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What is known about this topic? We discuss a recently published paper that alleges clinicians are causal agents of non-compliant billing of Medicare. What does this paper add? The paper's arguments are partially supported by unreferenced assertions, potential logical fallacies, inaccurate reporting of referenced material and unsubstantiated rhetoric. What are the implications for practitioners? Due to the lack of substantive evidence, it cannot be concluded that clinicians are the causal agents of non-compliant billing of Medicare. [ABSTRACT FROM AUTHOR]

Rupert Jethro Best (1903–91), working alone at the Waite Agricultural Research Institute in Adelaide between 1934 and 1937, was among the first to purify tobacco mosaic virus (TMV) and to propose that it was a complex macromolecule containing protein and another reactive group that was responsible for infectivity of the virus. However, his research was completely overshadowed by that of Wendell Stanley and the duo of Frederick Bawden and Norman (aka Bill) Pirie, working in the United States of America and Great Britain, respectively, to the point where Best is not even mentioned in modern histories of TMV. Many factors have contributed to this lack of recognition for Best. Professor James Prescott, a soil scientist and Best's supervisor at the Waite Institute, failed to appreciate the significance of his research, leading to critical delays in publication that prevented him from claiming precedence for purifying TMV. When Best's research was eventually published, it was in Australian journals that were not broadly distributed, resulting in minimal international exposure for his research. The plant virology community within which he worked in Australia was very small and entirely focused on plant disease control, and not concerned with fundamental questions about the composition of viruses. Communication with similarly interested scientists in the Northern Hemisphere was hindered by the great distances involved. In this paper, pioneering research done by Best on TMV is reviewed, and placed in context with that undertaken by Stanley and by Bawden and Pirie, who are best remembered for purifying TMV and characterising its physicochemical properties. Rupert Jethro Best, working alone in Adelaide at the Waite Agricultural Research Institute, was among the first to purify tobacco mosaic virus and to provide evidence that it was a heterogeneous macromolecule, composed mainly of protein but also small prosthetic groups with the properties of a weak acid, wherein lay the activity of the virus. This paper describes the contributions of Rupert Best to early theories on the material nature and mode of reproduction of viruses. Photographer unknown, State Library of South Australia. [ABSTRACT FROM AUTHOR]

Context: Mahseer fish, listed as Data Deficient with a decreasing population trend in The IUCN Red List of Threatened Species 2018, is regarded as a valuable organism. Aims: This study aims to evaluate the current state of mahseer research in Asia through scientometric analysis. Methods: We utilised the Web of Science (WOS) database, initiated in 1970, which began collecting scientific articles on mahseer research in Asia in 1978. Key results: Analysis of data from 1976 to 2024 showed a progressive trend in scientific publications on mahseer, with a notable increase in the number of papers published. Notably, from one publication in 1978, the number rose to 22 papers in 2021, constituting 10.63% of total scientific publications in this domain. The analysis identified 559 authors from 200 affiliations actively participating in mahseer research in Asia, accumulating 3661 citations. Cluster analysis showed eight co-citation clusters of research. Conclusions: Mahseer research in Asia shows significant potential to emerge as an important field of study in future scientific-research endeavours. Implications: Understanding the current state and trends of mahseer research is crucial for conservation efforts and sustainable management of this species in Asia. Mahseer fish, listed as Data Deficient with a decreasing population trend in The IUCN Red List, is valuable. Scientometric studies evaluate research efficacy. This study assessed mahseer research in Asia by using scientometric analysis. Analysis from Web of Science database showed a slight upward trend. Scientific publications on mahseer exhibited a significant increase. Research in Asia has potential for future scientific endeavours. The findings highlighted the importance of understanding research trends to inform conservation efforts for mahseer species in Asia. This article belongs to the collection Ecological Monitoring and Assessment of Freshwater Ecosystems: new trends and future challenges. [ABSTRACT FROM AUTHOR]

Background: The cloud-penetrating and fog-penetrating capability of Synthetic Aperture Radar (SAR) give it the potential for application in forest fire progress monitoring; however, the low extraction accuracy and significant salt-and-pepper noise in SAR remote sensing mapping of the burned area are problems. Aims: This paper provides a method for accurately extracting the burned area based on fully exploiting the changes in multiple different dimensional feature parameters of dual-polarised SAR images before and after a fire. Methods: This paper describes forest fire progress monitoring using dual-polarisation SAR images combined with multi-scale segmentation and unsupervised classification. We first constructed polarisation feature and texture feature datasets using multi-scene Sentinel-1 images. A multi-scale segmentation algorithm was then used to generate objects to suppress the salt-and-pepper noise, followed by an unsupervised classification method to extract the burned area. Key results: The accuracy of burned area extraction in this paper is 91.67%, an improvement of 33.70% compared to the pixel-based classification results. Conclusions: Compared with the pixel-based method, our method effectively suppresses the salt-and-pepper noise and improves the SAR burned area extraction accuracy. Implications: The fire monitoring method using SAR images provides a reference for extracting the burned area under continuous cloud or smoke cover. This paper describes a method to monitor forest fire progress using dual-polarisation Synthetic Aperture Radar (SAR) images combined with multi-scale segmentation and unsupervised classification. We aimed to take full advantage of the many different dimensions of feature parameter changes caused by forest fires, relying on time-series dual-polarised SAR imagery to achieve burned area extraction and forest fire progress monitoring. [ABSTRACT FROM AUTHOR]

Background: Electronic prescription (e-prescription) was introduced in 2020 in Australia during the COVID-19 pandemic. This research aimed to explore general practitioners (GPs) and community pharmacists' experience with, and facilitators and barriers to, the use of e-prescription. Methods: This qualitative study used semi-structured interviews with GPs and pharmacists in Greater Sydney to explore their experience with e-prescription. Thematic analysis used descriptive and mixed inductive and deductive approaches. The Technology Acceptance Model (TAM) was used to further interpret and organise the themes. Results: Eleven GPs and nine pharmacists were interviewed. Thirteen themes were elicited, seven of which were categorised as benefits (facilitators) and six were challenges (barriers). Four facilitator themes (convenience for healthcare providers (HCPs) and patients, addressing issues with paper prescriptions, contactless nature reducing access barriers during COVID-19 lockdown, and enabling patients to manage multiple prescriptions) were mapped to the TAM construct of 'perceived usefulness'; and one facilitator (an easier process) and two barrier themes (lack of information during implementation, and technological issues) were mapped to the TAM construct of 'perceived ease of use'. Themes that fell outside these constructs were separately categorised: four barrier themes (reluctance of some patients and HCPs to change, patient expectations of 'instant prescription' and lost opportunities for best-practice care, HCPs' perceptions of inadequate governmental governance, and ongoing costs) were 'other issues with e-prescription', and two facilitator themes (providing training on the use of e-prescription for HCPs and patients, and making e-prescription more streamlined) were 'suggestions to improve'. Conclusion: There are many facilitators and barriers to the use of e-prescription. Our findings may inform the future promotion of e-prescription post-COVID-19 pandemic. Further research should focus on consumers' perspectives of e-prescription. It is inevitable that electronic prescriptions will one day supersede paper prescriptions, but there is resistance to their implementation at the practitioner and patient levels. This paper explored GPs and pharmacists' experience and views, and found that while e-prescription improves the quality of patient care, there are several challenges to its effective use. Findings may inform the future promotion of e-prescription, particularly post-COVID-19 pandemic, and guide future research in exploring consumer perspectives. [ABSTRACT FROM AUTHOR]

This document is a corrigendum that corrects an error in a previously published paper titled "Monitoring tropical freshwater fish with underwater videography and deep learning." The authors apologize for the mistake, which involves the incorrect color of the bounding box and species name for Ambassis macleayi in Figure 7e. The correct color should have been yellow instead of green. The authors provide a corrected version of the figure and apologize for any confusion caused. [Extracted from the article]

As the number of livestock increased in the years following English colonisation of Australia in 1788, the need for nutritious fodder, including lucerne (Medicago sativa), grew. One of the first diseases found on lucerne was a leaf spot which was collected in 1879 by George Bancroft, a physician and naturalist, in a suburb of Brisbane. The Queensland Government Botanist Frederick Manson Bailey sent a specimen to the prominent English mycologists Miles Joseph Berkeley and Christopher Edmund Broome who in 1883 formally described and named the fungus Sphaerella destructiva. That fungus is now known as Pseudopeziza medicaginis , the causal agent of common leaf spot of lucerne. It was one of over 300 fungi that were included in a 1880 paper co-written by the Reverend Julian Tenison-Woods and Frederick Bailey. At that time almost all of these fungi which had been collected in Australia were identified by overseas mycologists, particularly Berkeley and Broome. It can be argued that their 1880 paper was the first significant one published in Australia which focussed on fungi. Just a decade or so later Australian scientists, in particular Daniel McAlpine, were describing new fungal taxa on their own. Among the fungi recorded in a paper published in the 1880 Proceedings of the Linnaean Society of New South Wales was Sphaerella destructiva , now Pseudopeziza medicaginis , the cause of common leaf spot of lucerne. The paper, co-authored by the naturalist Reverend Julian Tenison-Woods and the Queensland Government Botanist Frederick Manson Bailey was the first known comprehensive list of Australian fungi published by Australian residents. It is a milestone in the evolution of mycology and plant pathology studies in Australia. Photograph by H. H. Baily. [ABSTRACT FROM AUTHOR]

Objective: Lifetime Health Cover (LHC) was introduced in mid-2000 to increase participation in private health insurance that includes hospital cover (PHI-HC) and improve the risk profile of PHI-HC participants. It initially achieved both objectives, but since 2001 the PHI-HC population has aged faster than the general population. The aim of this study was to determine if the excess ageing of the PHI-HC risk pool has been due to passive age-based adverse selection, an inherent risk of LHC. This study has potential implications for the retention of LHC. Methods: A descriptive population-level analysis of publicly available administrative datasets was performed. Data relating to PHI-HC were obtained from the Australian Prudential Regulatory Authority. National population data were obtained from the Australian Bureau of Statistics. Trends in demography, PHI-HC participation rates and LHC loading payments were analysed. Results: By 2021, age-based adverse selection had returned to the pre-LHC level. Based on the available data, this was due to passive age-based adverse selection not active age-based adverse selection. Specifically, it reflected the combination of an avoidable unintended consequence of the introduction of LHC (the over-representation, in 2001, of individuals aged 45–59) and one of LHC's intended effects (incentivisation of insured individuals to retain PHI-HC). Conclusions: This study supports the retention of LHC. Nonetheless, it highlights the risk of passive age-based adverse selection created by incentivising insured individuals to retain PHI-HC in the presence of distortions in the age distribution of the PHI-HC risk pool. Early targeted interventions are required when such distortions arise. What is known about the topic? Since the introduction of Lifetime Health Cover (LHC) in mid-2000, the participation rate for private health insurance that includes hospital cover (PHI-HC) has remained relatively stable, but the PHI-HC population has aged faster than the general population. What does this paper add? This paper makes a novel distinction between 'active' and 'passive' age-based adverse selection to explain LHC's role in the excess ageing of the PHI-HC risk pool. What are the implications for practitioners? Governments need to be vigilant for the emergence of distortions in the age distribution of the PHI-HC risk pool and respond with targeted interventions to normalise the age distribution, or risk problematic passive age-based adverse selection. [ABSTRACT FROM AUTHOR]

This paper covers developments from International Embryo Technology Society (IETS) meetings over the past 50 years. The IETS was officially 'born' at a meeting in Denver, Colorado on Sunday 26 May 1974. There have been 51 IETS meetings (the first was in May 1974), and the first conference at which papers were presented was in 1975. The name of the IETS was changed from International Embryo Transfer Society to International Embryo Technology Society in 2016. The annual IETS conferences are held once a year in January. Embryo technology advanced from the laborious and slow techniques of surgical recovery and transfer of bovine embryos to non-surgical recovery and transfer in many species. Cryopreservation of embryos was initially a slow process that met with only moderate technical success before the development of technology that resulted in high embryo survival rates. The polymerase chain reaction was used to determine the sex of embryos following laminar flow cytology, which came into use to separate X- and Y-bearing spermatozoa. IVF has grown to become widely used, and several factors make it more useful than superovulation and embryo recovery/transfer. Perhaps the most important tool of all was the system that allowed the genetic 'mapping' of the genomic sequence of Bos taurus cattle. Charting key DNA differences by scientists, 'haplotypes' are now used routinely to identify animals with desirable traits of economic importance, discover new genetic disorders, and track carrier status of genotyped animals. Future technology is discussed. This paper deals with the 50-year history of embryo transfer technology. It covers the formation of the International Embryo Technology Society, a group of scientists and veterinarians who study or work in the field of embryos and the animals that produce them. These embryos can be frozen, moved from animal to animal, maintained outside the female, and modified by a number of procedures. Photograph by Jenson. [ABSTRACT FROM AUTHOR]

This research prepared a photochromic material of WO3 doped with Mo or Cu through a solvothermal method. The material exhibits selective absorption of UV light in the 200-350-nm range. The crystal structure of WO3 remained unchanged after doping, but the bandgap was reduced, thereby increasing its coloration rate. The doping of Mo or Cu brought different new features to WO3: Mo-doping imparted a purple hue upon UV irradiation, whereas Cu-doping accelerated the bleaching of WO3 due to its multi-valent state. WO3-0.1Mo and WO3-0.1Cu were preferentially selected through a practical photochromic process and bandgap calculations, and further used to prepare photochromic ink. This ink is suitable for the preparation of writing and photochromic rewriting paper and retains good photochromic properties even after 50 uses. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine changes in the demographics and regions of work of Australian doctors over a period of 9 years. Methods: A retrospective study of Australian Health Practitioner Regulation Agency (AHPRA) registration data was performed. Data were sourced from the Health Workforce Dataset Online Data Tool which was derived from annual registration data from AHPRA for 2013–2022. The demographic factors analysed were gender, age, and origin of qualification. Regions of work were defined using the Modified Monash (MM) model. Results: The number of registered doctors increased from 82,408 in 2013 to 111,908 in 2022 but mean hours worked per week decreased from 41 to 39 leading up to 2020. Trends in age and origin of qualification remained stable, but the proportion of female workers increased from 38.5% in 2013 to 44.5% in 2022. While female hours per week (~37) were consistent from 2013 to 2020, male hours per week decreased from 43 to 41. The number of registrations and total full-time equivalent (FTE) outcomes increased consistently in metropolitan (MM1) and rural (MM2–5) regions but did not increase for remote and very remote (MM6–7) regions. Conclusion: The Australian medical workforce both grew and changed between 2013 and 2022. An overall decrease in mean hours worked appears to be driven by a decline in hours worked by male workers and the increased proportion of female workers. While increased gender parity and a decrease in hours worked per week were positive outcomes, a lack of growth in the medical workforce was noted in remote and very remote regions of Australia. What is known about the topic? Changes in the medical workforce over time are likely to impact health service delivery. What does this paper add? This paper examined changes in the gender, age, origin of qualification, and the region of work of Australia's medical workforce from 2013 to 2022. What are the implications for practitioners? An increase in gender parity and a decrease in the mean hours worked suggests improvements in workforce participation and sustainability, but lack of growth in medical workforce was noted in remote and very remote regions of Australia. [ABSTRACT FROM AUTHOR]

Objective: Clinical care ratios are used to quantify and benchmark the activity of allied health professionals. This study aims to review previous recommendations and identify what variables may influence them. Method: Data was collected from the core allied health professions (audiology, nutrition and dietetics, occupational therapy, physiotherapy, podiatry, prosthetics and orthotics, psychology, social work and speech pathology) across eight Australian hospitals. Data for 113 staff who were casual or from smaller professions (audiology, podiatry, prosthetics and orthotics and psychology) were excluded due to insufficient numbers for analysis. The remaining data were analysed according to profession, seniority (tiers 1, 2 and 3) and employment status (permanent versus casual staff). A two-way ANOVA was performed to assess the association of clinical care ratios with tier, profession, employment status and gender. Results: Data from 1246 staff from the five larger professions at participating hospitals were analysed. There were no interactions between profession and gender (P = 0.185) or employment status (P = 0.412). The relationship between clinical care ratio and profession was modified by tier (interaction term, P = 0.014), meaning that differences in clinical care ratios between professions depended on the tier. Conclusion: This research has confirmed that clinical care ratios are a useful tool in workload management and determining staffing levels for allied health professionals. The recommendations from this research provide a starting point that can be finessed with reference to profession, model of care, workforce structure, governance and training requirements. This will lead to increased staff wellbeing and improved patient outcomes. What is known about this topic? Clinical care ratios are a useful tool to quantify, monitor and compare workloads of allied health professionals. What does this paper add? This paper confirms that clinical care ratios are a useful workforce planning tool and that when developing roles and models of care, clinical care ratios need to be incorporated into staffing requests and considered as part of workload management tools. What are the implications for practitioners? Clinical care ratios enable the quantification and benchmarking of direct and clinical support activity components of a workload and can be used when planning new services and reviewing current services. [ABSTRACT FROM AUTHOR]

Objective: To provide the first document map of sustainability and decarbonisation actions across the Australian healthcare sector, as reported in publicly available documents online, and to identify gaps in actions. Methods: Healthcare providers were identified across all state and territories. Structured Google searches between August and December 2022 were followed by document searches. Updates were undertaken, most recently in December 2023. Targeted documents included position statements, strategies, and reports. Key points from these documents pertaining to sustainability and/or decarbonisation were extracted and descriptively analysed. Results: A total of 294 documents were included, mostly focused on power generation, transport, building design, and circular procurement/waste pathways. In contrast, relatively few plans for decarbonisation of clinical care were identified (n = 42). National and two state governments (New South Wales, Western Australia) have established healthcare sustainability and decarbonisation units, and two further states have publicly committed to doing so (Queensland, Tasmania). However, these documents generally reported separate, siloed actions. While attempts were made to make this review comprehensive, some documents may have been missed or are only available inside an organisation, and new actions will continue to emerge. Conclusion: Broad sustainability plans have been developed by many healthcare providers; however, to achieve net zero, decarbonising of clinical practices is also needed, and this is where the least action is currently occurring. To decarbonise clinical care, the sector needs to come together in a more coordinated way. What is known about the topic? Little is known about what actions are occurring to make healthcare more sustainable and to reduce the carbon footprint of healthcare in Australia. What does this paper add? This paper provides a snapshot of publicly available documents from healthcare providers and professional organisations as they relate to healthcare sustainability and helps reveal the gaps and siloed nature of current actions. What are the implications for practitioners? This paper can help jurisdictions identify gaps or areas for improvement and may aid in targeted and coordinated interventions, especially as they relate to decarbonised clinical care. [ABSTRACT FROM AUTHOR]

Species of the genus Eubranchus Forbes, 1838 (Mollusca: Gastropoda: Nudibranchia) are common faunistic elements of boreal benthic ecosystems, associated with hydroid communities. Recent studies have suggested that the widely distributed trans-Arctic E. rupium (Møller, 1842) constitutes a complex of at least three candidate species, but the detailed taxonomy of the complex remains unresolved. The purpose of the present paper is to conduct an integrative taxonomic study including molecular genetic methods (a phylogenetic analysis using COI , 16S rRNA and histone H3 with application of species delimitation methods) and morphological study (light and scanning electron microscopy) of E. rupium and closely related species. The specific aims of this study were to establish the species boundaries, morphological variability, and the phylogeographic structure within this group. The phylogeographic analysis included a TCS -based network analysis, an analysis of molecular variance (AMOVA), divergence time estimations, and ancestral area reconstructions. We demonstrate that specimens initially identified as E. rupium included three distinctive species: the nominal E. rupium with an amphiboreal range, the new species Eubranchus novik sp. nov. from the Sea of Japan, for which a taxonomic description is provided in this paper, and Eubranchus sp. from the northern Kuril Islands, which requires the collection and study of additional material for formal description. Our results confirm the amphiboreal distribution of E. rupium , as no geographic structure was found across Pacific, Arctic and Atlantic populations, and the results of the AMOVA analysis showed no differences between groups of samples from different geographic regions. The divergence of the ' Eubrancus rupium species complex' is estimated from the late Miocene or the Miocene–Pliocene boundary to the late Pliocene. It is hypothesised that the most probable ancestral region for the Eubranchus rupium species complex is the north-western Pacific, and the subsequent speciation likely occurred due to dispersal followed by allopatric speciation. ZooBank: Species of the genus Eubranchus Forbes, 1838 are common in boreal benthic ecosystems. Recent studies suggest the trans-Arctic Eubranchus rupium (Møller, 1842) is a species complex. This paper conducts an integrative taxonomic study of Eubranchus rupium and related species, confirming its amphiboreal distribution. The divergence of the species complex is estimated from the late Miocene or the Miocene–Pliocene boundary to the late Pliocene with the north-western Pacific as the probable ancestral region, followed by dispersal and allopatric speciation. (Image credit: Darya Grishina.) [ABSTRACT FROM AUTHOR]

Background: Sonder's In-Home Withdrawal Service (IHWS) has been providing a unique home-based, multidisciplinary, wraparound withdrawal option for people with low-to-moderate levels of substance dependence since September 2019. This paper provides an evaluation of the service's overall impact on reducing substance use among clients through the delivery of this innovative service model. The evaluation explores the acceptability and feasibility of the service via client, stakeholder, and staff perspectives. Methods: A mixed-method design was used to evaluate the IHWS. Descriptive analysis of quantitative data was conducted using clinical assessments from client records and online feedback surveys. Qualitative data from client, staff, and stakeholder feedback surveys were analysed thematically. Results: Overall, 1166 referrals were received over the lifespan of the service, and a data set of 96 clients was included in the analysis. Self-reported measures showed that most clients decreased their substance use (89%), improved their psychological health status (75%), improved their physical health (65%), improved their quality of life (69%), and improved their understanding and ability to manage their alcohol and other drugs (AOD) use (84%). Client feedback suggests the service is providing a unique option for AOD withdrawal. Stakeholders commend the service's home-based setting, multidisciplinary and person-centred approach to care, and recommended expansion of the service to increase access for clients and reduce demand on inpatient settings. Conclusions: The IHWS is having a significant impact in reducing substance use and highlights the need for increased access to holistic approaches to withdrawal. This includes pre- and post-withdrawal support and the inclusion of multidisciplinary teams, and engaging lived experience practitioners. A focus on funding primary-based services is required to meet the rising costs of tertiary-based care and to better meet the needs of consumers. Individuals with low-to-moderate levels of substance dependence require targeted services to safely manage their withdrawal. This paper evaluates a holistic approach to withdrawal that broadens the common medicalised approach through pre- and post-withdrawal stages of care and support from a multidisciplinary team including lived experience practitioners. The service reduces levels of substance use while also improving overall quality of life, demonstrating the need for more withdrawal services to consider the inclusion of holistic approaches to substance dependence support. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a global pandemic, however, estimating its burden is a complex process. As a result, many countries rely on global estimates to infer burden within their own setting. With a growing number of recent publications quantifying AMR burden in Australia, and an expansion of surveillance programs, enumerating AMR mortality for Australia is feasible. We aimed to leverage existing published data to assess methodological factors contributing to the considerable variation in AMR-related mortality and provide two reliable estimates of AMR mortality in Australia. This is a necessary step towards generating meaningful measures of AMR burden in Australia. What is known about the topic? Antimicrobial resistance is a significant global health threat, but estimating the burden of disease is complicated by data challenges. What does this paper add? This paper highlights progress in estimating the number of people dying from antimicrobial resistance in Australia and highlights the importance of rigorous antimicrobial resistance mortality estimates in Australia to assess burden of disease. What are the implications for practitioners? Practitioners should use only rigorous estimates of burden of disease to inform actions on reducing the threat of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the perspective of healthcare workers on the resources they need to provide quality rehabilitation for people recovering from coronavirus disease 2019 (COVID-19) infection. Methods: A descriptive qualitative approach using reflexive thematic analysis was employed. Focus groups and interviews were performed with nine healthcare workers (one intensive care unit physiotherapist, one respiratory therapist and seven occupational therapists) with experience treating patients recovering from COVID-19 infection within hospital and in the community. Verbatim transcripts were coded and analysed for themes. Results: Healthcare workers perceive an urgent need for resources about recovery from COVID-19 infection to support quality care. They particularly want detailed guidance about potential trajectories of recovery, and what should be expected over time for people with long COVID. Many observed that this group of patients had higher oxygen requirement and experienced slower recovery than others with serious respiratory conditions. Supports for quality care do exist but were not perceived as sufficient by participants. They want any new resources developed to be accessible, quick to access and targeted to specific healthcare worker roles and services settings. Participants identified several barriers to accessing practice supports, including the time poor nature of health care and financial costs to both patients and healthcare workers. Conclusion: Healthcare workers perceive an urgent need for the development of resources to support quality rehabilitation for people recovering from COVID-19 infection, to support best outcomes for this group of patients. Any resources developed must consider identified barriers to their access and use to maximise their impact. What is known about the topic? Workforce development needs related to the management of people recovering from coronavirus disease 2019 (COVID-19) are relatively unknown, due to the novelty of the virus and sustained pressure on the healthcare system due to the pandemic. What does this paper add? The paper identifies resource gaps and potential improvements from the clinician perspective. It also emphasises the urgent need for tailored, multidisciplinary resources and workforce capacity building. What are the implications for practitioners? Access to accessible updated resources and continuing professional development is critical for allied health clinicians in the evolving field of COVID-19 rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: To scope how the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) has been applied to measure socio-economic status (SES) in peer-reviewed cardiovascular disease (CVD) research. Methods: The Joanna Briggs Institute's scoping review methodology was used. Results: The search retrieved 2788 unique citations, and 49 studies were included. Studies were heterogeneous in their approach to analysis using SEIFA. Not all studies provided information as to what version was used and how SEIFA was applied in analysis. Spatial unit of analysis varied between studies, with participant postcode most frequently applied. Study quality varied. Conclusions: The use of SEIFA in Australian CVD peer-reviewed research is widespread, with variations in the application of SEIFA to measure SES as an exposure. There is a need to improve the reporting of how SEIFA is applied in the methods sections of research papers for greater transparency and to ensure accurate interpretation of CVD research. What is known about the topic? A socio-economic status (SES) gradient is well established for cardiovascular disease (CVD). Research has generally applied two approaches to classifying SES: at an individual level using income, education or occupation data, and at an area level using a range of existing socio-economic information, including the Australian Bureau of Statistics (ABS) Socio-Economic Indexes for Areas (SEIFA). What does this paper add? This review examined how SEIFA has been applied to measure SES in Australian peer-reviewed CVD research and to identify any variations in research practice. What are the implications for practitioners? It is recommended that researchers provide a clear explanation in the methods section of research papers as to which SEIFA version and index was applied, how it was applied, at what spatial unit, and whether the spatial unit was an ABS or non-ABS unit. [ABSTRACT FROM AUTHOR]

Objectives: Unwarranted clinical variations in radical prostatectomy (RP) procedures are frequently reported, yet less attention is given to the variations in associated costs. This issue can further widen disparities in access to care and provoke questions about the overall value of the procedure. The present paper aimed to delve into the disparities in hospital, medical provider and out-of-pocket costs for RP procedures in Australia, discussing plausible causes and potential policy opportunities. Methods: A retrospective cohort study using Medibank Private claims data for RP procedures conducted in Australian hospitals between 1 January 2015 and 31 December 2020 was undertaken. Results: Considerable variations in both medical provider and out-of-pocket costs were observed across the country, with variations evident between different states or territories. Particularly striking were the discrepancies in the costs charged by medical providers, with a notable contrast between the 10th and 90th percentiles revealing a substantial difference of A$9925. Hospitals in Australia exhibited relatively comparable charges for RP procedures. Conclusions: Initiatives such as enhancing transparency regarding individual medical provider costs and implementing fee regulations with healthcare providers may be useful in curbing the variations in RP procedure costs. What is known about the topic? Unwarranted clinical variations in radical prostatectomy procedures are well documented in the literature; however, variations in cost are less widely reported. What does this paper add? This paper aims to highlight the cost variations in radical prostatectomy procedures in Australia, discussing their plausible causes, implications and proposing potential policy opportunities. What are the implications for practitioners? Excessive fees imposed by medical providers may contribute to inequalities in healthcare access. Enhancing transparency of individual medical provider costs and implementing fee regulations may be useful in controlling unwarranted variations in procedure costs. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Value based healthcare beyond the clinical domain is the focus of this case study. We share NSW Health's experiences in achieving value through a focus on outcomes in non-clinical and clinical support services using examples that demonstrate key aspects across the commissioning cycle. These include: the importance of stakeholder engagement in the planning phase to later success; the critical role of non-clinical services in patient experience; the opportunity to facilitate value by introducing new approaches in business areas such as procurement; and the role of clinical supports such as digital enablement to facilitate outcome-focussed clinical models. Applying a value lens to non-clinical services can increase the potential benefits to patients, clinicians and the system. What is known about the topic? Value based healthcare is a way of making transparent and equitable decisions about resource allocation to deliver better outcomes for individuals, health services and the system. What does this paper add? This paper reflects on the opportunity to deliver value based healthcare beyond clinical models of care, including in non-clinical and clinical support services, using a commissioning approach. What are the implications for practitioners? The learnings shared through the case studies presented can be applied by practitioners to their own projects to support value based approaches across all aspects of health care. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Background: The phenomenon of missed care has received increasing interest over the past decade. Previous studies have used a missed care framework to identify missed nursing tasks, although these have primarily been within the acute care environment. The aim of this research was to identify missed care specific to the role of the general practice nurse. Methods: An integrative review method was adopted, using The Mixed Methods Appraisal Tool to assist in a methodological appraisal of both experimental, theoretical, and qualitative studies. Thematic analysis was then used to analyse and present a narrative synthesis of the data. Data sources: CINAHL, SCOPUS, Web of Science and Google Scholar databases were searched between 2011 and 2022 for empirical research that reported missed care and the general practice nurse. Results: Of the 787 papers identified, 10 papers met the inclusion criteria. Three themes identified missed care in relation to primary healthcare nurses: under-staffing and resourcing, communication difficulties, and role confusion. Conclusion: Isolating missed care by general practice nurses was challenging because much of the research failed to separate out general practice nurses from community and primary health care nurses. This challenge was exacerbated by disparity in the way that a general practice nurse is defined and presented in the various databases. While some themes such as those related to communication and understaffing and resourcing demonstrate some parallels with the acute sector, more research is required to identify missed care specific to the general practice nurse. Identifying missed nursing care is an important avenue to achieving improvements in patient care. Predominantly undertaken in the acute sector, there is a need to expand missed care research to the primary healthcare sector. We conducted an integrative review to determine missed care and the general practice nurse. Some commonalities between the primary health and acute sectors were identified such as issues with communication and resource availability. Recent calls for general practice nurses to work to the top of their scope involve a more nuanced understanding of the role, and what is being missed. [ABSTRACT FROM AUTHOR]

Objective. This paper examines two aspects of treatment decision making: withdrawal of treatment decisions made by a patient; and decisions to not proceed with treatment by a health professional. The paper aims to provide an overview of the law relating to the provision of treatment, then highlight the uncertainty as to the meaning of and costs associated with futile treatment. Methods. The paper reviews the current legal and medical literature on futile treatment. Results. Continuing treatment which is futile is not in the patient's best interests. Futility may be understood in both quantitative and qualitative terms. Recent legal cases have expanded the definition of futility to focus not on the nature of the treatment itself, but also on the health of the patient to whom treatment is provided. Conclusions. As Australia's population ages, there is likely to be an increased focus on the allocation of scarce health resources. This will, inevitably, place constraints on the number and variety of treatments offered to patients. The level of constraint will be felt acutely where a proposed treatment offers little clinical efficacy. It is time to try to understand and agree on a workable definition of futility. [ABSTRACT FROM AUTHOR]

What is known about the topic ? Governments acknowledge that current health arrangements are unsustainable, and a better resourced, integrated, and connected primary care system is central to the future. What does this paper add ? This paper calls out the most significant barriers to implementing the required national reform and poses potential solutions in addressing them. What are the implications for practitioners ? Without action, we will see increased system cost, and decreased service access and quality for Australian communities. [ABSTRACT FROM AUTHOR]

This document is a special edition of Animal Production Science that features a selection of papers presented at the 2022 Australasian Dairy Science Symposium (ADSS). The symposium, held in Queensland, focused on pastoral dairy systems and addressed challenges such as climate change, competition from plant-based alternatives, and resource efficiency. The special issue covers various topics including dairy cattle welfare, heat stress on dairy production, grazing dairy cows, artificial breeding strategies, and greenhouse gas emissions from dairy systems. The ADSS expresses gratitude to the authors, reviewers, and sponsors for their contributions and support. [Extracted from the article]

Acacia (the wattles) is the largest genus of plants in Australia and its species occupy almost every habitat in the country. Hard galls on the branches, phyllodes and flower parts of wattle trees were noticed from the very early days of British colonisation, but their causes were unknown. Some insects were believed to be involved, but they were not the only cause of wattle galls. In 1889, the Italian mycologist Pier Andrea Saccardo described the rust fungus Uromyces tepperianus from the galls on Acacia salicina , and later, the Victorian government vegetable pathologist, Daniel McAlpine transferred the species tepperianus to his new genus Uromycladium which also included six new species. A total of 28 valid species of Uromycladium , most endemic to Australia, are currently described. Several species of Uromycladium were somehow introduced into South Africa and countries in southeast Asia where they cause significant losses in Acacia plantations, while others are used as biocontrol agents for invasive Acacia species. Short biographies of two of the early collectors of rust galls, the South Australian naturalist and later entomologist Johann Gottlieb Otto Tepper and the Victorian plant pathologist Charles Clifton Brittlebank are also presented. The wattles (Acacia species) are an ancient and iconic Australian genus of trees and shrubs which form part of the identity of the nation. Galls were a common feature on wattle trees, initially being attributed to the activity of some insects, but later a genus of rust fungi, Uromycladium , was found to also cause galls. The lives of two of the early collectors of wattle rust galls, Otto Tepper and Charles Brittlebank, are also illuminated in this paper. Photograph by Alastair McTaggart. [ABSTRACT FROM AUTHOR]

Within a few years of the establishment of the convict settlement at Sydney Cove, the potato became one of the staple crops of the population due to its relatively high yield and the prior experience of the convicts and free settlers with growing the crop. In 1894, Henry Tryon described a new disease in southern Queensland that caused rapid wilting of plants, a ring of slightly translucent tissue just below the surface of affected tubers, oozing of a thick, white fluid from the 'eyes', and ultimately rotting of the tubers. It soon became known as 'Tryon's disease'. He found that a microbe (bacterium) was always associated with affected tubers and stems, provided a very brief description of the bacterial cells and named the microbe Bacillus vascularum solani. A few years later the American scientist Erwin Frink Smith wrote a paper on a new disease (brown rot) of solanaceous plants including the potato and tomato, in which he called the causal agent Pseudomonas solanacearum , now known as Ralstonia solanacearum. Smith dismissed Tryon's prior claim to the discovery of the disease with some of his comments being personal and scathing. Tryon had the last word, however, cloaking his response in restrained and somewhat convoluted tones. In 1894, the Queensland government entomologist, and later vegetable pathologist, Henry Tryon (1856–1943) discovered a new disease that caused potato tubers to become rotted and putrid. He consistently found bacterial cells in a thick mucilaginous gum in the vascular tissues of wilted stems and infected tubers, and gave it the name Bacillus vascularum solani. The American bacteriologist Erwin Frink Smith would not accept Tryon's discovery, instead naming the causal agent Pseudomonas solanacearum. That bacterium, now called Ralstonia solanacearum is a significant plant pathogen worldwide. Photograph by an unknown person. [ABSTRACT FROM AUTHOR]

Background: Asynchronous observations refer to observations that are obtained at multiple moments. The observation moments of fire fronts may differ throughout an entire wildfire area. Asynchronous observations include historical data, which hinders the effectiveness of data assimilation due to the lack of timely updates on changing fire fronts. Aims: This paper proposed a distributed strategy combined with the Ensemble Transform Kalman filter (ETKF-distributed) for asynchronous observations. It can assimilate fire fronts immediately at any location by using new matching schemes between prediction and observation. Methods: The ETKF-distributed undergoes testing using a wildland fire generated based on real terrain, vegetation, and historical weather data from the local area. In addition, the ETKF and ETKF-centralised proposed in our previous work were employed as comparisons. Observing System Simulation Experiments were conducted to generate asynchronous observation fire fronts. Key results: The benefit of immediate assimilation enables the new method to maintain high accuracy predictions. Conclusions: The allocation of observation resources can be focused in regions with high rates of speed when employing ETKF-distributed. Implications: The ETKF-distributed has high efficiency and adaptability, making it highly promising for implementation in wildfire prediction. Observation composed of data from multiple moments is asynchronous observation, which will bring errors when performing data assimilation. This paper proposes a distributed strategy combined with the Ensemble Transform Kalman filter for asynchronous observation. It could conduct the analysis step immediately by a new matching scheme between prediction and observation. [ABSTRACT FROM AUTHOR]

Background: Every year, people in Canada are evacuated due to wildland fires to avoid death, injury, and illness from fire and smoke events. Aims: In this paper, we provide an overview of evacuations recorded in the Canadian Wildland Fire Evacuation Database between 1980 and 2021. Methods: Our analysis covers evacuations in Canada from 1980 to 2021. We provide summary statistics including number of evacuations and evacuees, evacuation duration, seasonality, evacuation causes, community types, structure losses, and fatalities. We also investigate temporal and spatial patterns. Key results: Between 1980 and 2021, there were 1393 wildland fire evacuation events with 576,747 people evacuated. During this period, there was an overall increase in frequency of evacuations, number of evacuees, and duration of events. Structure loss occurred during 194 evacuation events, with 4105 homes burned. We estimate wildland fire evacuations cost at least CAD3.7 billion (excluding structural losses), jumping to CAD4.6 billion if we include productivity losses. Indigenous peoples are disproportionately impacted in wildfire evacuations compared to the general Canadian population. Conclusions: Wildland fire evacuations continue to occur across Canada and are increasing. Implications: The findings from this study give us a better understanding of the characteristics of wildland fire evacuations, which can help guide emergency management. This paper summarises data on wildland fire evacuations in Canada between 1980 and 2021. There were 1393 wildland fire evacuation events with 576,747 people evacuated, costing approximately CAD4.6 billion CDN including productivity losses. [ABSTRACT FROM AUTHOR]

Background: While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. Methods: A semi-structured focus group was conducted with rehabilitation clinicians and those with lived experience of paediatric acquired brain injury (ABI). The 90-min focus group was audio-recorded and transcribed verbatim. Data were thematically coded and mapped against the Theoretical Domains Framework (TDF) to understand influencing factors, which were then linked to the Capability, Opportunity, Motivation – Behaviour (COM-B) model. Results: A total of 11 participants (nine paediatric rehabilitation clinicians, one parent and one young person with lived experience of paediatric ABI) participated in the focus group. Factors influencing collaborative goal setting mapped to the COM-B and six domains of the TDF: Capabilities (Skills, Knowledge, Beliefs about capabilities, and Behavioural regulation), Opportunities (Environmental context and resources), and Motivation (Social/professional role and identity). Results suggest that a multifaceted intervention is needed to enhance rehabilitation clinicians' and families' skills and knowledge of goal setting, restructure the goal communication processes, and clarify the roles clinicians play in goal setting within the interdisciplinary team. Conclusion: The use of the TDF and COM-B enabled a systematic approach to understanding the factors influencing goal setting for children with acquired brain injury in a large interdisciplinary rehabilitation team, and develop a targeted, multifaceted intervention for clinical use. These represent important considerations for the improvement of collaborative goal setting in paediatric rehabilitation services to ensure that best practice approaches to goal setting are implemented effectively in clinical practice. While goal setting with children and their families is considered best practice during rehabilitation following acquired brain injury, its successful implementation in an interdisciplinary team is not straightforward. This paper describes the application of a theoretical framework to understand factors influencing goal setting with children and their families in a large interdisciplinary rehabilitation team. This article belongs to the Collection Clinical Implementation to Optimise Outcomes. [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]

Objectives: This study aimed to evaluate patient outcomes from a 12-month pilot program establishing specialist surgical services in a small rural (Modified Monash Model, MM4) hospital on the south coast of NSW. Methods: Suitable patients for ambulatory surgery were selected based on strict anaesthetic, surgical and social criteria. Skills shortfalls among nursing staff, usually with emergency or inpatient experience, were addressed by appropriate re-training and in-service training in scrub, scout and anaesthetic duties. An anonymous post-operative patient survey was administered during the pilot program, which assessed patient experiences and outcomes. Of 162 patients undergoing surgery during the pilot, 50 consecutive participants completed the survey. Results: Of the 161 procedures during the pilot program, 100 were performed under sedation and locoregional anaesthesia and 62 under general anaesthesia. Half (n = 86, 53.4%) were complex excisions of malignant skin lesions, and of these 63% also required either a skin graft or local flap repair. Survey respondents reported adequate information and pain relief upon discharge (n = 45, 96%) and 100% were satisfied with the care received. No respondents needed to see a doctor following discharge. There were no mortality events or major issues of morbidity during the study period or subsequently, no further overnight admissions or return to theatre and no re-presentations within 48 h of operating. Two superficial surgical site infections were reported. Conclusions: There is merit in drawing on underutilised resources in small rural hospitals in support of initiatives to reduce surgical waitlists. Appropriate outpatient surgeries can be safely performed with high levels of patient satisfaction. What is known about the topic? Waitlist reduction strategies are required to deal with long surgical waitlists. Rural surgical services are declining due to centralisation of these services in larger hospitals. What does this paper add? Significant positive benefits arise from providing an ambulatory, rural surgical service. This paper provides an evidence base for rural hospitals to explore the benefits of re-activating, or increasing utilisation of, existing operating theatre facilities. What are the implications for practitioners? Significant reductions in surgical waitlists within health services can be safely achieved by servicing rural patients at their local hospital for some ambulatory procedures. [ABSTRACT FROM AUTHOR]

Objective: HealthPathways is a web-based platform designed for use during a consultation to offer health professionals locally agreed information to support clinical and referral decision making. This study aimed to investigate whether access to specific HealthPathways pages in the North Coast New South Wales (NSW) region increased during specific critical events. High pageviews is used as a proxy for platform usefulness, and/or trust as a source of up-to-date information. Methods: Data were extracted from Google Analytics from December 2015 to December 2021. Descriptive statistics were generated for the total number of pageviews for all pages by month and year (2015–2021); for the top 15 most viewed pages in 2019, February–March 2020 inclusive (early COVID-19 pandemic period), 10–24 March 2021 (North Coast NSW region local disaster declaration period) and 26 June–11 October 2021 (NSW COVID-19 lockdown period); and for monthly pageviews for the Influenza Immunisation pathway (2016–2021). Results: Access to specific pages in HealthPathways increased alongside the occurrence of critical events affecting the region. Spikes in access to specific pages were seen during COVID-19 lockdown periods, during natural disasters, as well as during the annual influenza season. Conclusions: HealthPathways is viewed as a useful and trusted source of information for health professionals in the North Coast NSW region. HealthPathways provides an opportunity for timely dissemination of information during critical events, including natural disasters and emergencies. What is known about the topic? Evidence from New Zealand suggests that HealthPathways is viewed as a useful and trusted source of information by health professionals during critical and emergency events, and when information needs are subject to frequent change. What does this paper add? This paper provides evidence in the Australian context that health professionals access specific pages in HealthPathways at higher rates during critical and emergency events. What are the implications for practitioners? HealthPathways has the capacity to provide timely and accurate information to health professionals during critical and emergency events, as well as to identify their emerging information needs. [ABSTRACT FROM AUTHOR]

Global demand for animal protein is on the rise, but many practices common in conventional production are no longer scalable due to environmental impact, public health concerns, and fragility of food systems. For these reasons and more, a pressing need has arisen for sustainable, nutritious, and animal welfare–conscious sources of protein, spurring research dedicated to the production of cultivated meat. Meat mainly consists of muscle, fat, and connective tissue, all of which can be sourced and differentiated from pluripotent stem cells to resemble their nutritional values in muscle tissue. In this paper, we outline the approach that we took to derive bovine embryonic stem cell lines (bESCs) and to characterise them using FACS (fluorescence-activated cell sorting), real-time PCR and immunofluorescence staining. We show their cell growth profile and genetic stability and demonstrate their induced differentiation to mesoderm committed cells. In addition, we discuss our strategy for preparation of master and working cell banks, by which we can expand and grow cells in suspension in quantities suitable for mass production. Consequently, we demonstrate the potential benefits of harnessing bESCs in the production of cultivated meat. Global demand for sustainable, nutritious, and animal welfare–conscious protein sources encourages research dedicated to the production of cultivated meat. In this paper, we outline the approach that we took to produce bovine embryonic stem cell lines and present our strategy to expand and grow cells in quantities suitable for mass production. Our work demonstrates the potential benefits of harnessing bESCs in the production of cultivated meat. Photograph by Dr. Irena Vertkin (researcher, R&D department, Aleph Farms). [ABSTRACT FROM AUTHOR]

Context. The aim of farm-systems research is to test concepts in a holistic context that enables results to be as applicable as possible to commercial farmers. A downside of such research has been that it can take several seasons to be confident in the consistency of the outcomes and interpretation of the results. Scientists are often reluctant to communicate outcomes until they have clear conclusions, which conflicts with farmers' desire to see rapid answers and engage with research. Aims. This paper reviews a 3-year farm-systems research project investigating flexible milking strategies for New Zealand dairy farmers. The aims of this paper are to (1) examine the impact of real-time science communication in achieving farm system change, and (2) develop a framework for science communication and engagement in adaptive farm-systems research. Methods. The project involved farmer interviews, a farmlet experiment, a component experiment, partner farms, modelling, and a farmer reference group. We use data from sources such as e-newsletter engagement, webinar participation, web-page engagement, presentation attendance, and farmer feedback to collect insights on the impact of the project. Key results. The analysis highlighted that farmers do not always seek complete information and will follow a project as it evolves, particularly when it is highly topical. We propose a framework for delivering adaptive farm systems research and communication. The framework includes the critical aspects for real-time farm-systems research: credible evidence, rapid results, inclusion of farmer voices, meaningful outcomes, flexible communication channels, iterative feedback loops, and adaptable research design. Conclusion. Farm-systems research can be designed to communicate results to farmers as a project develops, while simultaneously using the engagement with farmers to refine the direction of the research. Implications. This framework can guide scientists leading multi-year farm systems projects to design, implement, and communicate the project outcomes to improve farmer engagement and adoption. [ABSTRACT FROM AUTHOR]

What is known about the topic? Little is known about the state of mental health reform in Australia. This article describes the struggle to develop the systems of accountability necessary to assess national progress. What does this paper add? We provide some historical context regarding mental health reform and consider recent efforts in particular, before then describing current key opportunities. What are the implications for practitioners? Many people working in mental health are struggling to deliver quality services to Australians. This paper considers the broad policy issues which have led to this situation. This is useful for practitioners who can then better respond and participate in processes of systemic reform. Opportunities to engage now in key policy formulation are identified in the article. [ABSTRACT FROM AUTHOR]

Scope of practice regulation in medicine is crucial for ensuring patient safety, access to care and professional autonomy. This paper explores the impact of scope of practice regulation on healthcare delivery, professional responsibilities and patient outcomes. It discusses the variability in standards for safe practice, the challenges in defining boundaries between medical specialties and the recent controversies in cosmetic surgery practice. The paper also examines the potential benefits and drawbacks of rigorous scope of practice regulations, including their impact on clinical innovation, flexibility and access to care. Furthermore, it delves into the implications of defensive medicine and the consequences of restrictive regulations on patient care. The author proposes implementing a proactive, national, artificial intelligence-powered, real-time outcome monitoring system to address these challenges. This system aims to cover every patient undergoing a surgical procedure and could be gradually extended to non-surgical conditions, benefiting all key stakeholders in the health system. The paper emphasises the need for a balanced approach to scope of practice regulation to avoid stifling clinical innovation and professional autonomy, while ensuring patient safety and professional accountability. [ABSTRACT FROM AUTHOR]

Background: Despite availability of vaccines or medical prophylaxis for some sexually transmissible infections (STIs), promoting condom use remains an important public health strategy for the prevention of STIs. Recent research shows that regular condom use among young people in Australia has declined over the past decade, while the rate of common STIs has increased. Method: In this paper, we report findings from a large survey of school-aged young people in Australia (14–18 years old) in which we looked at the association between condom use and positive feelings about sex, beliefs about social acceptability of condoms and confidence talking with partners about sex and condoms. Results: Communication and relational factors supported more consistent condom use. Participants were more likely to regularly use condoms if they discussed condom use with a sexual partner, perceived condom use to be easy (a measure that included perceived ease of discussing condoms with a partner) and perceived condom use to offer social or relational benefits, including perceiving condom use as a demonstration of care for a partner. Young men were more likely to report positive feelings about sex and regular condom use than young women. Young women were less likely than young men or trans and non-binary young people to report regular condom use. Conclusions: The study shows the importance of supporting young people to build confidence expressing sexual needs and wants with partners. Public health approaches to STI prevention need to consider condom promotion in the context of young people's contemporary sexual, gendered and relationships cultures. This paper reports findings from a survey of school-aged young people in Australia looking at use of, and attitudes toward condoms. Social and relationship factors were most strongly associated with regular condom use, including feeling confident to talk about safer sex with a sexual partner. The paper highlights the importance of working with young people to build confidence and capacity to communicate about sex and condom use. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the development and implementation of a co-designed value-based healthcare (VBHC) framework within the public dental sector in Victoria. Methods: A mixed-method study was employed. Explorative qualitative design was used to examine patient, workforce and stakeholder perspectives of implementing VBHC. Participatory action research was used to bring together qualitative narrative-based research and service design methods. An experience-based co-design approach was used to enable staff and patients to co-design services. Quantitative data was sourced from Titanium (online patient management system). Results: Building a case for VBHC implementation required intensive work. It included co-designing, collaborating, planning and designing services based on patient needs. Evidence reviews, value-stream mapping and development of patient reported outcomes (PROMs) and patient reported experience measures (PREMs) were fundamental to VBHC implementation. Following VBHC implementation, a 44% lower failure to attend rate and 60% increase in preventive interventions was reported. A higher proportion of clinicians worked across their top scope of practice within a multi-disciplinary team. Approximately 80% of services previously provided by dentists were shifted to oral health therapists and dental assistants, thereby releasing the capacity of dentists to undertake complex treatments. Patients completed baseline International Consortium for Health Outcomes Measurement PROMs (n = 44,408), which have been used for social/clinical triaging, determining urgency of care based on risk, segmentation and tracking health outcomes. Following their care, patients completed a PREMs questionnaire (n = 15,402). Patients agreed or strongly agreed that: the care they received met their needs (87%); they received clear answers to their questions (93%); they left their visit knowing what is next (91%); they felt taken care of during their visit (94%); and they felt involved in their treatment and care (94%). Conclusion: The potential for health system transformation through implementation of VBHC is significant, however, its implementation needs to extend beyond organisational approaches and focus on sustaining the principles of VBHC across healthcare systems, policy and practice. What is known about the topic? Value-based healthcare (VBHC) has gained significant momentum within the healthcare sector and is seen as a driver for improving patient outcomes and equitable use of resources. What does this paper add? The paper describes firsthand experience and lessons learnt from implementing VBHC within a Victorian public healthcare system; the learnings are applicable to other organisations wanting to implement VBHC. What are the implications for practitioners? In implementing a co-designed VBHC framework, we ensured that its principles are applicable at both patient and population levels, centres on equity of access to care, achieves the best possible health outcomes and sustainable use of resources. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Objective: Clinician's experiences of providing care are identified as a key outcome associated with value-based healthcare (VBHC). In contrast to patient-reported experience measures, measurement tools to capture clinician's experiences in relation to VBHC initiatives have received limited attention to date. Progressing from an initial 18-item clinician experience measure (CEM), we sought to develop and evaluate the reliability of a set of 10 core clinician experience measure items in the CEM-10. Methods: A multi-method project was conducted using a consensus workshop with clinicians from a range of NSW Health local health districts to reduce the 18-item CEM to a short form 10-item core clinician experience measure (CEM-10). The CEM-10 was deployed with clinicians providing diabetes care, care for older adults and virtual care across all districts and care settings of New South Wales, Australia. Psychometric analysis was used to determine the internal consistency of the tool and its suitability for diverse clinical contexts. Results: Consensus building sessions led to a rationalised 10-item tool, retaining the four domains of psychological safety (two items), quality of care (three items), clinician engagement (three items) and interprofessional collaboration (two items). Data from four clinician cohorts (n = 1029) demonstrated that the CEM-10 four-factor model produced a good fit to the data and high levels of reliability, with factor loadings ranging from 0.77 to 0.92, with Cronbach's alpha (range: 0.79–0.90) and composite reliability (range: 0.80–0.92). Conclusions: The CEM-10 provides a core set of common clinician experience measurement items that can be used to compare clinician's experiences of providing care between and within cohorts. The CEM-10 may be supported by additional items relevant to particular initiatives when evaluating VBHC outcomes. What is known about the topic? Clinician experience of providing care is an outcome of interest for health systems and services internationally who are implementing value-based care initiatives. Review evidence indicates that measurement of clinician's experience of providing care should address experiences of being able to deliver quality care, collaborate with colleagues, experience psychological safety and engagement in decision-making in the workplace. What does this paper add? The paper reports the development of the short form clinician experience measure (CEM-10) and its initial validation in four value-based healthcare initiatives of NSW Health. What are the practical implications for practitioners? The CEM-10 can be used as a core set of items embedded within evaluations of value-based care initiatives to benchmark and examine experiences across clinician cohorts. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Millions of Australians use the private health system every year. They should receive safe, high-quality, value-based care. However, poor policy and inadequate regulation of medical technology is driving low-value care at great expense to consumers and the broader health system. Key drivers include the Prescribed List of Medical Devices and Human Tissue, gaps in quality and safety controls for devices being used, and marketing and conflicts of interest. All of these should be addressed to reduce low-value care in Australia's private health system, so consumers are protected from harm and limited health budgets are used effectively. What is known about the topic? With health expenditure rising unsustainably, there is a growing focus on ways to reduce low-value care to improve health outcomes and eliminate unnecessary costs. What does this paper add? This paper details drivers of low-value care in Australia's private health system and recommendations to overcome them. Drivers include the Prescribed List of Medical Devices, gaps in safety and quality controls, and conflicts of interest and marketing. What are the implications for practitioners? These insights are relevant to clinicians, researchers, policymakers, consumers and health business leaders with an interest in low-value care. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Value-based healthcare has been described as the sustainable, equitable and transparent use of healthcare resources to achieve improved experiences and outcomes for people and communities. It is supported by all levels of government in Australia, with recent initiatives championing a shift away from traditional, clinician-centric care delivery to a more contemporary, value-based approach. To date, however, efforts in Queensland have focused on smaller scale siloed models of care and have not extended to the transformational change required to create equitable and sustainable healthcare delivery. The Queensland Health Allied Health Framework for Value-Based Health Care (the Framework) builds on contemporary frameworks with reference to the local context in Queensland and provides a structure and starting point for clinicians and managers to work together with consumers to transform services to focus on preventative health and wellbeing, shifting the focus of care to the community and sustainably improving the quality of care delivered. The Framework outlines key considerations for the design and implementation of new services, including understanding the care pathway, supporting an outcome driven workplace culture, measuring what matters and designing for outcomes. Several key lessons were learnt during the development of the Framework, including the importance of early and sustained consumer partnerships, of establishing a shared definition of value-based healthcare that enables integration across the care pathway and the need for leadership at all levels to actively support the change management process. While developed for Queensland public allied health services, the Framework is intended to be a system-wide tool relevant to all health professionals and services. What is known about the topic? Value-based healthcare provides an approach to restructure healthcare systems to improve health outcomes and the holistic experience of care for people and communities. What does this paper add? This paper details the development of a framework to support health services to transition to a value-based approach. What are the implications for practitioners? By reflecting on the diversity of health practitioners, managers and consumer experiences and the unique opportunities and challenges of individual healthcare services, the framework provides a structure and starting point for services to transition to value-based healthcare. This article belongs to the Special Issue: Value-Based Healthcare. [ABSTRACT FROM AUTHOR]

This case study details the approach utilised to establish an easy to use, accessible and sustainable method for routine collection of Patient Reported Outcome Measures for patients newly diagnosed with lung cancer. We sought to enhance communication with patients and their families, particularly around shared decision making, their quality of life and symptoms, as well as the impacts of their care or treatment. We detail the co-design methodology utilised with consumers and healthcare providers to develop and implement a multi-lingual, fully automated digital care pathway which has been proven to be highly impactful and powerful for both healthcare providers working within the service and consumers enrolled within the digital pathway. This innovative initiative has changed the practice of the lung cancer service across a health service. Furthermore, its success has evolved the organisational strategy, to embed 'Outcomes for Impact' across the health service. What is known about the topic? While much has been written about the benefits of digital health, there are few practical examples of how a digital initiative, developed and implemented with clinicians and consumers, can positively change a healthcare service. What does this paper add? This paper discusses the importance of developing new digital healthcare services with the end user through co-design. A fully automated lung cancer digital care pathway and the lessons learned in implementation of the pathway are presented. This initiative was implemented within a public hospital to provide a service that has a vision of value-based health care and a person centric approach to care. What are the implications for practitioners? This study illustrates how the implementation of a digital care pathway for the monitoring and treatment of lung cancer can provide an approach that moves from reactive to proactive care. The implementation of the digital care pathway has positively changed the lung cancer service in a rapidly growing area. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally. What is known about the topic? There is limited palliative care support for the 36% of Australians who die in residential aged care. What does this paper add? This paper describes the development of the Specialist Palliative Care in Aged Care (SPACE) Project, using locally tailored models of care to improve palliative and end-of-life care in aged care facilities across Queensland. What are the implications for practitioners? Critical elements for improving residents' palliative and end-of-life care included creation of an expert working group to define the innovation state-wide, a central project team that supported implementation, a community of practice, and local facilitation. [ABSTRACT FROM AUTHOR]

The term 'mitochondrial vesicle' was first used in 2003 in a description of anuran sperm and persists to this day throughout the literature on assisted reproductive technologies (ART) for amphibians. In the present paper, we argue that the term is inappropriate because the widely accepted definition of a 'vesicle' refers to an integral structure with an enclosing lipid bilayer/membrane. Moreover, there are no electron micrographs that show a vesicular structure encapsulating mitochondria on amphibian sperm heads in the literature. In fact, in 1993, the mitochondria in the anuran sperm head had been described as positioned in 'mitochondrial collars ' or 'mitochondrial sheaths' surrounded by the plasma membrane of the sperm head. On the other hand, mitochondrial-derived vesicles are defined as vesicles shed from mitochondria surfaces, potentially creating confusion. Therefore, our view is that the term 'mitochondrial vesicle' should be avoided in describing the positioning of mitochondria on sperm. The term 'mitochondrial vesicle' was first used in 2003 in a description of anuran sperm and persists to this day in the literature on assisted reproductive technologies (ART) for amphibians. In the present paper, we argue that the term 'mitochondrial vesicle' is inappropriate because the widely accepted definition of a 'vesicle' refers to an integral structure with an enclosing lipid bilayer/membrane. Photograph by Robert Browne. This article belongs to the Collection Dedication to Jim Cummins. [ABSTRACT FROM AUTHOR]

Background: Fatigue following a traumatic brain injury (TBI) is a complex, chronic symptom, which can significantly impact quality of life. Investigation into the types of fatigue addressed by the multidisciplinary team and consequent outcomes may assist clinicians to target their care. The use of health frameworks to explore such phenomena may increase a teams' ability to incorporate multifaceted interventions. The objective of this paper is to profile and map the available evidence for fatigue management used for the TBI population onto the International Classification of Functioning, Disability, and Health framework. Methods: A scoping review was conducted and included papers that described an intervention focussing on post-TBI fatigue and used fatigue-specific outcome measures with an adult population. Studies were collated and summarised, and key findings are presented. Results: Forty-seven articles met the inclusion criteria. The results indicate that post-traumatic fatigue interventions in the literature are conducted by singular professions, that there is a strong focus on a body functions approach, and that there is a discrepancy between intervention intent and measurement. Conclusion: Although there is variety in multidisciplinary fatigue treatment, further opportunities to develop interventions that target other health and function components, including activities and participation, environment, and personal factors, may enable a greater impact of fatigue management approaches. Fatigue is one of the biggest problems for everyday life following a brain injury. There are some treatment approaches that have positive effects but these do not adopt the team approach that is promoted for brain injury rehabilitation. The findings highlight that further research is needed to develop, evaluate, and implement a team approach to fatigue that can reduce the impacts on everyday life. [ABSTRACT FROM AUTHOR]

Background: Fire danger rating systems are used daily across Australia to support fire management operations and communications to the general public regarding potential fire danger. Aims: In this paper, we introduce the Australian Fire Danger Rating System (AFDRS), providing a short historical account of fire danger rating in Australia as well as the requirements for an improved forecast system. Methods: The AFDRS combines nationally consistent, spatially explicit fuel information with forecast weather and advanced fire behaviour models and knowledge to produce locally relevant ratings of fire behaviour potential. Key results: A well-defined framework is essential for categorising and defining fire danger based on operational response, the potential for impact and observable characteristics of fire incidents. The AFDRS is modular, supporting continuous and incremental improvements and allowing upgrades to components in response to new science. Conclusions: The AFDRS provides a new method to estimate fire danger based on the best available fire behaviour models, leading to potentially significant improvements in the way fire danger is calculated, forecast and interpreted. Implications: The Australian Fire Danger Rating System was implemented in 2022, the most significant change to fire danger forecasting in Australia in more than 50 years. We introduce the Australian Fire Danger Rating System (AFDRS), providing a history of fire danger rating in Australia and requirement for advancements. We describe development, design principles and the supporting framework of the AFDRS as an introduction to subsequent papers in this series. This article belongs to the Collection Australian Fire Danger Rating System. [ABSTRACT FROM AUTHOR]

Background: Strategies pertaining to HIV and sexual health for gay, bisexual, and other men who have sex with men (GBMSM) have shifted focus towards underrepresented subgroups within some developed Western countries. Although emerging research exists on some subgroups, limited attention has been given to the needs of Arab GBMSM in these contexts. Considering they are part of a large diaspora, understanding their access to services is crucial. This paper focuses on Arab GBMSM as a case study within a scoping review, highlighting their hidden status within the broader landscape of HIV and sexual health research for GBMSM in the West. Methods: A multi-method search strategy was employed, including searching four electronic databases using several terms within each of the following search topics: Arab, GBMSM, HIV and other sexual health services, and developed Western countries. Results: Of the 384 articles found, only one addressed the research question and met the inclusion criteria, revealing a stark scarcity of research on access to HIV and sexual health services for this population. Conclusions: This review highlights a paucity of research on access to HIV and sexual health services for underrepresented GBMSM populations in developed Western countries. The literature indicates that, for Arab men, this may be due to a difficulty in participant recruitment and poor data collection efforts. By focusing on one hidden population, we aim to advocate for inclusive policies and interventions that promote equitable sexual health access for all. Addressing this research gap aligns with broader local and global HIV strategies to reduce disparities among underrepresented GBMSM populations. This study uncovers an often-overlooked issue: the limited research on access to sexual health services among gay Arab men in Western countries. Findings in this publication reveal significant gaps in knowledge for this population, particularly in areas where strides have been made in reducing HIV transmission. The implications are far-reaching, as addressing these disparities is essential for ensuring equitable healthcare for underrepresented communities. By shedding light on this hidden population, this study paves the way for targeted interventions and policy changes to promote inclusive and accessible sexual health services for all. [ABSTRACT FROM AUTHOR]

Background: Technologies such as the Internet, smartphones, and sex toys have demonstrated the capacity to facilitate and enhance sexual and intimate practice by offering new ways to meet sexual partners, maintain and establish intimate connections, and providing access to sexual education and exposure to new ways of engaging in sex. They have also afforded novel risks to safety, privacy, and sexual autonomy. Understanding how people perceive and experience both the risks and benefits of using technology to facilitate sex and intimacy is important to understanding contemporary sexual practice, health, and pleasure. However, research in this space is currently hampered by a lack of quantitative measures to accurately and holistically assess both the risks and benefits in the context of technologised sexual practices. Methods: To facilitate a nuanced quantitative exploration of these concepts, we present the psychometric properties of the newly developed Risks and Benefits of Technologised Sexual Practice Scale. Results: Using an exploratory (Study 1, n = 445) and confirmatory factor analysis (Study 2, n = 500), this paper presents evidence for a 6-factor scale (Benefits (3): 'sexual gratification', 'connection', and 'access to information and culture'; Risks (3): 'concerns', 'worries', and 'knowledge of rights and ownership'). Conclusion: This scale may be used to contribute to research areas including sexual health, sexual behaviour, sexual education, online connection, online safety, and digital literacy with the aim to contribute to a sex- and technology-positive framework for understanding sexual health and pleasure. Technology has the potential to benefit relationships – it can facilitate and enhance sexual and intimate practices in a variety of ways. However, it also has the potential to be risky, with people reporting concerns about safety and privacy. This paper presents a new measure that is designed to accurately assess perceptions of the risks and benefits of sexualised technology use. [ABSTRACT FROM AUTHOR]

Environmental context: Dust is a heterogeneous material deposited on the ground surface and is a source and sink for potentially toxic elements (PTEs) originating from the air and soil. Tracking the distribution and effects of PTEs in an abandoned mining area is critical as few studies have quantified the speciation and bioavailability of PTEs contained in dust and PM2.5. In this paper, we track the distribution of PTEs in an abandoned mining area, quantifying the mobility of PTEs using the speciation of PTEs in dust and PM2.5 and quantitatively assess the environmental and ecological risks of PTE in a mining area. Rationale: This study aimed to gain a better understanding of the distribution, speciation, mobility and ecological risks of potentially toxic elements (PTEs) in an abandoned mining area by measuring the PTEs in dust (indoor or atmospheric) and particulate matter <2.5 μm (PM2.5) simultaneously. Methodology: The particle size of dust, PTEs and the speciation of PTEs in dust and PM2.5 were determined. The risk assessment code (RAC) was used to analyse the mobility of PTEs, and the geo-accumulation index (I geo), pollution load index (PLI) and potential ecological risk index (RI) were used to assess the ecological risks of PTEs. Results: The results showed that the particle size of dust was mainly distributed in the range of 0–2.5 µm (61–81%). Cd, Mn, Cu and Zn in dust were mainly distributed in the acid extractable fraction, whereas other PTEs were distributed in the residual fraction. Most PTEs in PM2.5 were distributed in the acid extractable fraction, but V and As were distributed in the reducible fraction. The risk of Cd, Zn and Mn in dust and PM2.5 was very high (RAC > 50%). I geo values showed that the dust were practically uncontaminated by most of the PTEs, whereas the PM2.5 was moderately to highly contaminated by most of the PTEs. The PTE in dust and PM2.5 with the highest ecological risk was Cd (E i  >  320). The PLI showed a potential deterioration in environmental quality (1.30 < PLI < 3.17) and the further away from the mining centre, the less environmental degradation. Discussion: There is a potential for PTEs contamination and a high ecological risk in abandoned mining areas, which deserves serious attention. Environmental context. Dust is a heterogeneous material deposited on the ground surface and is a source and sink for potentially toxic elements (PTEs) originating from the air and soil. Tracking the distribution and effects of PTEs in an abandoned mining area is critical as few studies have quantified the speciation and bioavailability of PTEs contained in dust and PM2.5. In this paper, we track the distribution of PTEs in an abandoned mining area, quantifying the mobility of PTEs using the speciation of PTEs in dust and PM2.5 and quantitatively assess the environmental and ecological risks of PTE in a mining area. [ABSTRACT FROM AUTHOR]

Self-determination informed policies are key to improved outcomes for Aboriginal health. Aboriginal leadership must be reflected throughout any public health reform process that affects Aboriginal communities. This paper presents a body of oral health policy work, undertaken under Loddon Mallee Aboriginal Reference Group's (LMARG's) leadership, as an exemplar of a self-determination informed change, that led to an amendment of an Australian state (Victoria) regulation – The Drugs, Poisons and Controlled Substances Amendment (Registered Aboriginal and Torres Strait Islander Health Practitioners [AHPs]) Regulations 2022. A summary of activities undertaken by LMARG, from advocacy to leading the submission, to amend the regulation, is provided. The amendment, now in place, authorises registered AHPs to obtain, possess, and administer fluoride varnish (FV) as a part of health services they provide. FV is a concentrated form of fluoride applied to tooth surfaces to prevent tooth decay. The practical implication of this amendment is delivery of a culturally appropriate integrated oral health promotion FV model that addresses mainstream dental access barriers commonly experienced by Aboriginal people. The model aims at upskilling an Aboriginal workforce to facilitate timely FV application to Aboriginal children. Self-determination informed policies are key to improved outcomes for Aboriginal health. The paper presents work on an oral health policy, undertaken under Loddon Mallee Aboriginal Reference Group's leadership on an Australian state (Victoria) regulation – The Drugs, Poisons and Controlled Substances Amendment (Registered Aboriginal and Torres Strait Islander Health Practitioners) Regulations 2022, as an exemplar of a self-determination informed change. The amendment translates to a culturally appropriate integrated oral health promotion model that addresses dental access barriers experienced by Aboriginal people. This article belongs to the Collection Access to Primary Health Care. [ABSTRACT FROM AUTHOR]