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INTRODUCTION: The objective of this study was to investigate the diagnostic potential of bacterial biomarkers by comparing the performance of molecular detection assays with clinical assessments of dogs oral health performed by veterinarians. METHODS: Supragingival and subgingival plaque samples were collected from 127 client-owned dogs, pre-booked for procedures under general anesthesia, visiting veterinary practices in the United States. DNA was extracted and bacterial biomarkers quantified using quantitative polymerase chain reaction. Gingivitis and periodontitis were recorded by a trained clinician using the Weighted Gingivitis Periodontitis Score which involved assessing the buccal surfaces of 18 teeth while under general anesthesia. Intraoral dental radiographs of the left and right mandibular first molar teeth were also obtained. These data were then used to establish the diagnostic performance of the molecular assay to detect periodontitis. RESULTS: An initial conscious, visual oral examination performed by the veterinarian identified 67.7% of dogs as having periodontitis, but examination under general anesthesia indicated a higher proportion (86.6%). Analysis of supragingival plaque samples collected by veterinarians from conscious and unconscious dogs demonstrated the assay had an accuracy of 77.7 to 80.9%, a sensitivity of 77.6 to 81.0%, and a specificity of 80.0%. DISCUSSION: Use of this molecular screening tool in conscious dogs has the potential to improve early periodontal disease detection and support veterinary decision making, ultimately improving the oral health of dogs and consequently their quality of life.

Introduction: The objective of this study was to investigate the diagnostic potential of bacterial biomarkers by comparing the performance of molecular detection assays with clinical assessments of dog's oral health performed by veterinarians. Methods: Supragingival and subgingival plaque samples were collected from 127 client-owned dogs, pre-booked for procedures under general anesthesia, visiting veterinary practices in the United States. DNA was extracted and bacterial biomarkers quantified using quantitative polymerase chain reaction. Gingivitis and periodontitis were recorded by a trained clinician using the Weighted Gingivitis Periodontitis Score which involved assessing the buccal surfaces of 18 teeth while under general anesthesia. Intraoral dental radiographs of the left and right mandibular first molar teeth were also obtained. These data were then used to establish the diagnostic performance of the molecular assay to detect periodontitis. Results: An initial conscious, visual oral examination performed by the veterinarian identified 67.7% of dogs as having periodontitis, but examination under general anesthesia indicated a higher proportion (86.6%). Analysis of supragingival plaque samples collected by veterinarians from conscious and unconscious dogs demonstrated the assay had an accuracy of 77.7 to 80.9%, a sensitivity of 77.6 to 81.0%, and a specificity of 80.0%. Discussion: Use of this molecular screening tool in conscious dogs has the potential to improve early periodontal disease detection and support veterinary decision making, ultimately improving the oral health of dogs and consequently their quality of life. [ABSTRACT FROM AUTHOR]

This document is a tribute to two individuals, David Lowenthal and Paul Cantor. David Lowenthal was known for his moral authority and his ability to confront individuals whose behavior offended society. He was also a professor of political science at Boston College and successfully established a department devoted to political philosophy. Paul Cantor, on the other hand, was a self-described "fat Jewish boy" who enjoyed the pleasures of food and wine. He was a well-traveled individual with a deep appreciation for art, music, and literature. Cantor was a student of political philosophy and had a particular interest in the reconciliation of spontaneous order and regime. He applied this concept to the analysis of Shakespeare's plays, becoming a master in the field. Cantor also had a wide range of interests and published numerous articles on various topics. Overall, both Lowenthal and Cantor made significant contributions to their respective fields and left a lasting impact. [Extracted from the article]

In recent studies of housing financialisation, a "financial paradox" has been identified in which owner-occupied houses are simultaneously places of ontological security and financial investment. This paradox influences the way owner-occupiers interpret their primary and holiday houses, particularly if the latter are located in sought after high amenity locations. In this paper, we argue that, faced with rapidly increasing residential property prices, many long-term owners reluctantly reconceptualise their understanding of their holiday house as both a recreational and financial asset. Our study uses in-depth interviews with owners of holiday houses on Waiheke Island, Auckland, Aotearoa New Zealand to identify how they are interpreting and managing the normalisation of this paradox. The island is historically popular for holiday houses and is currently experiencing substantial property price increases. It is therefore an ideal place to study the complex and paradoxical nature of housing financialisation and thus potential biases in the housing market. [ABSTRACT FROM AUTHOR]

There is growing interest in the use and utility of news media content analysis in tourism research. We report a content analysis of 153 news media articles on a topic of growing interest among tourism researchers globally: tourism and biosecurity. Our work is based on media reports from Aotearoa New Zealand news sources over the period 2009–2019, identifying five key themes. Together they illustrate how tourism, nature conservation, agriculture, horticulture and forestry are utterly and irretrievably interconnected in global flows of people and organisms. They also highlight the important role played by the many actors at policy and operational levels in tourism and border control that have a role to play in minimising potential impacts of biosecurity breaches. We conclude by discussing the value of media content analyses in tourism research stressing that the method, on its own, will reveal only part of the story, and should always be followed up with more intense and critical interrogation of the issues under study. [ABSTRACT FROM AUTHOR]

The global burden of skin diseases affects over 3 billion individuals, posing important public health challenges worldwide, with profound impacts in both high-income and low-income and middle-income countries. These challenges are exacerbated by widespread disparities in access to dermatologic care and the prevalence of misinformation. This article, derived from the Skin and Digital Summit at the International Master Course on Aging Science critically evaluates how digital technologies such as artificial intelligence, teledermatology, and large language models can bridge these access gaps. It explores practical applications and case studies demonstrating the impact of these technologies in various settings, with a particular focus on adapting solutions to meet the diverse needs of low-income and middle-income countries. In addition, the narrative highlights the ongoing conversation within the dermatologic community about the role of digital advances in health care, emphasizing that this discussion is dynamic and the one that is continuously evolving. Dermatologists play an essential role in this transition, integrating digital tools into mainstream care to complement a patient-centered, culturally sensitive approach. The article advocates for a globally coordinated digital response that not only addresses current disparities in skin health care but also promotes equitable access to digital health resources, making dermatologic care more representative of all skin types and accessible worldwide.

Introduction: Homelessness is associated with a variety of stressors, including safety concerns, and uncertainty about the future as well as stigmatization, that can lead to or exacerbate pre-existing physical and mental health issues. This study explores the association between stress, hope, stigmatization, and social support among youth experiencing homelessness. Method: Quantitative, cross-sectional survey data were collected on n = 100 youth between the ages of 18 - 29 (60% identified as men, 28% as women, and 10% as transgender/gender diverse) experiencing homelessness in New York City. Result: Transgender or gender-diverse youth reported lower levels of hope and social support compared to the rest of the sample. Additionally, participants identifying as lesbian, gay, bisexual, transgender, and queer (LGBTQ) reported higher levels of professional support than heterosexual-identifying participants. Further analysis revealed a correlation between longer length of homelessness and less perceived social support. Finally, the association between discrimination, stress and hope was weaker for respondents with higher levels of social support quantity and quality, respectively. Conclusion: The results suggest that social support is an essential protective factor from both street-based stress and discrimination. It is vital to facilitate adequate support to youth experiencing homelessness, especially for the gender-diverse youth who report lower levels of hopefulness.

The multi-disciplinary data and information available at a community level comprise the foundation of natural hazard resilience modeling. These data enable and inform mitigation and recovery planning decisions prior to and following damaging events such as earthquakes. This paper presents a multi-disciplinary seismic resilience modeling methodology to assess the vulnerability of the built environment and economic systems. This methodology can assist decision-makers with developing effective mitigation policies to improve the seismic resilience of communities. Two complementary modeling strategies are designed to examine the impacts of scenario earthquakes from a combined engineering and economic perspective. The engineering model is developed using a probabilistic fragility-based modeling approach and is analyzed using Monte Carlo (MC) simulations subject to seismic multi-hazard, including simulated ground shaking and resulting liquefaction of the soil, to quantify the physical damage to buildings and electric power substations (EPS). The outcome of the analysis is subsequently used as input to repair and recovery models to quantify repair cost and recovery time metrics for buildings and as input to functionality models to estimate the functionality of individual buildings and substations by accounting for their interdependency. The economic model consists of a spatial computable general equilibrium (SCGE) model that aggregates commercial buildings into sectors for retail, manufacturing, services, etc., and aggregates residential buildings into a wide range of household groups. The SCGE model employs building functionality estimates to quantify the economic losses. The outcomes of this integrated modeling consist of engineering and economic impact metrics, which are used to investigate mitigation actions to help inform a community on approaches to achieve its resilience goals. An illustrative case study of Salt Lake County (SLC), Utah, developed through an extensive collaborative partnership and engagement with SLC officials, is presented. The results demonstrate the effectiveness of the proposed methodology in quantifying the loss and functional recovery of infrastructure systems, the impacts on capital stock, employment, and household income and the effect of various mitigation strategies in reducing the losses and functional recovery time subject to earthquakes with varying intensities.

Background:. There is significant variation in methods used for diagnosis and treatment of neurogenic thoracic outlet syndrome (NTOS). The lack of definitions and criteria for diagnosis as well as controversy in treatment options hampers standardized reporting of outcomes. In the orthopedic and plastic hand surgery literature, there are not standardized guidelines to direct evidence-based practice for hand surgeons relating to NTOS. Hence, expert consensus may provide guidance for clinical practice. Methods:. An international workgroup of 21 expert hand surgeons with cumulative experience of 5519 NTOS procedures was assembled. The Delphi method was used to arrive at consensus recommendations to guide diagnosis, treatment, surgery, and postoperative management of patients with NTOS. Results:. The workgroup achieved majority (greater than 75%) consensus with 17 statements. A modified version of the Society for Vascular Surgery clinical diagnostic criteria is recommended for diagnosis of NTOS. The elevated arm stress test and Tinel sign are recommended as provocative maneuvers. A cervical spine or chest radiograph should be routinely obtained preoperatively. Conservative management should be first line for NTOS, except in patients with significant muscle atrophy or weakness. An anterior supraclavicular approach is recommended for exposure of the supraclavicular brachial plexus, with the necessity for an additional infraclavicular approach or adjunctive surgeries indicated for specific patients. Conclusions:. Standardized consensus guidelines help guide management of NTOS by specialized hand surgeons, with an aim toward standardizing criteria for diagnosis and treatment of patients as well as measures and tools used for research and reporting of outcomes.

Key Clinical Message Long COVID, often following SARS‐CoV‐2 infection, may stem from sustained inflammation, overlapping with autoimmune diseases like sarcoidosis. Though specific treatments lack, this link could shape future diagnostic and therapeutic methods.

Evidence triangulation may help identify the impact of study design elements on study findings and to tease out biased results when evaluating potential causal relationships; however, methods for triangulating epidemiologic evidence are evolving and have not been standardized. Building upon key principles of epidemiologic evidence triangulation and risk of bias assessment, and responding to the National Academies of Sciences, Engineering, and Medicine (NASEM) call for applied triangulation examples, the objective of this manuscript is to propose a triangulation framework and to apply it as an illustrative example to epidemiologic studies examining the possible relationship between occupational formaldehyde exposure and risk of myeloid leukemias (ML) including acute (AML) and chronic (CML) types.A nine-component triangulation framework for epidemiological evidence was developed incorporating study quality and ROB guidance from various federal health agencies (i.e., US EPA TSCA and NTP OHAT). Several components of the triangulation framework also drew from widely used epidemiological analytic tools such as stratified meta-analysis and sensitivity analysis. Regarding the applied example, fourteen studies were identified and assessed using the following primary study quality domains to explore potential key sources of bias: 1) study design and analysis; 2) study participation; 3) exposure assessment; 4) outcome assessment; and 5) potential confounding. Across studies, methodological limitations possibly contributing to biased results were observed within most domains. Interestingly, results from one study – often providing the largest and least-precise relative risk estimates, likely reflecting study biases, deviated from most primary study findings indicating no such associations. Triangulation of epidemiological evidence appears to be helpful in exploring inconsistent results for the identification of study results possibly reflecting various biases. Nonetheless, triangulation methodologies require additional development and application to real-world examples to enhance objectivity and reproducibility.

Summary: Climate change has prompted many communities to set targets for carbon-free power supplies, but they often lack data-driven strategies to achieve them. We present a comprehensive analysis of an entirely renewable electric power system that can maintain operating reliability and resource adequacy using detailed models of the city of Los Angeles power grid. In consultation with the operating utility, the Los Angeles Department of Water and Power (LADWP), and the local community, we develop four supply scenarios across three demand projections to analyze which types of infrastructure and operational changes would achieve reliable electricity at least cost. We find that a reliable, 100%-renewable power system yielding more than $1 billion annually in health and climate co-benefits is achievable. Solar can supply most future energy needs, while combustion turbines that use renewable, storable carbon-neutral fuels are key to maintaining reliability. This study provides a replicable methodology that other jurisdictions globally can follow. Science for society: Communities and businesses nationwide have set ambitious goals to combat climate change by generating 100% of their electricity from carbon-free or renewable energy sources. Until now, there has been no comprehensive analysis of the possible pathways to achieve these goals on the scale needed to power the largest US cities. Here, we present findings from the Los Angeles 100% Renewable Energy Study (LA100), a thorough and wide-reaching assessment of the factors needed to make a fully renewable utility system operate reliably and deliver adequate electricity to more than 4 million residents. Our analysis uses detailed models of the city’s power grid to examine not just renewable resource options and technical solutions related to generation, transmission, and distribution systems but also the balance of supply and demand, variability and reliability, and affordability and viability—all through the lens of changing demographics and climate conditions.

High-risk human papillomavirus (HR-HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is a unique form of head and neck cancer with distinct biology and better prognosis than conventional SCC. Many patients with HR-HPV positive OPSCC initially present with metastases to lateral neck lymph nodes in levels II or III. Fine-needle aspiration (FNA) is routinely used to establish a diagnosis and evaluate HPV status at these sites. However, there is no consensus regarding the best testing methods for establishing HPV status in cytology specimens. The most common methods include p16 immunohistochemistry, HR-HPV in situ hybridization and molecular tests. This review summarizes the advantages and limitation of each method.

Quantum many-body scarred systems contain both thermal and non-thermal scar eigenstates in their spectra. When these systems are quenched from special initial states which share high overlap with scar eigenstates, the system undergoes dynamics with atypically slow relaxation and periodic revival. This scarring phenomenon poses a potential avenue for circumventing decoherence in various quantum engineering applications. Given access to an unknown scar system, current approaches for identification of special states leading to non-thermal dynamics rely on costly measures such as entanglement entropy. In this work, we show how two dimensionality reduction techniques, multidimensional scaling and intrinsic dimension estimation, can be used to learn structural properties of dynamics in the PXP model and distinguish between thermal and scar initial states. The latter method is shown to be robust against limited sample sizes and experimental measurement errors.

Aim Design Methods Results Conclusion Where and on Whom Will the Research Have an Impact? No Patient or Public Contribution To explore frontline health professionals' current understanding of non‐fatal strangulation and their need for and support for a comprehensive education and screening package to support health delivery.A descriptive mixed‐method approach was chosen to analyse responses to an anonymous, online survey consisting of ten Likert scale, open‐ended and five demographic questions. 103 frontline health professionals (nurses, doctors, paramedics, midwives) participated in this study.Content analysis of the Likert scale and open‐ended questions describing the subjective experiences and perceptions of the participants was undertaken along with percentage and frequency counts of the rated Likert responses.The findings identified that 51.1% of health professionals do not ask about strangulation routinely and that 59% of health professionals reported receiving no formal education or professional development on NFS to enhance their knowledge or inform clinical practice. No health professionals identified mild traumatic brain injury as a consequence or sign of strangulation, nor did they identify an understanding that 50% of people may have no visible injuries after being strangled. Health professionals also do not routinely document the different agencies referred to or involved in supporting the person who experienced NFS.Findings suggest that frontline health professionals lack the confidence, skills and education needed to meet medical obligations to their patients and to fulfil their duty to ‘do no harm’. Frontline health professionals would welcome a comprehensive education and screening package to guide recognition and response to non‐fatal strangulation in their clinical settings.The purpose of the study was to understand and explore health professionals' knowledge about non‐fatal strangulation so that improved education around better screening, and management of trauma‐focused care to people who have been subjected to non‐fatal strangulation could occur.This review contains no patient or public contribution since it examines health professionals' knowledge of identifying non‐fatal strangulation and the screening and assessment tools used in clinical practice. [ABSTRACT FROM AUTHOR]

Schools frequently adopt new interventions for each new public health issue, but this is both time- and resource-intensive. Adversity exposure is an example of a pervasive public health issue that emerged during Coronavirus Disease 2019 (COVID-19) with notable consequences, including an elevated risk of developing substance use disorders and mental illnesses. Adapting existing, universal, evidence-based interventions, such as the Michigan Model for HealthTM (MMH), by incorporating trauma-sensitive content is a promising approach to meet this need. We examined critical steps in promoting MMH adaptability as part of the Enhanced REP (Replicating Effective Programs) implementation strategy during the COVID-19 pandemic. We share usability testing from the 2020 to 2021 school year and describe how we apply the results to inform the group randomized trial pilot study. We applied key steps from implementation adaptation frameworks to integrate trauma-sensitive content as COVID-19 unfolded, documenting the process through field notes. We conducted initial usability testing with two teachers via interviews and used a rapid qualitative analysis approach. We conducted member checking by sharing the information with two health coordinators to validate results and inform additional curriculum refinement. We developed an adapted MMH curriculum to include trauma-sensitive content, with adaptations primarily centered on adding content, tailoring content, substituting content, and repeating/reinforcing elements across units. We designed adaptations to retain the core functional elements of MMH. Building foundational relationships and infrastructure supports opportunities to user-test intervention materials for Enhanced REP that enhance utility and relevance for populations that would most benefit. Enhanced REP is a promising strategy to use an existing evidence-based intervention to meet better the needs of youth exposed to adversity. Building on the foundations of existing evidence-based interventions, is vital to implementation success and achieving desired public health outcomes., (© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Glucagon-like peptide-1 (GLP-1) is a gastrointestinal regulatory hormone that stimulates insulin release from the pancreas. While GLP-1 receptor agonists (GLP-1 RAs) have traditionally been utilized to address insulin resistance, their potential application in treating polycystic ovary syndrome (PCOS) has recently garnered attention. This study aimed to investigate the therapeutic efficacy of GLP-1 RAs use for weight loss in women diagnosed with PCOS. We conducted a scoping review following the Joanna Briggs Institute (JBI) methodology and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our investigation delved into the clinical effects experienced by women of diverse racial and ethnic backgrounds with PCOS who were prescribed GLP-1 RAs for weight loss. Peer-reviewed articles from Ovid Medline, Web of Science, CINAHL, Cochrane CENTRAL, SCOPUS, and ClinicalTrials.gov spanning from 2012 to 2023 were scrutinized. After eliminating duplicates, 811 articles were identified, and ultimately, eight met the eligibility criteria for inclusion. All studies were published in English and exhibited wide geographic diversity. The included studies uniformly reported reductions in weight and body mass index (BMI) among patients who were prescribed GLP-1 RAs, specifically liraglutide or exenatide. Additionally, evidence pointed towards improvements in anthropometric parameters (MF1) (including total body weight, BMI, reduction in waist circumference, and total fat percentage), glucose homeostasis, cardiovascular inflammatory markers (midregional pro-atrial natriuretic peptide (MR-proANP) and mid-regional pro-adrenomedullin (MR-proADM)), rates of pregnancy, and menstrual regulation. However, findings regarding the impact of GLP-1 RAs on lipid profiles were inconsistent. Although some short-term adverse effects were noted, long-term effects of GLP-1 RAs use remain undetermined. GLP-1 RA use demonstrated promising clinical outcomes for women with PCOS, including reduced BMI, improved metabolic parameters, menstrual regularity, and increased rates of natural pregnancy. While the current evidence is encouraging, further research is warranted to elucidate both short- and long-term adverse effects of GLP-1 RA therapy for PCOS., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Frangie Machado et al.)

Background:  There exists a dearth of research on the psychological experiences of childhood communication disorders. Caregivers of these children are one source who can provide us with this information since the child exists within a system. Literature on the experiences of caregivers of children with communication disorders, specifically in the South African city context, is lacking., Objectives:  The article presents the reported experiences of six parental caregivers raising a child with a communication disorder within Johannesburg., Method:  Data were collected via semi-structured interviews and underwent an interpretative phenomenological analysis., Results:  Five themes are presented: feeling out of control; barriers to accessing services; caregivers left speechless; a misunderstood disability; and relinquishing control: 'I needed to be a mommy'., Conclusion:  The caregivers relayed an initially negative experience in raising a child with a communication disorder, marred with worry and fear for the future. In accessing services, they narrated their experiences of multiple barriers to access, including an overreliance on the private sector, financial barriers, time constraints, limited resources and poor information on available resources. Eventually, the caregivers were able to identify strengths, skills and capabilities within their children and themselves that allowed for adjustment and coping.Contribution: The findings highlight the importance of considering how barriers to care may marginalise and seclude parental caregivers. Over time, the caregivers were able to empower themselves through building their own knowledge and reformulating their narratives by challenging assumptions and retitling the source of disability as a product of the failure of society.

Introduction: Previous studies have explored facilitators and barriers to research conducted by allied health professionals in general medical settings. Since the mental health system is acknowledged to be significantly under-funded and more poorly functioning than general medical services, it is unclear whether the published facilitators and barriers also apply to mental health settings. This study sought to explore the research-related knowledge, understanding and practices of allied mental health clinicians based in a large public mental health service., Methods: A mixed methods study recruited 59 occupational therapists and social workers working in a dedicated metropolitan public mental health service in Melbourne, Australia. Quantitative survey results are reported elsewhere. Semi-structured interviews were conducted with 16 survey responder volunteers. Thematic analysis was conducted on the qualitative survey and interview data., Results: Four main themes were identified: research must connect with clinical practice; fragments of knowledge; research in practice; and research is not part of my professional identity. The third theme, research in practice, comprised four subthemes: no time for research in clinical roles, missing communication, lack of ownership, and what I need to do research., Conclusions: This study found that research and research-related activities were not considered part of the mental health social workers and occupational therapists' professional identities. Dealing with this issue may be instrumental to the realization of these clinicians' professional peak-body associations' code of practice and to government mandated practice standards. We provided several strategies to encourage both clinicians and services to view research-related activities as an everyday part of clinical roles. This is especially important if we think of allied health evidence-based practice requiring a reasonable level of research-related skills and/or competencies to appraise, practice, evaluate and adapt their evidence-based practice., (© 2024. The Author(s).)

Purpose/objective: The acquisition of a disability impacts one's corporeality and has been found to destabilize one's sense of personal and social identity. The article explores the psychological and behavioral adaptation strategies that are employed in response to resisting, incorporating, and/or integrating disability into one's identity. We refer to a study that considered factors that facilitate and/or impede disability identification, aiming to investigate the trajectory that the process of identity (re)construction takes., Research Method/design: Seven individual, in person, semistructured interviews were conducted with adults with acquired physical and sensory disabilities. Data underwent thematic analysis. To encapsulate the intrapersonal as well as interpersonal dynamics inherent in identity (re)construction, the analysis was guided by an interpretative phenomenological lens and social identity theory (SIT)., Results: Disability identification is a complex and contradictory phenomenon, with strategies of resistance, incorporation, and/or integration fluctuating by setting and circumstance. These findings represent a significant departure from SIT literature-participants rather made use of more collectivist as opposed to individualistic adaptation strategies. Arguably, progress is being made with regard to disability pride, opening up a space for more positive and affirming disabled identities. Furthermore, disability identification is largely facilitated by greater opportunities for political advocacy and social support-online and in the disabled community. However, stigma-internalized and external-is still a major inhibitory factor to disability identification., Conclusions/implications: Recommendations for rehabilitation programs and psychological professionals working with acquired physical and sensory disability are proposed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Naloxone is an effective medication used to reverse opioid overdoses. Distributing naloxone directly to those at risk, therefore, reduces the risk of opioid-related deaths. New legislation in Australia means a prescription is no longer required to access naloxone. Whilst acknowledging the benefits of increased access, we aim to evaluate the impact psychiatrists can have on naloxone provision due to their unique position as doctors often working with those who may be at risk., Methods: Data was recorded on those accessing naloxone from a co-located addiction and mental health service. Descriptive statistics were generated to establish the cohort characteristics, prior knowledge of naloxone and outcome of previously supplied naloxone., Results: Naloxone was dispensed 488 times from 2021 to 2023. 267 people had previously been prescribed naloxone from these sites where 137 (51.3%) were reportedly used in an opioid reversal., Conclusions: Our findings highlight the importance of community access to naloxone in reducing opioid-related harm. Whilst removing the need for a prescription makes naloxone more accessible, it remains vital that doctors remain involved in this process to broaden the reach of supply to those at risk., Competing Interests: DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The objective of this study was to evaluate growth and reproductive performance of heifers developed using 3 different winter systems in the midwestern U.S. Spring-born heifers (n = 1,156; 214 d of age; SD ± 17 d) were used in a 3-yr study to evaluate performance in winter development systems, which utilized cover crop (CC) and corn residue grazing. Heifers were assigned to 1 of 3 treatments: grazing corn residue with 0.77 kg/d dried distillers grains (CD) or 1.69 kg/d wheat midds (CW) supplementation followed by a grower ration in the drylot, or grazing late summer planted oat-brassica CC followed by corn residue grazing with 0.35 kg/d dried distillers grains supplementation (CC). Supplementation during the corn residue phase was targeted to result in a common body weight (BW) (276 kg; ~45% of mature BW) by the end of the winter development period. Grazing of corn residue (CD and CW) and CC began in early November. After 63 d, heifers assigned to CC were moved to corn residue; on day 77 heifers assigned to CD and CW began receiving a grower ration in the drylot. In mid-February (day 98), heifers were comingled and managed in a single group. Breeding season began in June and lasted for 29 d. The ADG of heifers assigned to CC when grazing CC (days 1 to 63) was greater (0.76 kg/d; P  < 0.01) than those assigned to CD or CW (0.58 kg/d and 0.49 kg/d, respectively). Gain during the last 35 d of the winter period for heifers assigned to CC (0.36 kg/d) was less ( P  < 0.01) than those assigned to CW (0.49 kg/d) but not different from CD heifers (0.41 kg/d). Overall (days 1 to 98), winter ADG was greater ( P  < 0.05) for heifers assigned to CC (0.62 kg/d) than CD (0.53 kg/d) or CW (0.50 kg/d), which did not differ ( P  = 0.42). Percent of mature BW in May (27 d pre-breeding) was greater ( P  < 0.01) for heifers assigned to CC (52%) than for those on CD and CW (50%), which did not differ ( P  = 0.64). Pregnancy rates were affected by treatment ( P  < 0.03), with heifers assigned to CC (76%) being greater than CW (64%) and CD heifers being intermediate (70%). When accounting for the differences in cost and the value of open and bred heifers, the economic return tended to differ ( P =  0.07) among treatments, with CC and CW not differing ( P  ≥ 0.20) from CD but return for CC being $73 greater than CW ( P  = 0.02). Utilizing oat-brassica CCs early in the winter followed by a slower rate of gain while grazing corn residue with distillers supplementation appears to be as effective for developing beef heifers in the midwestern U.S. as supplementing distillers grains., Competing Interests: The authors declare no conflicts of interest., (Published by Oxford University Press for the American Society of Animal Science 2024.)

Time-to-event prediction is a key task for biological discovery, experimental medicine, and clinical care. This is particularly true for neurological diseases where development of reliable biomarkers is often limited by difficulty visualising and sampling relevant cell and molecular pathobiology. To date, much work has relied on Cox regression because of ease-of-use, despite evidence that this model includes incorrect assumptions. We have implemented a set of deep learning and spline models for time-to-event modelling within a fully customizable 'app' and accompanying online portal, both of which can be used for any time-to-event analysis in any disease by a non-expert user. Our online portal includes capacity for end-users including patients, Neurology clinicians, and researchers, to access and perform predictions using a trained model, and to contribute new data for model improvement, all within a data-secure environment. We demonstrate a pipeline for use of our app with three use-cases including imputation of missing data, hyperparameter tuning, model training and independent validation. We show that predictions are optimal for use in downstream applications such as genetic discovery, biomarker interpretation, and personalised choice of medication. We demonstrate the efficiency of an ensemble configuration, including focused training of a deep learning model. We have optimised a pipeline for imputation of missing data in combination with time-to-event prediction models. Overall, we provide a powerful and accessible tool to develop, access and share time-to-event prediction models; all software and tutorials are available at www.predictte.org.

Purpose: The time required for in-clinic drug administration can substantially affect breast cancer patients' quality of life. Subcutaneous (SC) drug administration, as opposed to intravenous (IV), may reduce this time commitment. This study sought to estimate the difference in time burden between IV and SC administration of trastuzumab and pertuzumab (HP)., Methods: We prospectively enrolled a subcohort of patients participating in the ADEPT trial (ClinicalTrials.gov identifier: NCT04569747, investigating adjuvant HP plus endocrine therapy for stage I human epidermal growth factor receptor 2-positive breast cancer) to this single-arm crossover time and motion substudy. Patients received two cycles of IV HP followed by two cycles of SC HP. During each cycle, time points in drug preparation and administration were captured. The primary end point was total patient time in the treatment chair. Additional end points included total patient treatment experience time and total pharmacy workflow time. A sample size of 22 patients was estimated to provide 90.7% power with two-sided alpha .05 to detect a difference of 70 minutes in the primary end point by treatment arm (IV v SC)., Results: Twenty-two patients were enrolled. The mean total patient time in the treatment chair was 61.8 minutes shorter with SC versus IV HP (22.5 v 84.3 minutes; P < .0001). The mean total patient treatment experience time (incorporating time spent waiting for treatment initiation and time spent in the treatment chair) was 81.8 minutes shorter for SC administration (96 v 177.8 minutes; P < .0001). The pharmacy workflow time was 78.2 minutes shorter for SC versus IV formulation (41 v 119.2 minutes; P < .0001)., Conclusion: SC administration of HP shortened patient time burden by approximately 1 hour. SC drug administration can facilitate faster workflows for health care professionals and improve patients' breast cancer treatment experience.

Background: Prevention and Recovery Care services are residential sub-acute services in Victoria, Australia, guided by a commitment to recovery-oriented practice. The evidence regarding the effectiveness of this service model is limited, largely relying on small, localised evaluations. This study involved a state-wide investigation into the personal recovery, perceived needs for care, well-being and quality-of-life outcomes experienced by Prevention and Recovery Care services' consumers., Methods: A longitudinal cohort design examined the trajectory of self-reported personal recovery and other outcomes for consumers in 19 Victorian Prevention and Recovery Care services over 4 time points (T1 - 1 week after admission; T2 - within 1 week of discharge; T3 - 6 months after discharge; T4 - 12 months after discharge). T2-T4 time frames were extended by approximately 3 weeks due to recruitment challenges. The Questionnaire about the Process of Recovery was the primary outcome measure., Results: At T1, 298 consumers were recruited. By T4, 114 remained in the study. Participants scored higher on the Questionnaire about the Process of Recovery at all three time points after T1. There were also sustained improvements on all secondary outcome measures. Improvements were then sustained at each subsequent post-intervention time point. Community inclusion and having needs for care met also improved., Conclusion: The findings provide a consistent picture of benefits for consumers using Prevention and Recovery Care services, with significant improvement in personal recovery, quality of life, mental health and well-being following an admission to a Prevention and Recovery Care service. Further attention needs to be given to how to sustain the gains made through a Prevention and Recovery Care service admission in the long term., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Background: Long-term post-treatment surveillance imaging algorithms for head and neck squamous cell carcinoma are not standardized due to debates over optimal surveillance strategy and efficacy. Consequently, current guidelines do not provide long-term surveillance imaging recommendations beyond 6 months., Purpose: We performed a systematic review to evaluate the impact of long-term imaging surveillance (i.e., imaging beyond 6 months following treatment completion) on survival in patients treated definitively for head and neck squamous cell carcinoma., Data Sources: A search was conducted on PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science for English literature published between 2003 and 2024 evaluating the impact of long-term surveillance imaging on survival in patients with head and neck squamous cell carcinoma., Study Selection: 718 abstracts were screened and 9 5 underwent full-text review, with 2 articles meeting inclusion criteria. The Risk of Bias in Non-randomized Studies of Interventions assessment tool was used., Data Analysis: A qualitative assessment without a pooled analysis was performed for the two studies meeting inclusion criteria., Data Synthesis: No randomized prospective controlled trials were identified. Two retrospective two-arm studies were included comparing long-term surveillance imaging with clinical surveillance and were each rated as having moderate risk of bias. Each study included heterogeneous populations with variable risk profiles and imaging surveillance protocols. Both studies investigated the impact of long-term surveillance imaging on overall survival and came to a different conclusion with one study reporting a survival benefit for long-term surveillance imaging with FDG PET/CT in patients with stage III or IV disease or an oropharyngeal primary tumor and the other study demonstrating no survival benefit., Limitations: Limited heterogeneous retrospective data available precludes definitive conclusions on the impact of long-term surveillance imaging in head and neck squamous cell carcinoma., Conclusions: There is insufficient quality evidence regarding the impact of long-term surveillance imaging on survival in patients treated definitively for head and neck squamous cell carcinoma. There is a lack of standardized definition of long-term surveillance, variable surveillance protocols, and inconsistencies in results reporting, underscoring the need for a prospective multi-center registry assessing outcomes., Abbreviations: HNSCC = Head and Neck Squamous Cell Carcinoma; RT= radiotherapy; NCCN = National Comprehensive Cancer Network; MPC = metachronous primary cancer; CR = complete response; OS = overall survival; CRT = chemoradiotherapy; HPV = human papillomavirus; PFS = progression-free survival; CFU = clinical follow up; NI-RADS = Neck Imaging Reporting and Data System., Competing Interests: The authors declare no conflicts of interest related to the content of this article., (© 2024 by American Journal of Neuroradiology.)

Patients with myeloproliferative neoplasms (MPNs) face chronic symptom burden. Online symptom assessment studies allow for recruitment of large numbers of motivated patients, but patient self-selection can lead to sampling bias. This study evaluated how gender representativeness in MPN symptom surveys and trials impacted symptom score mean estimates, using data from 4825 survey respondents and 291 trial participants with MPNs. The survey data showed that men participated at a rate roughly 50% less than what would be expected based on prevalence, and women reported higher scores than men on average for six of 10 symptoms. Together, this led to potential over estimation in six of 10 symptom score means (ranging from 5.8% to 15.3% overestimated). The trial data showed less gender-based sampling bias compared to the survey data. Studies utilizing online symptom surveys should implement study design features to recruit more men, assess for gender participation imbalances, and provide weighted estimates where appropriate.

Introduction: Nurse Navigators were introduced in Queensland, Australia, in 2016. Nurse Navigators coordinate person-centred care, create partnerships, improve care coordination and outcomes and facilitate system improvement, independently of hospital or community models. They navigate across all aspects of hospital and social services, liaising, negotiating and connecting care as needed. People stay with Nurse Navigators for as long as required, though the intent is to transition them from high-care needs to self-management. Nurse Navigators are a working model in rural and remote areas of Queensland., Objective: To describe where the rural and remote Nurse Navigator position fits within the Rural Remote Nursing Generalist Framework and to define the depth and breadth of the rural and remote Nurse Navigator's scope of practice., Design: Using template analysis, data from focus groups and interviews were analysed against the domains of the recently released National Rural and Remote Nursing Generalist Framework. Navigators working in rural and remote areas across Queensland Health were invited to an interview (n = 4) or focus group (n = 9), conducted between October 2019 and August 2020., Findings: Rural and remote Nurse Navigators are proficient in all domains of the framework and actively champion for their patients, carers and the communities where they live and work., Discussion: This research demonstrates that rural and remote Nurse Navigators are a working model of advanced nursing practice, acting as 'champions' of The Framework., Conclusion: The Nurse Navigator model of care introduced to Queensland exemplifies proficient registered nurse practice to the full extent of their knowledge and skill., (© 2024 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

Purpose of Review: Artificial intelligence (AI) is transforming electrocardiography (ECG) interpretation. AI diagnostics can reach beyond human capabilities, facilitate automated access to nuanced ECG interpretation, and expand the scope of cardiovascular screening in the population. AI can be applied to the standard 12-lead resting ECG and single-lead ECGs in external monitors, implantable devices, and direct-to-consumer smart devices. We summarize the current state of the literature on AI-ECG., Recent Findings: Rhythm classification was the first application of AI-ECG. Subsequently, AI-ECG models have been developed for screening structural heart disease including hypertrophic cardiomyopathy, cardiac amyloidosis, aortic stenosis, pulmonary hypertension, and left ventricular systolic dysfunction. Further, AI models can predict future events like development of systolic heart failure and atrial fibrillation. AI-ECG exhibits potential in acute cardiac events and non-cardiac applications, including acute pulmonary embolism, electrolyte abnormalities, monitoring drugs therapy, sleep apnea, and predicting all-cause mortality. Many AI models in the domain of cardiac monitors and smart watches have received Food and Drug Administration (FDA) clearance for rhythm classification, while others for identification of cardiac amyloidosis, pulmonary hypertension and left ventricular dysfunction have received breakthrough device designation. As AI-ECG models continue to be developed, in addition to regulatory oversight and monetization challenges, thoughtful clinical implementation to streamline workflows, avoiding information overload and overwhelming of healthcare systems with false positive results is necessary. Research to demonstrate and validate improvement in healthcare efficiency and improved patient outcomes would be required before widespread adoption of any AI-ECG model., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and purpose . To investigate models developed using radiomic and dosiomic (multi-omics) features from planning and treatment imaging for late patient-reported dysphagia in head and neck radiotherapy. Materials and methods . Training (n = 64) and testing (n = 23) cohorts of head and neck cancer patients treated with curative intent chemo-radiotherapy with a follow-up time greater than 12 months were retrospectively examined. Patients completed the MD Anderson Dysphagia Inventory and a composite score ≤60 was interpreted as patient-reported dysphagia. A chart review collected baseline dysphagia and clinical factors. Multi-omic features were extracted from planning and last synthetic CT images using the pharyngeal constrictor muscle contours as a region of interest. Late patient-reported dysphagia models were developed using a random forest backbone, with feature selection and up-sampling methods to account for the imbalanced data. Models were developed and validated for multi-omic feature combinations for both timepoints. Results . A clinical and radiomic feature model developed using the planning CT achieved good performance (validation: sensitivity = 80 ± 27% / balanced accuracy = 71 ± 23%, testing: sensitivity = 80 ± 10% / balanced accuracy = 73 ± 11%). The synthetic CT models did not show improvement over the plan CT multi-omics models, with poor reliability of the radiomic features on these images. Dosiomic features extracted from the synthetic CT showed promise in predicting late patient-reported dysphagia. Conclusion . Multi-omics models can predict late patient-reported dysphagia in head and neck radiotherapy patients. Synthetic CT dosiomic features show promise in developing successful models to account for changes in delivered dose distribution. Multi-center or prospective studies are required prior to clinical implementation of these models., (Creative Commons Attribution license.)

Introduction: Bacterial urinary tract infections (UTI) and some sexually transmitted infections (STI) can have overlapping signs and symptoms or nonspecific findings, such as pyuria on urinalysis. Furthermore, results from the urine culture and the nucleic acid amplification test for an STI may not be available during the clinical encounter. We sought to determine whether gonorrhea, chlamydia, and trichomoniasis are associated with bacteriuria, information that might aid in the differentiation of STIs and UTIs., Methods: We used multinomial logistic regression to analyze 9,650 encounters of female patients who were aged ≥18 years and who underwent testing for STIs. The ED encounters took place from April 18, 2014-March 7, 2017. We used a multivariable regression analysis to account for patient demographics, urinalysis findings, vaginal wet-mount results, and positive or negative (or no) findings from the urine culture and testing for Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis., Results: In multivariable analysis, infection with T vaginalis , N gonorrhoeae, or C trachomatis was not associated with having a urine culture yielding 10,000 or more colony-forming units per mililiter (CFU/mL) of bacteria compared with a urine culture yielding less than 10,000 CFU/mL or no urine culture obtained. The diagnosis of a UTI in the ED was not associated with having a urine culture yielding 10,000 or more CFU/mL compared with a urine culture yielding less than 10,000 CFU/mL., Conclusion: After adjusting for covariates, no association was observed between urine culture results and testing positive for trichomoniasis, gonorrhea, or chlamydia. Our results suggest that having a concurrent STI and bacterial UTI is unlikely., Competing Interests: Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

PARTNER is a prospective, phase II-III, randomized controlled clinical trial that recruited patients with triple-negative breast cancer 1,2 , who were germline BRCA1 and BRCA2 wild type 3 . Here we report the results of the trial. Patients (n = 559) were randomized on a 1:1 basis to receive neoadjuvant carboplatin-paclitaxel with or without 150 mg olaparib twice daily, on days 3 to 14, of each of four cycles (gap schedule olaparib, research arm) followed by three cycles of anthracycline-based chemotherapy before surgery. The primary end point was pathologic complete response (pCR) 4 , and secondary end points included event-free survival (EFS) and overall survival (OS) 5 . pCR was achieved in 51% of patients in the research arm and 52% in the control arm (P = 0.753). Estimated EFS at 36 months in the research and control arms was 80% and 79% (log-rank P > 0.9), respectively; OS was 90% and 87.2% (log-rank P = 0.8), respectively. In patients with pCR, estimated EFS at 36 months was 90%, and in those with non-pCR it was 70% (log-rank P < 0.001), and OS was 96% and 83% (log-rank P < 0.001), respectively. Neoadjuvant olaparib did not improve pCR rates, EFS or OS when added to carboplatin-paclitaxel and anthracycline-based chemotherapy in patients with triple-negative breast cancer who were germline BRCA1 and BRCA2 wild type. ClinicalTrials.gov ID: NCT03150576 ., (© 2024. The Author(s).)

Objective: We describe the creation of a two-tier emergency response system with a nurse-led first responder program titled "MET-RN" (Medical Emergency Team-Registered Nurse) created for ambulatory settings supported by a critical care code blue team for escalation of care. This observational study evaluated the clinical characteristics and effects of a MET-RN program on the code blue response., Methods: A retrospective review of the MET-RN response data was assessed from January 2016 to June 2021. Data collected included time of call, call location, patient comorbidities, triage category (minor, urgent, or emergent), activation trigger, interventions performed, duration of the event, and patient disposition. In instances where the patient was admitted to the hospital, the discharge diagnosis and emergency department (ED) triage score were collected. Differences were tested using analysis of variance (ANOVA) F-tests, with Tukey post-hoc testing where applicable., Results: MET-RN responded to 6,564 encounters from January 2016 to June 2021. The most frequent trigger call was dizziness/lightheadedness, with a prevalence of 12.0%. 33.9% of the patients seen by MET-RN were transported to the ED for further evaluation. Establishing a MET-RN system led to an estimated median of 58.3% reduction in utilization of the code blue team per quarter., Conclusion: The creation of MET-RN first responder system enabled the ambulatory areas to receive minor, urgent, and emergent patient care support, leading to a decrease in utilization of the code blue team for the hospital. A two-tiered response system resulted in an improved allocation of hospital resources and kept critical care teams in high-acuity areas while maintaining patient safety., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

The research employs a single embodied case study design with the aim to examine the discourse of men accessing and receiving mental health support alongside those who are the providers of the support. Three groups of adults were interviewed: men who had experienced mental health problems and had attempted to access mental health support; lay people who supported them, such as partners and non-mental health professionals and professionals, such as mental health nurses, social workers, clinical psychologists and general practitioners. Critical discourse analysis (CDA) is used to identify discourses around three emergent themes: well-being, power and dominance and social capital. Participants seeking mental health support often referred to mental health services as not listening or that what was offered was not useful. A lack of belonging and community disconnectedness was apparent throughout all participant interviews. The study is reported according to the COREQ guidelines., (© 2024 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Background: Australia has one of the highest rates of asbestos-associated diseases. Mesothelioma remains an area of unmet need with a 5-year overall survival of 10%. First-line immunotherapy with ipilimumab and nivolumab is now a standard of care for unresectable pleural mesothelioma following the CheckMate 743 trial, with supportive data from the later line single-arm MAPS2 trial. RIOMeso evaluates survival and toxicity of this regimen in real-world practice., Methods: Demographic and clinicopathologic data of Australian patients treated with ipilimumab and nivolumab in first- and subsequent-line settings for pleural mesothelioma were collected retrospectively. Survival was reported using the Kaplan-Meier method and compared between subgroups with the log-rank test. Toxicity was investigator assessed using Common Terminology Criteria for Adverse Events version 5.0., Results: A total of 119 patients were identified from 11 centers. The median age was 72 years, 83% were male, 92% had Eastern Cooperative Oncology Group less than or equal to 1, 50% were past or current smokers, and 78% had known asbestos exposure. In addition, 50% were epithelioid, 19% sarcomatoid, 14% biphasic, and 17% unavailable. Ipilimumab and nivolumab were used first line in 75% of patients. Median overall survival (mOS) was 14.5 months (95% confidence interval [CI]: 13.0-not reached [NR]) for the entire cohort. For patients treated first line, mOS was 14.5 months (95% CI: 12.5-NR) and in second- or later-line patients was 15.4 months (95% CI: 11.2-NR). There was no statistically significant difference in mOS for epithelioid patients compared with nonepithelioid (19.1 mo [95% CI: 15.4-NR] versus 13.0 mo [95% CI: 9.7-NR], respectively, p = 0.064). Furthermore, 24% of the patients had a Common Terminology Criteria for Adverse Events grade greater than or equal to 3 adverse events, including three treatment-related deaths. Colitis was the most frequent adverse event., Conclusions: Combination immunotherapy in real-world practice has poorer survival outcomes and seems more toxic compared with clinical trial data. This is the first detailed report of real-world survival and toxicity outcomes using ipilimumab and nivolumab treatment of pleural mesothelioma., (Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Background: The first evaluation of radiotherapy results in patients with breast cancer treated as part of a multimodal oncologic therapy in the Nahe Breast Center is presented. Analysis of the results was performed using an in-practice registry., Patients and Methods: From September 2016 to December 2017, 138 patients (median age 62.5 years; range 36-94 years) with breast cancer (right side, n = 67; left side, n = 71) received adjuvant radiation therapy. Of these, 103 patients received gyneco-oncologic care at the Nahe Breast Center, and 35 were referred from outside breast centers. The distribution into stages was as follows: stage I, n = 48; stage II, n = 68; stage III, n = 19; stage IV, n = 3. Neoadjuvant chemotherapy was given to 19 and adjuvant chemotherapy to 50 patients. Endocrine treatment was given to 120 patients. Both 3D conformal (n = 103) and intensity-modulated (n = 35) radiotherapy were performed with a modern linear accelerator., Results: With a median follow-up of 60 months (1-67), local recurrence occurred in 4/138 (2.9%) and distant metastasis in 8/138 (5.8%) patients; 7/138 (5.1%) patients died of their tumors during the follow-up period. The actuarial 5‑year local recurrence-free survival of all patients was 97.1%, and the actuarial 5‑year overall survival of all patients was 94.9%. We observed no grade 3 or 4 radiogenic side effects., Conclusion: The results of radiotherapy for breast carcinoma at the Nahe Breast Center are comparable to published national and international results. In particular, the local recurrence rates in our study, determined absolutely and actuarially, are excellent, and demonstrate the usefulness of radiotherapy., (© 2023. The Author(s).)

The global COVID-19 pandemic challenged the world-how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person-centred care (PCC) is the philosophical premise upon which models of health care are developed and implemented. Given the strain that COVID-19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic., (© 2023 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd.)