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Background Worldwide, most people requiring kidney replacement therapy receive haemodialysis (HD) three times per week. Greater HD time and/or frequency may improve survival, but implementation requires understanding potential benefits across the range of patients. Methods Using data from the Australia and New Zealand Dialysis and Transplant Registry, we assessed whether quotidian HD (defined as >3 sessions/week and/or >5 h/session) was associated with reduced mortality in adult patients. The primary outcome of all-cause mortality was analysed by a time-varying Cox proportional hazards model with quotidian HD as the exposure of interest. Results Of 24 138 people who received HD between 2011 and 2019, 2632 (10.9%) received quotidian HD at some stage. These patients were younger, more likely male and more likely to receive HD at home. Overall, quotidian versus standard HD was associated with a decreased risk for all-cause mortality {crude hazard ratio [HR] 0.50 [95% confidence interval (CI) 0.45–0.56]}, but an interaction between quotidian HD and age was identified (P  = .005). Stratified by age groups and splitting follow-up time where proportional hazards were violated, the corresponding HR compared with standard HD was 2.43 (95% CI 1.56–3.79) for people >75 years of age in the first year of quotidian HD, 1.52 (95% CI 0.89–2.58) for 1–3 years and 0.95 (95% CI 0.51–1.78) for ≥3 years. There was no significant survival advantage in younger people. Conclusions Although quotidian HD conferred survival benefit in crude analyses, people ≥75 years of age had greater mortality with quotidian HD than standard HD. The mortality benefit in younger people was attenuated when adjusted for known confounders. [ABSTRACT FROM AUTHOR]

Aim: Haemodialysis treatment prescription varies widely internationally. This study explored patient‐ and centre‐level characteristics associated with weekly haemodialysis hours. Methods: Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry data were analysed. Characteristics associated with weekly duration were evaluated using mixed‐effects linear regression models with patient‐ and centre‐level covariates as fixed effects, and dialysis centre and state as random effects using the 2017 prevalent in‐centre haemodialysis (ICHD) and home haemodialysis (HHD) cohorts. Evaluation of patterns of weekly duration over time analysed the 2000 to 2017 incident ICHD and HHD cohorts. Results: Overall, 12 494 ICHD and 1493 HHD prevalent patients in 2017 were included. Median weekly treatment duration was 13.5 (interquartile range [IQR] 12‐15) hours for ICHD and 16 (IQR 15‐20) hours for HHD. Male sex, younger age, higher body mass index, arteriovenous fistula/graft use, Aboriginal and Torres Strait Islander ethnicity and longer dialysis vintage were associated with longer weekly duration for both ICHD and HHD. No centre characteristics were associated with duration. Variability in duration across centres was very limited in ICHD compared with HHD, with variation in HHD being associated with state. Duration did not vary significantly over time for ICHD, whereas longer weekly HHD treatments were reported between 2006 and 2012 compared with before and after this period. Conclusion: This study in the Australian and New Zealand haemodialysis population showed that weekly duration was primarily associated with patient characteristics. No centre effect was demonstrated. Practice patterns seemed to differ across states/countries, with more variability in HHD than ICHD. SUMMARY AT A GLANCE: Patient‐level characteristics such as age, sex, BMI, dialysis vintage, ethnicity rather than centre‐level ones were associated with weekly duration of haemodialysis, with more variability among home‐ than in‐centre haemodialysis patients in the Australian and New Zealand population. [ABSTRACT FROM AUTHOR]

This research determined variables potentially involved in influencing Lidcombe Program treatment time. The method used retrospective case studies of 10 pre-school children with rapid treatment responses and 10 with slow treatment responses. Results were consistent with existing findings that associated pretreatment stuttering severity with longer treatment time. A new suggestion emerged about children whose siblings had been successfully treated; those cases were more likely to be associated with shorter treatment times. Slow treatment was associated with file reports of parents having difficulty learning Lidcombe Program procedures and with parents not complying with recommended practice sessions. Some variables were identified more frequently for either the rapid or slow response groups of children. Considering the clinical importance of these preliminary findings, they compel a replication with prospective methods that involve strong statistical power. [ABSTRACT FROM AUTHOR]

Question: Can primary contact physiotherapists reduce waiting and treatment times and facilitate faster discharge in Australian emergency departments? Design: Data on patients treated by primary contact physiotherapists were collected prospectively and compared with historical and concurrent cohorts of patients treated by other clinicians, using diagnosis and urgency. Participants: Twenty-nine primary contact physiotherapists, working at 10 sites, treated a total of 14 452 patients with musculoskeletal conditions in triage categories 3, 4 and 5. Outcome measures: Data were analysed for two time periods: baseline (historical control) and implementation (12 to 15 months). A concurrent control cohort within the implementation period was selected using diagnosis (ICD-10-AM) and urgency of treatment (triage category). Waiting time, treatment time, and time to discharge from the emergency department were compared across periods and between cohorts. Results: Significant differences were found in waiting and treatment times. On average, patients treated by primary contact physiotherapists waited 31 minutes less than those treated by other practitioners and had an average treatment time of 108 minutes compared with 148 minutes. Overall, 93% of patients treated by primary contact physiotherapists and 75% treated by other practitioners were discharged from the emergency department within a 4-hour time period. To address concerns that these results could be due to other differences between cohorts, multiple regression models were used and the results were still significantly in favour of the primary contact physiotherapists. Conclusion: A primary contact physiotherapist model in hospital emergency departments can reduce waiting and treatment times for patients with musculoskeletal presentations, resulting in better performance in achieving discharge within the 4-hour national target. [Bird S, Thompson C, Williams KE (2016) Primary contact physiotherapy services reduce waiting and treatment times for patients presenting with musculoskeletal conditions in Australian emergency departments: an observational study. Journal of Physiotherapy 62: 209–214] [ABSTRACT FROM AUTHOR]