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Radio occultation (RO) techniques that use signals transmitted by Global Navigation Satellite Systems (GNSS) have emerged over the past decade as an important tool for measuring global changes in tropopause temperature and height, a valuable capacity given the tropopause's sensitivity to temperature variations. This study uses 45,091 RO data from the CHAMP (CHAllenging Minisatellite Payload, 80 months), GRACE (Gravity Recovery And Climate Experiment, 23 months) and COSMIC (Constellation Observing System for Meteorology, Ionosphere, and Climate, 20 months) satellites to analyse the variability of the tropopause's height and temperature over Australia. GNSS RO temperature profiles from CHAMP, GRACE, and COSMIC are first validated using radiosonde observations provided by the Bureau of Meteorology (Australia). These are compared to RO soundings from between 2001 and 2007 that occurred within 3 h and 100 km of a radiosonde. The results indicate that RO soundings provide data of a comparable quality to radiosonde observations in the tropopause region, with temperature deviations of less than 0.5 ± 1.5 K. An analysis of tropopause height and temperature anomalies indicates a height increase over Australia as a whole of ca. 4.8 ± 1.3 m between September 2001 and April 2008, with a corresponding temperature decrease of −0.019 ± 0.007 K. A similar pattern of increasing height/decreasing temperature was generally observed when determining the spatial distribution of the tropopause height and temperature rate of change over Australia. Although only a short period has been considered in this study, a function of the operating time of these satellites, the results nonetheless show an increase in the height of the tropopause over Australia during this period and thus may indicate regional warming. Several mechanisms could be responsible for these changes, such as an increase in the concentration of greenhouse gases in the atmosphere, and lower stratospheric cooling due to ozone loss, both of which have been observed during the last decades. [ABSTRACT FROM AUTHOR]

Background: Improving the coordination and integration of health services is recognised nationally and internationally as a key strategy for improving the quality of diabetes care. The Australian Diabetes Alliance Program (DAP) is an integrated care model implemented in the Hunter New England Local Health District (HNELHD), New South Wales (NSW), in which endocrinologists and diabetes educators collaborate with primary care teams via case-conferencing, practice performance review, and education sessions. The objective of this study was to report on general practitioners' (GPs) perspectives on DAP and whether the program impacts on their skills, knowledge, and approach in delivering care to adult patients with type 2 diabetes., Methods: Four primary care practices with high rates of monitoring haemoglobin A1c (HbA1c) levels (> 90% of patients annually) and five practices with low rates of monitoring HbA1c levels (< 80% of patients annually) from HNELHD, NSW provided the sampling frame. A total of nine GPs were interviewed. The transcripts from the interviews were reviewed and analysed to identify emergent patterns and themes., Results: Overall, GPs were supportive of DAP. They considered that DAP resulted in significant changes in their knowledge, skills, and approach and improved the quality of diabetes care. Taking a more holistic approach to care, including assessing patients with diabetes for co-morbidities and risk factors that may impact on their future health was also noted. DAP was noted to increase the confidence levels of GPs, which enabled active involvement in the provision of diabetes care rather than referring patients for tertiary specialist care. However, some indicated the program could be time consuming and greater flexibility was needed., Conclusions: GPs reported DAP to benefit their knowledge, skills and approach for managing diabetes. Future research will need to investigate how to improve the intensity and flexibility of the program based on the workload of GPs to ensure long-term acceptability of the program., (© 2023. Crown.)

Introduction: There is currently no test for pelvic inflammatory disease (PID) that is non-invasive and sufficiently sensitive and specific. Clinicians must therefore diagnose PID clinically, ruling out medical emergencies and conducting pelvic examinations where possible. While guidelines state that clinicians should be prepared to over-diagnose PID, it remains an under-diagnosed condition, with severe reproductive health impacts when left untreated. This research is the first to consider the perspectives of end-users on the development of a diagnostic test for PID., Methods: Semi-structured live video feed online (Zoom) interviews were conducted with 11 clinicians and nine women (aged 18-30 years) in Australia to understand how a diagnostic test might be used, and what characteristics a test would need for it to be acceptable to clinicians and young women. Participants were recruited via researcher and university student networks. Reflexive thematic analysis was used to identify key themes relating to the acceptability and characteristics of a diagnostic test for PID., Results: Seven general practitioners, four clinicians working in sexual health clinics, and nine young women (aged 21-27 years) were interviewed. Clinicians were aged between 31-58 years and were predominantly female. Clinicians recognised that the development of an accurate test to diagnose PID would be valuable to themselves and other clinicians, particularly those who lack experience diagnosing PID, and those working in certain settings, including emergency departments. They discussed how they might use a test to enhance their clinical assessment but highlighted that it would not replace clinical judgement. Clinicians also considered how a test would impact the patient experience and time to treatment, emphasising that it should be minimally invasive and have a quick turnaround time. Young women said a test would be acceptable if endorsed by a trustworthy clinician., Conclusions: PID remains a challenging diagnosis. Development of a minimally invasive and sufficiently accurate diagnostic test would be acceptable to young women and benefit some clinicians, although no test would completely replace an experienced clinician's judgement in making a PID diagnosis., Competing Interests: JSH is supported by a NHMRC Senior Research Fellowship (1136117). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

An imported case of Japanese encephalitis is reported and discussed. Recent literature on the clinical aspects of the disease is reviewed. Although the disease is unlikely to become a problem in Australia, it will remain a serious hazard to nonimmune personnel moving into an endemic area.