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Background: The work environment is an important determinant of health and health inequalities. Workplaces have a key role in preventing ill health. The WHO and Office for Health Improvement and Disparities encourage implementing employer-led workplace health award schemes tailored to specific contexts. Therefore, when designing and developing workplace initiatives it becomes imperative to know what works, for whom, and in what circumstances. This research aims to facilitate understanding of the various contexts and mechanisms through which workplace health initiatives are implemented while considering how these might affect employee health outcomes., Methods: We did a rapid realist review to explore the different contexts (C) in which workplace initiatives are implemented that may fire a mechanism (M), leading to a change in employee health-related and business outcomes (O). We searched 12 databases for peer-reviewed papers published from June 1, 2019, to March 31, 2022 that referred to a workplace health and or wellbeing programme or intervention. There were no restrictions placed on study design. We recorded the impact of context and mechanisms on any health and business-related outcomes. The review was carried out in accordance with RAMESES publication standards., Findings: 26 articles were included. Most studies were conducted in North America (n=13) and Europe (n=9), with four conducted in Australia and Oceania and one in Asia. We developed eight realist CMO programme theories. For example, when leaders are committed to employee health and wellbeing (C) (identified in 16 studies), demonstrated by role modelling healthy behaviours and actively promoting workers to engage in initiatives, employees feel valued and "permitted" to engage in healthy and wellbeing initiatives (M) which might lead to greater participation in health promotion activities (O). This review is registered with PROSPERO, CRD42022303262., Interpretation: Findings contribute towards raising employers' awareness of what interventions might work for their employees. For instance, those interventions that encompass engagement of leadership at all levels to promote health and wellbeing are likely to leave employees feeling valued, motivated, and permitted to engage in interventions. Limitations of this study include potential biases arising from using rapid review processes and the inability to produce standardised recommendations. However, knowledge gained, which considers complexity and flexibility, might help inform, tailor, and support the implementation of future workplace health initiatives., Funding: National Institute for Health and Care Research (NIHR)., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Continuous monitoring of oil discharges in coastal and open ocean waters using Earth Observation (EO) has undeniably contributed to diminishing their occurrence wherever a detection system was in place, such as in Europe (EMSA's CleanSeaNet) or in the United States (NOAA's OR&R). This study describes the development and testing of a semi-automated oil slick detection system tailored to the Great Barrier Reef (GBR) marine park solely based on EO data as no such service was routinely available in Australia until recently. In this study, a large, curated, historical global dataset of SAR imagery acquired by Sentinel-1 SAR, now publicly available, is used to assess classification techniques, namely an empirical approach and a deep learning model, to discriminate between oil-like features and look-alikes in the scenes acquired over the marine park. An evaluation of this detection system on 10 Sentinel-1 SAR images of the GBR using two performance metrics - the detection accuracy and the false-positive rate (FPR) - shows that the classifiers perform best when combined (accuracy >98 %; FPR 0.01) rather than when used separately. This study demonstrates the benefit of sequentially combining classifiers to improve the detection and monitoring of unreported oil discharge events in SAR imagery. The workflow has also been tested outside the GBR, demonstrating its robustness when applied to other regions such as Australia's Northwest Shelf, Southeast Asia and the Pacific., Competing Interests: Declaration of competing interest 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., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Background: Healthcare professionals (HCPs) provide an important point of contact through which people who use performance and image enhancing drugs (PIEDs) could access reliable information, advice, and interventions on a range of PIEDs, their use and related harms. However, HCPs often report difficulties engaging and building rapport with people who use PIEDs, and research suggests that they often lack specialist knowledge on these substances. Providing credible evidence-based resources to support HCPs is thus important. However, educational materials in this area are generally absent and the ones that exist have not been assessed for their utility in the HCP workforce. This paper examines the acceptability and usability of a PIED e-learning module (the Dopinglinkki e-module) targeted at HCPs in three EU Member States and Australia., Methods: A standardised two stage, mixed methodology was implemented. Stage 1 involved HCPs completing the e-module and completing an online survey (N = 77). Stage 2 involved conducting individual structured interviews with a subset of survey respondents (N = 37). Normalisation Process Theory and the Theoretical Framework of Acceptability were used as conceptual lenses., Findings: The e-module provided information that was perceived as useful for HCPs' current and future practice. However, several individual, organisational and societal level barriers were reported as preventing the e-module becoming an accepted and normalised aspect of the HCP workforce, including the need for up to date evidence, the time-consuming nature of completing the e-module, lack of organisational support, the use of over-complex language, and the module's potential to reinforce the stigmatisation of PIEDs., Conclusion: Providing credible evidence-based resources to support HCPs' knowledge development is important. Evidence-based and theory informed interventions are needed to equip HCPs with knowledge that can aid culturally sensitive interactions and effective engagement with people who use PIEDs. Reflecting on our study findings, it is important that the development of interventions should include the voices of both HCP and those using PIEDs, and that careful consideration is given to the various factors that may act as a barrier to effective implementation., Competing Interests: Declarations of Interest None., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The Value-Based Healthcare (VBH) concept is designed to improve individual healthcare outcomes without increasing expenditure, and is increasingly being used to determine resourcing of and reimbursement for medical services. Radiology is a major contributor to patient and societal healthcare at many levels. Despite this, some VBH models do not acknowledge radiology's central role; this may have future negative consequences for resource allocation., Methods, Findings and Interpretation: This multi-society paper, representing the views of Radiology Societies in Europe, the USA, Canada, Australia, and New Zealand, describes the place of radiology in VBH models and the health-care value contributions of radiology. Potential steps to objectify and quantify the value contributed by radiology to healthcare are outlined., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

Floral nectar harbors microbial communities which have significant impacts on its chemistry, volatiles, nutritional contents, and attractiveness for pollinators. Yet, fundamental knowledge regarding the structure and composition of nectar-associated microbiomes remains largely unknown. Especially elusive are the environmental factors and spatial effects that shape nectar-inhabiting microbial communities. The aim of this study was to explore and analyze the role of geographical and environmental factors affecting the composition and global distribution of floral nectar microbiota. We explored and compared the structure of bacterial communities inhabiting the floral nectar of the widely spread and invasive tobacco tree (Nicotiana glauca) in six continents: South and North America, Australia, Europe, Africa, and Asia, using 16S rRNA gene sequencing. Environmental abiotic data for each sampled plant was obtained from the Worldclim database and applied for inferring the effects of environmental conditions on bacterial community structure and diversity. Most abundant in the nectar were the Proteobacteria, Firmicutes, and Actinobacteria phyla, with Acinetobacter and Rosenbergiella (Proteobacteria) being the dominant bacterial genera that contributed most to the dissimilarities between sites. Acinetobacter and Rosenbergiella abundances were negatively correlated and significantly higher in the Mediterranean regions (Greece, Israel, and the Canary Islands) compared to Argentina and Australia. Temperature, site-elevation, rainfall, and density of vegetation were found to have significant effects on the structure and diversity of these bacterial communities in the nectar. Vegetation density was positively correlated with microbial diversity, while increased temperatures and elevation reduced the diversity and evenness of bacterial communities. Mantel's test showed that the similarity between the bacterial communities' composition significantly decreased as distances between them increased. We conclude that both geographical distance and local environmental abiotic conditions affect and shape the composition and diversity of nectar inhabiting bacterial communities., Competing Interests: Declaration of competing interest The authors declare no conflict of interests. The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: The aim of this study was to characterize the safety profile of an intra-annular self-expanding valve with a next-generation low-profile delivery system (DS)., Background: Key design modifications to the FlexNav DS include the addition of a hydrophilic-coated, integrated sheath and stability layer to facilitate gradual, controlled deployment in vessels with diameter ≥5 mm., Methods: Patients were pooled from 2 concurrent prospective, multicenter, single-arm studies (FlexNav DS arm of PORTICO IDE [Portico Re-Sheathable Transcatheter Aortic Valve System U.S. IDE Trial] [n = 134] and the FlexNav EU CE Mark Study [n = 46]) for the analysis. The primary endpoint was Valve Academic Research Consortium-2-defined major vascular complications at 30 days. Clinical outcomes and valve performance were assessed through 30 days by an independent clinical events committee and an echocardiography core laboratory, respectively., Results: One hundred forty high-risk and 40 extreme-risk subjects enrolled between October 15, 2018, and December 10, 2019, from 28 sites in the United States, Australia, and Europe who underwent attempted transfemoral Portico valve implantation were included. The mean age was 85.1 ± 5.6 years, 60% were women, the mean Society of Thoracic Surgeons score was 5.3%, and 96.1% presented with ≥1 frailty factor. Technical device success was 96.7%. At 30 days, the rate of major vascular complications was 5.0%, with 4.4% of complications adjudicated as access site-related (3.3% transcatheter aortic valve replacement DS access site-related). Death (0.6%) and disabling stroke (1.1%) were rare. The rate of new permanent pacemaker implantation was 15.4%. Echocardiography revealed a mean gradient of 7.1 ± 3.2 mm Hg, mean valve area of 1.77 ± 0.41 cm 2 , and a 4.1% rate of moderate paravalvular leak at 30 days., Conclusions: Portico valve implantation with the FlexNav DS was associated with an excellent safety profile at 30 days., Competing Interests: Author Relationship With Industry Dr. Fontana is a consultant for and has received proctoring fees from Abbott, Medtronic, and LivaNova; is a member of the structural heart safety advisory board for Abbott; and is a principal investigator for Abbott and Medtronic. Dr. Bedogni has served as a consultant for Boston Scientific, Medtronic, and Abbott. Dr. Groh is a member of the structural heart safety advisory board for Abbott. Dr. Smith has received speaking fees and proctoring fees from Abbott. Dr. Chehab has received grant and research support from Abbott; and has received speaking and proctoring fees from Abbott, Edwards Lifesciences, Medtronic, and Boston Scientific. Dr. Yong is a physician proctor for Abbott Vascular, Medtronic, and Edwards Lifesciences. Dr. Worthley has received research grants from Abbott and Biotronik. Dr. Manoharan has served as a proctor for Boston Scientific, Medtronic, and Abbott. Dr. Walton is a proctor for Medtronic and Abbott; is a medical advisory board member for Medtronic; and has received grant support from Medtronic, Abbott, and Edwards Lifesciences. Dr. Hermiller is a physician proctor for Abbott. Dr. Dhar is a proctor for Abbott Vascular, Edwards Lifesciences, and Medtronic; has received a research grant from Boston Scientific; is a member of the interventional cardiology medical advisory board for Boston Scientific; and is a member of the Speakers Bureau for Boston Scientific. Dr. Waksman is an advisory board member for Amgen, Boston Scientific, Cardioset, Cardiovascular Systems, Medtronic, Philips, and Pi-Cardia; is a consultant for Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems, Medtronic, Philips, and Pi-Cardia; has received grant support from AstraZeneca, Biotronik, Boston Scientific, and Chiesi; is a Speakers Bureau member for AstraZeneca and Chiesi; and is an investor in MedAlliance. Dr. Ramana has received speaking, consulting, and proctoring fees from Edwards Lifesciences; has received consulting fees from Abbott and Medtronic; and has received research support from Boston Scientific. Dr. Mahoney is a consultant and proctor for Edwards Lifesciences; and is a consultant for Abbott. Dr. Asch is director of an academic echocardiography core laboratory that has institutional research contracts with Abbott, Edwards Lifesciences, Boston Scientific, Medtronic, LivaNova, Biotronik, and Vascular Innovations. Dr. Chakravarty is a consultant for Edwards Lifesciences, Medtronic, Abbott, and Boston Scientific. Dr. Jilaihawi has been a consultant to Boston Scientific and Medtronic; and has received grant and research support from Medtronic, Edwards Lifesciences, Abbott Vascular, and HLT, Inc. Dr. Makkar has received research grants and speaking and proctoring fees from Edwards Lifesciences, Abbott, Medtronic, and Boston Scientific. Dr. Garrett has reported that he has no relationships relevant to the contents of this paper to disclose., (Copyright © 2020. Published by Elsevier Inc.)

The Ostreid herpesvirus 1 (OsHV-1) and variants, particularly the microvariants (μVars), are virulent and economically devastating viruses impacting oysters. Since 2008 OsHV-1 μVars have emerged rapidly having particularly damaging effects on aquaculture industries in Europe, Australia and New Zealand. We conducted field trials in Tomales Bay (TB), California where a non-μVar strain of OsHV-1 is established and demonstrated differential mortality of naturally exposed seed of three stocks of Pacific oyster, Crassostrea gigas, and one stock of Kumamoto oyster, C. sikamea. Oysters exposed in the field experienced differential mortality that ranged from 64 to 99% in Pacific oysters (Tasmania>Midori = Willapa stocks), which was much higher than that of Kumamoto oysters (25%). Injection trials were done using French (FRA) and Australian (AUS) μVars with the same oyster stocks as planted in the field and, in addition, two stocks of the Eastern oyster, C. virginica. No mortality was observed in control oysters. One C. virginica stock suffered ~10% mortality when challenged with both μVars tested. Two Pacific oyster stocks suffered 75 to 90% mortality, while one C. gigas stock had relatively low mortality when challenged with the AUS μVar (~22%) and higher mortality when challenged with the French μVar (~72%). Conversely, C. sikamea suffered lower mortality when challenged with the French μVar (~22%) and higher mortality with the AUS μVar (~44%). All dead oysters had higher viral loads (~1000×) as measured by quantitative PCR relative to those that survived. However, some survivors had high levels of virus, including those from species with lower mortality. Field mortality in TB correlated with laboratory mortality of the FRA μVar (69% correlation) but not with that of the AUS μVar, which also lacked correlation with the FRA μVar. The variation in response to OsHV-1 variant challenges by oyster species and stocks demonstrates the need for empirical assessment of multiple OsHV-1 variants., Competing Interests: Declaration of competing interest 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., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: To be fit-for-purpose, oral health-related quality of life instruments must possess a range of psychometric properties which had not been fully examined in the 16-item Short Form Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ 11-14 ISF-16). We used advanced statistical approaches to determine the CPQ's measurement accuracy, precision, invariance and dimensionality and analyzed whether age range could be extended from 8 to 15 years., Methods: Fit to the Rasch model was examined in 6648 8-to-15-year-olds from Australia, New Zealand, Brunei, Cambodia, Hong Kong, Malaysia, Thailand, Germany, United Kingdom, Brazil and Mexico., Results: In all but two items, the initial five answer options were reduced to three or four, to increase precision of the children's selection. Items 10 (Shy/embarrassed) and 11 (Concerned what others think) showed an 'extra' dependency between item scores beyond the relationship related to the underlying latent construct represented by the instrument, and so were deleted. Without these two items, the CPQ was unidimensional. The three oral symptoms items (4 Food stuck in teeth, 3 Bad breath and 1 Pain) were required for a sufficient person-item coverage. In three out of 14 items (21 %), Europe and South America showed regional differences in the patterns of how the answer options were selected. No differential item functioning was detected for age., Conclusion: Except for a few modifications, the present analysis supports the combination of items, the cross-cultural validity of the CPQ with 14 items and the extension of the age range from 8 to 15 years., Clinical Significance: The valid, reliable, shortened and age-extended version of the CPQ resulting from this study should be used in routine care and clinical research. Less items and a wider age range increase its usability. Symptoms items are needed to precisely differentiate between children with higher and lower quality of life., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: This article aims to provide an overview of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; personal use of cannabis and other drugs; participation in cannabis and other drug markets; contacts with the criminal justice system for respondents to an online survey about cannabis cultivation drawn from eleven countries (N=6530). Important similarities and differences between the national samples recruited will be discussed., Methods: This paper utilizes data from the online web survey of predominantly 'small-scale' cannabis cultivators in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Here we focus primarily on descriptive statistics to highlight key similarities and differences across the different national samples., Results: Overall there was a great deal of similarity across countries in terms of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; use of cannabis and other drugs; participation in cannabis and other drug markets, and; contacts with the criminal justice system. In particular, we can recognise that a clear majority of those small-scale cannabis cultivators who responded to our survey are primarily motivated for reasons other than making money from cannabis supply and have minimal involvement in drug dealing or other criminal activities., Conclusions: These growers generally come from 'normal' rather than 'deviant' backgrounds. Some differences do exist between the samples drawn from different countries suggesting that local factors (political, geographical, cultural, etc.) may have some influence on how small-scale cultivators operate, although differences in recruitment strategies in different countries may also account for some differences observed., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Internet-mediated research methods are increasingly used to access hidden populations. The International Cannabis Cultivation Questionnaire (ICCQ) is an online survey designed to facilitate international comparisons into the relatively under-researched but increasingly significant phenomenon of domestic cannabis cultivation. The Global Cannabis Cultivation Research Consortium has used the ICCQ to survey over 6000 cannabis cultivators across 11 countries. In this paper, we describe and reflect upon our methodological approach, focusing on the digital and traditional recruitment methods used to access this hidden population and the challenges of working across multiple countries, cultures and languages., Methods: Descriptive statistics showing eligibility and completion rates and recruitment source by country of residence., Results: Over three quarters of eligible respondents who were presented with the survey were included in the final sample of n=6528. English-speaking countries expended more effort to recruit participants than non-English-speaking countries. The most effective recruitment modes were cannabis websites/groups (33%), Facebook (14%) and news articles (11%). While respondents recruited through news articles were older, growing practice variables were strikingly similar between these main recruitment modes., Conclusion: Through this process, we learnt that there are trade-offs between hosting multiple surveys in each country vs. using one integrated database. We also found that although perceived anonymity is routinely assumed to be a benefit of using digital research methodologies, there are significant limits to research participant anonymity in the current era of mass digital surveillance, especially when the target group is particularly concerned about evading law enforcement. Finally, we list a number of specific recommendations for future researchers utilising Internet-mediated approaches to researching hidden populations., (Copyright © 2014 Elsevier B.V. All rights reserved.)

As part of the project "Religious slaughter (DIALREL): improving knowledge and expertise through dialogue and debate on issues of welfare, legislation and socio-economic aspects", this paper discusses an evaluation of current practices during Halal and Shechita slaughter in cattle, sheep, goats and poultry. During religious slaughter, animals are killed with and without stunning by a transverse incision across the neck that is cutting the skin, muscles (brachiocephalic, sternocephalic, sternohyoid, and sternothyroid), trachea, esophagus, carotid arteries, jugular veins and the major, superficial and deep nerves of the cervical plexus. In this report, the restraint methods, stunning, neck cutting, exsanguination, slaughter techniques and postcut handling in the abattoir were assessed for religious slaughter. Information about the procedures used during religious slaughter in Belgium, Germany, Italy, the Netherlands, Spain, the UK, Turkey and Australia was collected by means of spot visits to abattoirs. To standardize the information gathered during the spot visits three guidelines were designed, one for each species, and translated into the national languages of the countries involved. The document included questions on the handling and restraint methods (stunning, neck cutting/exsanguination/slaughter techniques and postcut handling performed under religious practices) and for pain and distress of the animal during the restraint, neck cutting and induction to death in each abattoir. Results showed differences in the time from restraining to stun and to cut in the neck cutting procedures and in the time from cut to death., (© 2013.)

Objective: In this paper, we review evidence of HCV prevalence among injecting drug users (IDUs) worldwide., Methods: We undertook a desk-based review of both 'grey' and published literature released between 1998 and 2005., Results: Data on HCV prevalence among IDUs was found in 57 countries and in 152 sub-national areas. We found reports of HCV prevalence of at least 50% among IDUs in 49 countries or territories. Available regional estimates varied widely, from 10 to 96% in Eastern Europe and Central Asia, from 10 to 100% in South and South-East Asia, from 34 to 93% in East-Asia and the Pacific, from 5 to 60% in North Africa and the Middle-East, from 2 to 100% in Latin America, from 8 to 90% in North America, from 25 to 88% in Australia and New Zealand, and from 2 to 93% in Western Europe. Only in Colombia and Lebanon were all HCV prevalence estimates below 20%. In addition, evidence of HIV/HCV co-infection among IDUs was found in 16 countries. In China, Poland, Puerto Rico, Russia, Spain, Switzerland, Thailand and Viet Nam, estimates of the prevalence of HIV/HCV co-infection among IDUs reached 90%., Discussion: Taken together, data suggest high global prevalence of HCV and HIV/HCV co-infection among IDUs. We suggest exploring protective factors in sites of low HCV prevalence.

Helminthosis is one of the major constraints in the successful wool and mutton industry throughout the world. Anthelmintic Resistance (AR) is said to have been established when previously effective drug ceases to kill exposed parasitic population at the therapeutically recommended dosages. Anthelmintic resistance is almost cosmopolitan in distribution and it has been reported in almost all species of domestic animals and even in some parasites of human beings. Some of the most important species of parasites of small ruminants in which AR has been reported include: Haemonchus spp., Trichostrongylus spp. Teladorsagia spp., Cooperia spp. Nematodirus spp., and Oesophagostomum spp. All the major groups of anthelmintics have been reported for development of variable degrees of resistance in different species of gastrointestinal nematodes. This paper describes the global scenario of prevalence and methods used for detection of AR in small ruminants. Different mechanisms and contributory factors for the development of AR are discussed. Various options and alternate strategies for the control and/or delay in the onset of AR are suggested in the light of available information.

Objectives: Using the concept of avoidable mortality, international studies suggest that healthcare has been effective in reducing mortality. This paper provides an analysis of avoidable mortality in Australia and compares trends with those of Western Europe., Methods: Using unit-record mortality data, we calculated avoidable mortality rates in Australia for 1968-2001. We partitioned avoidable causes into three categories: those amenable to medical care; those mainly responsive to health policy; and ischaemic heart disease. We used Poisson regression to model the trends. We compared trends with those of nine European countries using published data., Results: Total avoidable death rates fell by 68% in females and 72% in males. The corresponding non-avoidable death rates fell by 35 and 33%. The annual declines in avoidable mortality rates were: 3.47% [95% confidence intervals (CI) 3.44-3.50%] in males and 3.89% (95% CI 3.86-3.91%) in females. For non-avoidable mortality rates, the annual declines were 1.09% (95% CI 1.05-1.13%) and 0.95% (95% CI 0.92-0.98%), respectively. In females, declines in death rates from causes amenable to medical care contributed 54% to the decline in avoidable mortality rates, ischaemic heart disease contributed 45%, and causes responsive to health policy intervention contributed 1%. In males, the corresponding contributions were 32, 57 and 11%. These rates, and the declines between 1980 and 1998, were comparable with selected European countries, with Australia's ranking improving over the period., Conclusion: Trends in avoidable mortality in Australia suggest that the Australian healthcare system has been effective in improving population health. Australia's experience compares favourably with that of Europe.

This paper reports the findings of a worldwide survey of the teaching of glass ionomer (polyalkenoate) cements (GICs). A total of 324 questionnaires was returned from the 650 dental schools included in the study (50 per cent response), with the response ranging from 100 per cent (Australasia) to 4 per cent (USSR). The findings indicate that most primary dental degree students in the majority of countries investigated are presently taught the use of GICs in a wide range of applications using techniques which largely conform with those recommended by the manufacturers of such materials.

This paper describes the dental provides in six study areas. The data were collected through interviews with samples of dentists who participated in the World Health Organization/US Public Health Service International Collaborative Study. Comparisons between dental providers in the different areas focus upon their personal characteristics, characteristics of their practices, their work patterns, the way they used their time, their professional activities and their satisfaction with dentistry. These descriptive data are related to consumer survey data obtained in another section of the International Collaborative Study.