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Chronic disease identification and management is a significant issue in Australia, with general practice being the primary contact point for those at risk of, or living with, chronic disease. However, there is a well-described gap between guideline recommendations for chronic disease management and translation in the general practice setting. In 2018, a group of researchers, clinicians and software developers collaborated to develop a tool to support the identification and management of chronic disease in general practice, with the aim to create a platform that met the needs of general practice. The co-design process drew together core principles and expectations for the establishment of a technological platform, called Future Health Today (FHT), which would sit alongside the electronic medical record (EMR) management system within general practice. FHT used algorithms applied to EMR data to identify patients with, or at risk of, chronic disease and requiring review. Using chronic kidney disease as a clinical focus, the FHT prototype was piloted in a large, metropolitan general practice, and a large regional general practice. Based on user feedback, the prototype was further developed and improved. This paper provides a report on the key features and functionalities that participants identified and implemented in practice. Future Health Today is a new platform, co-designed by general practice for general practice, which aims to streamline the identification and management of chronic disease to improve health outcomes. This paper describes the development of the technology platform and how it was optimised through an implementation study in general practice. [ABSTRACT FROM AUTHOR]

Objective: This scoping review maps the approach undertaken by nurses to influence the implementation of artificial intelligence in health care. It also provides evidence of how frequently nurses drive the implementation of artificial intelligence, and how often nurses collaborate within the technical team. Methods: A systematic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was undertaken from 24 July to 22 August 2020 to identify six records that met the inclusion criteria. Results: Nurses influenced the implementation of artificial intelligence in health care by: problem solving; articulating contextual needs and priorities; providing real-world insight and solutions; providing examples of implementation; and determining end user satisfaction. There was one instance of nurses driving implementation, and four instances of nurses collaborating with a technical team approach. Conclusion: The expertise of nurses must be sought to ensure artificial intelligence can effectively meet the highly context-specific demands of the healthcare environment. What is known about the topic? Nurses have reported negative impacts that AI can have when they are not included in the implementation process. What does this paper add? This scoping review has identified the extent of nursing influence on the design, development and implementation of AI. What are the implications for practitioners? There are many potential avenues of nursing research to explore such as; the impact of nurse involvement in AI, what depth of nurse involvement is needed and whether clinical immersion of developers results in improved usability, and smoother implementation of AI technologies. [ABSTRACT FROM AUTHOR]

Dyslipidaemia is a major risk factor for cardiovascular disease (CVD) and is routinely managed by GPs. Lipid-modifying medicines, commonly statins, are used to treat dyslipidaemia and prevent CVD in high-risk individuals. A national education program for over 8000 Australian GPs was delivered and evaluated. The program aimed to optimise the use of statins and provide GPs with an Australian-developed statin-associated muscle symptoms (SAMS) management algorithm supporting assessment and management of suspected SAMS. Retrospective pre-test and control questionnaires were administered to measure changes in knowledge and intended practice following the education program. A total of 226 participant GPs and 150 control GPs completed the questionnaires. The program led to positive changes in GP knowledge and intended practice around the use of absolute CVD risk to make prescribing decisions. Participant GPs demonstrated increased knowledge, compared with control GPs, about the use of CVD risk calculators as the most effective approach to lipid management, and adequately trialling a statin before considering a second agent. One of the greatest improvements in participant GP-intended practice related to the assessment and management of suspected SAMS, with participant GPs more likely to appropriately identify and manage suspected SAMS than control GPs. Statins are often under-prescribed for individuals at high risk of CVD and over-prescribed for low-risk individuals. Multiple quality-use-of-medicine issues are associated with statins and often hinder their optimal use. This paper provides further evidence for the value of national education programs to communicate evidence-based information to GPs, leading to the potential for improved patient outcomes. It supports the translation of new clinical guidance for management of statin intolerance into practice. [ABSTRACT FROM AUTHOR]

Objective. To examine the effectiveness of telephone-based coaching services for the management of patients with chronic diseases. Methods. A rapid scoping review of the published peer reviewed literature, using Medline, Embase, CINAHL, PsychNet and Scopus. We included studies involving people aged 18 years or over with one or more of the following chronic conditions: type 2 diabetes, congestive cardiac failure, coronary artery disease, chronic obstructive pulmonary disease and hypertension. Patients were identified as having multi-morbidity if they had an index chronic condition plus one or more other chronic condition. To be included in this review, the telephone coaching had to involve two-way conversations by telephone or video phone between a patient and a provider. Behaviour change, goal setting and empowerment are essential features of coaching. Results. The review found 1756 papers, which was reduced to 30 after screening and relevance checks. Most coaching services were planned, as opposed to reactive, and targeted patients with complex needs who had one or more chronic disease. Several studies reported improvements in health behaviour, self-efficacy, health status and satisfaction with the service. More than one-third of the papers targeted vulnerable people and telephone coaching was found to be effective for these people. Conclusions. Telephone coaching for people with chronic conditions can improve health behaviour, self-efficacy and health status. This is especially true for vulnerable populations who had difficulty accessing health services. There is less evidence for improvements in quality of life and patient satisfaction with the service. The evidence for improvements in health service use was limited. This rapid scoping review found that telephone-based coaching can enhance the management of chronic disease, especially for vulnerable groups. Further work is needed to identify what models of telephone coaching are most effective according to patients' level of risk and co-morbidity. What is known about the topic? With the increasing prevalence of chronic diseases more demands are being made of limited health services and resources. Telephone health coaching for people with or at risk of chronic diseases is seen as a means of supporting people to manage their health and reducing the burden on the healthcare system. What does this paper add? Telephone coaching interventions were effective for vulnerable people with chronic disease(s). Often the vulnerable populations had worse control of their chronic condition at baseline and demonstrated the greatest improvement compared with those with better control at baseline. Planned (i.e. weekly or monthly telephone calls to support the patients with chronic disease) and unscripted telephone coaching interventions appear to be most effective for improving self-management skills in people from vulnerable groups: the planned telephone coaching services had the advantage of regular contact and helping people develop their skills over time, whereas the unscripted aspect allowed the coach to tailor support to the patient's individual needs What are the implications for practitioners? Telephone coaching is an effective means of supporting people with chronic diseases to manage their own health. Further work is needed to embed telephone coaching within existing services. Good linkages with the patient's general practitioner are important. This might be a regular report, updates via the patient e-health record, or provision for contact if a problem is identified or linking to the patient e-health record. [ABSTRACT FROM AUTHOR]

In the present paper, we develop a new biogeographic model for the biota of the Southwest Pacific, using 76 published phylogenies for a range of island endemics or near-endemic organisms. These phylogenies were converted to areagrams by substituting distributions for taxa. Paralogy-free subtrees (3-item statements) were derived from these areagrams and used as input data into LisBeth that uses compatibility analysis and an exhaustive branch and bound algorithm to produce optimal trees. A general areagram is derived from all three-item statements common to the optimal trees. The results of the analysis show that the Melanesian Rift is not a natural biogeographic area; the islands of the Southwest Pacific are more closely related to each other than they are to Australia; and New Caledonia has had a long history of biological isolation. There is support for a general period of mobilism during the mid-Cenozoic when the biota as a whole expanded its range in response to regional uplift. By comparing the general areagram with what is known about the tectonic development of the region, it is possible to both calibrate the nodes of the areagram, and to identify points of conflict between the geological and biological data. [ABSTRACT FROM AUTHOR]

This brief paper describes a recent exercise undertaken within a hospital and health service in south-east Queensland to attempt to link patient records between general practice and hospital services. It describes the technical and governance processes undertaken to achieve this link and the challenges experienced to date in linking the two data sources. [ABSTRACT FROM AUTHOR]

The development of functional–structural plant models requires an increasing amount of computer modelling. All these models are developed by different teams in various contexts and with different goals. Efficient and flexible computational frameworks are required to augment the interaction between these models, their reusability, and the possibility to compare them on identical datasets. In this paper, we present an open-source platform, OpenAlea, that provides a user-friendly environment for modellers, and advanced deployment methods. OpenAlea allows researchers to build models using a visual programming interface and provides a set of tools and models dedicated to plant modelling. Models and algorithms are embedded in OpenAlea ‘components' with well defined input and output interfaces that can be easily interconnected to form more complex models and define more macroscopic components. The system architecture is based on the use of a general purpose, high-level, object-oriented script language, Python, widely used in other scientific areas. We present a brief rationale that underlies the architectural design of this system and we illustrate the use of the platform to assemble several heterogeneous model components and to rapidly prototype a complex modelling scenario. [ABSTRACT FROM AUTHOR]

The shoot apical meristem is a small and delicate organ, usually hidden between the young leaves and flowers that it produces. One approach to study meristem geometry and growth consists of taking consecutive replicas from the living meristem surface. In this paper, we present a new stereoscopic reconstruction method for this non-invasive replica protocol, which is applicable to study of growth and geometry of individual cells. This method had been used by the authors to study shoot apical meristem of two species: Arabidopsis thaliana(L.) Heynh. and Anagallis arvensisL., and can be extended to other species and organs. Scanning electron micrographs of the same replica are made at two different angles of view. The obtained stereopairs are used for the dense, three dimensional reconstruction of the replica surface. At the same time, some of the microscope parameters are refined based on the differences between the two micrographs. Three dimensional cell outlines are next extracted from the dense continuous reconstruction, and provide a basis for the quantification of meristem geometry and growth. The new reconstruction protocol can be used with different types of scanning electron microscopes, single- or multi-staged, does not require the identical working distance for the two micrographs of the stereopair, and can be used within a large range of magnifications, corresponding to the cases of either orthogonal or central projection model. It is based largely on recently published algorithms for stereoscopic vision. The reconstruction protocol can be used also for other stereoscopic applications based on scanning electron microscopy. The codes are written in Matlab and are freely available on request to the authors. [ABSTRACT FROM AUTHOR]

Broad availability of molecular sequence data allows construction of phylogenetic trees with 1000s or even 10000s of taxa. This paper reviews methodological, technological and empirical issues raised in phylogenetic inference at this scale. Numerous algorithmic and computational challenges have been identified surrounding the core problem of reconstructing large trees accurately from sequence data, but many other obstacles, both upstream and downstream of this step, are less well understood. Before phylogenetic analysis, data must be generated de novo or extracted from existing databases, compiled into blocks of homologous data with controlled properties, aligned, examined for the presence of gene duplications or other kinds of complicating factors, and finally, combined with other evidence via supermatrix or supertree approaches. After phylogenetic analysis, confidence assessments are usually reported, along with other kinds of annotations, such as clade names, or annotations requiring additional inference procedures, such as trait evolution or divergence time estimates. Prospects for partial automation of large-tree construction are also discussed, as well as risks associated with ?outsourcing' phylogenetic inference beyond the systematics community. [ABSTRACT FROM AUTHOR]