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Objective: The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment ('Quitlink') among people receiving support for mental health conditions. Methods: We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our 'Quitlink' intervention. Both conditions received a brief intervention delivered by a peer researcher. Control participants received no further intervention. Quitlink participants were referred to a tailored 8-week quitline intervention delivered by dedicated Quitline counsellors plus combination nicotine replacement therapy. The primary outcome was self-reported 6 months continuous abstinence from end of treatment (8 months from baseline). Secondary outcomes included additional smoking outcomes, mental health symptoms, substance use and quality of life. A within-trial economic evaluation was conducted. Results: In total, 110 participants were recruited over 26 months and 91 had confirmed outcomes at 8 months post baseline. There was a difference in self-reported prolonged abstinence at 8-month follow-up between Quitlink (16%, n = 6) and control (2%, n = 1) conditions, which was not statistically significant (OR = 8.33 [0.52, 132.09] p = 0.131 available case). There was a significant difference in favour of the Quitlink condition on 7-day point prevalence at 2 months (OR = 8.06 [1.27, 51.00] p = 0.027 available case). Quitlink costs AU$9231 per additional quit achieved. Conclusion: The Quitlink intervention did not result in significantly higher rates of prolonged abstinence at 8 months post baseline. However, engagement rates and satisfaction with the 'Quitlink' intervention were high. While underpowered, the Quitlink intervention shows promise. A powered trial to determine its effectiveness for improving long-term cessation is warranted. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusions To (1) evaluate the efficacy of OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein in managing glycaemia compared with carbohydrate counting in adolescents and adults with type 1 diabetes using flexible multiple daily injection therapy (MDI, ≥4 injections/day) and (2) assess user acceptability of OptimAAPP.In this free‐living trial, participants aged 12–50 years were randomised to use carbohydrate counting or OptimAAPP for meal insulin dose calculation for 3 months, then use the alternate method for 3 months. The primary outcome, time‐in‐range (3.9–10.0 mmol/L) was measured in weeks 3–4 of each arm using continuous glucose monitoring. The acceptability of OptimAAPP was assessed at end intervention using a purpose‐designed questionnaire.An intention‐to‐treat analysis of 41 participants, mean age 28 ± 12 years and HbA1c 56 ± 10 mmol/mol (7.3 ± 0.9%) found no significant difference in glycaemic outcomes when using OptimAAPP compared with carbohydrate counting including time‐in‐range (70.5 vs. 67.6%, p = 0.102), above range (24.5% vs. 28.0%, p = 0.068), below range (4.9% vs. 4.4%, p = 0.318), and coefficient of variation (32.2% vs. 33.3%, p = 0.136). There was no severe hypoglycaemia. Participants reported that OptimAAPP was easy to use (79%), and they were confident in giving the recommended doses (82%). Barriers to use were the small food database and the time associated with food entry.In adolescents and adults using flexible MDI therapy, OptimAAPP use did not produce glycaemic outcomes that were significantly different from carbohydrate counting. Participant views of OptimAAPP indicate a high level of acceptability. Increasing the size of the food database will likely enhance the user experience. [ABSTRACT FROM AUTHOR]

Background: Emergency medical services attend out-of-hospital cardiac arrests all across Australia. Resuscitation by emergency medical services is attempted in nearly half of all cases. However, resuscitation skills can degrade over time without adequate exposure, which negatively impacts patient survival. Consequently, for paramedics working in areas with low out-of-hospital cardiac arrest case volumes, ambulance services and professional bodies recognize the importance of alternative ways to maintain resuscitation skills. Simulation-based training via resuscitation manikins offers a potential solution for maintaining paramedic clinical practice skills., Objective: The aim of the study is to examine the effectiveness of advanced technology clinical simulation manikins and accompanying simulation resources (targeted clinical scenarios and debriefing tools) in improving the demonstrable capability of paramedics to deliver high-quality patient care, as measured by external cardiac compression (ECC) performance., Methods: A pre- and postintervention study design without a control group was used. Data were collected at the start of the manikin training forum (baseline), immediately following the training forum (time 2), and 6 to 11 months after the training forum (time 3). The study was conducted with paramedics from 95 NSW Ambulance locations (75 regional locations and 20 metropolitan locations). Eligible participants were paramedics who were employed by NSW Ambulance (N=106; 100% consent rate). As part of the intervention, paramedics attended a training session on the use of advanced technology simulation manikins. Manikins were then deployed to locations for further use. The main outcome measure was an overall compression score that was automatically recorded and calculated by the simulator manikin in 2-minute cycles. This score was derived from compressions that were fully released and with the correct hand position, adequate depth, and adequate rate., Results: A total of 106 (100% consent rate) paramedics participated, primarily representing regional ambulance locations (n= 75, 78.9%). ECC compression scores were on average 95% or above at all time points, suggesting high performance. No significant differences over time (P>.05) were identified for the overall ECC performance score, compressions fully released, compressions with adequate depth, or compressions with the correct hand position. However, paramedics had significantly lower odds (odds ratio 0.30, 95% CI 0.12-0.78) of achieving compressions with adequate rate at time 3 compared to time 2 (P=.01). Compressions were of a slower rate, with an average difference of 2.1 fewer compressions every minute., Conclusions: Despite this difference in compression rate over time, this did not cause significant detriment to overall ECC performance. Training and deployment of simulator manikins did not significantly change paramedics' overall ECC performance. The high baseline performance (ceiling effect) of paramedics in this sample may have prevented the potential increase in skills and performance., (© Alison Zucca, Jamie Bryant, Jeffrey Purse, Stuart Szwec, Robert Sanson-Fisher, Lucy Leigh, Mike Richer, Alan Morrison. Originally published in JMIR Cardio (https://cardio.jmir.org).)