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Background The Australian National Bowel Cancer Screening Program sends an immunochemical faecal occult blood test to Australians aged 50–74 years to screen for bowel cancer, but uptake is low (40.9%). The SMARTscreen trial demonstrated that sending a short messaging services (SMS) prompt from the participant's general practitioner (GP) increased the proportion of kit returns by 16.5%. This research aimed to determine the acceptability and feasibility of implementing SMARTscreen. Method SMARTscreen was a cluster randomized controlled trial set in 21 Australian general practices in regional Australia. Participants and general practice staff involved in the trial were included in this study. Acceptability and feasibility were measured quantitatively by calculating proportions of the SMS received, viewed, or opted out of, and qualitatively by interviewing people who sent and received the SMS. Results Of 2914 SMS sent, 2645 SMS (91%) were received by participants, 1128 (43%) people opened the weblink, and 59 (2%) people opted out of receiving future SMS. Interviews with general practice staff (n = 17) and participants (n = 18) found that sending and receiving the SMS was acceptable and feasible. The SMS was considered a low-burden activity that easily integrated into the clinic's workflow without impacting clinicians' time. Participants reported an increased intention to participate in screening, but some people worried the weblink was spam, and some suggested sending it out of working hours. Conclusion The SMS-based intervention was widely accepted by GP staff and participants. Future research should test the SMS with and without the weblink, and send the SMS at a more convenient time of the day/week. [ABSTRACT FROM AUTHOR]

Background: Paediatric tuberculosis (TB), or TB in children younger than 15 years of age, is a growing public health concern in First Nations communities. Objective: To describe the epidemiology of paediatric TB in northern Saskatchewan's on-reserve First Nations communities. Methods: We examined the paediatric TB cases reported in northern Saskatchewan First Nations on-reserve communities from 2018 to 2022 using the Northern Inter-Tribal Health Authority database. We employed descriptive statistics to understand the paediatric TB epidemiology in these susceptible populations. Results: Sixty paediatric TB cases were identified over the study period: four cases in 2018, six cases each in 2019 and 2020, 16 cases in 2021 and 28 cases in 2022. The average annual incidence was 112.6 cases per 100,000 children, ranging from 36.1 in 2018 to 268.6 in 2022. Children younger than five years of age constituted 55% of cases, with males comprising 60%. The Far North Central and East zones accounted for 90% of cases. Most cases (85%) were detected through contact tracing and pulmonary TB comprised 85% of cases. Of these, 71% completed therapy, while 27% were still in treatment. Cases were predominantly from communities with low education (100%), inadequate housing (67%) and low income (67%). Conclusion: Paediatric TB incidence among First Nations in northern Saskatchewan is increasing, especially among children younger than five years of age. Our study identifies disparities in paediatric TB incidence across demographics and geographic areas, suggesting that reducing the disease burden requires a combination of community- and person-driven TB initiatives. [ABSTRACT FROM AUTHOR]

Background: Australia has one of the highest incidences of colorectal cancer (CRC) worldwide. The Australian National Bowel Cancer Screening Program (NBCSP) is a best-practice, organised screening programme, but uptake is low (40.9%) and increasing participation could reduce morbidity and mortality associated with CRC. Endorsement by GPs is strongly associated with increasing screening uptake. Aim: This study (SMARTscreen) aimed to test whether a multi-intervention short message service (SMS) sent by general practices to 50–60-year-old patients who were due to receive the NBCSP kit would increase NBCSP uptake, by comparing it with usual care. Design and setting: A stratified cluster randomised controlled trial was undertaken, involving 21 Australian general practices in Western Victoria, Australia. Method: For intervention practices, people due to receive the NBCSP kit within a 6-month study period were sent an SMS just before receiving the kit. The SMS included a personalised message from the person's general practice endorsing the kit, a motivational narrative video, an instructional video, and a link to more information. Control practices continued with usual care, comprising at-home testing with a faecal immunochemical test (FIT) through the NBCSP. The primary outcome was the between-arm percentage difference in uptake of FIT screening within 12 months from randomisation, which was estimated using generalised linear model regression. Results: In total, 39.2% (1143/2914) of people in 11 intervention practices and 23.0% (583/2537) of people in 10 control practices had a FIT result in their electronic health records — a difference of 16.5% (95% confidence interval = 2.02 to 30.9). Conclusion: The SMS intervention increased NBCSP kit return in 50–60-year-old patients in general practice. This finding informed a larger trial — SMARTERscreen — to test this intervention in a broader Australian population. [ABSTRACT FROM AUTHOR]

I. INTRODUCTION II. THE DEFENSE OF MARRIAGE ACT A. TEXT OF THE DEFENSE OF MARRIAGE ACT B. BACKGROUND OF THE DEFENSE OF MARRIAGE ACT C. IMPLICATIONS ON FEDERAL LAW IF [...]

Aim: To describe a protocol for the pilot phase of a trial designed to test the effect of an mHealth intervention on representation and readmission after adult cardiac surgery. Design: A multisite, parallel group, pilot randomized controlled trial (ethics approval: HREC2020.331‐RMH69278). Methods: Adult patients scheduled to undergo elective cardiac surgery (coronary artery bypass grafting, valve surgery, or a combination of bypass grafting and valve surgery or aortic surgery) will be recruited from three metropolitan tertiary teaching hospitals. Patients allocated to the control group with receive usual care that is comprised of in‐patient discharge education and local paper‐based written discharge materials. Patients in the intervention group will be provided access to tailored 'GoShare' mHealth bundles preoperatively, in a week of hospital discharge and 30 days after surgery. The mHealth bundles are comprised of patient narrative videos, animations and links to reputable resources. Bundles can be accessed via a smartphone, tablet or computer. Bundles are evidence‐based and designed to improve patient self‐efficacy and self‐management behaviours, and to empower people to have a more active role in their healthcare. Computer‐generated permuted block randomization with an allocation ratio of 1:1 will be generated for each site. At the time of consent, and 30, 60 and 90 days after surgery quality of life and level of patient activation will be measured. In addition, rates of representation and readmission to hospital will be tracked and verified via data linkage 1 year after the date of surgery. Discussion: Interventions using mHealth technologies have proven effectiveness for a range of cardiovascular conditions with limited testing in cardiac surgical populations. Impact: This study provides an opportunity to improve patient outcome and experience for adults undergoing cardiac surgery by empowering patients as end‐users with strategies for self‐help. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000082808. [ABSTRACT FROM AUTHOR]

Even if you have been in the Army for a while, there is a place you've probably never heard of associated with dental; it is the United States Army Dental [...]