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Background Direct-to-consumer (DTC) electronic prescription services (EPS) are a novel addition to the Australian healthcare landscape. This study aimed to explore consumers’ perceptions on how this model of care supports the delivery of best-practice care. Method Focus groups participants were recruited through social media and included adults aged 18 years or older, Queensland (Australia) residents, and interested in DTC EPS. Focus groups were conducted via Zoom ® and repeated until data saturation. Inductive thematic analysis was undertaken to elicit consumer perception themes from focus group discussions and field notes. Results Three focus groups were conducted between July and August 2022 and included 13 participants of which two (15%) had previously used DTC EPS. Four major perception themes were induced: (a) Consumer responsibility. There is an assumed level of consumer health literacy leading to an unacceptable burden of responsibility on the patient; (b) System processes appear to be underdeveloped to support best-practice care; (c) Access to convenient and timely healthcare will be improved for many patients, however, out of pocket expenses may promote inequity; and (d) Service model improvements can address safety and quality concerns including integration of the model within existing national digital health platforms. Conclusion Participants believed that DTC EPS was a valuable addition to the Australian health care landscape increasing convenient and timely access to medicines for consumers. Participants were concerned that a heavy reliance on health literacy and underdeveloped system processes may lead to unsafe prescribing.

Tremor, headache and insomnia have been linked to the immunosuppressant, tacrolimus. The aim of this systematic review was to determine if there is a correlation between tacrolimus exposure and new-onset tremor, headache and insomnia experienced by adult kidney transplant recipients. PubMed, Embase, Cochrane Library and CINAHL databases were searched up to 11 April 2023 for published studies which reported on tacrolimus exposure in adult kidney transplant recipients, alongside information on treatment-emergent neurologic manifestations, including tremor, headache and insomnia. Review articles, case studies, conference abstracts and articles not published in English in peer-reviewed journals were excluded. The Physiotherapy Evidence Database and Newcastle-Ottawa Quality Assessment Scales were used to assess risk of bias. Extracted data was analysed via a narrative synthesis. Eighteen studies involving 4030 patients in total were included in the final analysis. These comprised five randomised control trials and thirteen observational studies. Studies failed to find significant association between tacrolimus trough concentrations in whole blood and the incidence of neurologic side effects such as tremor, headache and insomnia; however, in one study the incidence of toxicity requiring a dose reduction increased with increasing, supratherapeutic targeted levels. Females, especially Black females, and older age were positively associated with the prevalence of neurologic adverse effects. Results were conflicting regarding whether extended-release formulations were associated with fewer neurologic complications than immediate-release formulations. The varied study designs and criteria for reporting tremor, headache and insomnia impacted on the quality of the data for exploring the relationship between tacrolimus exposure and the onset of neurologic manifestations experienced after kidney transplantation. Studies that examine defined neurologic complications as the primary outcome, and that consider novel markers of tacrolimus exposure while assessing the potential contribution of multiple covariate factors, are required. • The association between tacrolimus exposure and tremor has yet to be identified. • Neurologic complications of tacrolimus therapy are linked to several determinants. • New exposure metrics are needed to identify and reduce tacrolimus' toxicity risk. [ABSTRACT FROM AUTHOR]

On September 20-22 September 2023, the international conference 'Microbiology 2023: from single cell to microbiome and host' convened microbiologists from across the globe for a very successful symposium, showcasing cutting-edge research in the field. Invited lecturers delivered exceptional presentations covering a wide range of topics, with a major emphasis on phages and microbiomes, on the relevant bacteria within these ecosystems, and their multifaceted roles in diverse environments. Discussions also spanned the intricate analysis of fundamental bacterial processes, such as cell division, stress resistance, and interactions with phages. Organized by four renowned Academies, the German Leopoldina, the French Académie des sciences, the Royal Society UK, and the Royal Swedish Academy of Sciences, the symposium provided a dynamic platform for experts to share insights and discoveries, leaving participants inspired and eager to integrate new knowledge into their respective projects. The success of Microbiology 2023 prompted the decision to host the next quadrennial academic meeting in Sweden. This choice underscores the commitment to fostering international collaboration and advancing the frontiers of microbiological knowledge. The transition to Sweden promises to be an exciting step in the ongoing global dialogue and specific collaborations on microbiology, a field where researchers will continue to push the boundaries of knowledge, understanding, and innovation not only in health and disease but also in ecology., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of FEMS.)