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The diagnostic image must be carried out with the minimum necessary exposure of the patient that allows the objective of the diagnosis to be satisfactorily achieved. For this reason, diagnostic reference levels emerge and are established as dynamic tools to help optimize radiation protection, contribute to the standardization of practices and strengthen culture of safety, without compromising the clinical purpose of each examination or process. The objective of this work is to provide an updated overview of the establishment and use of these levels for nuclear medicine and hybrid imaging. It is identified that to establish and use them properly, trained personnel and coordination and collaboration activities are required among multiple actors, including medical services, health authorities, professional organizations and regulatory bodies. The accelerated development of technology generally exceeds the change in regulations, so these levels must be updated periodically, in order to fulfil their role as a guide and spur for optimization. The worldwide expansion of hybrid technologies and their growing use are a phenomenon of the last decade, so the establishment of these levels for such technologies has not been consolidated, although countries such as the United Kingdom and Australia show solid steps in this address. Research has been carried out with phantoms and directly with patients, the latter with a more useful contribution of information. The installation of hybrid equipment in Cuba demands this study, hence its importance. [ABSTRACT FROM AUTHOR]

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Objective: In the context of increasing over-testing and the implications for patient safety, to establish the prevalence and nature of pathology test-ordering of GP trainees, and to describe the associations of this test-ordering.Design: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) cohort study.Setting: Five of Australia's 17 general practice regional training providers, encompassing urban-to-very remote practices.Participants: GP trainees.Main Outcome Measures: The number of pathology tests ordered per problem/diagnosis managed.Results: A total of 856 individual trainees (response rate 95.2%) contributed data from 1832 trainee-terms, 108 759 encounters and 169 304 problems. Pathology test-ordering prevalence was 79.3 tests (95% CI: 78.8-79.8) per 100 encounters, 50.9 (95% CI: 50.6-51.3) per 100 problems, and at least 1 test was requested in 22.4% of consultations. Most commonly ordered was full blood count (6.1 per 100 problems). The commonest problem prompting test-ordering was 'check-up' (18.6%). Test-ordering was significantly associated, on multivariable analysis, with the trainee having worked at the practice previously; the patient being adult, male and new to both trainee and practice; the practice being urban; the problem/diagnosis being new; imaging being ordered; referral being made and follow-up being arranged. Trainees were significantly less likely to order tests for problems/diagnoses for which they had sought in-consultation information or advice.Conclusions: Compared with the established GPs, trainees order more pathology tests per consultation and per problem managed, and in a higher proportion of consultations. Our findings will inform educational policy to enhance quality and safety in general practice training. [ABSTRACT FROM AUTHOR]

The aim of the present survey of the history of medicine is to provide a series of succinct assessments of the role of women in the development of nephrology. The inadequate role played by women in some areas of medicine underlines the trend that considers health history as part of external history modulating the branches of science. If "external" or social history considers women's role as marginal in many segments of society, no wonder they play a marginal role in the history of medicine. Nonetheless, when women are offered the opportunity to map out new medical paths or handle new health systems they have always been excellent. Tratula, a doctor from Salerno's medical school, is just an example. Women have been excellent in nursing and popular medicine. Florence Nightingale (1823-1910), an English woman of rare ability and humanitarian enthusiasm, was the first to understand the role of women in organising nursing. In this area she had such a striking success that her method contributed to the founding of the first school of nursing in England and in the world. On the other hand, women doctors have had many difficulties in the medical area. The first modern woman to take her degree in medicine was Elisabeth Blackwell, who graduated from the Geneva Medical School of Western New York in 1849. She managed to open a private dispensary, which within a few years developed into a great hospital and training school for women. In the nephrology area a great Australian woman entered the universal history of medicine, Priscilla Kincaid-Smith. Her outstanding contribution was to improve the diagnosis and treatment of glomerulonephritis. Her positive attitude and the novelty of a woman being on the same scientific level as men, combined to secure her unique reputation in both her own country and the world. We hope that new social trends will develop in which women with scientific ideas will be able to completely express their medical ability and the tendency to eliminate the vestiges of old traditions will be reinforced through the granting of new scientific and academic opportunities. In Italian nephrology this tendency has been accelerating.

Purpose: Post COVID-19 Condition (PCC), being persistent COVID-19 symptoms, is reminiscent of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)-a chronic multi-systemic illness characterised by neurocognitive, autonomic, endocrinological and immunological disturbances. This novel cross-sectional investigation aims to: (1) compare symptoms among people with ME/CFS (pwME/CFS) and people with PCC (pwPCC) to inform developing PCC diagnostic criteria; and (2) compare health outcomes between patients and people without acute or chronic illness (controls) to highlight the illness burdens of ME/CFS and PCC., Methods: Sociodemographic and health outcome data were collected from n = 61 pwME/CFS, n = 31 pwPCC and n = 54 controls via validated, self-administered questionnaires, including the 36-Item Short-Form Health Survey version 2 (SF-36v2) and World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0). PwME/CFS and pwPCC also provided self-reported severity and frequency of symptoms derived from the Canadian and International Consensus Criteria for ME/CFS and the World Health Organization case definition for PCC., Results: Both illness cohorts similarly experienced key ME/CFS symptoms. Few differences in symptoms were observed, with memory disturbances, muscle weakness, lymphadenopathy and nausea more prevalent, light-headedness more severe, unrefreshed sleep more frequent, and heart palpitations less frequent among pwME/CFS (all p < 0.05). The ME/CFS and PCC participants' SF-36v2 or WHODAS 2.0 scores were comparable (all p > 0.05); however, both cohorts returned significantly lower scores in all SF-36v2 and WHODAS 2.0 domains when compared with controls (all p < 0.001)., Conclusion: This Australian-first investigation demonstrates the congruent and debilitating nature of ME/CFS and PCC, thereby emphasising the need for multidisciplinary care to maximise patient health outcomes., (© 2024. The Author(s).)

Copyright of Revista Española de Física is the property of Real Sociedad Espanola de Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article discusses the research-based design choices and general rationale underpinning the creation of a video game called Medicina. This game is designed to broadly foster better language skills among international nursing students with English as a second language (ESL) and more specifically to teach confusable medication names while also improving reaction time to verbal orders. Research shows that the learning of vocabulary is important to language learning. Without adequate vocabulary knowledge, it is difficult for an international student to interact in professional and university settings. This situation is compounded by the expectation that students will learn key vocabulary incidentally through academic pre-readings, despite the research demonstrating this to be an inefficient and inadequate method of learning. Moreover, medication names are low-frequency vocabulary. Thus, the international student who seeks to enter the health profession encounters the task of learning a large subset of language but without the amount of exposure theorised as being necessary to it. The article will outline how the language-learning video game is designed to encourage rapid discrimination of word form and give multiple exposures to both written and spoken medication names. It concludes with a summary of the preliminary testing of the game and a brief summary of the findings. [ABSTRACT FROM AUTHOR]

Establishing healthy feeding habits during infancy is crucial for optimal growth. However, certain parental feeding and cultural practices might hinder the development of children's healthy eating behaviours. This research explored responsive feeding practices among migrant mothers in Australia. Semi‐structured telephone interviews were conducted in their native language with 20 Arabic and 20 Mongolian‐speaking migrant mothers with children under 2 years old or currently pregnant. Thematic analysis was conducted using the framework method. Both cultural groups followed a variety of feeding practices, including on demand responsive feeding or structured schedules. Arabic‐speaking mothers tended to demonstrate responsive feeding practices more frequently than Mongolian‐speaking mothers, except for those using formula feeding, who consistently followed a fixed feeding routine. When introducing solid foods, mothers from both groups often overlooked their babies' hunger and satiety cues, frequently pressuring their children to finish their entire plate. One cited reason for this was the challenge parents faced in identifying such cues. Arabic‐speaking mothers often supplemented with formula top‐ups after introducing solid foods, due to the belief that breast milk or solid foods alone might not sufficiently nourish their infants. Additionally, some Arabic‐speaking mothers used food‐based rewards to encourage eating. Mongolian mothers expressed a cultural preference for chubby babies, a potential reason why they may have been inclined to pressure‐feed their children. Moreover, both groups reported using digital devices to distract their children during meals. This study highlights the necessity of tailoring future resources and services related to responsive feeding practices to accommodate diverse literacy levels and cultural backgrounds. Key messages: Arabic‐speaking mothers generally exhibited responsive feeding practices more often than Mongolian‐speaking mothers, except for those employing formula feeding who consistently adhered to a set feeding schedule.Both Arabic and Mongolian‐speaking mothers reported difficulty in identifying their babies' hunger and satiety cues, resulting in instances where they felt compelled to pressure their children to eat.Future resources and services should be co‐designed with parents to accommodate diverse literacy levels and cultural backgrounds.Future resources should also prioritise guiding mothers to identify hunger and satiety cues when feeding their infants, as well as addressing misconceptions about food, health, and body image. This includes challenging the notion that chubby babies are inherently healthier. [ABSTRACT FROM AUTHOR]

Novel species of fungi described in this study include those from various countries as follows: Antarctica, Leuconeurospora bharatiensis from accumulated snow sediment sample. Argentina, Pseudocercospora quetri on leaf spots of Luma apiculata. Australia, Polychaetomyces verrucosus on submerged decaying wood in sea water, Ustilaginoidea cookiorum on Scleria levis, Xylaria guardiae as endophyte from healthy leaves of Macaranga tanarius. Belgium, Iodophanus taxi on leaf of Taxus baccata. Belize, Hygrocybe mirabilis on soil. Brazil, Gongronella irregularis from soil, Linodochium splendidum on decaying sheath of Euterpe oleracea, Nothophysalospora agapanthi (incl. Nothophysalospora gen. nov.) on flower stalks of Agapanthus praecox, Phaeosphaeria tabebuiae on leaf of Tabebuia sp., Verrucohypha endophytica (incl. Verrucohypha gen. nov.) from healthy roots of Acrocomia aculeata. Estonia, Inosperma apricum on soil under Quercus robur. Greece, Monosporascus solitarius isolated from surfacesterilised, asymptomatic roots of Microthlaspi perfoliatum. India, Diaporthe neocapsici on young seedling stems of Capsicum annuum, Fuscoporia naditirana on dead wood, Sebacina spongicarpa on soil, Torula kanvae from the gut of a Copris signatus beetle. Iran, Sarcinomyces pruni from twig and petiole tissues of Prunus persica and Prunus armeniaca, Xenodidymella quercicola from leaf spots of Quercus brantii. Italy, Agaricus aereiceps on grass, Agaricus bellui in meadows, Agaricus fabrianensis in urban grasslands, Beaucarneamyces muscorum on moss growing in forest, Xenoanthostomella quercus on leaf litter of Quercus ilex. Netherlands, Alfaria neerlandica on stem lesions of Cortaderia selloana, Neodictyosporium juncicola on culms of Juncus maritimus, Penicillium geertdesnooi from soil under Papaver rhoeas, Russula abscondita on rich calcareous soil with Quercus, Russula multiseptata on rich clay soil with Quercus, Russula purpureopallescens on soil with Populus, Sarocladium caricicola on leaves of Carex riparia. Pakistan, Circinaria shimlaensis on limestone rocks. Panama, Acrocalymma philodendri on leaf spots of Philodendron sp., Caligospora panamaensis on leaf litter, Chlamydocillium simulans associated with a Xylaria sp., Corynesporina panamaensis on leaf litter, Cylindromonium panamaense on twig litter of angiosperm, Cyphellophora panamaensis on twig litter of angiosperm, Microcera panamensis on leaf litter of fern, Pseudotricholoma pusillum in tropical montane forest dominated by Quercus spp., Striaticonidium panamaense on leaf litter, Yunnanomyces panamaensis on leaf litter. Poland, Albocremella abscondita (incl. Albocremella gen. nov.) from rhizoids of liverwort Conocephalum salebrosum. Portugal, Agaricus occidualis in meadows. South Africa, Alternaria elsarustiae on culms of unidentified Poaceae, Capronia capensis on dead twig of unidentified angiosperm, Codinaeella bulbinicola on dead leaves of Bulbine frutescens, Cytospora carpobroticola on leaf of Carpobrotus quadrifidus, Neophaeomoniella watsoniae on leaf of Watsonia sp., Neoplatysporoides aloigena on leaf of Aloe khamiesensis, Nothodactylaria comitabilis on living leaf of Itea rhamnoides, Nothopenidiella beaucarneae (incl. Nothopenidiella gen. nov.) on dead leaves of Beaucarnea stricta, Orbilia kirstenboschensis on dead flower stalks of Agapanthus praecox, Phragmocephala agapanthi on dead flower stalks of Agapanthus praecox, Podocarpigena hagahagaensis (incl. Podocarpigena gen. nov.) on leaf spots of Podocarpus falcatus, Sporisorium enterogonipteri from the gut of Gonipterus sp., Synnemapestaloides searsiae on leaf of Searsia populifolia, Xenophragmocapnias diospyri (incl. Xenophragmocapnias gen. nov.) on leaf spots of Diospyros sp., Yunnanomyces hagahagaensis on leaf spots of Sideroxylon inerme. Spain, Agaricus basicinctus in meadows, Agaricus quercetorum among leaf litter in oak forests, Coprinopsis palaciosii on degraded woody debris, Inocybe complutensis in calcareous loamy soil, Inocybe tanitiae in calcareous sandy soil, Mycena subfragosa on dead leaves of Salix atrocinerea, Pseudobaeospora cortegadensis in laurel forests, Trichoderma sedimenticola from fluvial sediments. Sweden, Inocybe badjelanndana on calcareous soil. Ukraine, Beaucarneamyces lupini on overwintered stems of Lupinus polyphyllus, Protocreopsis globulosa on thallus and apothecia of Lecania cyrtella on bark of Populus sp., Thyridium tiliae on dead twigs of Tilia sp. USA, Cladosporium louisianense, Cyphellophora americana from a bedroom vent, Extremus massachusettsianus from lyse buffer, Myxotrichum tapetae on carpet in basement, Neospissiomyces floridanus (incl. Neospissiomyces gen. nov.) on swab from hospital, Polychaetomyces marinus (incl. Polychaetomyces gen. nov.) on submerged driftwood in sea water, Steccherinum fragrans on hardwood fallen on the beach, Steinbeckomyces carnegieae (incl. Steinbeckomyces gen. nov.) on Carnegiea gigantea, Tolypocladium pennsylvanicum from air sampled in basement. Vietnam, Acidomyces ducanhii from Aglaia flowers, Acidomyces paludis from dead bark of Acacia sp., Phakopsora sageretiae on Sageretia theezans, Puccinia stixis on Stixis scandens. Morphological and culture characteristics are supported by DNA barcodes. [ABSTRACT FROM AUTHOR]

Introduction: Occupational recovery for people living with myalgic encephalomyelitis/chronic fatigue syndrome requires better assessment and understanding of the occupational impact of this debilitating condition. This study explores the lived experience of Australian adults with myalgic encephalomyelitis/chronic fatigue syndrome using the Model of Human Occupation. Methods: The research design was a cross-sectional descriptive study, and participants were recruited via social media to complete an online survey. A Model of Human Occupation Tool, The Occupational Self-Assessment, captured an individual's perceptions of occupational identity and competence. Results: Results were analysed using descriptive statistics and non-parametric tests. The free-text responses were summarised. Twenty-nine participants completed the Occupational Self-Assessment. A decrease in occupational participation across all domains was evident. Qualitative themes of loneliness, feeling confined, feeling like a burden and loss of previous life/roles were collated, showing an adverse impact on occupational identity. A lack of independence and control showed a reduction in occupational competence. Conclusions: The study confirmed the impact of myalgic encephalomyelitis/chronic fatigue syndrome on occupational identity and competence. These individuals struggled with occupational adaptation and would benefit from occupational support. Occupational therapists could use the Occupational Self-Assessment to identify areas of need, set goals and facilitate better occupational adaptation. [ABSTRACT FROM AUTHOR]

Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives, when hormonal and physical changes are often accompanied by psychological and social evolution. Access to sexual health and sexual well-being (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high-income countries. A systematic review of the enablers and barriers to women (including trans-gender and non-binary people) aged 40–65 years accessing SHSW services in high-income countries was undertaken. Four databases (PubMed, PsycINFO, Web of Science and Google Scholar) were searched for peer-reviewed publications. Findings were thematically extracted and reported in a narrative synthesis. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their healthcare professionals (HCPs), and the over-arching effect of stigma, social connections and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities and financial incentives to access services for under-served groups. Efforts are needed to enhance education about SHSW and related services among midlife women and their healthcare providers. This increased education should be leveraged to improve research, public health messaging, interventions, policy development and access to comprehensive services, especially for midlife women from underserved groups. Plain language summary: Sexual health and sexual wellbeing services for midlife women in high income countries Midlife, beginning at 40 years and extending to 65 years, a range that encompasses the late reproductive to late menopausal stages, is a unique time in women's lives. Access to Sexual Health and Sexual Wellbeing (SHSW) services, which include the prevention and management of sexually transmitted infections, contraception and the support of sexual function, pleasure and safety, is important for the health of midlife women, their relationships and community cohesion. The objective of this systematic review was to use the socio-ecological model to synthesise the barriers and enablers to SHSW services for midlife women in high income countries. Eighty-one studies were included; a minority specifically set out to study SHSW care for midlife women. The key barriers that emerged were the intersecting disadvantage of under-served groups, poor knowledge, about SHSW, and SHSW services, among women and their HealthCare Professionals (HCPs), and the over-arching effect of stigma, social connections, and psychological factors on access to care. Enablers included intergenerational learning, interdisciplinary and one-stop women-only services, integration of SHSW into other services, peer support programmes, representation of minoritised midlife women working in SHSW, local and free facilities, and financial incentives for under-served groups to access services. The appetite for education about SHSW and SHSW services among midlife women and their HCPs should be capitalised upon, and utilised to improve research, public health messaging, interventions and access to holistic services, particularly for midlife women from under-served groups. [ABSTRACT FROM AUTHOR]

The effects of an eight-week off-season strength training program upon lower-body strength, power, eccentric capacity, front foot contact (FFC) kinetics, and ball release speed (BRS) in pace bowlers were investigated. Ten elite-academy pace bowlers completed the intervention, and pre- and post-testing. Pre- and post-testing included: double (DLDL) and single leg (SLDL) drop landings; isometric mid-thigh pull (IMTP); countermovement jump; and pace bowling performance (two-over bowling spell measuring BRS and FFC kinetics). Changes from pre- to post-testing were assessed with paired sample t tests (p≤ 0.01), effects sizes and statistical parametrical mapping. Post-testing revealed a significant decrease in peak normalised vertical force during DLDL and SLDL with large effects and a significant, moderate effect increase in IMTP. There was no significant changes in BRS. Concomitantly, neither discrete scalar (p= 0.15-0.58) nor vector field analysis kinetics during FFC indicated significant changes. No significant alterations in FFC kinetics may explain the lack of improvement in BRS (pre = 31.55 ± 1.44 m/s; post = 31.79 ± 1.33 m/s). This study indicated an eight-week strength training program can improve strength and eccentric capacity in pace bowlers, and these changes when developed in the absence of skills training neither improved nor decreased pace bowling performance. [ABSTRACT FROM AUTHOR]

The objective of this research was to compare social, emotional, and cognitive determinants of depression and anxiety symptoms and mental wellbeing using the two-continua model of mental health and illness in two age groups. The two-continua model proposes that mental health and mental illness are not two ends of the same spectrum but are, in fact, two separate but related spectrums. This cross-sectional study used a multi-age group comparison approach to identify the relative predictive strengths of risk and protective factors for the two-continua model of mental health and mental illness. Participants (n = 458: 251 16–25 year olds, and 207 35–64 year olds) completed an online survey that measured the outcome variables of depression and anxiety symptoms and mental wellbeing. Independent variables from three conceptual areas in psychology—(1) positive psychology: optimism, pessimism, and accomplishment; (2) emotion regulation: cognitive reappraisal and expressive suppression; and (3) interpersonal theories: belonging and relationship with parent/child—were measured to ascertain the determinants of these outcome variables. The all-variables models explained 58–68% of the variance in depression symptoms, 77–80% in mental wellbeing, and 26–43% in anxiety symptoms. For both groups, the strongest predictor of mental wellbeing in these models was accomplishment. The strongest predictors in these models of mental illness symptoms differed between groups: belonging in the younger group and accomplishment in the older group. Programs targeting belonging and accomplishment could be highly effective in promoting mental wellbeing and reducing mental ill-health for these groups. Interventions require contextual investigation to locate drivers of mental wellbeing and illness for different age groups prior to implementation. [ABSTRACT FROM AUTHOR]

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Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The literature is replete with articles describing the many and varied interactions between endodontic treatment and orthodontic tooth movement (OTM), often reporting conflicting views and findings, which creates confusion for clinicians. Original research and review articles have described aspects such as apical root resorption and potential pulpal complications of teeth related to OTM. Some interactions are of relatively minor clinical significance, whilst others may have adverse consequences. A history of dental trauma before or during OTM further complicates the interactions. This review re-assesses the historical literature on endodontic-orthodontic interactions in light of more recent research and presents guidelines for managing clinical situations involving both disciplines. © 2023 Australian Dental Association., (© 2023 The Authors. Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

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Copyright of International Journal of Integrated Care (IJIC) is the property of Ubiquity Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Interest in voluntary assisted death (VAD) has been growing among researchers, policy makers and the public. This study aimed to explore older adults' perspectives on VAD in Australia. Using purposive sampling, 15 adults ≥65 years participated in in-depth semi-structured interviews. Interpretative phenomenological analysis identified four themes: cultural reflections; beliefs and worldviews; health aspects; and fabric of life. Participants expressed a desire to have control over end-of-life options, challenged by religious beliefs. Participants expressed concern that VAD legislation could leave people vulnerable to coercion and saw a need for safeguards. Reasons for and against supporting and utilising VAD were discussed. Physical illness was seen a more compelling reason for VAD than mental ill-health. Finally, connections to life and other were discussed, and being able to do the things one loved were named aspects of what it meant to live a good life. Implications are discussed along with future research directions. [ABSTRACT FROM AUTHOR]

The giant kelp (Macrocystis pyrifera (Linnaeus) C. Agardh 1820) is a habitatforming brown seaweed in temperate systems with an unexplored potential as a source of seaweed bioproducts. This study used M. pyrifera sporophytes sourced in Tasmania, Australia, to investigate the effect of photoperiod and temperature on growth rates and the nutritional characteristics of the resulting juvenile biomass. Four cultivation treatments combined growth temperatures of 12 °C, 15 °C, 18 °C with light:dark (L:D) of 12:12 and 16:8 (L:D) photoperiods, (12 °C – (12:12); 12 °C – (16:8); 15 °C – (12:12); 18 °C – (12:12) to investigate their effect on the number and size of sporophytes, biomass accumulation and nutritional composition. After 60 days of cultivation the 12 °C – (12:12) treatment had the greatest number of juvenile sporophytes, and the greatest biomass of 14 ± 1.3 g dry weight (DW). The lowest biomass of 1 g DW, was obtained from the 18 °C – (12:12) treatment. The protein content across all treatments ranged from 16- 22.48% DW, with the 12 °C (12:12) treatment having largest range, then the 12°C (16:18) treatment was next with 18.48-22.48% DW, and the 15°C (12:12) treatment had the lowest protein range with 16.48-18% DW. These results are in the range of protein content previously reported for brown seaweeds of 5- 20%. Total polysaccharide content ranged from 9.6-16.2% DW with the highest content of 16.2% DW obtained for the 15 °C – (12:12) treatment, and the lowest total polysaccharide content of 9.6% DW obtained for the 12 °C (16:18) treatment. After 66 days of cultivation, the highest yield of sulphated polysaccharides of 0.4% DW was obtained for the 12 °C (12:12) treatment. Total fatty acids were analysed, with the highest polyunsaturated fatty acid content of 60.4% detected in the 12 °C (12:12) treatment. This study demonstrates that temperature and photoperiod are factors impacting juvenile sporophyte growth, biomass accumulation and biochemical composition. The study showed the least stressed sporophytes produced the most potentially beneficial nutritional or bioactive profile. [ABSTRACT FROM AUTHOR]

Objectives: Internationally, hip or knee arthroplasty (TJA) with a 1-day hospital length of stay (LOS) is common and demonstrates improved patient and health service outcomes. This study aimed to develop and pilot an enhanced recovery program (ERP) for patients undergoing TJA to achieve a next-day discharge in an Australian public hospital setting. Methods: A project lead and six perioperative clinical craft group leads developed an ERP protocol based on enhanced recovery after surgery (ERAS) principles. Strict patient eligibility criteria were developed. Quality improvement methodology was used to implement the ERP. A patient navigator was put in place as a single contact point for patients. Results: A total of 825 patients were screened for the ERP and 47 patients completed the protocol. The mean ± standard deviation (s.d.) of the LOS was 34.7 (± 7.2) h with 41 patients (87%) achieving next-day discharge, the remaining six (13%) discharged on Day 2. Compliance with ERAS was high (96%) with mobilisation within 12 h occurring on 87% of occasions. There were no adverse events. Patient experience was positive. Conclusion: Next-day discharge was achieved with a selected cohort of patients with no adverse events and positive patient experience, using a multidisciplinary approach and an improvement framework. Broadening inclusion criteria will make ERP available to more patients. What is known about the topic? Next-day discharge following hip or knee arthroplasty in Australian public hospital settings is uncommon and little has been published reflecting enhanced recovery principles in this local context. What does this paper add? This paper describes the development and piloting of an enhanced recovery program using a novel approach to achieve next-day discharge following hip and knee replacement. What are the implications for practitioners? Other health services may leverage this approach to design and implement an enhanced recovery program to reduce hospital length of stay and improve patient and health service outcomes. [ABSTRACT FROM AUTHOR]

Introduction: In people with type 2 diabetes (PwT2D) who also have obesity, efforts targeting weight loss, including lifestyle, medication and surgical interventions, are recommended. The objective of this study was to explore the relationship between glycemic control and obesity among PwT2D in Europe and Australia using recent real-world data and applying consistent methodology across countries. Methods: Retrospective study utilizing IQVIA electronic medical records (EMR) databases grouped into panels based on specialty of contributing physicians. General practitioner (GP) and endocrinologist/diabetologist (E/D) panels were used in Germany and France, while GP panels were used in Italy, UK and Australia. The Spanish database included all physician specialties. The sample included PwT2D with glycated hemoglobin A1c (HbA1c) and body mass index (BMI) values measured within 90 days of each other between January 2015 and December 2018 (second record termed the 'index date'). PwT2D had a 1-year baseline period and a recorded HbA1c at the end of the 1-year post-index period. Results: The final sample comprised 194,729 PwT2D. At baseline, across countries/panels, 36.8–58.0% were above HbA1c target (HbA1c ≥ 7%) and 39.4–56.7% had obesity (BMI ≥ 30.0 kg/m2). Mean HbA1c ranged from 6.9 to 7.6% and mean BMI ranged from 29.3–31.6 kg/m2. At baseline, a higher proportion of PwT2D with obesity (40.8–64.2%) were above HbA1c target compared to their counterparts without obesity (32.2–52.4%). A higher proportion of patients with obesity at baseline (38.1–60.6%) had post-index HbA1c above target compared to their counterparts without obesity (30.9–56.0%). In logistic regression, patients with obesity had substantially lower odds of post-index HbA1c below target compared to those without obesity in all countries/panels except for France (E/D), Spain and Australia. Conclusions: This study presents data on HbA1c and BMI among type 2 diabetes (T2D) populations in Europe and Australia. A notable proportion of PwT2D had obesity and were above HBA1c target. Higher BMI was associated with poorer glycemic control. [ABSTRACT FROM AUTHOR]

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Introduction: As artificial intelligence (AI) rapidly evolves in dentistry, understanding dentists' and dental students' perspectives is key. This survey evaluated Australian dentists' and students' attitudes and perceptions of AI in dentistry., Methods: An online questionnaire developed on Qualtrics was distributed among registered Australian dentists and students enrolled in accredited Australian dental or oral health programmes. Descriptive and bivariate analyses were used to examine the demographic variables and participant attitudes., Results: 177 responses were received, and 155 complete responses were used in data analysis. 54.8% were aware of dental AI applications, but 70.3% could not name a specific AI software. A majority (91.6%) viewed AI as a supportive tool, with 69% believing that it would be beneficial in clinical tasks and 35.6% expecting it to perform similarly to an average specialist. 40% anticipated that dental AI would be routinely used in the next 5-10 years, with more dental students expecting this short-term integration. Concerns included job displacement, inflexibility in patient care, and mistrust of AI's accuracy. Attitudes towards AI were influenced by age, gender, clinical experience and technological proficiency., Conclusions: The survey underscores the potential of AI to revolutionise dental care, enhancing clinical workflows and decision-making. However, challenges like trust in AI and ethical concerns remain. It is recommended that practising dentists receive hands-on training with AI tools and continuing dental education programmes. Integrating AI into dental curricula and fostering interdisciplinary teaching and research collaborations between computer science and dentistry is necessary to prepare graduates to use AI effectively and responsibly., (© 2024 The Author(s). European Journal of Dental Education published by John Wiley & Sons Ltd.)

Background/Objectives : Ultramarathon runners exceed the physical activity guidelines and in doing so are constantly exposed to physical and metabolic demands, requiring strategic dietary practices to support training, performance, and recovery. This study aimed to assess the diet quality and nutrient intake in runners enrolled in an Australian-based ultramarathon. Methods : A 3-day food diary was collected using the Australian smartphone application 'Easy Diet Diary' during both peak and taper periods. Macronutrient and micronutrient intakes were analysed using the AUSNUT 2011-2013 food composition database within the Foodworks professional software, and diet quality was evaluated using the Healthy Eating Index for Australians (HEIFA-2013). Results : A total of 26 runners participated in the study. The results revealed that, although runners met or exceeded protein recommendations, their carbohydrate intake fell short of endurance-specific guidelines, whilst total dietary fat intake exceeded recommendations (excluding long-chain polyunsaturated fatty acids). Diet quality scores averaged 63.1 out of 100, reflecting moderate alignment with dietary recommendations. Fruit, vegetable, and wholegrain food groups were inadequately consumed. Conclusions : The findings indicate that ultramarathon runners who easily exceed physical activity recommendations, may paradoxically consume suboptimal diets, characterized by insufficient intake of core food groups such as whole grains and fruits, alongside excessive consumption of discretionary items. This dietary pattern may not only elevate their risk of chronic disease but also impair optimal performance by compromising recovery and adaptation to training. Further research is warranted to better understand the dietary behaviors and nutritional needs of this population.

Background: Evidence is limited on the factors influencing successful stroke rehabilitation in regional contexts. Additionally, the relationship between rehabilitation costs following acute stroke, based on Australian National Subacute and Non-Acute Patient (AN-SNAP) casemix classification, and rehabilitation success remains unclear., Objective: This retrospective cohort study investigated the factors contributing to improved functional outcomes following stroke rehabilitation in an Australian regional hospital, also evaluating the respective average daily and total payments., Methods: Stroke patients' admission records, during 2010-2020, were linked with rehabilitation registry data. Rehabilitation success was defined as relative functional gain (RFG) ≥ 0.5 and Functional Independence Measure (FIM) efficiency ≥ 1. Multivariate mixed effects logistical regressions modelled the sociodemographic and medical (i.e., comorbidities and stroke type) predictors of rehabilitation success, while logarithms of average daily and total rehabilitation payments were modelled using robust regressions., Results: Of 582 included patients, 315 (54.1%) achieved RFG ≥ 0.5 and 258 (52.2%) achieved FIM efficiency ≥ 1. A longer delay in starting rehabilitation was associated with a lower likelihood of achieving RFG success [Odds Ratio (OR): 0.85, 95% confidence interval (CI): 0.78-0.93, P < 0.001] and FIM efficiency success (OR: 0.89, 95% CI: 0.82-0.97, P = 0.010). A higher FIM score at admission was associated with decreased odds of FIM efficiency success (OR: 0.35, 95% CI: 0.20-0.60, P < 0.001). The average daily and total rehabilitation payments for inpatients were $AU1,255 (median) [interquartile range (IQR): 1,040, 1,771] and $AU28,363 (median) (IQR: 18,822, 41,815), respectively. FIM efficiency success was positively associated with the average daily payment (Beta: 0.25, 95% CI: 0.20-0.30, P < 0.001), but negatively correlated with the total payment (Beta: -0.18, 95% CI: -0.24-0.13, P < 0.001). No significant associations were found between RFG success and these payments., Conclusion: This study identifies key factors affecting stroke rehabilitation outcomes in a regional Australian setting. Delays in starting rehabilitation were linked to lower success rates, underscoring the importance of timely intervention. While higher average daily costs were associated with better FIM efficiency, total costs did not correlate with relative functional gains. These findings may inform rehabilitation practices and may influence future funding strategies for rehabilitation services., Competing Interests: Declarations. Ethics approval and consent to participate: Ethics approvals were granted by the Human Research Ethics Committees of Albury Wodonga Health (HREC/73611/AWHEC-2021–256466), La Trobe University (HREC73611), and Australian Institute of Health and Welfare (EO2021/5/1311). A waiver of consent was granted by the ethics committees. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Herpes zoster (HZ) is a painful rash which typically affects older adults. This is of concern in Asia-Pacific given its aging population. As HZ epidemiology and burden are evolving, this systematic literature review aimed to update the current understanding of HZ burden and associated costs for selected Asia-Pacific locales. MEDLINE and Embase were searched for English articles of HZ studies conducted in Australia, China, Hong Kong, Japan, Korea, New Zealand, Singapore, and Taiwan. Eligible outcomes included HZ incidence and prevalence, occurrence of HZ-related complications, healthcare resource utilization, costs, and HZ-associated quality of life outcomes. This paper focused on HZ data in the general adult population ( N  = 90 articles). Substantial HZ-related disease and economic burden were observed in these locales, consistent with global trends. These findings reinforce the increasing burden of HZ and need for preventive strategies, which may include raising awareness and encouraging timely vaccination.

Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is associated with long-term disability and poor quality of life (QoL). Cardinal ME/CFS symptoms (including post-exertional malaise, cognitive dysfunction and sleep disturbances) have been observed in Post COVID-19 Condition (PCC). To gain further insight into the potential role of ME/CFS as a post-COVID-19 sequela, this study investigates associations between symptoms and patient-reported outcomes, as well as symptom clusters., Methods: Participants included Australian residents aged between 18 and 65 years formally diagnosed with ME/CFS fulfilling the Canadian or International Consensus Criteria or PCC meeting the World Health Organization case definition. Validated, self-administered questionnaires collected participants' sociodemographic and illness characteristics, symptoms, QoL and functional capacity. Associations between symptoms and patient-reported outcomes were investigated with multivariate linear regression models. Hierarchical cluster analysis was performed to identify symptom clusters., Results: Most people with ME/CFS (pwME/CFS) and people with PCC (pwPCC) were female (n = 48/60, 80.0% and n = 19/30, 63.3%, respectively; p = 0.12). PwME/CFS were significantly younger (x̄=41.75, s = 12.91 years) than pwPCC (x̄=48.13, s =10.05 years; p =0.017). Autonomic symptoms (notably dyspnoea) were associated with poorer scores in most patient-reported outcome domains for both cohorts. None of the four symptom clusters identified were unique to ME/CFS or PCC. Clusters were largely delineated by the presence of gastrointestinal and neurosensory symptoms, illness duration, ME/CFS criteria met and total symptoms., Conclusions: Illness duration may explain differences in symptom burden between pwME/CFS and pwPCC. PCC diagnostic criteria must be refined to distinguish pwPCC at risk of long-term ME/CFS-like illness and subsequently deliver necessary care and support., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was obtained for the present study from the Griffith University HREC (Reference Number: 2019/1005) and the Gold Coast University Hospital HREC (Reference Number: HREC/2019/QGC/56469). Access to the online questionnaire was granted upon agreement to a mandatory consent question, ensuring that informed consent was electronically obtained from all study participants prior to their participation. The present study was conducted in accordance with the Griffith University Research Ethics Manual, the Australian Government National Health and Medical Research Council National Statement on Ethical Conduct in Human Research 2023 [37] and the World Medical Association Declaration of Helsinki [38]. Consent to publish: Prior to participation, all study participants provided informed consent for the publication of their data as unidentifiable, combined group results. Competing interests: The authors have no relevant financial or non-financial interests to disclose., (© 2024. The Author(s).)

Background: Decision-making in dentistry is a complex process, and this study evaluated factors that influence dentists' approaches in permanent mature teeth with irreversible pulpitis., Methods: An online questionnaire was distributed to a group of dental practitioners. The questionnaire surveyed dentists' opinions about the management of vital permanent teeth with irreversible pulpitis including a case scenario., Results: Data from 262 respondents were analysed. Barriers to perform vital pulp therapy (VPT) included presuming it an inappropriate long-term treatment (29.7%), lack of knowledge, insufficient access to materials, inadequate training and lack of confidence. Patient's preference (79.44%) and tooth restorability (91%) were the most frequently reported factors influencing treatment decisions. Dentists aged 25-35 years and who have 1-5 years of experience ranked extraction as a more successful treatment (P = 0.008; P = 0.003, respectively). Non-Australian graduates ranked pulpotomy to be a more successful procedure (P = 0.007), and public sector/hospital practitioners favoured extraction more than practitioners from other sectors (P = 0.003). Postgraduates/specialists preferred pulpotomy (P = 0.012) more than general dentists. Participants' clinical approaches for the management of symptomatic irreversible pulpitis: root canal treatment (45.0%), indirect pulp capping (22.9%), direct pulp capping (15.8%), pulpotomy (17.1%) and extraction (6.3%)., Conclusions: Female, more experienced, overseas-educated dentists and endodontists preferred VPT for irreversible pulpitis in permanent mature teeth more than other participants. © 2024 Australian Dental Association., (© 2024 The Author(s). Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

Reducing high mechanical stress is imperative to heal diabetes-related foot ulcers. We explored the association of cumulative plantar tissue stress (CPTS) and plantar foot ulcer healing, and the feasibility of measuring CPTS, in two prospective cohort studies (Australia (AU) and The Netherlands (NL)). Both studies used multiple sensors to measure factors to determine CPTS: plantar pressures, weight-bearing activities, and adherence to offloading treatments, with thermal stress response also measured to estimate shear stress in the AU-study. The primary outcome was ulcer healing at 12 weeks. Twenty-five participants were recruited: 13 in the AU-study and 12 in the NL-study. CPTS data were complete for five participants (38%) at baseline and one (8%) during follow-up in the AU-study, and one (8%) at baseline and zero (0%) during follow-up in the NL-study. Reasons for low completion at baseline were technical issues (AU-study: 31%, NL-study: 50%), non-adherent participants (15% and 8%) or combinations (15% and 33%); and at follow-up refusal of participants (62% and 25%). These underpowered findings showed that CPTS was non-significantly lower in people who healed compared with non-healed people (457 [117; 727], 679 [312; 1327] MPa·s/day). Current feasibility of CPTS seems low, given technical challenges and non-adherence, which may reflect the burden of treating diabetes-related foot ulcers. [ABSTRACT FROM AUTHOR]

This meta-data exploration aimed to determine the impact of exertional-heat stress (EHS) on gastrointestinal status of masters age and young adult endurance athletes. Sixteen MASTERS (mean: 44y) and twenty-one YOUNG (26y) recreational endurance athletes completed 2 h of running at 60% ˙V O2max in 35˚C ambient conditions. Blood samples were collected pre-, immediately and 1 h post-EHS, and analyzed for markers of exercise-induced gastrointestinal syndrome (EIGS). Thermo-physiological measures and gastrointestinal symptoms (GIS) were recorded every 10–20 min during EHS. Peak Δ pre- to post-EHS did not substantially differ (p>0.05) between MASTERS and YOUNG for intestinal epithelial injury [I-FABP: 1652pg/ml vs. 1524pg/ml, respectively], bacterial endotoxic translocation [sCD14: -0.09µg/mL vs. 0.84µg/mL, respectively], lipopolysaccharide-binding protein [LBP: 0.26µg/mL vs. 1.76µg/mL, respectively], and systemic inflammatory response profile (SIR-Profile: 92.0arb.unit vs. 154arb.unit, respectively). A significantly higher peak Δ pre- to post-EHS in endogenous endotoxin anti-body IgM (p=0.042), and pro-inflammatory cytokine IL-1β (p=0.038), was observed in YOUNG compared to MASTERS. No difference was observed between incidence (81% and 80%, respectively) and severity (summative accumulation: 21 and 30, respectively) of reported GIS during EHS between MASTERS and YOUNG. Pathophysiology of EIGS in response to EHS does not substantially differ with age progression, since masters and younger adult endurance athletes responded comparably. [ABSTRACT FROM AUTHOR]

To identify specific factors influencing the participation experiences of young people with cerebral palsy (CP) aged 15 to 26 years. A three-round Delphi survey study design was used. Consumers (young people with CP and caregivers) and health professionals were asked to generate and then rate items influencing positive and negative participation experiences. Qualitative content analysis and descriptive statistics were used to classify items across the family of Participation-Related Constructs (fPRC) framework. Sixty-eight participants completed Round I (25 consumers, 43 health professionals). Round II resulted in a consensus for all but two items, with Round III not required. The fPRC construct with the most items rated as extremely important for positive participation experiences was Environment–Availability, and for negative participation, experiences were Environment-Acceptability for both adolescents and young adults. A consensus was reached on the most important items influencing the positive and negative participation experiences of young people with CP. These items should be prioritised when developing support services and allocating funding to improve the participation experiences of young people with CP. This study is reporting consumer and professional consensus on the factors promoting positive and negative participation for young people with cerebral palsy. Ensuring availability of appropriate activities and services is extremely important for enabling positive participation experiences. Promoting acceptable attitudes of others is extremely important for alleviating negative participation experiences. [ABSTRACT FROM AUTHOR]

Background: ME/CFS is a disorder characterized by recurrent fatigue and intolerance to exertion which manifests as profound post-exertional malaise. Prevalence studies internationally have reported highly variable results due to the 20 + diagnostic criteria. For Australia, the prevalence of ME/CFS based on current case definitions is unknown., Objectives: To report prevalence of ME/CFS in patients aged ≥ 13 years attending Australian primary care settings for years 2015-2019, and provide context for patterns of primary care attendance by people living with ME/CFS., Methodology: Conducted in partnership with the Patient Advisory Group, this study adopted a mixed methods approach. De-identified primary care data from the national MedicineInsight program were analyzed. The cohort were regularly attending patients, i.e. 3 visits in the preceding 2 years. Crude prevalence rates were calculated for years 2015-2019, by sex, 10-year age groups, remoteness and socioeconomic status. Rates are presented per 100,000population (95% confidence intervals (CI)). Qualitative data was collected through focus groups and in-depth 1:1 interview., Results: Qualitative evidence identified barriers to reaching diagnosis, and limited interactions with primary care due to a lack of available treatments/interventions, stigma and disbelief in ME/CFS as a condition. In each year of interest, crude prevalence in the primary care setting ranged between 94.9/100,000 (95% CI: 91.5-98.5) and 103.9/100,000 population (95%CI: 100.3-107.7), equating to between 20,140 and 22,050 people living with ME/CFS in Australia in 2020. Higher rates were observed for age groups 50-59 years and 40-49 years. Rates were substantially higher in females (130.0-141.4/100,000) compared to males (50.9-57.5/100,000). In the context of the qualitative evidence, our prevalence rates likely represent an underestimate of the true prevalence of ME/CFS in the Australian primary care setting., Conclusion: ME/CFS affects a substantial number of Australians. Whilst this study provides prevalence estimates for the Australian primary care setting, the qualitative evidence highlights the limitations of these. Future research should focus on using robust case ascertainment criteria in a community setting. Quantification of the burden of disease can be used to inform health policy and planning, for this understudied condition., (© 2022. The Author(s).)

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Copyright of Medic.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To review the application of telehealth guidelines developed by Bondini et al for clinicians to determine patient suitability for telehealth in an outpatient Chronic Wound Service, including the proportion of patients suitable for telehealth, type and mode of telehealth encounters. Retrospective, random convenience sample of patients attending the Chronic Wound Service in 2021. Fifty‐six patients were included, most with leg/foot wounds (93%), median age 74 [54–84], 64% male. Four patients at admission and 19 patients at review met criteria for telehealth. Six percent of encounters were telehealth; phone‐only (82%), unscheduled nursing reviews (77%) in patients with healing wounds. Thirty patients (54%) received at least one telehealth encounter. Telehealth occurred 35.6 days later in the admission than face‐to‐face encounters (p < 0.05, 95% CI 14.9–56.3). There was a significant relationship between patients receiving telehealth and meeting telehealth suitability criteria on reviews (X2 (1) = 19.6*, p < 0.001). Eighteen percent of patients required wound‐related hospitalisation during their outpatient admission. Telehealth guidelines identified patients suitable for telehealth, although the proportion of patients was small. Telehealth was mostly utilised for nurse‐led telephone calls in patients with improving wounds. Future research into use of telephone review for clinical standards of wound care is warranted. [ABSTRACT FROM AUTHOR]

Homesick disposition, an individual's expectation about becoming homesick in the future, has been identified as an important predictor of homesickness. Homesick disposition can be detected and measured even before the separation from home has taken place, making it particularly relevant to understanding feelings and perceptions of rural school students who have yet to relocate and transition to university. A timely detection of homesickness may facilitate prevention strategies for students to feel more confident about going to university. Based on the theory of homesickness , this study uses a quantitative approach with a sample of 620 Australian rural students to examine the relationship between homesick disposition and some factors that have been discussed as its likely predictors in rural students, such as perceptions of control over the decision of transitioning to university, the levels of information managed about university, and the support students perceive they have from their social capital. Results show that rural students' levels of perceptions of control and social capital are important predictors of homesick disposition. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Persistent truncus arteriosus (TA) is a congenital heart disorder that is characterized by various anomalies that can be fatal without corrective medical intervention. Surgical techniques were initially developed to correct this condition in infants, consequently, this has led to a paucity of scientific research on adults with TA. In this case study, the authors examine TA in the heart of an adult. The specimen derives from the pathology museum from the Vernon-Roberts Museum of The University of Adelaide. Given the rarity of individuals surviving with TA into adulthood, more scientific attention needs to be invested in unique people with TA in order to provide a comprehensive understanding of this condition as well as adequate medical treatment and care. [ABSTRACT FROM AUTHOR]

Purpose: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic condition with a constellation of symptoms presenting as severe and profound fatigue of ≥ 6 months not relieved by rest. ME/CFS affects health-related quality of life (HRQoL), which can be measured using multi-attribute health state utility (HSU) instruments. The aims of this study were to quantify HSUs for people living with ME/CFS, and to identify an instrument that is preferentially sensitive for ME/CFS. Methods: Cross-sectional national survey of people with ME/CFS using the AQoL-8D and EQ-5D-5L. Additional questions from the AQoL-8D were used as 'bolt-ons' to the EQ-5D-5L (i.e., EQ-5D-5L-Psychosocial). Disability and fatigue severity were assessed using the De Paul Symptom Questionnaire-Short Form (DSQ-SF). HSUs were generated using Australian tariffs. Mean HSUs were stratified for sociodemographic and clinical factors. Bland–Altman plots were used to compare the three HSU instruments. Results: For the 198 participants, mean HSUs (95% confidence intervals) were EQ-5D-5L: 0.46 (0.42–0.50); AQoL-8D: 0.43 (0.41–0.45); EQ-5D-5L-Psychosocial: 0.44 (0.42–0.46). HSUs were substantially lower than population norms: EQ-5D-5L: 0.89; AQoL-8D: 0.77. As disability and fatigue severity increased, HSUs decreased in all three instruments. Bland–Altman plots revealed interchangeability between the AQoL-8D and EQ-5D-5LPsychosocial. Floor and ceiling effects of 13.5% and 2.5% respectively were observed for the EQ-5D-5L instrument only. Conclusions: ME/CFS has a profound impact on HRQoL. The AQoL-8D and EQ-5D-5L-Psychosocial can be used interchangeably: the latter represents a reduced participant burden. [ABSTRACT FROM AUTHOR]

Resumen: Pese a la evidencia de que la educación universitaria mejora las perspectivas laborales, preocupan sus desiguales rendimientos. Sobre los datos administrativos de toda la población de graduados en universidades australianas en el periodo 2005‐2011, se estudian las trayectorias laborales de los individuos procedentes de entornos sociales desfavorecidos (por estatus socioeconómico, migración, discapacidad, origen étnico y zona de residencia) en comparación con los más favorecidos, a lo largo de diez años. La heterogeneidad de la evolución de los ingresos laborales y la percepción de prestaciones por desempleo entre los graduados de distintos grupos es notable. Esto tiene hondas implicaciones para las políticas de equidad social. [ABSTRACT FROM AUTHOR]

Background: With the increasing availability of information, patients are becoming more informed about radiology procedures and requesting imaging studies. This qualitative study aims to explore factors that influence general practitioners' (GPs) decisions to fulfil patient requests for imaging studies during clinical consultation. Methods: Semi‐structured interviews were conducted with 10 GPs working across five private medical centres in Northwest Sydney. Conventional content analysis was used with emergent themes to identify GPs perspectives. Results: Six themes stood out from the interviews with GPs fulfilling patient requests for imaging studies. They included four pertaining to patient factors: patient expectations, 'therapeutic scans', 'impressive labels' and entitled. Two further themes pertained to the GP perspective and included defensive medicine, and 'new patients'. Requests are fulfilled from anxious or health‐obsessed patients, with GPs worrying about litigation if they refuse. However, GPs decline requests from patients with entitlement attitudes or during first visits. Discussion: The findings suggest that GPs struggle to balance their responsibilities as gatekeepers of imaging with patients' expectations of request fulfilment. Clear guidelines on the appropriate use of diagnostic imaging and its limitations could help patients understand its proper use and ease anxiety. Additionally, education and training for GPs could help them manage patient expectations and provide appropriate care. Patient Contributions: Patients, service users, caregivers, people with lived experiences or members of the public were not directly involved in the design, conduct, analysis or interpretation of the study. However, our study was conducted in primary care facilities where the GPs were interviewed about patients' requests for diagnostic imaging based on their own initiatives. GPs' perspectives in managing patient expectations and healthcare utilisation were explored within the Australian Medicare system, where medical imaging and image‐guided procedures come at little to no cost to the individual. The study findings contribute to a better understanding of the challenges faced by GPs in dealing with patient consumerism and requests for diagnostic imaging, as well as factors influencing request fulfilment or denial. Insights gained from this study may inform future research about delivering patient‐centred care within a similar context. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had indirect and deleterious effects on patient health due to interruptions to routine provision of healthcare. This is particularly true for patients with chronic conditions like peripheral vascular disease (PVD). This study aims to evaluate the impact of the pandemic on patients with PVD in Australia by analysing rates of amputation, indications for amputation and urgency of surgery in the pre-pandemic and pandemic periods.Methods: The Australian Vascular Audit was used to capture lower extremity amputation data in Victoria, Australia, in the 22 months before and after the start of the pandemic.Results: The number of total amputations increased from 1770 pre-pandemic to 1850 during the pandemic, a 4.3% increase. This was largely driven by a statistically significant, 19% increase in major amputations. The number of minor amputations remained relatively similar in the two time periods. Amputations due to tissue loss secondary to arterial insufficiency increased from 474 to 526, an 11% increase, potentially indicating disruptions to revascularisation procedures contributing to the rise in amputations. Elective and emergency surgeries fell by 14% and 18%, respectively, while semi-urgent amputations increased by 32%.Conclusion: This study found an increase in the number of amputations overall and a significant increase in major amputations during the pandemic compared to pre-pandemic times. Tissue loss secondary to arterial insufficiency was an increasingly common indication for amputation that was observed in the pandemic group, indicating that disruption to revascularisation likely contributed to this increase in amputations. These findings can inform and direct future vascular surgery service delivery to prepare for the post-pandemic recovery. Additionally, this study further confirms that patients with chronic diseases are often disproportionately disadvantaged when global crises affect routine provision of healthcare and calls for better systems to be developed that can be used in such crises in the future. [ABSTRACT FROM AUTHOR]