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Implicit (i.e. unconscious) racial biases held by health professionals negatively affect patient–practitioner communication and health outcomes. Implicit biases are typically assessed through implicit association tests (IATs). We extracted cross‐sectional IAT data originating in Australia from two large publicly available data sets hosted by Project Implicit. In total, IATs were available from 1956 healthcare workers (1249 of European ethnicity; 829 professionals/technicians as opposed to support workers). All had participated between 2006 and 2022. Levels of implicit skin tone bias were found to be moderate according to Project Implicit guidelines and substantially greater than zero (d = 0.87). Participants of European ethnicity and older age scored higher, but there were no differences across occupation types (professional vs. support worker) or over years. Consistent with findings around the world, the findings highlight a need for interventions that could reduce implicit bias and thereby improve the healthcare experiences of people from minority groups. [ABSTRACT FROM AUTHOR]

Background: Patients with obstructed defecatory symptoms (ODS) are commonly referred to either gastroenterologists (GE) or colorectal surgeons (CS). Further management of these patients may be impacted by this choice of referral. Methods: An online survey of specialist practice was disseminated to GE and CS in Australia and New Zealand. A case vignette of a patient presenting with ODS was described, with multiple subsequent scenarios designed to delineate the responder's preferred approach to management of this patient. Key Results: A total of 107 responders participated in the study, 62 CS and 45 GE. For a female patient with ODS not responding to pharmacological treatment, GE were more likely than CS to refer patients for anorectal manometry, while CS were more likely to refer for dynamic imaging. A quarter of CS and GE referred patients directly to pelvic floor physiotherapy, without any pre‐treatment testing. Knowing the result of dynamic imaging, especially if a rectocele was demonstrated, substantially influenced management for both of the specialties: GE became more likely to refer the patients for CS consultation and less likely to refer directly for biofeedback or physiotherapy and CS were more likely to opt for an operative pathway over conservative management than they were prior to knowledge of the imaging findings. The majority (>75%) of GE and CS did not find it necessary to obtain a gynecological consultation, even in the presence of a rectocele. Conclusions & Inferences: Practice variation across medical specialties affects diagnostic and management recommendations for patients with ODS, impacting treatment pathways. Our findings provide an incentive toward establishing interdisciplinary, uniform, management guidelines. [ABSTRACT FROM AUTHOR]

The article presents a study on the long-term symptom profile, quality of lief, and need for surgery among fecal incontinence (FI) patients after biofeedback (BF). It discusses the risk factors of poor quality of life and how the response to BF is an indicator of long-term improvement or need for alternative therapies.

Background: Anorectal manometry (ARM) and balloon expulsion test (BET) are pivotal in investigation of anorectal disorders. There is controversy, however, about normal values and optimum methodology for performing these tests. Our aims were to compare BET using three different balloons and to establish normal values for ARM and BET in health. Methods: Forty‐four female healthy subjects (mean age 56 ± 12 years) underwent ARM, followed by BET which was performed in a private toilet using three different catheters (party balloon, Foley catheter and a commercially available catheter) in a single‐blinded randomized order. Outcome measures were time to balloon expulsion and comprehensive measures of anal sphincter function, the push maneuver and rectal sensation. Key Results: The Foley catheter took longer to expel compared to both party and commercial balloons (both pairwise P < 0.001) with a wider distribution of results (P < 0.001). Ten of 40 healthy subjects could not expel the Foley catheter within 120 seconds. On ARM, older age was associated with lower resting anal sphincter pressure (ρ = −0.3, P = 0.05) and lower anal squeeze pressure (ρ = −0.3, P = 0.05). Having at least one vaginal delivery (compared to none) was associated with lower anal squeeze pressures (P = 0.03) and a smaller difference between cough and squeeze pressures (P = 0.03). Conclusions & Inferences: A commercial balloon exhibited superior results in vivo compared to the Foley catheter without the concerns of latex allergy and quality control present with the use of a party balloon. Normal values for high‐resolution water‐perfused manometry have been established and an effect seen for age and parity. Balloon expulsion testing and anorectal manometry are commonly performed in the investigation of anorectal disorders, but the ideal methodology and normal ranges are not well established. In this randomized study of healthy subjects, we compare three commonly used catheters for balloon expulsion testing, and demonstrate that a commercially available balloon is preferred. Normal ranges for comprehensive high resolution, water‐perfused anorectal manometry are provided. [ABSTRACT FROM AUTHOR]

An abstract of the conference paper "Abnormal placentation-prospects of ultrasound diagnosis," by L. S. Ejova and colleagues is presented.