence time estimations, and ancestral area reconstructions. We demonstrate that specimens initially identified as E. rupium included three distinctive species: the nominal E. rupium with an amphiboreal range, the new species Eubranchus novik sp. nov. from the Sea of Japan, for which a taxonomic description is provided in this paper, and Eubranchus sp. from the northern Kuril Islands, which requires the collection and study of additional material for formal description. Our results confirm the amphiboreal distribution of E. rupium , as no geographic structure was found across Pacific, Arctic and Atlantic populations, and the results of the AMOVA analysis showed no differences between groups of samples from different geographic regions. The divergence of the ' Eubrancus rupium species complex' is estimated from the late Miocene or the Miocene–Pliocene boundary to the late Pliocene. It is hypothesised that the most probable ancestral region for the Eubranchus rupium species complex is the north-western Pacific, and the subsequent speciation likely occurred due to dispersal followed by allopatric speciation. ZooBank: Species of the genus Eubranchus Forbes, 1838 are common in boreal benthic ecosystems. Recent studies suggest the trans-Arctic Eubranchus rupium (Møller, 1842) is a species complex. This paper conducts an integrative taxonomic study of Eubranchus rupium and related species, confirming its amphiboreal distribution. The divergence of the species complex is estimated from the late Miocene or the Miocene–Pliocene boundary to the late Pliocene with the north-western Pacific as the probable ancestral region, followed by dispersal and allopatric speciation. (Image credit: Darya Grishina.) [ABSTRACT FROM AUTHOR]

Background: Asynchronous observations refer to observations that are obtained at multiple moments. The observation moments of fire fronts may differ throughout an entire wildfire area. Asynchronous observations include historical data, which hinders the effectiveness of data assimilation due to the lack of timely updates on changing fire fronts. Aims: This paper proposed a distributed strategy combined with the Ensemble Transform Kalman filter (ETKF-distributed) for asynchronous observations. It can assimilate fire fronts immediately at any location by using new matching schemes between prediction and observation. Methods: The ETKF-distributed undergoes testing using a wildland fire generated based on real terrain, vegetation, and historical weather data from the local area. In addition, the ETKF and ETKF-centralised proposed in our previous work were employed as comparisons. Observing System Simulation Experiments were conducted to generate asynchronous observation fire fronts. Key results: The benefit of immediate assimilation enables the new method to maintain high accuracy predictions. Conclusions: The allocation of observation resources can be focused in regions with high rates of speed when employing ETKF-distributed. Implications: The ETKF-distributed has high efficiency and adaptability, making it highly promising for implementation in wildfire prediction. Observation composed of data from multiple moments is asynchronous observation, which will bring errors when performing data assimilation. This paper proposes a distributed strategy combined with the Ensemble Transform Kalman filter for asynchronous observation. It could conduct the analysis step immediately by a new matching scheme between prediction and observation. [ABSTRACT FROM AUTHOR]

Background: Every year, people in Canada are evacuated due to wildland fires to avoid death, injury, and illness from fire and smoke events. Aims: In this paper, we provide an overview of evacuations recorded in the Canadian Wildland Fire Evacuation Database between 1980 and 2021. Methods: Our analysis covers evacuations in Canada from 1980 to 2021. We provide summary statistics including number of evacuations and evacuees, evacuation duration, seasonality, evacuation causes, community types, structure losses, and fatalities. We also investigate temporal and spatial patterns. Key results: Between 1980 and 2021, there were 1393 wildland fire evacuation events with 576,747 people evacuated. During this period, there was an overall increase in frequency of evacuations, number of evacuees, and duration of events. Structure loss occurred during 194 evacuation events, with 4105 homes burned. We estimate wildland fire evacuations cost at least CAD3.7 billion (excluding structural losses), jumping to CAD4.6 billion if we include productivity losses. Indigenous peoples are disproportionately impacted in wildfire evacuations compared to the general Canadian population. Conclusions: Wildland fire evacuations continue to occur across Canada and are increasing. Implications: The findings from this study give us a better understanding of the characteristics of wildland fire evacuations, which can help guide emergency management. This paper summarises data on wildland fire evacuations in Canada between 1980 and 2021. There were 1393 wildland fire evacuation events with 576,747 people evacuated, costing approximately CAD4.6 billion CDN including productivity losses. [ABSTRACT FROM AUTHOR]

Within a few years of the establishment of the convict settlement at Sydney Cove, the potato became one of the staple crops of the population due to its relatively high yield and the prior experience of the convicts and free settlers with growing the crop. In 1894, Henry Tryon described a new disease in southern Queensland that caused rapid wilting of plants, a ring of slightly translucent tissue just below the surface of affected tubers, oozing of a thick, white fluid from the 'eyes', and ultimately rotting of the tubers. It soon became known as 'Tryon's disease'. He found that a microbe (bacterium) was always associated with affected tubers and stems, provided a very brief description of the bacterial cells and named the microbe Bacillus vascularum solani. A few years later the American scientist Erwin Frink Smith wrote a paper on a new disease (brown rot) of solanaceous plants including the potato and tomato, in which he called the causal agent Pseudomonas solanacearum , now known as Ralstonia solanacearum. Smith dismissed Tryon's prior claim to the discovery of the disease with some of his comments being personal and scathing. Tryon had the last word, however, cloaking his response in restrained and somewhat convoluted tones. In 1894, the Queensland government entomologist, and later vegetable pathologist, Henry Tryon (1856–1943) discovered a new disease that caused potato tubers to become rotted and putrid. He consistently found bacterial cells in a thick mucilaginous gum in the vascular tissues of wilted stems and infected tubers, and gave it the name Bacillus vascularum solani. The American bacteriologist Erwin Frink Smith would not accept Tryon's discovery, instead naming the causal agent Pseudomonas solanacearum. That bacterium, now called Ralstonia solanacearum is a significant plant pathogen worldwide. Photograph by an unknown person. [ABSTRACT FROM AUTHOR]

Acacia (the wattles) is the largest genus of plants in Australia and its species occupy almost every habitat in the country. Hard galls on the branches, phyllodes and flower parts of wattle trees were noticed from the very early days of British colonisation, but their causes were unknown. Some insects were believed to be involved, but they were not the only cause of wattle galls. In 1889, the Italian mycologist Pier Andrea Saccardo described the rust fungus Uromyces tepperianus from the galls on Acacia salicina , and later, the Victorian government vegetable pathologist, Daniel McAlpine transferred the species tepperianus to his new genus Uromycladium which also included six new species. A total of 28 valid species of Uromycladium , most endemic to Australia, are currently described. Several species of Uromycladium were somehow introduced into South Africa and countries in southeast Asia where they cause significant losses in Acacia plantations, while others are used as biocontrol agents for invasive Acacia species. Short biographies of two of the early collectors of rust galls, the South Australian naturalist and later entomologist Johann Gottlieb Otto Tepper and the Victorian plant pathologist Charles Clifton Brittlebank are also presented. The wattles (Acacia species) are an ancient and iconic Australian genus of trees and shrubs which form part of the identity of the nation. Galls were a common feature on wattle trees, initially being attributed to the activity of some insects, but later a genus of rust fungi, Uromycladium , was found to also cause galls. The lives of two of the early collectors of wattle rust galls, Otto Tepper and Charles Brittlebank, are also illuminated in this paper. Photograph by Alastair McTaggart. [ABSTRACT FROM AUTHOR]

Objective. This paper examines two aspects of treatment decision making: withdrawal of treatment decisions made by a patient; and decisions to not proceed with treatment by a health professional. The paper aims to provide an overview of the law relating to the provision of treatment, then highlight the uncertainty as to the meaning of and costs associated with futile treatment. Methods. The paper reviews the current legal and medical literature on futile treatment. Results. Continuing treatment which is futile is not in the patient's best interests. Futility may be understood in both quantitative and qualitative terms. Recent legal cases have expanded the definition of futility to focus not on the nature of the treatment itself, but also on the health of the patient to whom treatment is provided. Conclusions. As Australia's population ages, there is likely to be an increased focus on the allocation of scarce health resources. This will, inevitably, place constraints on the number and variety of treatments offered to patients. The level of constraint will be felt acutely where a proposed treatment offers little clinical efficacy. It is time to try to understand and agree on a workable definition of futility. [ABSTRACT FROM AUTHOR]

Background: The phenomenon of missed care has received increasing interest over the past decade. Previous studies have used a missed care framework to identify missed nursing tasks, although these have primarily been within the acute care environment. The aim of this research was to identify missed care specific to the role of the general practice nurse. Methods: An integrative review method was adopted, using The Mixed Methods Appraisal Tool to assist in a methodological appraisal of both experimental, theoretical, and qualitative studies. Thematic analysis was then used to analyse and present a narrative synthesis of the data. Data sources: CINAHL, SCOPUS, Web of Science and Google Scholar databases were searched between 2011 and 2022 for empirical research that reported missed care and the general practice nurse. Results: Of the 787 papers identified, 10 papers met the inclusion criteria. Three themes identified missed care in relation to primary healthcare nurses: under-staffing and resourcing, communication difficulties, and role confusion. Conclusion: Isolating missed care by general practice nurses was challenging because much of the research failed to separate out general practice nurses from community and primary health care nurses. This challenge was exacerbated by disparity in the way that a general practice nurse is defined and presented in the various databases. While some themes such as those related to communication and understaffing and resourcing demonstrate some parallels with the acute sector, more research is required to identify missed care specific to the general practice nurse. Identifying missed nursing care is an important avenue to achieving improvements in patient care. Predominantly undertaken in the acute sector, there is a need to expand missed care research to the primary healthcare sector. We conducted an integrative review to determine missed care and the general practice nurse. Some commonalities between the primary health and acute sectors were identified such as issues with communication and resource availability. Recent calls for general practice nurses to work to the top of their scope involve a more nuanced understanding of the role, and what is being missed. [ABSTRACT FROM AUTHOR]

Global demand for animal protein is on the rise, but many practices common in conventional production are no longer scalable due to environmental impact, public health concerns, and fragility of food systems. For these reasons and more, a pressing need has arisen for sustainable, nutritious, and animal welfare–conscious sources of protein, spurring research dedicated to the production of cultivated meat. Meat mainly consists of muscle, fat, and connective tissue, all of which can be sourced and differentiated from pluripotent stem cells to resemble their nutritional values in muscle tissue. In this paper, we outline the approach that we took to derive bovine embryonic stem cell lines (bESCs) and to characterise them using FACS (fluorescence-activated cell sorting), real-time PCR and immunofluorescence staining. We show their cell growth profile and genetic stability and demonstrate their induced differentiation to mesoderm committed cells. In addition, we discuss our strategy for preparation of master and working cell banks, by which we can expand and grow cells in suspension in quantities suitable for mass production. Consequently, we demonstrate the potential benefits of harnessing bESCs in the production of cultivated meat. Global demand for sustainable, nutritious, and animal welfare–conscious protein sources encourages research dedicated to the production of cultivated meat. In this paper, we outline the approach that we took to produce bovine embryonic stem cell lines and present our strategy to expand and grow cells in quantities suitable for mass production. Our work demonstrates the potential benefits of harnessing bESCs in the production of cultivated meat. Photograph by Dr. Irena Vertkin (researcher, R&D department, Aleph Farms). [ABSTRACT FROM AUTHOR]

Context. The aim of farm-systems research is to test concepts in a holistic context that enables results to be as applicable as possible to commercial farmers. A downside of such research has been that it can take several seasons to be confident in the consistency of the outcomes and interpretation of the results. Scientists are often reluctant to communicate outcomes until they have clear conclusions, which conflicts with farmers' desire to see rapid answers and engage with research. Aims. This paper reviews a 3-year farm-systems research project investigating flexible milking strategies for New Zealand dairy farmers. The aims of this paper are to (1) examine the impact of real-time science communication in achieving farm system change, and (2) develop a framework for science communication and engagement in adaptive farm-systems research. Methods. The project involved farmer interviews, a farmlet experiment, a component experiment, partner farms, modelling, and a farmer reference group. We use data from sources such as e-newsletter engagement, webinar participation, web-page engagement, presentation attendance, and farmer feedback to collect insights on the impact of the project. Key results. The analysis highlighted that farmers do not always seek complete information and will follow a project as it evolves, particularly when it is highly topical. We propose a framework for delivering adaptive farm systems research and communication. The framework includes the critical aspects for real-time farm-systems research: credible evidence, rapid results, inclusion of farmer voices, meaningful outcomes, flexible communication channels, iterative feedback loops, and adaptable research design. Conclusion. Farm-systems research can be designed to communicate results to farmers as a project develops, while simultaneously using the engagement with farmers to refine the direction of the research. Implications. This framework can guide scientists leading multi-year farm systems projects to design, implement, and communicate the project outcomes to improve farmer engagement and adoption. [ABSTRACT FROM AUTHOR]

What is known about the topic ? Governments acknowledge that current health arrangements are unsustainable, and a better resourced, integrated, and connected primary care system is central to the future. What does this paper add ? This paper calls out the most significant barriers to implementing the required national reform and poses potential solutions in addressing them. What are the implications for practitioners ? Without action, we will see increased system cost, and decreased service access and quality for Australian communities. [ABSTRACT FROM AUTHOR]

This document is a special edition of Animal Production Science that features a selection of papers presented at the 2022 Australasian Dairy Science Symposium (ADSS). The symposium, held in Queensland, focused on pastoral dairy systems and addressed challenges such as climate change, competition from plant-based alternatives, and resource efficiency. The special issue covers various topics including dairy cattle welfare, heat stress on dairy production, grazing dairy cows, artificial breeding strategies, and greenhouse gas emissions from dairy systems. The ADSS expresses gratitude to the authors, reviewers, and sponsors for their contributions and support. [Extracted from the article]

The ninth International Conference on Forest Fire Research (ICFFR) was recently held in Coimbra, Portugal, bringing together scientists and fire managers from around world to advance and update knowledge in the area of fire management. The conference was held jointly with the International Association of Wildland Fire's 17th International Wildland Fire Safety Summit (IWFSS). Here we introduce Part 1 of a special issue series arising from the 2022 ICFFR/IWFFS joint meeting. This issue of the International Journal of Wildland Fire contains eight papers covering a wide variety of topics including: seasonal fire activity and spatio-temporal fire-weather patterns under climate change, the role of atmospheric conditions on fire and flaming zone behaviour, analytical techniques for measuring oxidative pyrolysis gases, particulate morphology of fires in the wildland–urban interface, deep peat fire smouldering and the impact of post-fire treatments on soil. All papers in the issue are published Open Access. Here we introduce Part 1 of a special issue series arising from the IX International Conference on Forest Fire Research, held 14–18 November 2022, Coimbra, Portugal. This issue comprises eight papers covering a wide variety of topics. All papers in the issue are published Open Access. [ABSTRACT FROM AUTHOR]

Objectives: Internationally, hip or knee arthroplasty (TJA) with a 1-day hospital length of stay (LOS) is common and demonstrates improved patient and health service outcomes. This study aimed to develop and pilot an enhanced recovery program (ERP) for patients undergoing TJA to achieve a next-day discharge in an Australian public hospital setting. Methods: A project lead and six perioperative clinical craft group leads developed an ERP protocol based on enhanced recovery after surgery (ERAS) principles. Strict patient eligibility criteria were developed. Quality improvement methodology was used to implement the ERP. A patient navigator was put in place as a single contact point for patients. Results: A total of 825 patients were screened for the ERP and 47 patients completed the protocol. The mean ± standard deviation (s.d.) of the LOS was 34.7 (± 7.2) h with 41 patients (87%) achieving next-day discharge, the remaining six (13%) discharged on Day 2. Compliance with ERAS was high (96%) with mobilisation within 12 h occurring on 87% of occasions. There were no adverse events. Patient experience was positive. Conclusion: Next-day discharge was achieved with a selected cohort of patients with no adverse events and positive patient experience, using a multidisciplinary approach and an improvement framework. Broadening inclusion criteria will make ERP available to more patients. What is known about the topic? Next-day discharge following hip or knee arthroplasty in Australian public hospital settings is uncommon and little has been published reflecting enhanced recovery principles in this local context. What does this paper add? This paper describes the development and piloting of an enhanced recovery program using a novel approach to achieve next-day discharge following hip and knee replacement. What are the implications for practitioners? Other health services may leverage this approach to design and implement an enhanced recovery program to reduce hospital length of stay and improve patient and health service outcomes. [ABSTRACT FROM AUTHOR]

Objective: HealthPathways is a web-based platform designed for use during a consultation to offer health professionals locally agreed information to support clinical and referral decision making. This study aimed to investigate whether access to specific HealthPathways pages in the North Coast New South Wales (NSW) region increased during specific critical events. High pageviews is used as a proxy for platform usefulness, and/or trust as a source of up-to-date information. Methods: Data were extracted from Google Analytics from December 2015 to December 2021. Descriptive statistics were generated for the total number of pageviews for all pages by month and year (2015–2021); for the top 15 most viewed pages in 2019, February–March 2020 inclusive (early COVID-19 pandemic period), 10–24 March 2021 (North Coast NSW region local disaster declaration period) and 26 June–11 October 2021 (NSW COVID-19 lockdown period); and for monthly pageviews for the Influenza Immunisation pathway (2016–2021). Results: Access to specific pages in HealthPathways increased alongside the occurrence of critical events affecting the region. Spikes in access to specific pages were seen during COVID-19 lockdown periods, during natural disasters, as well as during the annual influenza season. Conclusions: HealthPathways is viewed as a useful and trusted source of information for health professionals in the North Coast NSW region. HealthPathways provides an opportunity for timely dissemination of information during critical events, including natural disasters and emergencies. What is known about the topic? Evidence from New Zealand suggests that HealthPathways is viewed as a useful and trusted source of information by health professionals during critical and emergency events, and when information needs are subject to frequent change. What does this paper add? This paper provides evidence in the Australian context that health professionals access specific pages in HealthPathways at higher rates during critical and emergency events. What are the implications for practitioners? HealthPathways has the capacity to provide timely and accurate information to health professionals during critical and emergency events, as well as to identify their emerging information needs. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate patient outcomes from a 12-month pilot program establishing specialist surgical services in a small rural (Modified Monash Model, MM4) hospital on the south coast of NSW. Methods: Suitable patients for ambulatory surgery were selected based on strict anaesthetic, surgical and social criteria. Skills shortfalls among nursing staff, usually with emergency or inpatient experience, were addressed by appropriate re-training and in-service training in scrub, scout and anaesthetic duties. An anonymous post-operative patient survey was administered during the pilot program, which assessed patient experiences and outcomes. Of 162 patients undergoing surgery during the pilot, 50 consecutive participants completed the survey. Results: Of the 161 procedures during the pilot program, 100 were performed under sedation and locoregional anaesthesia and 62 under general anaesthesia. Half (n = 86, 53.4%) were complex excisions of malignant skin lesions, and of these 63% also required either a skin graft or local flap repair. Survey respondents reported adequate information and pain relief upon discharge (n = 45, 96%) and 100% were satisfied with the care received. No respondents needed to see a doctor following discharge. There were no mortality events or major issues of morbidity during the study period or subsequently, no further overnight admissions or return to theatre and no re-presentations within 48 h of operating. Two superficial surgical site infections were reported. Conclusions: There is merit in drawing on underutilised resources in small rural hospitals in support of initiatives to reduce surgical waitlists. Appropriate outpatient surgeries can be safely performed with high levels of patient satisfaction. What is known about the topic? Waitlist reduction strategies are required to deal with long surgical waitlists. Rural surgical services are declining due to centralisation of these services in larger hospitals. What does this paper add? Significant positive benefits arise from providing an ambulatory, rural surgical service. This paper provides an evidence base for rural hospitals to explore the benefits of re-activating, or increasing utilisation of, existing operating theatre facilities. What are the implications for practitioners? Significant reductions in surgical waitlists within health services can be safely achieved by servicing rural patients at their local hospital for some ambulatory procedures. [ABSTRACT FROM AUTHOR]

Background: While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. Methods: A semi-structured focus group was conducted with rehabilitation clinicians and those with lived experience of paediatric acquired brain injury (ABI). The 90-min focus group was audio-recorded and transcribed verbatim. Data were thematically coded and mapped against the Theoretical Domains Framework (TDF) to understand influencing factors, which were then linked to the Capability, Opportunity, Motivation – Behaviour (COM-B) model. Results: A total of 11 participants (nine paediatric rehabilitation clinicians, one parent and one young person with lived experience of paediatric ABI) participated in the focus group. Factors influencing collaborative goal setting mapped to the COM-B and six domains of the TDF: Capabilities (Skills, Knowledge, Beliefs about capabilities, and Behavioural regulation), Opportunities (Environmental context and resources), and Motivation (Social/professional role and identity). Results suggest that a multifaceted intervention is needed to enhance rehabilitation clinicians' and families' skills and knowledge of goal setting, restructure the goal communication processes, and clarify the roles clinicians play in goal setting within the interdisciplinary team. Conclusion: The use of the TDF and COM-B enabled a systematic approach to understanding the factors influencing goal setting for children with acquired brain injury in a large interdisciplinary rehabilitation team, and develop a targeted, multifaceted intervention for clinical use. These represent important considerations for the improvement of collaborative goal setting in paediatric rehabilitation services to ensure that best practice approaches to goal setting are implemented effectively in clinical practice. While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. This article belongs to the Collection Clinical Implementation to Optimise Outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite availability of vaccines or medical prophylaxis for some sexually transmissible infections (STIs), promoting condom use remains an important public health strategy for the prevention of STIs. Recent research shows that regular condom use among young people in Australia has declined over the past decade, while the rate of common STIs has increased. Method: In this paper, we report findings from a large survey of school-aged young people in Australia (14–18 years old) in which we looked at the association between condom use and positive feelings about sex, beliefs about social acceptability of condoms and confidence talking with partners about sex and condoms. Results: Communication and relational factors supported more consistent condom use. Participants were more likely to regularly use condoms if they discussed condom use with a sexual partner, perceived condom use to be easy (a measure that included perceived ease of discussing condoms with a partner) and perceived condom use to offer social or relational benefits, including perceiving condom use as a demonstration of care for a partner. Young men were more likely to report positive feelings about sex and regular condom use than young women. Young women were less likely than young men or trans and non-binary young people to report regular condom use. Conclusions: The study shows the importance of supporting young people to build confidence expressing sexual needs and wants with partners. Public health approaches to STI prevention need to consider condom promotion in the context of young people's contemporary sexual, gendered and relationships cultures. This paper reports findings from a survey of school-aged young people in Australia looking at use of, and attitudes toward condoms. Social and relationship factors were most strongly associated with regular condom use, including feeling confident to talk about safer sex with a sexual partner. The paper highlights the importance of working with young people to build confidence and capacity to communicate about sex and condom use. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the development and implementation of a co-designed value-based healthcare (VBHC) framework within the public dental sector in Victoria. Methods: A mixed-method study was employed. Explorative qualitative design was used to examine patient, workforce and stakeholder perspectives of implementing VBHC. Participatory action research was used to bring together qualitative narrative-based research and service design methods. An experience-based co-design approach was used to enable staff and patients to co-design services. Quantitative data was sourced from Titanium (online patient management system). Results: Building a case for VBHC implementation required intensive work. It included co-designing, collaborating, planning and designing services based on patient needs. Evidence reviews, value-stream mapping and development of patient reported outcomes (PROMs) and patient reported experience measures (PREMs) were fundamental to VBHC implementation. Following VBHC implementation, a 44% lower failure to attend rate and 60% increase in preventive interventions was reported. A higher proportion of clinicians worked across their top scope of practice within a multi-disciplinary team. Approximately 80% of services previously provided by dentists were shifted to oral health therapists and dental assistants, thereby releasing the capacity of dentists to undertake complex treatments. Patients completed baseline International Consortium for Health Outcomes Measurement PROMs (n = 44,408), which have been used for social/clinical triaging, determining urgency of care based on risk, segmentation and tracking health outcomes. Following their care, patients completed a PREMs questionnaire (n = 15,402). Patients agreed or strongly agreed that: the care they received met their needs (87%); they received clear answers to their questions (93%); they left their visit knowing what is next (91%); they felt taken care of during their visit (94%); and they felt involved in their treatment and care (94%). Conclusion: The potential for health system transformation through implementation of VBHC is significant, however, its implementation needs to extend beyond organisational approaches and focus on sustaining the principles of VBHC across healthcare systems, policy and practice. What is known about the topic? Value-based healthcare (VBHC) has gained significant momentum within the healthcare sector and is seen as a driver for improving patient outcomes and equitable use of resources. What does this paper add? The paper describes firsthand experience and lessons learnt from implementing VBHC within a Victorian public healthcare system; the learnings are applicable to other organisations wanting to implement VBHC. What are the implications for practitioners? In implementing a co-designed VBHC framework, we ensured that its principles are applicable at both patient and population levels, centres on equity of access to care, achieves the best possible health outcomes and sustainable use of resources. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Objective: Clinician's experiences of providing care are identified as a key outcome associated with value-based healthcare (VBHC). In contrast to patient-reported experience measures, measurement tools to capture clinician's experiences in relation to VBHC initiatives have received limited attention to date. Progressing from an initial 18-item clinician experience measure (CEM), we sought to develop and evaluate the reliability of a set of 10 core clinician experience measure items in the CEM-10. Methods: A multi-method project was conducted using a consensus workshop with clinicians from a range of NSW Health local health districts to reduce the 18-item CEM to a short form 10-item core clinician experience measure (CEM-10). The CEM-10 was deployed with clinicians providing diabetes care, care for older adults and virtual care across all districts and care settings of New South Wales, Australia. Psychometric analysis was used to determine the internal consistency of the tool and its suitability for diverse clinical contexts. Results: Consensus building sessions led to a rationalised 10-item tool, retaining the four domains of psychological safety (two items), quality of care (three items), clinician engagement (three items) and interprofessional collaboration (two items). Data from four clinician cohorts (n = 1029) demonstrated that the CEM-10 four-factor model produced a good fit to the data and high levels of reliability, with factor loadings ranging from 0.77 to 0.92, with Cronbach's alpha (range: 0.79–0.90) and composite reliability (range: 0.80–0.92). Conclusions: The CEM-10 provides a core set of common clinician experience measurement items that can be used to compare clinician's experiences of providing care between and within cohorts. The CEM-10 may be supported by additional items relevant to particular initiatives when evaluating VBHC outcomes. What is known about the topic? Clinician experience of providing care is an outcome of interest for health systems and services internationally who are implementing value-based care initiatives. Review evidence indicates that measurement of clinician's experience of providing care should address experiences of being able to deliver quality care, collaborate with colleagues, experience psychological safety and engagement in decision-making in the workplace. What does this paper add? The paper reports the development of the short form clinician experience measure (CEM-10) and its initial validation in four value-based healthcare initiatives of NSW Health. What are the practical implications for practitioners? The CEM-10 can be used as a core set of items embedded within evaluations of value-based care initiatives to benchmark and examine experiences across clinician cohorts. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Millions of Australians use the private health system every year. They should receive safe, high-quality, value-based care. However, poor policy and inadequate regulation of medical technology is driving low-value care at great expense to consumers and the broader health system. Key drivers include the Prescribed List of Medical Devices and Human Tissue, gaps in quality and safety controls for devices being used, and marketing and conflicts of interest. All of these should be addressed to reduce low-value care in Australia's private health system, so consumers are protected from harm and limited health budgets are used effectively. What is known about the topic? With health expenditure rising unsustainably, there is a growing focus on ways to reduce low-value care to improve health outcomes and eliminate unnecessary costs. What does this paper add? This paper details drivers of low-value care in Australia's private health system and recommendations to overcome them. Drivers include the Prescribed List of Medical Devices, gaps in safety and quality controls, and conflicts of interest and marketing. What are the implications for practitioners? These insights are relevant to clinicians, researchers, policymakers, consumers and health business leaders with an interest in low-value care. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Value-based healthcare has been described as the sustainable, equitable and transparent use of healthcare resources to achieve improved experiences and outcomes for people and communities. It is supported by all levels of government in Australia, with recent initiatives championing a shift away from traditional, clinician-centric care delivery to a more contemporary, value-based approach. To date, however, efforts in Queensland have focused on smaller scale siloed models of care and have not extended to the transformational change required to create equitable and sustainable healthcare delivery. The Queensland Health Allied Health Framework for Value-Based Health Care (the Framework) builds on contemporary frameworks with reference to the local context in Queensland and provides a structure and starting point for clinicians and managers to work together with consumers to transform services to focus on preventative health and wellbeing, shifting the focus of care to the community and sustainably improving the quality of care delivered. The Framework outlines key considerations for the design and implementation of new services, including understanding the care pathway, supporting an outcome driven workplace culture, measuring what matters and designing for outcomes. Several key lessons were learnt during the development of the Framework, including the importance of early and sustained consumer partnerships, of establishing a shared definition of value-based healthcare that enables integration across the care pathway and the need for leadership at all levels to actively support the change management process. While developed for Queensland public allied health services, the Framework is intended to be a system-wide tool relevant to all health professionals and services. What is known about the topic? Value-based healthcare provides an approach to restructure healthcare systems to improve health outcomes and the holistic experience of care for people and communities. What does this paper add? This paper details the development of a framework to support health services to transition to a value-based approach. What are the implications for practitioners? By reflecting on the diversity of health practitioners, managers and consumer experiences and the unique opportunities and challenges of individual healthcare services, the framework provides a structure and starting point for services to transition to value-based healthcare. This article belongs to the Special Issue: Value-Based Healthcare. [ABSTRACT FROM AUTHOR]

There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally. What is known about the topic? There is limited palliative care support for the 36% of Australians who die in residential aged care. What does this paper add? This paper describes the development of the Specialist Palliative Care in Aged Care (SPACE) Project, using locally tailored models of care to improve palliative and end-of-life care in aged care facilities across Queensland. What are the implications for practitioners? Critical elements for improving residents' palliative and end-of-life care included creation of an expert working group to define the innovation state-wide, a central project team that supported implementation, a community of practice, and local facilitation. [ABSTRACT FROM AUTHOR]

This case study details the approach utilised to establish an easy to use, accessible and sustainable method for routine collection of Patient Reported Outcome Measures for patients newly diagnosed with lung cancer. We sought to enhance communication with patients and their families, particularly around shared decision making, their quality of life and symptoms, as well as the impacts of their care or treatment. We detail the co-design methodology utilised with consumers and healthcare providers to develop and implement a multi-lingual, fully automated digital care pathway which has been proven to be highly impactful and powerful for both healthcare providers working within the service and consumers enrolled within the digital pathway. This innovative initiative has changed the practice of the lung cancer service across a health service. Furthermore, its success has evolved the organisational strategy, to embed 'Outcomes for Impact' across the health service. What is known about the topic? While much has been written about the benefits of digital health, there are few practical examples of how a digital initiative, developed and implemented with clinicians and consumers, can positively change a healthcare service. What does this paper add? This paper discusses the importance of developing new digital healthcare services with the end user through co-design. A fully automated lung cancer digital care pathway and the lessons learned in implementation of the pathway are presented. This initiative was implemented within a public hospital to provide a service that has a vision of value-based health care and a person centric approach to care. What are the implications for practitioners? This study illustrates how the implementation of a digital care pathway for the monitoring and treatment of lung cancer can provide an approach that moves from reactive to proactive care. The implementation of the digital care pathway has positively changed the lung cancer service in a rapidly growing area. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Deer antlers are unique because they are cast and regenerate each year. They are the fastest-growing structure, reaching an astonishing growth rate of up to 2.75 cm/day in length and more than 20 cm2/day of skin. Surprisingly, no study so far has assessed the metabolic rate of the antler. High metabolic rate needs highly efficient (or large) mitochondria, and it involves a high creation or reactive oxygen species (ROS), origin of oxidative stress. The speed of creation of ROS and the oxidative stress are inversely related to ageing and many diseases such as cancer or age-related diseases. However, antler must have the most efficient anti-oxidant system, as it rarely shows any departure from a perfect growth. This paper examines recent studies showing surprising applications in medicine of growing-antler extracts, or the information regarding its physiology. A recent study (Wang et al. (2019) , Science 364, eaav6335) has shown that antlers have evolved a speed of growth faster than cancer, based on high expression of proto-oncogenes. As a result, deer has evolved tumour-suppression genes to control the high risk of developing cancer. This may explain why several studies have found in vitro and in vivo anti-cancer effects of deer velvet-antler extract in human tumours, such as cell cultures and animal models of cancers such as brain cancer (glioblastoma), prostate cancer, and others. We will also discuss findings in the study of the cyclic osteoporosis of the deer, with unexpected similarities in their proteomics and gene expression with that of the human pathological osteoporosis. Last, we will examine potential applications based on having the highest metabolic rate. If the future studies establish the antler as the tissue having the fastest metabolism and the best antioxidant system, this may have implications for understanding how to fight oxidative stress, which, in turn, will have direct implications for aging and age-related diseases (and others, from cancer to osteoporosis and Alzheimer's for example). It may also show that velvet-antler extract is a general anti-cancer compound, and this may show the path to find an anti-cancer medicine that has no secondary toxic effects in healthy cells. Antler is the only mammal structure regenerating each year, and it is the fastest-growing tissue (much faster-growing than cancer). For this reason, several interesting medical applications are reviewed in this paper, such as anti-cancer activity of growing-antler extract. Studying growing antler may help develop powerful and general anti-cancer treatments without secondary effects, and the high metabolic rate and antioxidant system of the antler may also have other potential medical applications, such as delaying aging- or fight-associated diseases. [ABSTRACT FROM AUTHOR]

Health justice partnerships (HJP) are innovative models for delivering integrated health and legal services to people experiencing complex issues. An HJP was established in regional Victoria, Australia, for young people. Promoting the program to young people and workers was essential for program uptake. There is a dearth of published information about strategies that support program promotion for young people and workers. In this practice and innovation paper, three promotional strategies were employed: a dedicated program website, secondary consultations, and legal education and information sessions. Each strategy is examined, with information presented about why and how these strategies were implemented alongside this HJP. The strengths and limitations of each strategy are explored, with some strategies appearing to engage audiences with the program more than others. The insights about each of the strategies established for this program may inform other HJPs with their planning and implementation for increased program awareness. This paper offers insights about strategies for promoting service uptake of a health justice partnerships for young people, external workers and partner agency staff. Various methods for promotion were implemented. Practical considerations are offered to assist others when promoting HJPs. [ABSTRACT FROM AUTHOR]

INTRODUCTION: There are important changes in the health care needs of women presenting to general practice in New Zealand, which prompted an evaluation of postgraduate training needs of general practitioners (GPs) who care for women in the community. AIM: To evaluate the perceived relevance of the curriculum of Otago University postgraduate programmes in women's health to GPs' work profile to identify any need for curricular change. This study was also performed to investigate the need for refresher courses or a Master's degree in obstetrics, gynaecology and women's health. METHODS: In total, 426 GPs and GP trainees who had completed the postgraduate Certificate and Diploma programmes in women's health were invited to complete an online survey. The survey consisted of multiple-choice questions with five-point Likert scale ratings to rate the relevance of papers to general practice, and options for free-text comments. RESULTS: There were 86 responses (20.2% response rate) and we analysed 73 (17.1%). Curriculum modules related to gynaecological care were rated as more relevant than obstetric and newborn care. GPs suggested more training in contraception and management of infertility, abnormal uterine bleeding and pelvic pain including procedural skills such as insertion of long-acting reversible contraceptives, implants and intrauterine devices. An interest in a refresher course was indicated by 76.6% of GPs. DISCUSSION: GPs recognised the need for enhanced training in women's gynaecological care. Revision of the postgraduate women's health curriculum and development of new refresher courses will enable GPs, trainees and prospective GPs to improve their care for women in the community. [ABSTRACT FROM AUTHOR]

What is known about the topic? Little is known about the state of mental health reform in Australia. This article describes the struggle to develop the systems of accountability necessary to assess national progress. What does this paper add? We provide some historical context regarding mental health reform and consider recent efforts in particular, before then describing current key opportunities. What are the implications for practitioners? Many people working in mental health are struggling to deliver quality services to Australians. This paper considers the broad policy issues which have led to this situation. This is useful for practitioners who can then better respond and participate in processes of systemic reform. Opportunities to engage now in key policy formulation are identified in the article. [ABSTRACT FROM AUTHOR]